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Parsons Leigh J, FitzGerald EA, Moss SJ, Cherak MS, Brundin-Mather R, Dodds A, Stelfox HT, Dubé È, Fiest KM, Halperin DM, Ahmed SB, MacDonald SE, Straus SE, Manca T, Ng Kamstra J, Soo A, Longmore S, Kupsch S, Sept B, Halperin SA. The evolution of vaccine hesitancy through the COVID-19 pandemic: A semi-structured interview study on booster and bivalent doses. Hum Vaccin Immunother 2024; 20:2316417. [PMID: 38390696 PMCID: PMC10896168 DOI: 10.1080/21645515.2024.2316417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 02/06/2024] [Indexed: 02/24/2024] Open
Abstract
We sought in-depth understanding on the evolution of factors influencing COVID-19 booster dose and bivalent vaccine hesitancy in a longitudinal semi-structured interview-based qualitative study. Serial interviews were conducted between July 25th and September 1st, 2022 (Phase I: univalent booster dose availability), and between November 21st, 2022 and January 11th, 2023 (Phase II: bivalent vaccine availability). Adults (≥18 years) in Canada who had received an initial primary series and had not received a COVID-19 booster dose were eligible for Phase I, and subsequently invited to participate in Phase II. Twenty-two of twenty-three (96%) participants completed interviews for both phases (45 interviews). Nearly half of participants identified as a woman (n = 11), the median age was 37 years (interquartile range: 32-48), and most participants were employed full-time (n = 12); no participant reported needing to vaccinate (with a primary series) for their workplace. No participant reported having received a COVID-19 booster dose at the time of their interview in Phase II. Three themes relating to the development of hesitancy toward continued vaccination against COVID-19 were identified: 1) effectiveness (frequency concerns; infection despite vaccination); 2) necessity (less threatening, low urgency, alternate protective measures); and 3) information (need for data, contradiction and confusion, lack of trust, decreased motivation). The data from interviews with individuals who had not received a COVID-19 booster dose or bivalent vaccine despite having received a primary series of COVID-19 vaccines highlights actionable targets to address vaccine hesitancy and improve public health literacy.
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Affiliation(s)
- Jeanna Parsons Leigh
- Faculty of Health, School of Health Administration, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada
- Canadian Center for Vaccinology & IWK Health Center, Halifax, Nova Scotia, Canada
| | - Emily A FitzGerald
- Faculty of Health, School of Health Administration, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Stephana Julia Moss
- Faculty of Health, School of Health Administration, Dalhousie University, Halifax, Nova Scotia, Canada
- CRISMA Center, Department of Critical Care, University of Pittsburgh, Pittsburgh, USA
| | - Michal S Cherak
- Faculty of Health, School of Health Administration, Dalhousie University, Halifax, Nova Scotia, Canada
- Canadian Center for Vaccinology & IWK Health Center, Halifax, Nova Scotia, Canada
| | | | - Alexandra Dodds
- Faculty of Health, School of Health Administration, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Henry T Stelfox
- Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Ève Dubé
- Centre de Recherche du CHU de Québec, Université Laval, Québec, Canada
- Département d'anthropologie, Université Laval, Québec, Canada
| | - Kirsten M Fiest
- Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada
- O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
- Department of Psychiatry & Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Donna M Halperin
- Canadian Center for Vaccinology & IWK Health Center, Halifax, Nova Scotia, Canada
- Rankin School of Nursing, St. Francis Xavier University, Antigonish, Nova Scotia, Canada
| | - Sofia B Ahmed
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Shannon E MacDonald
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Sharon E Straus
- Li Ka Shing Knowledge Institute of St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Terra Manca
- Faculty of Health Disciplines, Athabasca University, Athabasca, Alberta, Canada
- Sociology and Social Anthropology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Josh Ng Kamstra
- Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Andrea Soo
- Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada
- Alberta Health Services, Calgary, Alberta, Canada
| | - Shelly Longmore
- Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Shelly Kupsch
- Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Bonnie Sept
- Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Scott A Halperin
- Canadian Center for Vaccinology & IWK Health Center, Halifax, Nova Scotia, Canada
- Department of Pediatrics, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Microbiology and Immunology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
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Newman PA, Dinh DA, Massaquoi N, Williams CC, Lacombe-Duncan A, Tepjan S, Nyoni T. "Going vaccine hunting": Multilevel influences on COVID-19 vaccination among racialized sexual and gender minority adults-a qualitative study. Hum Vaccin Immunother 2024; 20:2301189. [PMID: 38346919 PMCID: PMC10863362 DOI: 10.1080/21645515.2023.2301189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024] Open
Abstract
High levels of COVID-19 vaccine hesitancy have been reported among Black and Latinx populations, with lower vaccination coverage among racialized versus White sexual and gender minorities. We examined multilevel contexts that influence COVID-19 vaccine uptake, barriers to vaccination, and vaccine hesitancy among predominantly racialized sexual and gender minority individuals. Semi-structured online interviews explored perspectives and experiences around COVID-19 vaccination. Interviews were recorded, transcribed, uploaded into ATLAS.ti, and reviewed using thematic analysis. Among 40 participants (mean age, 29.0 years [SD, 9.6]), all identified as sexual and/or gender minority, 82.5% of whom were racialized. COVID-19 vaccination experiences were dominated by structural barriers: systemic racism, transphobia and homophobia in healthcare and government/public health institutions; limited availability of vaccination/appointments in vulnerable neighborhoods; absence of culturally-tailored and multi-language information; lack of digital/internet access; and prohibitive indirect costs of vaccination. Vaccine hesitancy reflected in uncertainties about a novel vaccine amid conflicting information and institutional mistrust was integrally linked to structural factors. Findings suggest that the uncritical application of "vaccine hesitancy" to unilaterally explain undervaccination among marginalized populations risks conflating structural and institutional barriers with individual-level psychological factors, in effect placing the onus on those most disenfranchised to overcome societal and institutional processes of marginalization. Rather, disaggregating structural determinants of vaccination availability, access, and institutional stigma and mistrust from individual attitudes and decision-making that reflect vaccine hesitancy, may support 1) evidence-informed interventions to mitigate structural barriers in access to vaccination, and 2) culturally-informed approaches to address decisional ambivalence in the context of structural homophobia, transphobia, and racism.
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Affiliation(s)
- Peter A. Newman
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Duy Anh Dinh
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
- Faculty of Health Sciences, Queen’s University, Kingston, Ontario, Canada
| | - Notisha Massaquoi
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
- Department of Health and Society, University of Toronto, Scarborough, Ontario, Canada
| | - Charmaine C. Williams
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | | | | | - Thabani Nyoni
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
- School of Social Work, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
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Nguyen KH, Chung EL, McChesney C, Vasudevan L, Allen JD, Bednarczyk RA. Changes in general and COVID-19 vaccine hesitancy among U.S. adults from 2021 to 2022. Ann Med 2024; 56:2357230. [PMID: 38813804 PMCID: PMC11141308 DOI: 10.1080/07853890.2024.2357230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 04/26/2024] [Indexed: 05/31/2024] Open
Abstract
INTRODUCTION Understanding changes in vaccine hesitancy, overall and by sociodemographic characteristics, may highlight sub-populations for whom more intensive efforts are needed to increase vaccine uptake and confidence. METHODS We analyzed data using the CDC's Research and Development Survey (RANDS), a nationally representative survey of U.S. adults ≥18 years, collected from 17 May 2021-30 June 2021 (n = 5,458) and 3 November 2022-12 December 2022 (n = 6,821). We assessed changes in vaccine hesitancy, changes in vaccine attitudes and attitudes, and factors associated with hesitancy toward both vaccines in general and COVID-19 vaccines among a nationally representative sample of U.S. adults. RESULTS Although COVID-19 vaccination (≥1 dose) increased from 67.2% (2021) to 74.7% (2022), COVID-19 vaccine hesitancy increased from 40.7% to 44.6% during the same period. During the same period, hesitancy toward both COVID-19 vaccines and vaccines in general increased among those who were aged ≥65 years and who were non-Hispanic White. However, COVID-19 vaccine hesitancy decreased among non-Hispanic Black adults. Current or former smokers were more hesitant toward vaccines in general (aPR = 1.13, 95%CI: 1.03-1.24) and toward COVID-19 vaccines (aPR = 1.08, 95%CI: 1.01-1.16) compared to never smokers. Among adults who did not receive any COVID-19 vaccines, COVID-19 vaccine hesitancy increased from 86.6% in 2021 to 92.4% in 2022. Furthermore, belief in the overall social benefit of the COVID-19 vaccine decreased from 47.5% to 25.1%. CONCLUSION This study highlights concerning trends in vaccine hesitancy and uptake of the COVID-19 and other recommended vaccines. We found that some high-risk groups (e.g. smokers) and population subgroups have become more vaccine hesitant, suggesting the need for improved and intensified strategies to increase vaccine confidence and uptake. Future research may focus on qualitative inquiry to understand specific concerns and determinants contributing to increased hesitancy among these groups to help inform interventions and communication campaigns to support vaccination.
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Affiliation(s)
- Kimberly H. Nguyen
- Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - E. Lisa Chung
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Cheyenne McChesney
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - Lavanya Vasudevan
- Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | | | - Robert A. Bednarczyk
- Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA
- Emory Vaccine Center, Emory University, Atlanta, GA, USA
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Fisher KA, Singh S, Stone RT, Nguyen N, Crawford S, Mazor KM. Primary care providers' views of discussing COVID-19 vaccination with vaccine hesitant patients: A qualitative study. PATIENT EDUCATION AND COUNSELING 2024; 127:108369. [PMID: 38996575 DOI: 10.1016/j.pec.2024.108369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 06/19/2024] [Accepted: 06/29/2024] [Indexed: 07/14/2024]
Abstract
OBJECTIVE To describe primary care providers' (PCPs) perspectives on discussing COVID-19 vaccination with their patients. METHODS All PCPs from 11 primary care clinics at 3 health systems were invited to participate. Focus groups were conducted between December 2021-January 2022, and were recorded and transcribed. Participants were asked about their experience communicating about the COVID-19 vaccine. Themes and subthemes were inductively identified using thematic analysis. RESULTS 40 PCPs participated. All PCPs viewed discussing COVID-19 vaccination as high priority. Strategies for promoting COVID-19 vaccination included influencing what people think and feel, building trust and leveraging their relationship with patients, and practical strategies such as on-site vaccination. Most strategies aimed at influencing what people think and feel and leveraging relationships were viewed as generally ineffective. On-site vaccine availability was identified as the most influential factor. PCPs expressed frustration by their interactions with vaccine hesitant patients, leading them to truncate their communication with these patients. CONCLUSIONS Despite using a broad range of strategies, most PCPs were unable to change the strongly held beliefs among the most vaccine hesitant patients that were often informed by misinformation and mistrust. PRACTICE IMPLICATIONS Promising strategies for promoting vaccination include social/relational (expressing empathy) and practical (on-site COVID-19 vaccine availability).
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Affiliation(s)
- Kimberly A Fisher
- Division of Health Systems Science, Department of Medicine, UMass Chan Medical School, Worcester, MA 01655, USA; Division of Pulmonary and Critical Care Medicine, Department of Medicine, UMass Chan Medical School, Worcester, MA 01655, USA.
| | - Sonal Singh
- Division of Health Systems Science, Department of Medicine, UMass Chan Medical School, Worcester, MA 01655, USA; Department of Family and Community Medicine, UMass Chan Medical School, Worcester, MA 01655, USA.
| | | | - Ngoc Nguyen
- Meyers Health Care Institute, A Joint Endeavor of the UMass Chan Medical School, Reliant Medical Group, and Fallon Health, Worcester, MA 01605, USA.
| | - Sybil Crawford
- Tan Chingfen Graduate School of Nursing, UMass Chan Medical School, Worcester, MA 01655, USA.
| | - Kathleen M Mazor
- Division of Health Systems Science, Department of Medicine, UMass Chan Medical School, Worcester, MA 01655, USA.
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Totzkay D, Fraustino JD, Smith BT, Jarrett T, Dino GA, Costello LM, Kristjansson AL. Predicting COVID-19 Vaccination Intentions to Inform Evidence-Based Messaging for Building Vaccine Confidence Among Rural Americans. Am J Health Promot 2024; 38:1004-1013. [PMID: 38652835 DOI: 10.1177/08901171241249281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
PURPOSE Examine possible message topics to promote rural vaccination using psychosocial antecedents of vaccination. DESIGN Cross-sectional survey administered by Research America, Inc. SETTING West Virginia (WV). SAMPLE 756 WV adults via convenience sample (n = 370; ∼2% response rate from online panel of ∼20 000 WV residents), and random digit dial of landlines (n = 174; ∼1% response rate from 18 432 numbers) and cellphones (n = 212; ∼1% response rate from 20 486 numbers). MEASURES Outcome measures included self-reported vaccination intention and behavior. Predictor measures, rooted in theories of social and behavioral science that have been found to be predictive of vaccination outcomes (i.e., Reasoned Action Approach, Extended Parallel Process Model), included perceived severity and susceptibility, negative affect, instrumental and affective attitudes, social norms, self-efficacy, response efficacy, and perceived control. ANALYSIS Multivariate linear regression for intention and logistic regression for behavior. RESULTS Intention was positively predicted by affective attitude, β = .30, P < .05, instrumental attitude, β = .19, P < .05, response efficacy, β = .19, P < .05, negative affect, β = .16, P < .05, self-efficacy, β = .13, P < .05, and subjective norm, β = .13, P < .05, F(10, 267) = 30.12, Adj. R2 = .53. Vaccination status was predicted by instrumental attitude, exp(B) = 2.09, and subjective norm, exp(B) = 2.00, Pseudo R2 = .29, log likelihood = 125.11, χ2(10) = 38.34, P < .05. Promising message targets were instrumental attitude, M = 3.21, SD = 1.46, and subjective norms, M = 3.76, SD = 1.71. CONCLUSION COVID-19 vaccine confidence messages should address (1) positive feelings and safety perceptions, (2) vaccination's effectiveness in preventing serious COVID-19, and (3) subjective vaccination norms.
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Affiliation(s)
- Daniel Totzkay
- West Virginia University, Morgantown, WV, USA
- WVU Public Interest Communication Research Laboratory, Morgantown, WV, USA
| | - Julia Daisy Fraustino
- West Virginia University, Morgantown, WV, USA
- WVU Public Interest Communication Research Laboratory, Morgantown, WV, USA
| | - Brittany T Smith
- West Virginia University, Morgantown, WV, USA
- West Virginia Prevention Research Center, Morgantown, WV, USA
| | - Traci Jarrett
- West Virginia University, Morgantown, WV, USA
- West Virginia Prevention Research Center, Morgantown, WV, USA
| | - Geri A Dino
- West Virginia University, Morgantown, WV, USA
- West Virginia Prevention Research Center, Morgantown, WV, USA
| | - Lisa M Costello
- West Virginia University, Morgantown, WV, USA
- WVU Public Interest Communication Research Laboratory, Morgantown, WV, USA
| | - Alfgeir L Kristjansson
- West Virginia University, Morgantown, WV, USA
- West Virginia Prevention Research Center, Morgantown, WV, USA
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Peterson JC, Williams E, Goes-Ahead Lopez C, Jansen K, Albers AN, Newcomer SR, Caringi J. Influences on COVID-19 vaccine Decision-Making: A Qualitative Study With Urban Indigenous and Rural Adults. COMMUNITY HEALTH EQUITY RESEARCH & POLICY 2024:2752535X241273816. [PMID: 39151928 DOI: 10.1177/2752535x241273816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/19/2024]
Abstract
Despite the safety and effectiveness of the COVID-19 vaccine, public hesitancy about receiving vaccination remains strong among disproportionately affected populations in the United States. To design more locally and culturally appropriate strategies, research is needed to explore the qualitative characteristics of vaccine hesitancy in these populations. Thus, we conducted in-depth interviews with 19 Indigenous and 20 rural participants and utilized a grounded theory approach to identify factors associated with their COVID-19 vaccine decision making. Wariness regarding safety of vaccines, resignation over the quality of available health care, and a historical mistrust of government-led interventions influenced vaccine rejection for indigenous participants. Rural participants remained divided on the perceived threat and consequences of COVID-19 and the efficacy and safety of the vaccines. The influence of friends and family members impacted vaccine hesitancy, as did discussions with healthcare providers when discussions were perceived to be respectful, sensitive, and non-judgmental.
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Affiliation(s)
- Jeffery Chaichana Peterson
- Center for Population Health Research, University of Montana, Missoula, MT, USA
- School of Public and Community Health Sciences, University of Montana, Missoula, MT, USA
| | - Elizabeth Williams
- Center for Population Health Research, University of Montana, Missoula, MT, USA
- School of Public and Community Health Sciences, University of Montana, Missoula, MT, USA
- All Nations Health Center, Missoula, MT, USA
| | | | - Kelley Jansen
- Center for Alaska Native Health Research, University of Alaska Fairbanks , Fairbanks, AK, USA
| | - Alexandria N Albers
- Center for Population Health Research, University of Montana, Missoula, MT, USA
- School of Public and Community Health Sciences, University of Montana, Missoula, MT, USA
| | - Sophia R Newcomer
- Center for Population Health Research, University of Montana, Missoula, MT, USA
- School of Public and Community Health Sciences, University of Montana, Missoula, MT, USA
| | - James Caringi
- Center for Population Health Research, University of Montana, Missoula, MT, USA
- School of Public and Community Health Sciences, University of Montana, Missoula, MT, USA
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Vashist K, Yankey D, Elam-Evans LD, Mu Y, Valier MR, Pingali C, Hill HA, Santibanez TA, Singleton JA. Changes in vaccine hesitancy among parents of children aged 6 months - 17 Years, National Immunization Surveys, 2019-2022. Vaccine 2024; 42:125989. [PMID: 38806351 DOI: 10.1016/j.vaccine.2024.05.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 05/16/2024] [Accepted: 05/16/2024] [Indexed: 05/30/2024]
Abstract
BACKGROUND Vaccine hesitancy (VH) has been a major contributor to large outbreaks of vaccine-preventable diseases globally, including in the United States. METHODS Data from the 2019-2022 National Immunization Surveys were analyzed to assess parental hesitancy toward routine vaccination of their children aged 6 months -17 years. Joinpoint regression was employed to investigate trends in VH from 2019 to 2022 nationally overall and among socio-demographic subgroups. Using logistic regression, the difference between the prevalence of VH before and after the authorization of the COVID-19 vaccine for children aged 6 months-4 years, 5-11 years, and 12-17 years was computed. Both unadjusted and adjusted estimates were reported. VH was also compared within each socio-demographic subgroup with a reference level, at two-time points- before and after the authorization of the COVID-19 vaccine for each age group. RESULTS Overall, VH remained around 19.0 % from Q2 2019 to Q3 2022. Parents of non-Hispanic Black children had the largest average quarterly decrease in VH (β = -0.55; p < 0.05 by test for trend). After the authorization of the COVID-19 vaccine for children aged 6 months to 4 years, the adjusted percentage of children having parents that reported VH decreased by 2.2 (95 % CI: -3.9, -0.6) percentage points (pp) from 21.6 % to 19.4 %. Conversely, for children aged 5-11 years, VH increased by 1.2 (95 % CI: 0.2, 2.3) pp, from 19.8 % to 21.0 %. VH among parents of non-Hispanic Black children decreased after the authorization of the COVID-19 vaccine for adolescents aged 12-17 years but remained significantly higher compared to parents of non-Hispanic White children before and after authorization of the COVID-19 vaccine for all age groups. DISCUSSION About 1 in 5 children had parents reporting VH from 2019 to 2022. Parental VH increased after the authorization of the COVID-19 vaccine for children aged 5-11 years and declined for children aged 6 months-4 years.
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Affiliation(s)
- Kushagra Vashist
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States; Rollins School of Public Health, Emory University, Atlanta, GA, United States.
| | - David Yankey
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Laurie D Elam-Evans
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Yi Mu
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Madeleine R Valier
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Cassandra Pingali
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Holly A Hill
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Tammy A Santibanez
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - James A Singleton
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
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Sandborn H, Delamater P, Brewer NT, Gilkey MB, Emch M. The geography of COVID-19 vaccine completion by age in North Carolina, U.S. PLoS One 2024; 19:e0304812. [PMID: 39121103 PMCID: PMC11315330 DOI: 10.1371/journal.pone.0304812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 05/18/2024] [Indexed: 08/11/2024] Open
Abstract
BACKGROUND Geographic variation in COVID-19 vaccination can create areas at higher risk of infection, complications, and death, exacerbating health inequalities. This ecological study examined geographic patterns of COVID-19 vaccine completion, using age and sociodemographic characteristics as possible explanatory mechanisms. METHODS AND FINDINGS Using 2020-2022 data from the North Carolina COVID-19 Vaccination Management System and U.S. Census Bureau American Community Survey, at the Zip code-level, we evaluated completion of the primary COVID-19 vaccine series across age groups. We examined geographic clustering of age-specific completion by Zip code and evaluated similarity of the age-specific geographic patterns. Using unadjusted and adjusted spatial autoregressive models, we examined associations between sociodemographic characteristics and age-specific vaccine completion. COVID-19 vaccine completion was moderately geographically clustered in younger groups, with lower clustering in older groups. Urban areas had clusters of higher vaccine completion. Younger and middle-aged groups were the most similar in completion geographically, while the oldest group was most dissimilar to other age groups. Higher income was associated with higher completion in adjusted models across all age groups, while a higher percent of Black residents was associated with higher completion for some groups. CONCLUSIONS COVID-19 vaccination completion is more variable among younger age groups in North Carolina, and it is higher in urban areas with higher income. Higher completion in areas with more Black residents may reflect the success of racial equity efforts in the state. The findings show a need to reach younger populations and lower income areas that were not prioritized during early vaccination distribution.
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Affiliation(s)
- Hilary Sandborn
- Department of Geography and Environment, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Paul Delamater
- Department of Geography and Environment, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Noel T. Brewer
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Melissa B. Gilkey
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Michael Emch
- Department of Geography and Environment, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
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Herrera K, Mojica MM, Sintigo KM, Hur K. Demographic Differences in Emergency Room Epistaxis Treatment Patterns and Outcomes. Otolaryngol Head Neck Surg 2024. [PMID: 39118575 DOI: 10.1002/ohn.940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 07/15/2024] [Accepted: 07/27/2024] [Indexed: 08/10/2024]
Abstract
OBJECTIVE Investigate the association between demographic characteristics and emergency department (ED) epistaxis management and outcomes. STUDY DESIGN Retrospective cohort study. SETTING TriNetX US collaborative database. METHODS Adults presenting to the ED for epistaxis were retrospectively followed for 7 days. Spanish-speaking patients were propensity score matched to English-speaking patients by demographics and medical history. Outcomes included use of nasal decongestant, nasal packing or cautery, diagnostic nasal endoscopy, endoscopic control of hemorrhage, hospital admission, and mortality. The analysis was also performed with stratification by race and ethnicity. RESULTS Spanish-speaking patients were less likely to receive nasal packing or cautery [odds ratio, OR: 0.78; 95% confidence interval, CI: (0.68; 0.90)] or diagnostic nasal endoscopy [OR: 0.72; 95% CI: (0.52; 0.98)] compared to English-speaking patients. Black patients were more likely to receive treatment with a nasal decongestant spray [OR: 1.31; 95% CI: (1.27, 1.36)], but less likely to receive any other treatment compared to White patients. Asian patients were less likely to undergo nasal packing or cautery [OR: 0.90; 95% CI: (0.82; 0.99)], but had more ED visits [(1.37; 1.32) P < .01] compared to White patients. Hispanic patients were less likely to be admitted [OR: 0.93; 95% CI: (0.87; 0.98)], and averaged fewer ED visits [(1.27; 1.30) P = <.0001] compared to non-Hispanic patients. CONCLUSION While demographic trends in ED epistaxis management are nuanced, our results suggest that Spanish-speaking, Black, Asian, and Hispanic patients are less likely to receive diagnostic and epistaxis control procedures. Additional research is needed to determine the etiology of these differences.
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Affiliation(s)
- Kevin Herrera
- Caruso Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine of University of Southern California, Los Angeles, California, USA
| | - Marcela Moran Mojica
- Caruso Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine of University of Southern California, Los Angeles, California, USA
| | - Karla Marlene Sintigo
- Caruso Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine of University of Southern California, Los Angeles, California, USA
| | - Kevin Hur
- Caruso Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine of University of Southern California, Los Angeles, California, USA
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10
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Deng Z, Grépin KA. Achilles' heel: elderly COVID-19 vaccination policy in China. Health Res Policy Syst 2024; 22:90. [PMID: 39103903 DOI: 10.1186/s12961-024-01155-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 05/20/2024] [Indexed: 08/07/2024] Open
Abstract
BACKGROUND Despite high overall COVID-19 vaccine coverage, the continuously low elderly vaccination rate in mainland China remains a dangerous threat as the country shifts away from its zero-Covid policy. This retrospective study uses the Multiple Streams Framework to examine how macro-level factors may explain poor elderly vaccination outcomes. METHODS We performed a thematic analysis of qualitative data obtained from 95 official press conferences from October 20, 2020, to February 27, 2023, vaccination-related policy documents, and media coverage, using both inductive and deductive coding approaches. RESULTS Our findings suggest that in the problem stream, elderly vaccination was not a "focusing event" during the initial vaccine rollout, resulting in delayed outreach to this population. Additionally, ideologically driven complacency and discrepancies in top-down implementation undermined elderly vaccination in the political stream. In the policy stream, precautious and ambiguous statements, inconsistent policy content, radical shifting media messages, and less age-friendly digital technologies also affected elderly vaccination. CONCLUSIONS The poor convergence of the three streams led the elderly to be the Achilles' heel of China's COVID-19 containment strategy. Future studies should focus on priority identification, adoption of enforcement measures, and timely and effective policy dissemination. The empirical lessons from China can inform and optimize elderly vaccination policy design and implementation in the post-pandemic era.
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Affiliation(s)
- Ziru Deng
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Patrick Manson Building, 7 Sassoon Road, Pokfulam, Hong Kong
| | - Karen A Grépin
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Patrick Manson Building, 7 Sassoon Road, Pokfulam, Hong Kong.
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11
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Kim JEC, Kranzler EC, Yu K, Denison B, Dahlen HM, Luchman JN, Ihongbe TO, Marshall MC, Hoffman B, Moffett K, Dupervil D, Margolis KA, Hoffman L. The Association Between the We Can Do This Campaign and Vaccination Beliefs in the United States, January 2021-March 2022. JOURNAL OF HEALTH COMMUNICATION 2024; 29:502-513. [PMID: 38958603 DOI: 10.1080/10810730.2024.2373159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/04/2024]
Abstract
Public health campaigns addressing COVID-19 vaccination beliefs may be effective in changing COVID-19 vaccination behaviors, particularly among people who remain vaccine hesitant. The "We Can Do This" COVID-19 public education campaign (the Campaign) was designed to increase COVID-19 vaccine confidence and uptake. This study aims to evaluate whether Campaign dose was associated with changes in vaccination beliefs related to COVID-19 vaccine concerns and perceived risks, the importance of COVID-19 vaccines, the perceived benefits of COVID-19 vaccination, normative beliefs about COVID-19 vaccination, and perceptions about general vaccine safety and effectiveness. The study linked data from four waves of a nationally representative longitudinal panel of U.S. adults (January 2021-March 2022) with Campaign paid digital media data (April 2021-May 2022). We used mixed-effects linear regressions to examine the association between Campaign paid digital impressions and changes in vaccination beliefs. The results provide evidence that Campaign digital impressions were significantly associated with changes in respondent beliefs regarding COVID-19 vaccine concerns and perceived risks, perceived benefits of COVID-19 vaccination, and perceptions about general vaccine safety and effectiveness. Findings suggest that public education campaigns may influence vaccine confidence and uptake by increasing positive vaccination beliefs and reducing vaccine concerns.
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Affiliation(s)
- Jae-Eun C Kim
- Communication Campaign Research & Evaluation, Fors Marsh, Arlington, Virginia
| | - Elissa C Kranzler
- Communication Campaign Research & Evaluation, Fors Marsh, Arlington, Virginia
| | - Kathleen Yu
- Center for Food Safety and Applied Nutrition, U.S. Department of Health and Human Services Office of the Assistant Secretary for Public Affairs, Washington, District of Columbia, United States
| | - Benjamin Denison
- Communication Campaign Research & Evaluation, Fors Marsh, Arlington, Virginia
| | - Heather M Dahlen
- Communication Campaign Research & Evaluation, Fors Marsh, Arlington, Virginia
| | - Joseph N Luchman
- Communication Campaign Research & Evaluation, Fors Marsh, Arlington, Virginia
| | - Timothy O Ihongbe
- Communication Campaign Research & Evaluation, Fors Marsh, Arlington, Virginia
| | - Michael C Marshall
- Communication Campaign Research & Evaluation, Fors Marsh, Arlington, Virginia
| | - Blake Hoffman
- Communication Campaign Research & Evaluation, Fors Marsh, Arlington, Virginia
| | - Kenneth Moffett
- Communication Campaign Research & Evaluation, Fors Marsh, Arlington, Virginia
| | - Daphney Dupervil
- Center for Food Safety and Applied Nutrition, U.S. Department of Health and Human Services Office of the Assistant Secretary for Public Affairs, Washington, District of Columbia, United States
| | - Katherine A Margolis
- Center for Food Safety and Applied Nutrition, U.S. Department of Health and Human Services Office of the Assistant Secretary for Public Affairs, Washington, District of Columbia, United States
| | - Leah Hoffman
- Communication Campaign Research & Evaluation, Fors Marsh, Arlington, Virginia
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12
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SteelFisher GK, Findling MG, Caporello HL, Stein RI, Lubell KM, Fisher AM, Lane LA, Boyea A, Espino L, Sutton J. Public Willingness to Mask and Vaccinate in the Future: Results From a 2023 Nationally Representative Survey of US Adults. Health Secur 2024; 22:311-323. [PMID: 39172114 DOI: 10.1089/hs.2023.0136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/23/2024] Open
Abstract
The enduring spread of COVID-19 and other respiratory viruses highlights a need for greater focus on long-term public willingness to perform protective behaviors. Although COVID-19 is no longer considered a public health emergency of international concern, it is unknown whether people in the United States plan to continue protective behaviors to protect themselves and others against infection. To inform planning and communications, we used a nationally representative survey of 1,936 US adults to examine attitudes and intentions toward future vaccination and mask-wearing. A majority believed COVID-19 vaccines were safe (73%) and effective in protecting against serious illness (72%). One-third (33%) had strong intentions to get an updated COVID-19 vaccine most years in the future. Among those with weaker intentions (n=1,287), many cited concerns about safety (71%) and efficacy (64%), lack of trust in institutions (64%), or beliefs that prior vaccination or infection protected them (62%). Approximately two-thirds (69%) of respondents believed masks were effective in protecting the wearer from getting COVID-19, and a majority appeared moderately receptive to future public mask-wearing, particularly when there was proximate risk of infection from COVID-19 (67%) or other respiratory viruses (59%). Men, non-Hispanic White adults, younger adults, rural residents, and adults with higher incomes, without college degrees, and without serious medical conditions or physical limitations were more likely to indicate resistance toward future COVID-19 vaccination and/or mask-wearing. Findings support tailored messaging to address concerns and opportunities among different populations, as well as support for communications programs and community engagement to motivate future uptake.
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Affiliation(s)
- Gillian K SteelFisher
- Gillian K. SteelFisher, PhD, MSc, is Principal Research Scientist and Director of Global Polling; Mary G. Findling, PhD, ScM, is Assistant Director; Hannah L. Caporello is Senior Research Projects Manager; and Rebekah I. Stein is a Research Assistant, Harvard Opinion Research Program; all in the Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA. Keri M. Lubell, PhD, is a Behavioral Scientist, and Lindsay A. Lane, MPH, is a Health Communications Specialist, Center for Preparedness and Response; and Allison M. Fisher, MPH, is a Health Communications Specialist, National Center for Immunization and Respiratory Diseases; all at the US Centers for Disease Control and Prevention, Atlanta, GA. Alyssa Boyea, MPH, CPH, is Director, Infectious Disease Preparedness, Association of State and Territorial Health Officials, Arlington, VA. Laura Espino is Program Director, National Public Health Information Coalition, Canton, GA. Jazmyne Sutton, PhD, is Research Director, SSRS, Glen Mills, PA
| | - Mary G Findling
- Gillian K. SteelFisher, PhD, MSc, is Principal Research Scientist and Director of Global Polling; Mary G. Findling, PhD, ScM, is Assistant Director; Hannah L. Caporello is Senior Research Projects Manager; and Rebekah I. Stein is a Research Assistant, Harvard Opinion Research Program; all in the Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA. Keri M. Lubell, PhD, is a Behavioral Scientist, and Lindsay A. Lane, MPH, is a Health Communications Specialist, Center for Preparedness and Response; and Allison M. Fisher, MPH, is a Health Communications Specialist, National Center for Immunization and Respiratory Diseases; all at the US Centers for Disease Control and Prevention, Atlanta, GA. Alyssa Boyea, MPH, CPH, is Director, Infectious Disease Preparedness, Association of State and Territorial Health Officials, Arlington, VA. Laura Espino is Program Director, National Public Health Information Coalition, Canton, GA. Jazmyne Sutton, PhD, is Research Director, SSRS, Glen Mills, PA
| | - Hannah L Caporello
- Gillian K. SteelFisher, PhD, MSc, is Principal Research Scientist and Director of Global Polling; Mary G. Findling, PhD, ScM, is Assistant Director; Hannah L. Caporello is Senior Research Projects Manager; and Rebekah I. Stein is a Research Assistant, Harvard Opinion Research Program; all in the Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA. Keri M. Lubell, PhD, is a Behavioral Scientist, and Lindsay A. Lane, MPH, is a Health Communications Specialist, Center for Preparedness and Response; and Allison M. Fisher, MPH, is a Health Communications Specialist, National Center for Immunization and Respiratory Diseases; all at the US Centers for Disease Control and Prevention, Atlanta, GA. Alyssa Boyea, MPH, CPH, is Director, Infectious Disease Preparedness, Association of State and Territorial Health Officials, Arlington, VA. Laura Espino is Program Director, National Public Health Information Coalition, Canton, GA. Jazmyne Sutton, PhD, is Research Director, SSRS, Glen Mills, PA
| | - Rebekah I Stein
- Gillian K. SteelFisher, PhD, MSc, is Principal Research Scientist and Director of Global Polling; Mary G. Findling, PhD, ScM, is Assistant Director; Hannah L. Caporello is Senior Research Projects Manager; and Rebekah I. Stein is a Research Assistant, Harvard Opinion Research Program; all in the Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA. Keri M. Lubell, PhD, is a Behavioral Scientist, and Lindsay A. Lane, MPH, is a Health Communications Specialist, Center for Preparedness and Response; and Allison M. Fisher, MPH, is a Health Communications Specialist, National Center for Immunization and Respiratory Diseases; all at the US Centers for Disease Control and Prevention, Atlanta, GA. Alyssa Boyea, MPH, CPH, is Director, Infectious Disease Preparedness, Association of State and Territorial Health Officials, Arlington, VA. Laura Espino is Program Director, National Public Health Information Coalition, Canton, GA. Jazmyne Sutton, PhD, is Research Director, SSRS, Glen Mills, PA
| | - Keri M Lubell
- Gillian K. SteelFisher, PhD, MSc, is Principal Research Scientist and Director of Global Polling; Mary G. Findling, PhD, ScM, is Assistant Director; Hannah L. Caporello is Senior Research Projects Manager; and Rebekah I. Stein is a Research Assistant, Harvard Opinion Research Program; all in the Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA. Keri M. Lubell, PhD, is a Behavioral Scientist, and Lindsay A. Lane, MPH, is a Health Communications Specialist, Center for Preparedness and Response; and Allison M. Fisher, MPH, is a Health Communications Specialist, National Center for Immunization and Respiratory Diseases; all at the US Centers for Disease Control and Prevention, Atlanta, GA. Alyssa Boyea, MPH, CPH, is Director, Infectious Disease Preparedness, Association of State and Territorial Health Officials, Arlington, VA. Laura Espino is Program Director, National Public Health Information Coalition, Canton, GA. Jazmyne Sutton, PhD, is Research Director, SSRS, Glen Mills, PA
| | - Allison M Fisher
- Gillian K. SteelFisher, PhD, MSc, is Principal Research Scientist and Director of Global Polling; Mary G. Findling, PhD, ScM, is Assistant Director; Hannah L. Caporello is Senior Research Projects Manager; and Rebekah I. Stein is a Research Assistant, Harvard Opinion Research Program; all in the Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA. Keri M. Lubell, PhD, is a Behavioral Scientist, and Lindsay A. Lane, MPH, is a Health Communications Specialist, Center for Preparedness and Response; and Allison M. Fisher, MPH, is a Health Communications Specialist, National Center for Immunization and Respiratory Diseases; all at the US Centers for Disease Control and Prevention, Atlanta, GA. Alyssa Boyea, MPH, CPH, is Director, Infectious Disease Preparedness, Association of State and Territorial Health Officials, Arlington, VA. Laura Espino is Program Director, National Public Health Information Coalition, Canton, GA. Jazmyne Sutton, PhD, is Research Director, SSRS, Glen Mills, PA
| | - Lindsay A Lane
- Gillian K. SteelFisher, PhD, MSc, is Principal Research Scientist and Director of Global Polling; Mary G. Findling, PhD, ScM, is Assistant Director; Hannah L. Caporello is Senior Research Projects Manager; and Rebekah I. Stein is a Research Assistant, Harvard Opinion Research Program; all in the Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA. Keri M. Lubell, PhD, is a Behavioral Scientist, and Lindsay A. Lane, MPH, is a Health Communications Specialist, Center for Preparedness and Response; and Allison M. Fisher, MPH, is a Health Communications Specialist, National Center for Immunization and Respiratory Diseases; all at the US Centers for Disease Control and Prevention, Atlanta, GA. Alyssa Boyea, MPH, CPH, is Director, Infectious Disease Preparedness, Association of State and Territorial Health Officials, Arlington, VA. Laura Espino is Program Director, National Public Health Information Coalition, Canton, GA. Jazmyne Sutton, PhD, is Research Director, SSRS, Glen Mills, PA
| | - Alyssa Boyea
- Gillian K. SteelFisher, PhD, MSc, is Principal Research Scientist and Director of Global Polling; Mary G. Findling, PhD, ScM, is Assistant Director; Hannah L. Caporello is Senior Research Projects Manager; and Rebekah I. Stein is a Research Assistant, Harvard Opinion Research Program; all in the Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA. Keri M. Lubell, PhD, is a Behavioral Scientist, and Lindsay A. Lane, MPH, is a Health Communications Specialist, Center for Preparedness and Response; and Allison M. Fisher, MPH, is a Health Communications Specialist, National Center for Immunization and Respiratory Diseases; all at the US Centers for Disease Control and Prevention, Atlanta, GA. Alyssa Boyea, MPH, CPH, is Director, Infectious Disease Preparedness, Association of State and Territorial Health Officials, Arlington, VA. Laura Espino is Program Director, National Public Health Information Coalition, Canton, GA. Jazmyne Sutton, PhD, is Research Director, SSRS, Glen Mills, PA
| | - Laura Espino
- Gillian K. SteelFisher, PhD, MSc, is Principal Research Scientist and Director of Global Polling; Mary G. Findling, PhD, ScM, is Assistant Director; Hannah L. Caporello is Senior Research Projects Manager; and Rebekah I. Stein is a Research Assistant, Harvard Opinion Research Program; all in the Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA. Keri M. Lubell, PhD, is a Behavioral Scientist, and Lindsay A. Lane, MPH, is a Health Communications Specialist, Center for Preparedness and Response; and Allison M. Fisher, MPH, is a Health Communications Specialist, National Center for Immunization and Respiratory Diseases; all at the US Centers for Disease Control and Prevention, Atlanta, GA. Alyssa Boyea, MPH, CPH, is Director, Infectious Disease Preparedness, Association of State and Territorial Health Officials, Arlington, VA. Laura Espino is Program Director, National Public Health Information Coalition, Canton, GA. Jazmyne Sutton, PhD, is Research Director, SSRS, Glen Mills, PA
| | - Jazmyne Sutton
- Gillian K. SteelFisher, PhD, MSc, is Principal Research Scientist and Director of Global Polling; Mary G. Findling, PhD, ScM, is Assistant Director; Hannah L. Caporello is Senior Research Projects Manager; and Rebekah I. Stein is a Research Assistant, Harvard Opinion Research Program; all in the Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA. Keri M. Lubell, PhD, is a Behavioral Scientist, and Lindsay A. Lane, MPH, is a Health Communications Specialist, Center for Preparedness and Response; and Allison M. Fisher, MPH, is a Health Communications Specialist, National Center for Immunization and Respiratory Diseases; all at the US Centers for Disease Control and Prevention, Atlanta, GA. Alyssa Boyea, MPH, CPH, is Director, Infectious Disease Preparedness, Association of State and Territorial Health Officials, Arlington, VA. Laura Espino is Program Director, National Public Health Information Coalition, Canton, GA. Jazmyne Sutton, PhD, is Research Director, SSRS, Glen Mills, PA
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Takagi MA, Rhodes ST, Kim JH, King M, Soukar S, Martin C, Sasaki Cole A, Chan A, Brennan C, Zyzanski S, Kissoondial B, Ragina N. Evaluating Two Educational Interventions for Enhancing COVID-19 Knowledge and Attitudes in a Sample American Indian/Alaska Native Population. Vaccines (Basel) 2024; 12:787. [PMID: 39066425 PMCID: PMC11281502 DOI: 10.3390/vaccines12070787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2024] [Revised: 07/15/2024] [Accepted: 07/15/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic has exacerbated existing healthcare disparities among American Indian/Alaska Native (AI/AN) populations rooted in historical traumas and systemic marginalization. METHODS This study conducted at a single Indian Health Service (IHS) clinic in central Michigan evaluates two educational interventions for enhancing COVID-19 knowledge and attitudes in a sample AI/AN population. Utilizing a pre/post-intervention prospective study design, participants received either a video or infographic educational intervention, followed by a survey assessing their COVID-19 knowledge and attitudes. RESULTS The results indicate significant improvements in knowledge and attitudes post-intervention, with both modalities proving effective. However, specific factors such as gender, political affiliation, and place of residence influenced COVID-19 attitudes and knowledge, emphasizing the importance of tailored interventions. CONCLUSIONS Despite limitations, this study highlights the critical role of educational interventions in addressing vaccine hesitancy and promoting health equity within AI/AN communities. Moving forward, comprehensive strategies involving increased Indian Health Service funding, culturally relevant interventions, and policy advocacy are crucial in mitigating healthcare disparities and promoting health equity within AI/AN communities.
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Affiliation(s)
- Maya Asami Takagi
- College of Medicine, Central Michigan University, Mount Pleasant, MI 48858, USA; (S.T.R.); (J.H.K.); (M.K.); (S.S.); (C.M.); (A.S.C.); (A.C.); (C.B.); (N.R.)
- Department of Internal Medicine, University of California Davis School of Medicine, Sacramento, CA 95817, USA
| | - Simone T. Rhodes
- College of Medicine, Central Michigan University, Mount Pleasant, MI 48858, USA; (S.T.R.); (J.H.K.); (M.K.); (S.S.); (C.M.); (A.S.C.); (A.C.); (C.B.); (N.R.)
| | - Jun Hwan Kim
- College of Medicine, Central Michigan University, Mount Pleasant, MI 48858, USA; (S.T.R.); (J.H.K.); (M.K.); (S.S.); (C.M.); (A.S.C.); (A.C.); (C.B.); (N.R.)
| | - Maxwell King
- College of Medicine, Central Michigan University, Mount Pleasant, MI 48858, USA; (S.T.R.); (J.H.K.); (M.K.); (S.S.); (C.M.); (A.S.C.); (A.C.); (C.B.); (N.R.)
| | - Stephanie Soukar
- College of Medicine, Central Michigan University, Mount Pleasant, MI 48858, USA; (S.T.R.); (J.H.K.); (M.K.); (S.S.); (C.M.); (A.S.C.); (A.C.); (C.B.); (N.R.)
| | - Chad Martin
- College of Medicine, Central Michigan University, Mount Pleasant, MI 48858, USA; (S.T.R.); (J.H.K.); (M.K.); (S.S.); (C.M.); (A.S.C.); (A.C.); (C.B.); (N.R.)
| | - Angela Sasaki Cole
- College of Medicine, Central Michigan University, Mount Pleasant, MI 48858, USA; (S.T.R.); (J.H.K.); (M.K.); (S.S.); (C.M.); (A.S.C.); (A.C.); (C.B.); (N.R.)
| | - Arlene Chan
- College of Medicine, Central Michigan University, Mount Pleasant, MI 48858, USA; (S.T.R.); (J.H.K.); (M.K.); (S.S.); (C.M.); (A.S.C.); (A.C.); (C.B.); (N.R.)
| | - Ciara Brennan
- College of Medicine, Central Michigan University, Mount Pleasant, MI 48858, USA; (S.T.R.); (J.H.K.); (M.K.); (S.S.); (C.M.); (A.S.C.); (A.C.); (C.B.); (N.R.)
| | - Stephen Zyzanski
- Department of Family Medicine and Community Health, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA;
| | - Barry Kissoondial
- College of Medicine Affiliated Community Clinic, Central Michigan University, Mount Pleasant, MI 48858, USA;
| | - Neli Ragina
- College of Medicine, Central Michigan University, Mount Pleasant, MI 48858, USA; (S.T.R.); (J.H.K.); (M.K.); (S.S.); (C.M.); (A.S.C.); (A.C.); (C.B.); (N.R.)
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14
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Yang Y, Park H, Li C, Song D, Wang J. Comparing COVID-19 vaccination coverage, adverse reactions and impact of social determinants of health on vaccine hesitancy in ADRD/MCI and non-ADRD/MCI population: protocol for a retrospective cross-sectional study. BMJ Open 2024; 14:e082988. [PMID: 39013656 PMCID: PMC11253747 DOI: 10.1136/bmjopen-2023-082988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 07/07/2024] [Indexed: 07/18/2024] Open
Abstract
INTRODUCTION COVID-19 vaccination is crucial for vulnerable people with underlying chronic conditions such as Alzheimer's disease and related dementias (ADRD) and mild cognitive impairment (MCI). These individuals face unique challenges, including higher risk of COVID-19, difficulties in adopting preventive behaviours and vaccine hesitancy due to concerns about adverse reactions. Therefore, efforts to promote vaccination, including boosters tailored to the currently circulating virus, are essential for people with ADRD/MCI. OBJECTIVE The primary purpose of this study protocol is to conduct a comprehensive analysis of COVID-19 vaccination coverage and adverse reactions among individuals with ADRD/MCI in comparison to those without ADRD/MCI. Additionally, the proposed study aims to investigate the impact of social determinants of health on COVID-19 vaccination and vaccine hesitancy in individuals with ADRD/MCI. METHODS AND ANALYSIS A retrospective cross-sectional study will be conducted utilising data from the All of Us (AoU) Researcher Workbench. Relevant data fields are extracted from sources including demographic information, COVID-19 Vaccine Survey, Basic Survey, Health Access & Utilization, Social Determinants of Health, and Electronic Health Record (EHR) data. Data on vaccination, adverse reactions and vaccine hesitancy will be collected through COVID-19 vaccine survey questionnaires. Propensity score matching and binary logistic regression will be applied to assess the vaccination rates and vaccine hesitancy, while controlling for demographic characteristics and social determinants of health factors. ETHICS AND DISSEMINATION This study protocol received approval from the Institutional Review Board at Florida State University (STUDY00004571). Results will be disseminated through publication in peer-reviewed journals and presented at scientific conferences.
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Affiliation(s)
- Yijiong Yang
- College of Nursing, Florida State University, Tallahassee, Florida, USA
| | - Hyejin Park
- College of Nursing, Florida State University, Tallahassee, Florida, USA
| | - Chengdong Li
- College of Nursing, Florida State University, Tallahassee, Florida, USA
| | - Dan Song
- College of Nursing, Florida State University, Tallahassee, Florida, USA
| | - Jing Wang
- College of Nursing, Florida State University, Tallahassee, Florida, USA
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15
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Nwachukwu G, Rihan A, Nwachukwu E, Uduma N, Elliott KS, Tiruneh YM. Understanding COVID-19 Vaccine Hesitancy in the United States: A Systematic Review. Vaccines (Basel) 2024; 12:747. [PMID: 39066385 PMCID: PMC11281578 DOI: 10.3390/vaccines12070747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2024] [Revised: 06/21/2024] [Accepted: 06/28/2024] [Indexed: 07/28/2024] Open
Abstract
The COVID-19 pandemic has presented the importance of vaccination as a pivotal strategy for controlling its spread. However, vaccine hesitancy poses a significant barrier to achieving widespread immunization in the United States. This systematic review utilizes the 5C model to examine the factors contributing to hesitancy, which include confidence in vaccines, complacency about disease risk, calculations of individual benefit, convenience of vaccination, and collective responsibility for the protection of others. METHODS We conducted a comprehensive search across several relevant databases and the gray literature, identifying 544 studies that used quantitative and qualitative methods to explore COVID-19 vaccine hesitancy in the general U.S. POPULATION RESULTS This review identifies a complex interplay of factors affecting hesitancy, such as concerns over vaccine safety and efficacy, misinformation and conspiracy theories, demographic variables, and socioeconomic conditions. Key strategies for increasing vaccine uptake include transparent and effective communication along with proactive community engagement. CONCLUSIONS To effectively mitigate vaccine hesitancy, it is crucial to understand its multifaceted causes. Tailored interventions that consider socioeconomic and cultural contexts and prioritize clear communication, community involvement, and specific strategies to address unique concerns can enhance vaccine acceptance.
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Affiliation(s)
- Godspower Nwachukwu
- Department of Public Health, School of Health Professions, University of Texas at Tyler Health Science Center, Tyler, TX 75708, USA;
| | - Alaa Rihan
- Department of Preventive Medicine and Population Health, School of Medicine, University of Texas at Tyler Health Science Center, Tyler, TX 75708, USA;
| | - Esther Nwachukwu
- Department of Biology, University of Texas at Tyler, Tyler, TX 75799, USA; (E.N.); (N.U.)
| | - Ndukwe Uduma
- Department of Biology, University of Texas at Tyler, Tyler, TX 75799, USA; (E.N.); (N.U.)
| | - Kimberly S. Elliott
- Department of Health Policy, Economics and Management, School of Health Professions, University of Texas at Tyler Health Science Center, Tyler, TX 75708, USA;
| | - Yordanos M. Tiruneh
- Department of Preventive Medicine and Population Health, School of Medicine, University of Texas at Tyler Health Science Center, Tyler, TX 75708, USA;
- Department of Internal Medicine, Division of Infectious Diseases, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
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Kale D, Shoesmith E, Herbec A, Shahab L. Willingness to get vaccinated initially and yearly against COVID-19 and its association with vaccine hesitancy, vaccine knowledge and psychological well-being: a cross-sectional study in UK adults. BMJ Open 2024; 14:e080778. [PMID: 38969372 PMCID: PMC11227763 DOI: 10.1136/bmjopen-2023-080778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 06/21/2024] [Indexed: 07/07/2024] Open
Abstract
OBJECTIVES This study explores the association between vaccine hesitancy, vaccine knowledge and psychological well-being with (1) receipt of/willingness to receive an initial vaccine against COVID-19, and (2) willingness to get vaccinated yearly against COVID-19. The importance of different vaccine attributes (eg, vaccine technology, effectiveness, side effects) to choose a specific COVID-19 vaccine was also assessed. DESIGN Cross-sectional survey administered during May to June 2021 on vaccine hesitancy, vaccine knowledge, psychological well-being, willingness to receive COVID-19 vaccines, sociodemographics and COVID-19-related factors. SETTING UK. PARTICIPANTS A self-selected sample of 1408 adults. OUTCOME MEASURES Receipt of/willingness to receive COVID-19 vaccine for the first time and yearly. RESULTS Receipt of/willingness to receive a vaccine against COVID-19 initially and yearly were high (97.0% and 86.6%, respectively). Vaccine hesitancy was negatively associated with receipt of/willingness to receive vaccine initially/yearly (adjusted OR (aOR)=0.09, 95% CI 0.04 to 0.26, p<0.001/aOR=0.05, 95% CI 0.03 to 0.09, p<0.001). Vaccine knowledge and psychological well-being were positively associated with willingness to receive a yearly vaccine (aOR=1.81, 95% CI 1.43 to 2.29, p<0.001 and aOR=1.25, 95% CI 1.02 to 1.51, p=0.014, respectively), and general vaccine knowledge also with receipt of/willingness to receive vaccine initially (aOR=1.69, 95% CI 1.18 to 2.42, p=0.004). Vaccine effectiveness was the most important attribute for participants to choose a specific COVID-19 vaccine. CONCLUSIONS Improving vaccine knowledge and emphasising vaccine efficacy may minimise vaccine hesitancy and increase COVID-19 vaccine uptake.
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Affiliation(s)
- Dimitra Kale
- Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, London, UK
| | | | - Aleksandra Herbec
- Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, London, UK
- Institute-European Observatory of Health Inequalities, Calisia University, Kalisz, Poland
| | - Lion Shahab
- Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, London, UK
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17
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Smith DG, Smith CD, DeLeon JA, Sandoz JL, Ochoa CO, Pearson MP, Macena RHM. Factors influencing COVID-19 vaccine uptake among Latinos: A cross-sectional study. PLoS One 2024; 19:e0302332. [PMID: 38968176 PMCID: PMC11226026 DOI: 10.1371/journal.pone.0302332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 04/02/2024] [Indexed: 07/07/2024] Open
Abstract
Vaccination against COVID-19 can prevent severe illness and reduce hospitalizations and deaths. Understanding and addressing determinants contributing to vaccine uptake among high-risk groups, such as Latinos, are pivotal in ensuring equitable vaccine distribution, promoting health equity, and fostering community engagement to bridge the gap in vaccine acceptance and ultimately enhance public health. This study aimed to examine factors influencing vaccine uptake among Latinos. We conducted a cross-sectional study using an online platform (n = 242). The survey was administered using a multimodal approach. Strategies for recruitment included community outreach, social media, and targeting community networks serving Latinos. Descriptive statistics, chi-square, and multivariable analysis were performed. Overall, 81.4% of respondents had received at least one dose of the COVID-19 vaccine, with 77.0% recommending it and 70.6% believing it to be safe, 66.7% believing in its efficacy, 62.3% able to find trustful information in Spanish or Portuguese, and almost 40% who relied on health organizations as their primary resource for COVID-19 vaccine information. Factors significantly associated with vaccine uptake included higher education level (p<0.001), English level (p = 0.023), living in an urban area (p = 0.048), having insurance (p<0.001), and having a healthcare provider (p = 0.007). Furthermore, belief in vaccine safety and efficacy, trust in public health authorities, concerns about COVID-19, the ability to determine true/false vaccine information during the pandemic, and the availability of trustworthy information in Spanish/Portuguese had statistically significant associations (p<0.05) with COVID-19 vaccine uptake. COVID-19 vaccine uptake differed based on sociodemographic and other modifiable factors. Our findings emphasize the importance of implementing targeted interventions and culturally sensitive communication strategies to improve vaccination uptake among the Latino community in the United States.
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Affiliation(s)
- Deborah G Smith
- Department of Public Health, Louisiana State University Health Science Center Shreveport, Shreveport, Louisiana, United States of America
| | - Corey D Smith
- Department of Medicine, Louisiana State University Health Science Center Shreveport, Shreveport, Louisiana, United States of America
| | - Jennifer A DeLeon
- Department of Public Health, Louisiana State University Health Science Center Shreveport, Shreveport, Louisiana, United States of America
| | - Jillian L Sandoz
- Department of Medicine, Louisiana State University Health Science Center Shreveport, Shreveport, Louisiana, United States of America
| | - Carolina O Ochoa
- Department of Medicine, Louisiana State University Health Science Center Shreveport, Shreveport, Louisiana, United States of America
| | - Martha P Pearson
- Department of Nursing, Northwestern State University of Louisiana, Shreveport, Louisiana, United States of America
| | - Raimunda H M Macena
- Department of Medicine, Federal University of Ceara, Fortaleza, Ceara, Brazil
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18
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Alosta MR, Alsadi M, Othman EH, Khalifeh AH, Atiyeh H. Factors influencing Jordanian parents' COVID-19 vaccination decision for children: A cross-sectional study. J Pediatr Nurs 2024; 77:45-52. [PMID: 38479062 DOI: 10.1016/j.pedn.2024.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 03/07/2024] [Accepted: 03/08/2024] [Indexed: 07/07/2024]
Abstract
BACKGROUND Vaccine hesitancy is a major public health problem that emerged post-COVID-19 pandemic, especially for children. Different factors influence parents' perspectives about vaccinating their children and can vary across different populations and contexts. PURPOSE This study aimed to explore the vaccine hesitancy among parents in Jordan to vaccinate their children between the ages of 5 and 18. DESIGN AND METHODS A descriptive cross-sectional design was used. A convenient sample was used to recruit Jordanian parents. Data was collected via an online questionnaire including demographic data, the Vaccine Hesitancy Questionnaire, the Questionnaire of Vaccine Hesitancy Reasons, and the Vaccine Conspiracy Beliefs Scale. RESULTS Over 177 parents, the mean age was 37.74 years (SD = 8.39); the majority of them were females (74%). 51.4% of the participants refused to give the COVID-19 vaccine to their children. Concerns about the safety and efficacy of the vaccine and lack of information about disease and vaccine were the common reasons for the parents' hesitancy. In addition, 54.2% of participants agreement was with the conspiracy theory that pharmaceutical companies cover up the dangers of vaccines. Parents' younger age and fewer children were associated with hesitancy to vaccinate their children with COVID-19. CONCLUSIONS Many parents are hesitant to vaccinate their children against COVID-19. Concerns about the vaccine's efficacy and safety as well as potential long-term negative effects were the main reasons for vaccine hesitancy. PRACTICE IMPLICATIONS Nurses play a critical role in determining parental hesitancy. Providing detailed, accurate, evidence-based vaccine information is essential to reduce this hesitancy.
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Affiliation(s)
- Mohammad R Alosta
- Department of Clinical Nursing, Faculty of Nursing, Zarqa University, P.O.Box 132222, Zarqa 13132, Jordan
| | - Mohammad Alsadi
- Nursing Administration & Education Department, College of Nursing, Jouf University, Sakaka, 72388, Saudi Arabia
| | - Elham H Othman
- Faculty of Nursing, Applied Science Private University, Amman, Jordan
| | - Anas H Khalifeh
- Department of Community & Mental Health Nursing, Faculty of Nursing, Zarqa University, P.O.Box 132222, Zarqa 13132, Jordan.
| | - Huda Atiyeh
- Department of Clinical Nursing, Faculty of Nursing, Zarqa University, P.O.Box 132222, Zarqa 13132, Jordan
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Murali A, Sojati J, Levochkina M, Pressimone C, Griffith K, Fan E, Dakroub A. A Cross-Sectional Analysis of Community Perceptions of Flu and COVID-19 Vaccines at Turtle Creek Primary Care Center. COMMUNITY HEALTH EQUITY RESEARCH & POLICY 2024; 44:439-451. [PMID: 37837451 DOI: 10.1177/2752535x231205665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/16/2023]
Abstract
BACKGROUND Influenza (flu) and COVID-19 vaccination rates are subpar across the US, especially in racial and/or socioeconomic minority groups who are understudied in public health literature. OBJECTIVE The objective of this mixed-methods study was to elucidate attitudes of patients at the Turtle Creek Primary Care Center, a clinic that cares for ∼70% non-white patients, towards flu and COVID-19 vaccines, with the goal of establishing vaccine education gaps and increasing vaccine uptake in minority communities. DESIGN/PATIENTS This study was conducted as a cross-sectional analysis. Authors completed 123 patient phone surveys of patients cared for at the Turtle Creek clinic inquiring about flu and COVID-19 infection status and vaccination uptake (August 26-October 10, 2021). APPROACH/KEY RESULTS We found that rates of vaccination were subpar in the Turtle Creek community, with only 54% having received the COVID-19 vaccine and only 44% receiving the flu vaccine regularly. There was a strong association between COVID-19 and flu vaccine acceptance and a notable correlation between vaccine acceptance and age. When assessing how vaccine acceptance was influenced by trusted sources of information, those who cited trusting "medical professionals" and "word of mouth" had higher odds of COVID-19 vaccine acceptance but those who cited trusting "social media" had decreased odds of acceptance. Finally, we uncovered 14 common factors for either vaccine acceptance or refusal that clustered into four overarching themes of trust, need, safety, and availability. CONCLUSION These data highlight the necessity of improved vaccine education and reveal targetable populations and approaches for disseminating vaccine information.
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Affiliation(s)
- Anjana Murali
- School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jorna Sojati
- School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Marina Levochkina
- School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Kobi Griffith
- School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, USA
| | - Erica Fan
- School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Allie Dakroub
- Department of General Internal Medicine, University of Pittsburgh, Pittsburgh, PA, USA
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20
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Omer Z, Khalid Y, Zakaria G, Sabir S, MohamedAbdallah A. Cross-sectional study: mindset towards Coronavirus in developing countries and lessons learned: the case of Sudan. Ann Med Surg (Lond) 2024; 86:3900-3908. [PMID: 38989223 PMCID: PMC11230755 DOI: 10.1097/ms9.0000000000002056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 04/02/2024] [Indexed: 07/12/2024] Open
Abstract
Introduction People's mindset towards COVID-19 in developing countries has an impact on how they perceive and react to the preventative measures taken by the governments to contain the virus. Understanding the factors influencing the mindset and identifying lessons learned amidst COVID-19 are critical to inform any future intervention strategy. Methods This was a cross-sectional, community-based study conducted to assess the mindset changes and lessons learned post-COVID-19 in developing countries, focusing on Sudan. The study adopted a sequential mixed approach (SMA), combining qualitative and quantitative methods. The study used a structured questionnaire with 300 respondents and in-depth interviews with two experts. To identify the factors influencing the mindset of the people towards COVID-19, the study employed logistic regression. The data was analyzed using SPSS software. Results Of the total (N = 300) respondents, 59.0% are female, 59.3% are between the ages of 20 and 39, 79.7% have a university education, 25.3% have the Coronavirus, and 42.3% has their family or relative contracted the virus. Further, only 22.7% had taken the vaccine. Reasons for vaccine hesitancy include lack of trust (29.5%), fear of side effects (24.1%), and absence of the need to travel outside the country (25.5%). When the virus first appeared, 77.3% thought it posed a health risk, while 22.7% perceived it as a hoax or conspiracy. After 3 years, 73% still regarded it as a health threat, while 27% believed it was a hoax or conspiracy. The mindset was found to be influenced by age, history of the disease, the extent of trust in foreign media coverage, and the belief in the effectiveness of the vaccination. Conclusion Assessing the mindset towards the virus and identifying the lessons learned from the pandemic could be of vital importance to control the spread of the virus in developing countries. Making use of such lessons and influencing the mindset of the people towards positive attitudes and behaviours are required to enhance the effectiveness of the health precaution measures adopted. Further research is required on the public's mistrust of foreign media coverage and the contribution of local media to educate the public about the virus, particularly among the elderly.
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Affiliation(s)
| | - Yousra Khalid
- Faculty of Medicine and Surgery, National University, Khartoum, Sudan
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21
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Yu H, Bonett S, Oyiborhoro U, Aryal S, Kim A, Kornides ML, Jemmott JB, Glanz K, Villarruel AM, Bauermeister JA. Psychosocial correlates of parents' willingness to vaccinate their children against COVID-19. PLoS One 2024; 19:e0305877. [PMID: 38913679 PMCID: PMC11195945 DOI: 10.1371/journal.pone.0305877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 06/05/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND Public health guidance recommended that children who are 6 months or older be vaccinated against COVID-19 in June of 2022. In the U.S., 56% of children under 17 had not received the COVID-19 vaccination in 2023. We examine parents' willingness to vaccinate their children against COVID-19 using the theory of planned behavior in order to design effective strategies to promote vaccine uptake. METHODS The Philadelphia Community Engagement Alliance is part of an NIH community-engaged consortium focused on addressing COVID-19 disparities across the U.S. We surveyed 1,008 Philadelphia parents (mean age 36.86, SD 6.55; 42.3% racial/ethnic minorities) between September 2021 and February 2022, a period when guidance for child vaccination was anticipated. Structural Equation Modeling analysis examined associations between parental willingness and vaccine-related attitudes, norms, and perceived control. Covariates included parents' COVID-19 vaccination status, race/ethnicity, gender, and survey completion post-CDC pediatric COVID-19 vaccination guidelines. Subgroup analyses by race/ethnicity and gender were conducted. RESULTS Our model demonstrated good fit (χ2 = 907.37, df = 419, p<0.001; comparative fit index [CFI] = 0.951; non-normed fit index [NNFI] = 0.946; root mean square error of approximation [RMSEA] = 0.034 with 95% CI = 0.030-0.038). Attitudes ([Formula: see text] = 0.447, p<0.001) and subjective norms ([Formula: see text] = 0.309, p = 0.002) were predictors of intention. Racial/ethnic minority parents exhibited weaker vaccination intentions ([Formula: see text] = -0.053, p = 0.028) than non-Hispanic White parents. CONCLUSIONS Parents' attitudes and norms influence their vaccination intentions. Despite the survey predating widespread child vaccine availability, findings are pertinent given the need to increase and sustain pediatric vaccinations against COVID-19. Interventions promoting positive vaccine attitudes and prosocial norms are warranted. Tailored interventions and diverse communication strategies for parental subgroups may be useful to ensure comprehensive and effective vaccination initiatives.
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Affiliation(s)
- Hyunmin Yu
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Stephen Bonett
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Ufuoma Oyiborhoro
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Subhash Aryal
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Andrew Kim
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Melanie L. Kornides
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - John B. Jemmott
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Karen Glanz
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Antonia M. Villarruel
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - José A. Bauermeister
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
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22
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Zhang X, Monnat SM. Watchful, skeptics, and system distrusters: Characteristics associated with different types of COVID-19 vaccine hesitancy among U.S. working-age adults. Vaccine 2024:S0264-410X(24)00721-7. [PMID: 38902188 DOI: 10.1016/j.vaccine.2024.06.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 06/14/2024] [Accepted: 06/17/2024] [Indexed: 06/22/2024]
Abstract
COVID-19 vaccine hesitancy is complex, with adults identifying various reasons for not getting vaccinated. Using data from the 2022 National Wellbeing Survey on 7612 U.S. adults aged 18-64, we identified how age, race/ethnicity, sex, marital status, education, income, employment status, partisanship, and metropolitan status are associated with COVID-19 vaccination status and three non-mutually exclusive types of vaccine hesitancy: 1) watchful, concerned about vaccine side effects and efficacy; 2) skeptics, distrust the vaccine, and 3) system distrusters, distrust government. A third of respondents overall (N = 2643) had not received at least one dose at the time of the survey. Among respondents who were not vaccinated, 67 % are classified as watchful, 53 % are skeptics, and 32 % are system distrusters. Results from logistic regression show that concerns about side effects and safety (watchfulness) appear to be major drivers for not getting vaccinated among females and among non-Hispanic Black and unmarried adults, whereas skepticism and distrust appear to be more important barriers among ages 25-44. All three types of hesitancy appear to be important contributors to lower vaccination uptake among low-income, low-education, and unemployed adults, and among individuals who voted for Donald Trump in the 2020 election (with skepticism and distrust being most endorsed by this group). Findings suggest that universal messaging and intervention strategies are unlikely to be effective in reducing vaccine hesitancy. Different messages, messengers, and tactics must be used with different groups.
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Affiliation(s)
- Xue Zhang
- Department of City and Regional Planning, Cornell University, NY 14850, USA.
| | - Shannon M Monnat
- Department of Sociology, Syracuse University, NY 13244, USA; Lerner Center for Public Health Promotion and Population Health, Syracuse University, NY 13244, USA; Center for Policy Research, Syracuse University, NY 13244, USA
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23
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Keane A, Tippett A, Taylor EG, Reese O, Salazar L, De Castro K, Choi C, Ciric C, Taylor M, Mitchell A, Gibson T, Puzniak L, Hubler R, Valluri SR, Wiemken TL, Lopman BA, Kamidani S, Anderson LJ, McLaughlin JM, Rostad CA, Anderson EJ. Effectiveness of BNT162b2 Vaccine for Preventing COVID-19-Related Hospitalizations: A Test-Negative Case-Control Study. Vaccines (Basel) 2024; 12:657. [PMID: 38932386 PMCID: PMC11209557 DOI: 10.3390/vaccines12060657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 06/07/2024] [Accepted: 06/10/2024] [Indexed: 06/28/2024] Open
Abstract
It is important to understand real-world BNT162b2 COVID-19 vaccine effectiveness (VE), especially among racial and ethnic minority groups. We performed a test-negative case-control study to measure BNT162b2 COVID-19 VE in the prevention of COVID-19-associated acute respiratory illness (ARI) hospitalizations at two Atlanta hospitals from May 2021-January 2023 and adjusted for potential confounders by multivariate analysis. Among 5139 eligible adults with ARI, 2763 (53.8%) were enrolled, and 1571 (64.5%) were included in the BNT162b2 analysis. The median age was 58 years (IQR, 44-68), 889 (56.6%) were female, 1034 (65.8%) were African American, 359 (22.9%) were White, 56 (3.6%) were Hispanic ethnicity, 645 (41.1%) were SARS-CoV-2-positive, 412 (26.2%) were vaccinated with a primary series, and 273 (17.4%) had received ≥1 booster of BNT162b2. The overall adjusted VE of the BNT162b2 primary series was 58.5% (95% CI 46.0, 68.1), while the adjusted VE of ≥1 booster was 78.9% (95% CI 70.0, 85.1). The adjusted overall VE of primary series for African American/Black individuals was 64.0% (95% CI 49.9, 74.1) and 82.7% (95% CI 71.9, 89.4) in those who received ≥1 booster. When analysis was limited to the period of Omicron predominance, overall VE of the primary series decreased with widened confidence intervals (24.5%, 95% CI -4.5, 45.4%), while VE of ≥1 booster was maintained at 60.9% (95% CI 42.0, 73.6). BNT162b2 primary series and booster vaccination provided protection against COVID-19-associated ARI hospitalization among a predominantly African American population.
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Affiliation(s)
- Amy Keane
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA; (A.K.); (A.T.); (E.G.T.); (O.R.); (L.S.); (K.D.C.); (C.C.); (C.C.); (M.T.); (A.M.); (T.G.); (L.J.A.); (E.J.A.)
| | - Ashley Tippett
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA; (A.K.); (A.T.); (E.G.T.); (O.R.); (L.S.); (K.D.C.); (C.C.); (C.C.); (M.T.); (A.M.); (T.G.); (L.J.A.); (E.J.A.)
| | - Elizabeth Grace Taylor
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA; (A.K.); (A.T.); (E.G.T.); (O.R.); (L.S.); (K.D.C.); (C.C.); (C.C.); (M.T.); (A.M.); (T.G.); (L.J.A.); (E.J.A.)
| | - Olivia Reese
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA; (A.K.); (A.T.); (E.G.T.); (O.R.); (L.S.); (K.D.C.); (C.C.); (C.C.); (M.T.); (A.M.); (T.G.); (L.J.A.); (E.J.A.)
| | - Luis Salazar
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA; (A.K.); (A.T.); (E.G.T.); (O.R.); (L.S.); (K.D.C.); (C.C.); (C.C.); (M.T.); (A.M.); (T.G.); (L.J.A.); (E.J.A.)
| | - Khalel De Castro
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA; (A.K.); (A.T.); (E.G.T.); (O.R.); (L.S.); (K.D.C.); (C.C.); (C.C.); (M.T.); (A.M.); (T.G.); (L.J.A.); (E.J.A.)
| | - Chris Choi
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA; (A.K.); (A.T.); (E.G.T.); (O.R.); (L.S.); (K.D.C.); (C.C.); (C.C.); (M.T.); (A.M.); (T.G.); (L.J.A.); (E.J.A.)
| | - Caroline Ciric
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA; (A.K.); (A.T.); (E.G.T.); (O.R.); (L.S.); (K.D.C.); (C.C.); (C.C.); (M.T.); (A.M.); (T.G.); (L.J.A.); (E.J.A.)
| | - Meg Taylor
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA; (A.K.); (A.T.); (E.G.T.); (O.R.); (L.S.); (K.D.C.); (C.C.); (C.C.); (M.T.); (A.M.); (T.G.); (L.J.A.); (E.J.A.)
| | - Anna Mitchell
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA; (A.K.); (A.T.); (E.G.T.); (O.R.); (L.S.); (K.D.C.); (C.C.); (C.C.); (M.T.); (A.M.); (T.G.); (L.J.A.); (E.J.A.)
| | - Theda Gibson
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA; (A.K.); (A.T.); (E.G.T.); (O.R.); (L.S.); (K.D.C.); (C.C.); (C.C.); (M.T.); (A.M.); (T.G.); (L.J.A.); (E.J.A.)
| | - Laura Puzniak
- Pfizer, Inc., New York, NY 10017, USA; (L.P.); (R.H.); (S.R.V.); (T.L.W.); (J.M.M.)
| | - Robin Hubler
- Pfizer, Inc., New York, NY 10017, USA; (L.P.); (R.H.); (S.R.V.); (T.L.W.); (J.M.M.)
| | - Srinivas Rao Valluri
- Pfizer, Inc., New York, NY 10017, USA; (L.P.); (R.H.); (S.R.V.); (T.L.W.); (J.M.M.)
| | - Timothy L. Wiemken
- Pfizer, Inc., New York, NY 10017, USA; (L.P.); (R.H.); (S.R.V.); (T.L.W.); (J.M.M.)
| | - Ben A. Lopman
- Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA;
| | - Satoshi Kamidani
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA; (A.K.); (A.T.); (E.G.T.); (O.R.); (L.S.); (K.D.C.); (C.C.); (C.C.); (M.T.); (A.M.); (T.G.); (L.J.A.); (E.J.A.)
- Center for Childhood Infections and Vaccines, Children’s Healthcare of Atlanta, Atlanta, GA 30322, USA
| | - Larry J. Anderson
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA; (A.K.); (A.T.); (E.G.T.); (O.R.); (L.S.); (K.D.C.); (C.C.); (C.C.); (M.T.); (A.M.); (T.G.); (L.J.A.); (E.J.A.)
- Center for Childhood Infections and Vaccines, Children’s Healthcare of Atlanta, Atlanta, GA 30322, USA
| | - John M. McLaughlin
- Pfizer, Inc., New York, NY 10017, USA; (L.P.); (R.H.); (S.R.V.); (T.L.W.); (J.M.M.)
| | - Christina A. Rostad
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA; (A.K.); (A.T.); (E.G.T.); (O.R.); (L.S.); (K.D.C.); (C.C.); (C.C.); (M.T.); (A.M.); (T.G.); (L.J.A.); (E.J.A.)
- Center for Childhood Infections and Vaccines, Children’s Healthcare of Atlanta, Atlanta, GA 30322, USA
| | - Evan J. Anderson
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA; (A.K.); (A.T.); (E.G.T.); (O.R.); (L.S.); (K.D.C.); (C.C.); (C.C.); (M.T.); (A.M.); (T.G.); (L.J.A.); (E.J.A.)
- Center for Childhood Infections and Vaccines, Children’s Healthcare of Atlanta, Atlanta, GA 30322, USA
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA
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Oliveira MDS, Carvalho RF, Meurer CM, Rodrigues ÉM, Dias BP, Santos IGCD, Nascimento CA, Rodrigues YM, Santos AJFD, Almeida KDS, de Souza UJB, Campos FS, Ribeiro J, Soares CMDA, Ribeiro Júnior JC. Prevalence, under-reporting, and epidemiological surveillance of COVID-19 in the Araguaína City of Brazil. PLoS One 2024; 19:e0300191. [PMID: 38838042 DOI: 10.1371/journal.pone.0300191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 02/19/2024] [Indexed: 06/07/2024] Open
Abstract
Asymptomatic and underreported individuals remain a source of coronafig disease 2019 (COVID-19) transmission to others. Data on the prevalence and epidemiological factors influencing transmission are fundamental for establishing control measures, especially in vulnerable regions such as the Amazon. This study aimed to determine the point prevalence and active infection of COVID-19 among the population in Araguaína, a Brazilian city located in the Amazon region, analyzed the socioeconomic and behavioral variables of a statistically representative sample of this population using an epidemiological survey, and identify the viral genomic diversity in the region. During the sixth epidemiological week of 2021 (February 8 to 12), samples of 497 inhabitants of the municipality asymptomatic for respiratory syndromes underwent reverse transcription-quantitative polymerase chain reaction and serological tests (immunoglobulin M and immunoglobulin G). A questionnaire collated data on socioeconomic factors, prevention measures, and health status history. The active infection rate was 6.2%, and the prevalence was 13.5% of the study population. Active infection cases were under-reported; each reported positive case represented 14-28 under-reported cases. Lineages P.2, P.1, and B.1.1 were detected. Working from home was a protective factor against the infection, and clinical signs of fever, dry cough, and loss of taste or smell were associated with testing positive (p <0.05). A descriptive analysis of the indicators revealed that the entire population was susceptible to the disease. Intensified vaccination strategies are required regardless of socioeconomic factors, health conditions, and preventive measures. Implementation of objective, comprehensive, and efficient management tools to minimize the spread of COVID-19 in this municipality can serve as a model for other regions of Brazil.
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Affiliation(s)
- Monike da Silva Oliveira
- Molecular Biology Laboratory, Institute of Biological Sciences, Federal University of Goiás, Goiânia, Goiás, Brazil
- Microbiology Laboratory, Federal University of North Tocantins, Araguaína, Tocantins, Brazil
| | | | - Carolina Merlin Meurer
- Microbiology Laboratory, Federal University of North Tocantins, Araguaína, Tocantins, Brazil
| | - Ézio Machado Rodrigues
- Microbiology Laboratory, Federal University of North Tocantins, Araguaína, Tocantins, Brazil
| | - Bianca Pereira Dias
- Microbiology Laboratory, Federal University of North Tocantins, Araguaína, Tocantins, Brazil
| | | | | | - Yron Moreira Rodrigues
- Microbiology Laboratory, Federal University of North Tocantins, Araguaína, Tocantins, Brazil
| | | | | | | | - Fabrício Souza Campos
- Bioinformatics and Biotechnology Laboratory, Federal University of Tocantins, Gurupi, Tocantins, Brazil
- Institute of Basic Health Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Juliane Ribeiro
- Molecular Biology and Animal Virology Laboratory, State University of Londrina, Londrina, Paraná, Brazil
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Abad N, Bonner KE, Huang Q, Baack B, Petrin R, Das D, Hendrich MA, Gosz MS, Lewis Z, Lintern DJ, Fisun H, Brewer NT. Behavioral and social drivers of COVID-19 vaccination initiation in the US: a longitudinal study March─ October 2021. J Behav Med 2024; 47:422-433. [PMID: 38587765 PMCID: PMC11026250 DOI: 10.1007/s10865-024-00487-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 03/15/2024] [Indexed: 04/09/2024]
Abstract
Many studies have examined behavioral and social drivers of COVID-19 vaccination initiation, but few have examined these drivers longitudinally. We sought to identify the drivers of COVID-19 vaccination initiation using the Behavioral and Social Drivers of Vaccination (BeSD) Framework. Participants were a nationally-representative sample of 1,563 US adults who had not received a COVID-19 vaccine by baseline. Participants took surveys online at baseline (spring 2021) and follow-up (fall 2021). The surveys assessed variables from BeSD Framework domains (i.e., thinking and feeling, social processes, and practical issues), COVID-19 vaccination initiation, and demographics at baseline and follow-up. Between baseline and follow-up, 65% of respondents reported initiating COVID-19 vaccination. Vaccination intent increased from baseline to follow-up (p < .01). Higher vaccine confidence, more positive social norms towards vaccination, and receiving vaccine recommendations at baseline predicted subsequent COVID-19 vaccine initiation (all p < .01). Among factors assessed at follow-up, social responsibility and vaccine requirements had the greatest associations with vaccine initiation (all p < .01). Baseline vaccine confidence, social norms, and vaccination recommendations were associated with subsequent vaccine initiation, all of which could be useful targets for behavioral interventions. Furthermore, interventions that highlight social responsibility to vaccinate or promote vaccination requirements could also be beneficial.
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Affiliation(s)
- Neetu Abad
- Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | | | - Qian Huang
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Brittney Baack
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Dhiman Das
- Ipsos US Public Affairs, Washington, DC, USA
| | | | | | | | | | - Helen Fisun
- Ipsos US Public Affairs, Washington, DC, USA
| | - Noel T Brewer
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
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Bodjongo MJM. How to increase acceptance of the COVID-19 vaccine among poor people in Africa? INTERNATIONAL JOURNAL OF HEALTH ECONOMICS AND MANAGEMENT 2024; 24:173-210. [PMID: 38451447 DOI: 10.1007/s10754-024-09370-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 02/10/2024] [Indexed: 03/08/2024]
Abstract
This study aims to analyze whether good government management of the COVID-19 pandemic can increase the likelihood of vaccine uptake among poor people in Africa. The analysis is based on a sample of 18,010 people living in 34 African countries, drawn from data collected by Afrobarometer (Merged Round 8 data (34 countries), database, 2022). The econometric results, obtained using a bivariate probit regression, show that poverty significantly reduces the odds of accepting the said COVID-19 vaccine. However, acceptance of the vaccine increases among poor individuals when there is (i) trust in the government's published statistics on COVID-19, (ii) control of corruption by the government in managing the pandemic, (iii) individual confidence in the government's ability to ensure the safety of the COVID-19 vaccine, and (iv) belief that the Covid 19 vaccine will be more effective than religious prayer in the fight against this pandemic.
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Leigland A, Arnold T, Giorlando KK, Barnett AP, Sims-Gomillia CE, Bertone Z, Edet PP, Whiteley L, Brown LK. A qualitative study evaluating COVID-19 vaccine hesitancy among individuals living in Mississippi. SSM. QUALITATIVE RESEARCH IN HEALTH 2024; 5:100377. [PMID: 38605935 PMCID: PMC11005795 DOI: 10.1016/j.ssmqr.2023.100377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
Background COVID-19 vaccination rates are lower in the Southern United States compared to other regions. This study investigated COVID-19 vaccination hesitancy in Mississippi (MS) to identify preferences that may boost MS vaccination strategies in areas with poor vaccine uptake. Methods Qualitative interviews were completed between April 2021 and January 2022 with staff and patients at four Federally Qualified Health Centers in MS. Interviews included the following COVID-19 vaccine topics: willingness to be vaccinated, barriers and facilitators, and methods for providing vaccine information. Data were organized with NVivo software and analyzed using reflexive thematic analysis. Results Fifteen clinic staff and 49 patients were interviewed. Barriers to vaccine uptake included a lack of knowledge and understanding of how the vaccine worked, distrust of the government, fear of side effects, and social pressure to stay unvaccinated. Vaccination facilitators included its widespread accessibility, a desire to protect themselves and vulnerable populations, and a previous unpleasant COVID-19 illness experience. Participants stated that vaccine information should be provided by health organizations and familiar, respected community members. Conclusions Results identified barriers to vaccination, such as mistrust of the government and healthcare system, and facilitators like vaccination advocacy originating from congregations and religious leaders. These findings can inform future COVID-19 vaccination efforts to increase overall immunization rates in MS. Future research in other locations could further assess commonalities and differences in the barriers and facilitators to vaccination.
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Affiliation(s)
- Avery Leigland
- Department of Psychiatry, Rhode Island Hospital, Providence, RI 02903, USA
| | - Trisha Arnold
- Department of Psychiatry, Rhode Island Hospital, Providence, RI 02903, USA
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI 02903, USA
| | - Kayla K. Giorlando
- Department of Psychiatry, Rhode Island Hospital, Providence, RI 02903, USA
| | - Andrew P. Barnett
- Department of Psychiatry, Rhode Island Hospital, Providence, RI 02903, USA
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI 02903, USA
| | - Courtney E. Sims-Gomillia
- Department of Population Health Science, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - Zoe Bertone
- Department of Psychiatry, Rhode Island Hospital, Providence, RI 02903, USA
| | - Precious Patrick Edet
- Department of Population Health Science, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - Laura Whiteley
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI 02903, USA
| | - Larry K. Brown
- Department of Psychiatry, Rhode Island Hospital, Providence, RI 02903, USA
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI 02903, USA
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Tiruneh YM, Cuccaro PM, Elliott KS, Xie J, Martinez J, Owens M, Alvarado CR, Yamal JM. Vaccine Uptake and Intentions: Insights from a Texas Survey on Factors Influencing COVID-19 Vaccination Decisions. Vaccines (Basel) 2024; 12:601. [PMID: 38932330 PMCID: PMC11209159 DOI: 10.3390/vaccines12060601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 05/23/2024] [Accepted: 05/27/2024] [Indexed: 06/28/2024] Open
Abstract
The effectiveness of COVID-19 vaccines depends on widespread vaccine uptake. Employing a telephone-administered weighted survey with 19,502 participants, we examined the determinants of COVID-19 vaccine acceptance among adults in Texas. We used multiple regression analysis with LASSO-selected variables to identify factors associated with COVID-19 vaccine uptake and intentions to receive the vaccine among the unvaccinated. The prevalence of unvaccinated individuals (22%) was higher among those aged 18-39, males, White respondents, English speakers, uninsured individuals, those facing financial challenges, and individuals expressing no concern about contracting the illness. In a fully adjusted regression model, higher odds of being unvaccinated were observed among males (aOR 1.11), the uninsured (aOR 1.38), smokers (aOR 1.56), and those facing financial struggles (aOR 1.62). Conversely, Asians, Blacks, and Hispanics were less likely to be unvaccinated compared to Whites. Among the unvaccinated, factors associated with stronger intent to receive the vaccine included age (over 65 years), Black and Hispanic ethnicity, and perceived risk of infection. Hispanic individuals, the uninsured, those covered by public insurance, and those facing financial challenges were more likely to encounter barriers to vaccine receipt. These findings underscore the importance of devising tailored strategies, emphasizing nuanced approaches that account for demographic, socioeconomic, and attitudinal factors in vaccine distribution and public health interventions.
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Affiliation(s)
- Yordanos M. Tiruneh
- Department of Preventive Medicine and Population Health, School of Medicine, University of Texas at Tyler, Tyler, TX 75708, USA
- Department of Internal Medicine, School of Medicine, University of Texas at Tyler, Tyler, TX 75708, USA
- Department of Internal Medicine, Division of Infectious Diseases, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Paula M. Cuccaro
- Center for Health Promotion and Prevention Research, Department of Health Promotion and Behavioral Sciences, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX 78701, USA;
| | - Kimberly S. Elliott
- Department of Health Policy, Economics, and Management, School of Professions, University of Texas at Tyler, Tyler, TX 75708, USA;
| | - Jing Xie
- Coordinating Center for Clinical Trials, Department of Biostatistics and Data Science, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX 77030, USA; (J.X.); (J.M.); (J.-M.Y.)
| | - Journey Martinez
- Coordinating Center for Clinical Trials, Department of Biostatistics and Data Science, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX 77030, USA; (J.X.); (J.M.); (J.-M.Y.)
| | - Mark Owens
- Department of Political Science, School of Humanities and Social Sciences, The Citadel, Charleston, SC 29409, USA;
| | - Christian R. Alvarado
- Department of Epidemiology and Biostatistics, School of Medicine, University of Texas at Tyler, Tyler, TX 75708, USA;
| | - Jose-Miguel Yamal
- Coordinating Center for Clinical Trials, Department of Biostatistics and Data Science, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX 77030, USA; (J.X.); (J.M.); (J.-M.Y.)
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Spector S, Shah S, ul Rasool MH, Hilt E, Goldstein H, Meade J, Korn E, Lipetskaia L. Attitudes toward COVID-19 vaccination among urogynecology patients. Heliyon 2024; 10:e30092. [PMID: 38778988 PMCID: PMC11108857 DOI: 10.1016/j.heliyon.2024.e30092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 04/01/2024] [Accepted: 04/19/2024] [Indexed: 05/25/2024] Open
Abstract
Objective Urogynecology patients skew older and often require intimate exams to treat non-life-threatening conditions, thus making care particularly susceptible to the effects of COVID-19. We aim to understand COVID-19 vaccination attitudes amongst urogynecology patients during the pandemic, which has adversely affected healthcare delivery, to identify measures that can be undertaken to improve care going forward. Study design Cross-sectional surveys of urogynecology patients were conducted in three different states (Delaware, New Jersey, and Pennsylvania) between March and August 2021. Demographics, vaccination status, and COVID-19 attitudes were analyzed. Chi-square tests investigated group differences between vaccine-hesitant and unhesitant subjects. Results Out of 158 surveys, eighty-three percent of respondents were vaccinated or planning to get vaccinated. Older age and regular flu vaccination predicted COVID-19 vaccination. Ninety-three percent of subjects were comfortable attending in-person visits. However, vaccine-hesitant individuals were less comfortable attending in-person and were significantly less likely to be comforted by clinic interventions, such as masking. Hesitant and unhesitant groups trusted doctors or medical professionals most for their source of COVID-19 information. Conclusions Urogynecology patients mirror the general older population's COVID-19 vaccination attitudes, with distinct differences between hesitant and unhesitant groups. Vaccine-hesitant subjects appear less comfortable coming to in-person visits and less comforted by possible interventions, posing a difficult obstacle for clinics to overcome. High levels of patient trust suggest healthcare providers can play a crucial role in encouraging COVID-19 vaccination and combating misinformation.
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Affiliation(s)
- Sean Spector
- Department of Obstetrics and Gynecology, Cooper University Healthcare, Camden, NJ, USA
| | - Shanaya Shah
- Cooper Medical School of Rowan University, Camden, NJ, USA
| | | | - Elizabeth Hilt
- Cooper Medical School of Rowan University, Camden, NJ, USA
| | - Howard Goldstein
- Center for Urogynecology and Pelvic Surgery, Christiana Care Health System, Newark, DE, USA
| | - Jason Meade
- UroGynecology Specialty Center, Fresno, CA, USA
| | | | - Lioudmila Lipetskaia
- Department of Obstetrics and Gynecology, Cooper University Healthcare, Camden, NJ, USA
- Cooper Medical School of Rowan University, Camden, NJ, USA
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McCollum G, Allgood A, Agne A, Cleveland D, Gray C, Ford E, Baral S, Mugavero M, Hall AG. Associations Between Social Networks and COVID-19 Vaccine Uptake in 4 Rural Alabama Counties: Survey Findings. Public Health Rep 2024:333549241250223. [PMID: 38780015 DOI: 10.1177/00333549241250223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024] Open
Abstract
OBJECTIVES The COVID-19 pandemic demonstrated how vaccination decisions are influenced by misinformation, disinformation, and social pressures, leading to varied and inequitable uptake rates. In this study, we examined how COVID-19 vaccine messages received via social networks were associated with vaccine uptake in rural Alabama. METHODS From November 2021 through March 2022, we collected 700 responses to a telephone survey administered in 4 rural Alabama counties. We asked respondents to indicate whether certain social relationships (eg, family, businesses) tried to influence them to (1) obtain or (2) avoid a COVID-19 vaccine. We used χ2 tests, Kruskal-Wallis tests, Mantel-Haenszel χ2 tests, and Fisher exact tests to examine the associations between vaccination status and survey responses. RESULTS Respondents in majority-African American counties were significantly more likely than those in majority-White counties to have received ≥1 dose of COVID-19 vaccine (89.8% vs 72.3%; P < .001). Respondents who received ≥1 dose had a significantly higher mean age than those who had not (58.0 vs 39.0 years; P < .001). Respondents who were encouraged to get vaccinated by religious leaders were more likely to have received ≥1 dose (P = .001), and those who were encouraged to avoid vaccination by family (P = .007), friends (P = .02), coworkers (P = .003), and health care providers (P < .001) were less likely to have received ≥1 dose. Respondents with more interpersonal relationships that encouraged them to avoid vaccination were more likely to be unvaccinated (P < .001). CONCLUSIONS Interpersonal relationships and demographic characteristics appeared to be important in COVID-19 vaccine decision-making in rural Alabama. Further research needs to identify how to facilitate vaccine-positive interpersonal relationships, such as peer mentoring and trusted messenger interventions.
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Affiliation(s)
- Greer McCollum
- Division of Infectious Diseases, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Ashleigh Allgood
- Department of Health Services Administration, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, USA
| | - April Agne
- Division of Preventive Medicine, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Dave Cleveland
- Division of Infectious Diseases, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Cicily Gray
- Community Health Program, Department of Health and Human Services, School of Education, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Eric Ford
- Department of Health Services Administration, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Stefan Baral
- Department of Epidemiology, Bloomberg School of Public Health, John Hopkins University, Baltimore, MD, USA
| | - Michael Mugavero
- Division of Infectious Diseases, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Allyson G Hall
- Department of Health Services Administration, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, USA
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Nguyen KH, Bao Y, Mortazavi J, Corlin L, Allen JD. Reasons for COVID-19 Non-Vaccination from 2021 to 2023 for Adults, Adolescents, and Children. Vaccines (Basel) 2024; 12:568. [PMID: 38932297 PMCID: PMC11209602 DOI: 10.3390/vaccines12060568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2024] [Revised: 05/17/2024] [Accepted: 05/18/2024] [Indexed: 06/28/2024] Open
Abstract
Understanding how attitudes and beliefs about COVID-19 vaccination have changed over time is essential for identifying areas where targeted messaging and interventions can improve vaccination confidence and uptake. Using data from multiple waves of the nationally representative U.S. Census Bureau's Household Pulse Survey collected from January 2021 to May 2023, we assessed reasons for the non-vaccination of adults, adolescents, and children using the Health Belief Model as the framework for understanding behavior. Among unvaccinated adults, perceived vulnerability increased from 11.9% to 44.1%, attitudinal factors/mistrust increased from 28.6% to 53.4%, and lack of cue to action increased from 7.5% to 9.7% from January 2021 to May 2022. On the other hand, safety/efficacy concerns decreased from 74.0% to 60.9%, and logistical barriers to vaccination decreased from 9.1% to 3.4% during the same time period. Regarding reasons for non-vaccination of youth, perceived vulnerability increased from 32.8% to 40.0%, safety/efficacy concerns decreased from 73.9% to 60.4%, and lack of cue to action increased from 10.4% to 13.4% between September 2021 and May 2023. While safety/efficacy concerns and logistic barriers have decreased, increases in perceived vulnerability to COVID-19, mistrust, and lack of cues to action suggest that more efforts are needed to address these barriers to vaccination.
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Affiliation(s)
- Kimberly H. Nguyen
- Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA 30322, USA
| | - Yingjun Bao
- Department of Public Health & Community Medicine, Tufts University School of Medicine, Boston, MA 02111, USA
| | - Julie Mortazavi
- Department of Public Health & Community Medicine, Tufts University School of Medicine, Boston, MA 02111, USA
| | - Laura Corlin
- Department of Public Health & Community Medicine, Tufts University School of Medicine, Boston, MA 02111, USA
- Department of Civil and Environmental Engineering, Tufts University School of Engineering, Medford, MA 02155, USA
- Department of Community Health, Tufts School of Arts and Sciences, Medford, MA 02115, USA
| | - Jennifer D. Allen
- Department of Community Health, Tufts School of Arts and Sciences, Medford, MA 02115, USA
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Kalu K, Shah G, Tung HJ, Bland HW. Social and Structural Determinants of Health Associated with COVID-19 Vaccine Hesitancy among Older Adults in the United States. Vaccines (Basel) 2024; 12:521. [PMID: 38793773 PMCID: PMC11125749 DOI: 10.3390/vaccines12050521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 05/02/2024] [Accepted: 05/06/2024] [Indexed: 05/26/2024] Open
Abstract
State-level COVID-19 vaccination rates among older adults have been uneven in the United States. Due to the immunocompromised nature of older adults, vaccine hesitancy increases the risk of morbidity and mortality. This study aims to determine the association between the social determinants of health, the structural determinants of health, and COVID-19 vaccine hesitancy among older adults in the United States. Secondary data from the Health and Retirement Study (HRS) dataset were used. A descriptive analysis and multinomial multivariable logistic regression were performed to examine the association of the independent variables-gender, age, race, immigration status, marital status, broadband internet access, social security income, Medicare coverage, education, and frequency of religious service-with the dependent variable, vaccine hesitancy. Compared to the respondents with no vaccine hesitancy and without the specific predictor, the respondents who reported religious attendance at least once/week were more likely to be "somewhat hesitant", divorced respondents had higher odds of being "somewhat hesitant", and older adults aged 65-74 years were more likely to be "very hesitant" or "somewhat hesitant" about the COVID-19 vaccine. Compared to the respondents with no vaccine hesitancy and without the specific predictor, females had higher odds of being "very hesitant", "somewhat hesitant", or a "little hesitant", and African Americans were more likely to be "very hesitant", "somewhat hesitant", or a "little hesitant" about the COVID-19 vaccine. Addressing these factors may limit the barriers to vaccine uptake reported among older adults and improve herd immunity among the immunocompromised population.
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Affiliation(s)
| | - Gulzar Shah
- Jian-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA 30458, USA; (K.K.); (H.-J.T.); (H.W.B.)
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Umucu E, Lee B, Bezyak J. Measuring COVID-19 vaccine hesitancy among college students with disabilities: Sociodemographic and psychological correlates of COVID-19 vaccine hesitancy. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:1208-1214. [PMID: 35613333 DOI: 10.1080/07448481.2022.2071619] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 03/13/2022] [Accepted: 04/25/2022] [Indexed: 06/15/2023]
Abstract
Objective: The purpose of the study was to explore characteristics of vaccine hesitancy and behaviors among college students with disabilities. Participants and Methods: Participants consisted of 105 college students with disabilities (Mage=26.82, SD = 8.42), and a majority of participants were female (69.5%) and Hispanic (85%). Results: No demographic differences were observed in vaccine hesitancy scores in this sample. Those who do not know where to get reliable information about COVID-19 vaccination had higher scores on vaccine hesitancy than those who know how to obtain reliable information; and participants who had a negative experience with a previous vaccination also had higher scores of vaccine hesitancy. Additionally, findings demonstrated COVID-19 vaccine hesitancy scores were negatively associated with openness to experience personality trait and COVID-19-related perceived stress. Conclusions: Implications provide additional insight into factors associated with vaccine hesitancy among college students with disabilities.
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Affiliation(s)
- Emre Umucu
- Michigan State University, East Lansing, Michigan, USA
| | - Beatrice Lee
- Michigan State University, East Lansing, Michigan, USA
| | - Jill Bezyak
- The University of Northern Colorado, Greeley, Colorado, USA
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Wessman BT, Yeary J, Newland H, Jotte R. Operation CoVER Saint Louis (COVID-19 Vaccine in the Emergency Room): Impact of a Vaccination Program in the Emergency Department. West J Emerg Med 2024; 25:374-381. [PMID: 38801044 PMCID: PMC11112669 DOI: 10.5811/westjem.18325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 01/04/2024] [Accepted: 01/09/2024] [Indexed: 05/29/2024] Open
Abstract
Introduction Coronavirus 2019 (COVID-19) inequitably impacted minority populations and regions with limited access to healthcare resources. The Barnes-Jewish Emergency Department in St. Louis, MO, serves such a population. The COVID-19 vaccine is an available defense to help achieve community immunity. The emergency department (ED) is a potential societal resource to provide access to a vaccination intervention. Our objective in this study was to describe and evaluate a novel ED COVID-19 vaccine program, including its impact on the local surrounding underserved community. Methods This was a retrospective, post-protocol implementation review of an ED COVID-19 vaccination program. Over the initial six-month period, we compiled data on all vaccinated patients out of the ED to evaluate demographic data and the impact on underserved regional areas. Results We report a successful ED-based COVID-19 vaccine program (with over 1,000 vaccines administered). This program helped raise regional and state vaccination rates. Over 50% of the population that received the COVID-19 vaccine from the ED were from defined socially vulnerable patient populations. No adverse effects were documented. Conclusion Operation CoVER (COVID-19 Vaccine in the Emergency Room) Saint Louis was able to successfully vaccinate a socially vulnerable patient population. This free, COVID-19 ED-based vaccine program with dedicated pharmacy support, was novel in emergency medicine practice. Similar ED-based vaccine programs could help with future vaccine distribution.
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Affiliation(s)
- Brian T. Wessman
- Washington University in Saint Louis, Department of Emergency Medicine, St. Louis, Missouri
- Washington University in Saint Louis, Department of Anesthesiology, Division of Critical Care Medicine, St. Louis, Missouri
| | - Julianne Yeary
- BJC HealthCare, Department of Pharmacy Services, St. Louis, Missouri
| | - Helen Newland
- BJC HealthCare, Department of Pharmacy Services, St. Louis, Missouri
| | - Randy Jotte
- Washington University in Saint Louis, Department of Emergency Medicine, St. Louis, Missouri
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Ndasauka Y, Twabi HS, Kainja J, Gunde AM, Makhumula-Mtimuni C. Knowledge, attitudes and demographic drivers for COVID-19 vaccine hesitancy in Malawi. Sci Rep 2024; 14:9578. [PMID: 38671014 PMCID: PMC11053073 DOI: 10.1038/s41598-024-60042-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 04/18/2024] [Indexed: 04/28/2024] Open
Abstract
This study assessed the association among knowledge, attitudes and uptake of COVID-19 vaccine in Malawi, examining demographic factors influencing these variables. The study employed a quantitative research design. It thus sampled 394 participants from Malawi's three districts of Zomba, Dowa and Nkhatabay. Results showed that 163 (41.4%) participants had low levels of knowledge of COVID-19 vaccine, 231 (58.6%) had high levels of knowledge, 237 (60.2%) had a positive attitude, and 156 (39.8%) had a negative attitude towards the COVID-19 vaccine. On vaccine uptake, the study found that only 29 (17%) male and 52 (23%) female participants had received the vaccine. Further, participants with low levels of knowledge and a positive attitude towards the vaccine were 5.9 times more likely (p-value = 0.001) to be vaccinated than those with low levels of knowledge and negative attitudes towards the vaccine. On the other hand, those with high knowledge and a positive attitude towards the vaccine were 8.2 times more likely (p-value < 0.001) to be vaccinated compared to those with low knowledge and negative attitudes towards the vaccine. The findings highlight the importance of vaccine-related knowledge and attitudes in shaping uptake and reveal disparities across demographic groups. To improve vaccination coverage in Malawi, targeted interventions focusing on enhancing COVID-19 vaccine knowledge, addressing attitudinal barriers, and countering misinformation are needed. Strategies should be tailored to reach populations with lower uptake, such as males, younger adults, and those with lower education levels. Strengthening public health messaging, engaging community leaders, and building trust in healthcare systems are crucial for promoting widespread acceptance and uptake of COVID-19 vaccines in Malawi.
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Affiliation(s)
| | | | - Jimmy Kainja
- Language and Communication Skills Department, University of Malawi, Zomba, Malawi
| | - Anthony Mavuto Gunde
- Language and Communication Skills Department, University of Malawi, Zomba, Malawi
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Fasehun OO, Adedoyin O, Iheagwara C, Ofuase-Lasekan IH, Manandhar S, Akoto NA, Ajani T, Nwume CG, Green JT, Okobi OE. COVID-19 Vaccination Rates and Predictors of Vaccine Uptake Among Adults With Chronic Obstructive Pulmonary Disease: Insights From the 2022 National Health Interview Survey. Cureus 2024; 16:e59230. [PMID: 38813301 PMCID: PMC11132902 DOI: 10.7759/cureus.59230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2024] [Indexed: 05/31/2024] Open
Abstract
Background and objective The coronavirus disease 2019 (COVID-19) vaccination rates and predictors of vaccine uptake among patients with chronic obstructive pulmonary disease (COPD) in the United States are unknown. In light of this, we assessed COVID-19 vaccination rates in this population and evaluated predictors of vaccine uptake. Methods Using 2022 survey data from the National Health Interview Survey (NHIS), 1486 adults with COPD who responded with "yes/no" to whether they had received the COVID-19 vaccine were identified, including those who had received booster doses. A chi-square test was used to ascertain differences between those who had received the vaccine and those who had not, as well as between those who had received booster doses and those who had not. A logistic regression was used to evaluate predictors of COVID-19 vaccination uptake. Results A total of 1195 individuals among 1486 respondents with chronic pulmonary disease (78.4%) had been vaccinated against COVID-19, and 789/1195 (62.5%) had received booster shots. The majority of individuals were aged 65 years and above, exceeded the 1+ threshold for the ratio of family income to poverty (RFIP), and were covered by insurance. Positive predictors of COVID-19 vaccination were as follows: age 40 - 64 years (OR: 2.34, 95% CI: 1.31 - 4.19; p=0.004) and 65 years and above (OR: 1.93, 95% CI: 1.36 - 2.72; p<0.001), RFIP threshold of ≥1 (OR: 2.02, 95% CI: 1.42 - 2.88; p<0.001), having a college degree (OR: 1.92, 95% CI: 1.92 - 3.26, p=0.016), and being insured (OR: 3.12, 95% CI: 1.46 - 6.66, p=0.003). The current smoking habit negatively predicted the uptake (OR: 0.54, 95% CI: 0.33 - 0.87, p=0.012). The positive predictors of COVID-19 vaccination boosters were as follows: age 40 - 64 years (OR: 2.72, 95% CI: 1.39 - 5.30, p=0.003) and 65 years and above (OR: 4.85, 95% CI: 2.45 - 9.58, p<0.001). Being from the non-Hispanic (NH) black ethnicity negatively predicted receiving the COVID-19 booster (OR: 0.55, 95% CI: 0.36 - 0.85, p=0.007). Conclusions While COVID-19 vaccination rates are fairly satisfactory in COPD patients, the uptake of booster vaccines is relatively lower in this population. Socioeconomic and behavioral factors are associated with poor vaccine uptake, and targeted interventions should be implemented to address these factors.
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Affiliation(s)
- Oyinlola O Fasehun
- Internal Medicine, University of Texas Rio Grande Valley Knapp Medical Center, Weslaco, USA
| | | | | | | | | | - Natalie A Akoto
- Epidemiology, Emory University Rollins School of Public Health, Atlanta, USA
| | - Taiwo Ajani
- Internal Medicine, Obafemi Awolowo University, Ile-Ife, NGA
| | - Chuka G Nwume
- Family Medicine, University of Port Harcourt, Port Harcourt, NGA
| | | | - Okelue E Okobi
- Family Medicine, Larkin Community Hospital Palm Springs Campus, Miami, USA
- Family Medicine, Medficient Health Systems, Laurel, USA
- Family Medicine, Lakeside Medical Center, Belle Glade, USA
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Kasting ML, Laily A, Burney HN, Head KJ, Daggy JK, Zimet GD, Schwab-Reese LM. County-Level Factors Associated With Influenza and COVID-19 Vaccination in Indiana, 2020‒2022. Am J Public Health 2024; 114:415-423. [PMID: 38386970 PMCID: PMC10937598 DOI: 10.2105/ajph.2023.307553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2023] [Indexed: 02/24/2024]
Abstract
Objectives. To assess COVID-19 and influenza vaccination rates across Indiana's 92 counties and identify county-level factors associated with vaccination. Methods. We analyzed county-level data on adult COVID-19 vaccination from the Indiana vaccine registry and 2021 adult influenza vaccination from the Centers for Disease Control and Prevention. We used multiple linear regression (MLR) to determine county-level predictors of vaccinations. Results. COVID-19 vaccination ranged from 31.2% to 87.6% (mean = 58.0%); influenza vaccination ranged from 33.7% to 53.1% (mean = 42.9%). In MLR, COVID-19 vaccination was significantly associated with primary care providers per capita (b = 0.04; 95% confidence interval [CI] = 0.02, 0.05), median household income (b = 0.23; 95% CI = 0.12, 0.34), percentage Medicare enrollees with a mammogram (b = 0.29; 95% CI = 0.08, 0.51), percentage uninsured (b = -1.22; 95% CI = -1.57, -0.87), percentage African American (b = 0.31; 95% CI = 0.19, 0.42), percentage female (b = -0.97; 95% CI = -1.79, ‒0.15), and percentage who smoke (b = -0.75; 95% CI = -1.26, -0.23). Influenza vaccination was significantly associated with percentage uninsured (b = 0.71; 95% CI = 0.22, 1.21), percentage African American (b = -0.07; 95% CI = -0.13, -0.01), percentage Hispanic (b = -0.28; 95% CI = -0.40, -0.17), percentage who smoke (b = -0.85; 95% CI = -1.06, -0.64), and percentage who completed high school (b = 0.54; 95% CI = 0.21, 0.87). The MLR models explained 86.7% (COVID-19) and 70.2% (influenza) of the variance. Conclusions. Factors associated with COVID-19 and influenza vaccinations varied. Variables reflecting access to care (e.g., insurance) and higher risk of severe disease (e.g., smoking) are notable. Programs to improve access and target high-risk populations may improve vaccination rates. (Am J Public Health. 2024;114(4):415-423. https://doi.org/10.2105/AJPH.2023.307553).
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Affiliation(s)
- Monica L Kasting
- Monica L. Kasting, Alfu Laily, and Laura M. Schwab-Reese are with the Department of Public Health at Purdue University, West Lafayette, IN. Heather N. Burney and Joanne K. Daggy are with the Department of Biostatistics and Health Data Science at the Indiana University School of Medicine, Indianapolis. Katharine J. Head is with the Department of Communication Studies at Indiana University‒Purdue University, Indianapolis. Gregory D. Zimet is professor emeritus of Pediatrics and Psychiatry at the Indiana University School of Medicine, Indianapolis
| | - Alfu Laily
- Monica L. Kasting, Alfu Laily, and Laura M. Schwab-Reese are with the Department of Public Health at Purdue University, West Lafayette, IN. Heather N. Burney and Joanne K. Daggy are with the Department of Biostatistics and Health Data Science at the Indiana University School of Medicine, Indianapolis. Katharine J. Head is with the Department of Communication Studies at Indiana University‒Purdue University, Indianapolis. Gregory D. Zimet is professor emeritus of Pediatrics and Psychiatry at the Indiana University School of Medicine, Indianapolis
| | - Heather N Burney
- Monica L. Kasting, Alfu Laily, and Laura M. Schwab-Reese are with the Department of Public Health at Purdue University, West Lafayette, IN. Heather N. Burney and Joanne K. Daggy are with the Department of Biostatistics and Health Data Science at the Indiana University School of Medicine, Indianapolis. Katharine J. Head is with the Department of Communication Studies at Indiana University‒Purdue University, Indianapolis. Gregory D. Zimet is professor emeritus of Pediatrics and Psychiatry at the Indiana University School of Medicine, Indianapolis
| | - Katharine J Head
- Monica L. Kasting, Alfu Laily, and Laura M. Schwab-Reese are with the Department of Public Health at Purdue University, West Lafayette, IN. Heather N. Burney and Joanne K. Daggy are with the Department of Biostatistics and Health Data Science at the Indiana University School of Medicine, Indianapolis. Katharine J. Head is with the Department of Communication Studies at Indiana University‒Purdue University, Indianapolis. Gregory D. Zimet is professor emeritus of Pediatrics and Psychiatry at the Indiana University School of Medicine, Indianapolis
| | - Joanne K Daggy
- Monica L. Kasting, Alfu Laily, and Laura M. Schwab-Reese are with the Department of Public Health at Purdue University, West Lafayette, IN. Heather N. Burney and Joanne K. Daggy are with the Department of Biostatistics and Health Data Science at the Indiana University School of Medicine, Indianapolis. Katharine J. Head is with the Department of Communication Studies at Indiana University‒Purdue University, Indianapolis. Gregory D. Zimet is professor emeritus of Pediatrics and Psychiatry at the Indiana University School of Medicine, Indianapolis
| | - Gregory D Zimet
- Monica L. Kasting, Alfu Laily, and Laura M. Schwab-Reese are with the Department of Public Health at Purdue University, West Lafayette, IN. Heather N. Burney and Joanne K. Daggy are with the Department of Biostatistics and Health Data Science at the Indiana University School of Medicine, Indianapolis. Katharine J. Head is with the Department of Communication Studies at Indiana University‒Purdue University, Indianapolis. Gregory D. Zimet is professor emeritus of Pediatrics and Psychiatry at the Indiana University School of Medicine, Indianapolis
| | - Laura M Schwab-Reese
- Monica L. Kasting, Alfu Laily, and Laura M. Schwab-Reese are with the Department of Public Health at Purdue University, West Lafayette, IN. Heather N. Burney and Joanne K. Daggy are with the Department of Biostatistics and Health Data Science at the Indiana University School of Medicine, Indianapolis. Katharine J. Head is with the Department of Communication Studies at Indiana University‒Purdue University, Indianapolis. Gregory D. Zimet is professor emeritus of Pediatrics and Psychiatry at the Indiana University School of Medicine, Indianapolis
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Mundo Ortiz A, Nasri B. Socio-demographic determinants of COVID-19 vaccine uptake in Ontario: Exploring differences across the Health Region model. Vaccine 2024; 42:2106-2114. [PMID: 38413281 DOI: 10.1016/j.vaccine.2024.02.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 02/11/2024] [Accepted: 02/14/2024] [Indexed: 02/29/2024]
Abstract
The COVID-19 pandemic continues to be a worldwide public health concern. Although vaccines against this disease were rapidly developed, vaccination uptake has not been equal across all the segments of the population, particularly in the case of underrepresented groups. However, there are also differences in vaccination across geographical areas, which might be important to consider in the development of future public health vaccination policies. In this study, we examined the relationship between vaccination status (having received the first dose of a COVID-19 vaccine), socio-economic strata, and the Health Regions for individuals in Ontario, Canada. Our results show that between October of 2021 and January of 2022, individuals from underrepresented communities were three times less likely to be vaccinated than White/Caucasian individuals across the province of Ontario, and that in some cases, within these groups, individuals in low-income brackets had significantly higher odds of vaccination when compared to their peers in high income brackets. Finally, we identified significantly lower odds of vaccination in the Central, East and West Health Regions of Ontario within certain underrepresented groups. This study shows that there is an ongoing need to better understand and address differences in vaccination uptake across diverse segments of the population of Ontario that the pandemic has largely impacted.
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Affiliation(s)
- Ariel Mundo Ortiz
- Centre de Recherches Mathématiques, Université de Montréal. 2920 Ch de la Tour, Montréal, QC H3T 1N8, Canada; Department of Social and Preventive Medicine, École de Santé Publique, Université de Montréal. 7101 Av du Parc, Montréal, QC H3N 1X9, Canada; Centre de recherche en santé publique, Université de Montréal. 7101 Av du Parc, Montréal, QC H3N 1X9, Canada
| | - Bouchra Nasri
- Centre de Recherches Mathématiques, Université de Montréal. 2920 Ch de la Tour, Montréal, QC H3T 1N8, Canada; Department of Social and Preventive Medicine, École de Santé Publique, Université de Montréal. 7101 Av du Parc, Montréal, QC H3N 1X9, Canada; Centre de recherche en santé publique, Université de Montréal. 7101 Av du Parc, Montréal, QC H3N 1X9, Canada.
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Yu H, Bauermeister JA, Oyiborhoro U, Aryal S, Lipman TH, Tan ASL, Glanz K, Villarruel AM, Bonett S. Trust in federal COVID-19 vaccine oversight and parents' willingness to vaccinate their children against COVID-19: a cross-sectional study. BMC Public Health 2024; 24:830. [PMID: 38493101 PMCID: PMC10943829 DOI: 10.1186/s12889-024-18342-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 03/12/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND Over half of the youth population in the United States, aged 6 months to 17 years, have not received the Coronavirus Disease 2019 (COVID-19) vaccine. Given parents' central role in vaccinating their children, we examined associations between parents' trust of the federal oversight of COVID-19 vaccine safety and their willingness to vaccinate their children against COVID-19. METHODS This cross-sectional study included 975 parents of minor children residing in Philadelphia who completed the online survey between September 2021 and February 2022. Trust was measured using a four-point Likert scale ranging from 'do not trust' to 'fully trust' for two variables: (1) trust in federal oversight of COVID-19 vaccine safety for children and (2) trust in federal oversight of COVID-19 vaccine safety for the general public. A multiple logistic regression evaluated associations between trust and parents' willingness to vaccinate their children, which was measured on a five-point Likert scale ranging from 'strongly disagree' to 'strongly agree.' The analysis was adjusted for race/ethnicity, age, sexual orientation, gender, education, insurance, and parents' vaccination status. RESULTS Analyses included 975 parents whose children had not previously been vaccinated against COVID-19 (mean age 36.79, standard deviation 6.4; 42.1% racial/ethnic minorities; 93.2% heterosexual; and 73.7% with a college degree). Greater trust regarding federal oversight of COVID-19 vaccine safety for children [adjusted odds ratio (aOR) = 1.52, 95% confidence interval (CI): 1.13-2.04] and for the public (aOR = 1.58, 95% CI: 1.17-2.14) were each associated with increased willingness to have their child vaccinated against COVID-19. Unvaccinated parents had decreased willingness compared to parents who had received at least one dose of the vaccine (aOR = 0.14, 95% CI: 0.04-0.41). College-graduate parents exhibited increased willingness compared to those without a college degree (aOR = 2.07, 95% CI: 1.52-2.81). Non-heterosexual parents showed increased willingness compared to heterosexual parents (aOR = 2.30, 95% CI: 1.20-4.76). CONCLUSIONS Trust in federal COVID-19 vaccine oversight was associated with parental willingness to vaccinate their children against COVID-19 among parents whose children have not yet been vaccinated. Identifying and addressing causes of mistrust are crucial next steps to promote child vaccination. Intervention efforts to address trust gaps should remain a public health priority.
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Affiliation(s)
- Hyunmin Yu
- School of Nursing, University of Pennsylvania, 418 Curie Blvd, Philadelphia, Pennsylvania, 19104, USA.
| | - José A Bauermeister
- School of Nursing, University of Pennsylvania, 418 Curie Blvd, Philadelphia, Pennsylvania, 19104, USA
| | - Ufuoma Oyiborhoro
- School of Nursing, University of Pennsylvania, 418 Curie Blvd, Philadelphia, Pennsylvania, 19104, USA
| | - Subhash Aryal
- School of Nursing, University of Pennsylvania, 418 Curie Blvd, Philadelphia, Pennsylvania, 19104, USA
| | - Terri H Lipman
- School of Nursing, University of Pennsylvania, 418 Curie Blvd, Philadelphia, Pennsylvania, 19104, USA
| | - Andy S L Tan
- Annenberg School for Communication, University of Pennsylvania, 3620 Walnut Street, Philadelphia, Pennsylvania, 19104, USA
| | - Karen Glanz
- School of Nursing, University of Pennsylvania, 418 Curie Blvd, Philadelphia, Pennsylvania, 19104, USA
- Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, Pennsylvania, 19104, USA
| | - Antonia M Villarruel
- School of Nursing, University of Pennsylvania, 418 Curie Blvd, Philadelphia, Pennsylvania, 19104, USA
| | - Stephen Bonett
- School of Nursing, University of Pennsylvania, 418 Curie Blvd, Philadelphia, Pennsylvania, 19104, USA
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Lacy A, Khan MM, Deb Nath N, Das P, Igoe M, Lenhart S, Lloyd AL, Lanzas C, Odoi A. Geographic disparities and predictors of COVID-19 vaccination in Missouri: a retrospective ecological study. Front Public Health 2024; 12:1329382. [PMID: 38528866 PMCID: PMC10961407 DOI: 10.3389/fpubh.2024.1329382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 02/23/2024] [Indexed: 03/27/2024] Open
Abstract
Background Limited information is available on geographic disparities of COVID-19 vaccination in Missouri and yet this information is essential for guiding efforts to improve vaccination coverage. Therefore, the objectives of this study were to (a) investigate geographic disparities in the proportion of the population vaccinated against COVID-19 in Missouri and (b) identify socioeconomic and demographic predictors of the identified disparities. Methods The COVID-19 vaccination data for time period January 1 to December 31, 2021 were obtained from the Missouri Department of Health. County-level data on socioeconomic and demographic factors were downloaded from the 2020 American Community Survey. Proportions of county population vaccinated against COVID-19 were computed and displayed on choropleth maps. Global ordinary least square regression model and local geographically weighted regression model were used to identify predictors of proportions of COVID-19 vaccinated population. Results Counties located in eastern Missouri tended to have high proportions of COVID-19 vaccinated population while low proportions were observed in the southernmost part of the state. Counties with low proportions of population vaccinated against COVID-19 tended to have high percentages of Hispanic/Latino population (p = 0.046), individuals living below the poverty level (p = 0.049), and uninsured (p = 0.015) populations. The strength of association between proportion of COVID-19 vaccinated population and percentage of Hispanic/Latino population varied by geographic location. Conclusion The study findings confirm geographic disparities of proportions of COVID-19 vaccinated population in Missouri. Study findings are useful for guiding programs geared at improving vaccination coverage and uptake by targeting resources to areas with low proportions of vaccinated individuals.
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Affiliation(s)
- Alexanderia Lacy
- Department of Mathematics, University of Tennessee, Knoxville, TN, United States
| | - Md Marufuzzaman Khan
- Department of Public Health, University of Tennessee, Knoxville, TN, United States
| | - Nirmalendu Deb Nath
- Department of Biomedical and Diagnostics Sciences, University of Tennessee, Knoxville, TN, United States
| | - Praachi Das
- Biomathematics Graduate Program, North Carolina State University, Raleigh, NC, United States
| | - Morganne Igoe
- Department of Mathematics, University of Tennessee, Knoxville, TN, United States
| | - Suzanne Lenhart
- Department of Mathematics, University of Tennessee, Knoxville, TN, United States
| | - Alun L. Lloyd
- Biomathematics Graduate Program, North Carolina State University, Raleigh, NC, United States
| | - Cristina Lanzas
- Department of Population Health and Pathobiology and Comparative Medicine Institute, North Carolina State University, Raleigh, NC, United States
| | - Agricola Odoi
- Department of Biomedical and Diagnostics Sciences, University of Tennessee, Knoxville, TN, United States
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O'Regan E, Svalgaard IB, Sørensen AIV, Spiliopoulos L, Bager P, Nielsen NM, Hansen JV, Koch A, Meder IK, Videbech P, Ethelberg S, Hviid A. A register and questionnaire study of long-term general health symptoms following SARS-CoV-2 vaccination in Denmark. NPJ Vaccines 2024; 9:52. [PMID: 38438399 PMCID: PMC10912726 DOI: 10.1038/s41541-024-00844-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 02/21/2024] [Indexed: 03/06/2024] Open
Abstract
Many individuals who refuse COVID-19 vaccination have concerns about long-term side effects. Here, we report findings on self-reported symptoms from a Danish survey- and register study. The study included 34,868 vaccinated primary course recipients, 95.8% of whom received mRNA vaccines, and 1,568 unvaccinated individuals. Participants had no known history of SARS-CoV-2 infection. Using g-computation on logistic regression, risk differences (RDs) for symptoms between vaccinated and unvaccinated persons were estimated with adjustments for possible confounders. Within six weeks after vaccination, higher risks were observed for physical exhaustion (RD 4.9%, 95% CI 1.1% to 8.4%), fever or chills (RD 4.4%, 95% CI 2.1% to 6.7%), and muscle/joint pain (RD 7.0%, 95% CI 3.1% to 10.7%), compared to unvaccinated individuals. Beyond twenty-six weeks, risks were higher among the vaccinated for sleeping problems (RD 3.0, 95% 0.2 to 5.8), fever or chills (RD 2.0, 95% CI 0.4 to 3.6), reduced/altered taste (RD 1.2, 95% CI 0.2 to 2.3) and shortness of breath (RD 2.6, 95% CI 0.9 to 4.0). However, when examining pre-omicron responses only, the difference for reduced/altered taste was significant. As expected, the risk of experiencing physical exhaustion, fever or chills, and muscle/joint pain was higher among persons who responded within six weeks of completing the primary course. No significant differences were observed for the 7-25-week period after vaccination. Associations for the period beyond 26 weeks must be interpreted with caution and in the context of undetected SARS-CoV-2 infection, wide confidence intervals, and multiple testing. Overall, we observe no concerning signs of long-term self-reported physical, cognitive, or fatigue symptoms after vaccination.
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Affiliation(s)
- Elisabeth O'Regan
- Department of Epidemiology Research, Statens Serum Institut, 2300, Copenhagen, Denmark.
| | - Ingrid Bech Svalgaard
- Department of Epidemiology Research, Statens Serum Institut, 2300, Copenhagen, Denmark
| | | | - Lampros Spiliopoulos
- Department of Epidemiology Research, Statens Serum Institut, 2300, Copenhagen, Denmark
| | - Peter Bager
- Department of Epidemiology Research, Statens Serum Institut, 2300, Copenhagen, Denmark
- Infectious Disease Epidemiology and Prevention, Statens Serum Institut, 2300, Copenhagen, Denmark
| | - Nete Munk Nielsen
- Department of Epidemiology Research, Statens Serum Institut, 2300, Copenhagen, Denmark
- Focused Research Unit in Neurology, Department of Neurology, Hospital of Southern Jutland, University of Southern Denmark, 6200, Aabenraa, Denmark
| | - Jørgen Vinsløv Hansen
- Department of Epidemiology Research, Statens Serum Institut, 2300, Copenhagen, Denmark
| | - Anders Koch
- Infectious Disease Epidemiology and Prevention, Statens Serum Institut, 2300, Copenhagen, Denmark
- Department of Public Health, Global Health Section, University of Copenhagen, Copenhagen, Denmark
- Department of Infectious Diseases, Rigshospitalet University Hospital, 2100, Copenhagen, Denmark
| | - Inger Kristine Meder
- Department of Epidemiology Research, Statens Serum Institut, 2300, Copenhagen, Denmark
| | - Poul Videbech
- Center for Neuropsychiatric Depression Research, Mental Health Center Glostrup, 2600 Glostrup, Denmark and University of Copenhagen, Copenhagen, Denmark
| | - Steen Ethelberg
- Infectious Disease Epidemiology and Prevention, Statens Serum Institut, 2300, Copenhagen, Denmark
- Department of Public Health, Global Health Section, University of Copenhagen, Copenhagen, Denmark
| | - Anders Hviid
- Department of Epidemiology Research, Statens Serum Institut, 2300, Copenhagen, Denmark
- Pharmacovigilance Research Centre, Department of Drug Design and Pharmacology, University of Copenhagen, 2100, Copenhagen, Denmark
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Glaurdić J, Lesschaeve C. The Politics of Covid-19 Vaccination Hesitancy in Southeastern Europe. COMPARATIVE SOUTHEAST EUROPEAN STUDIES 2024; 72:33-57. [PMID: 38525430 PMCID: PMC10956124 DOI: 10.1515/soeu-2023-0006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 09/18/2023] [Indexed: 03/26/2024]
Abstract
The execution of Covid-19 vaccination drives in former Yugoslavia's successor states has been disappointing. The rapidly evolving literature on the Covid-19 pandemic suggests the levels of support for vaccination are correlated with education, trust in public-health institutions, and exposure to the negative economic and health effects of the pandemic. The explanations of the political foundations of vaccination hesitancy, however, need better empirical grounding. We shed light on this subject by analyzing the results of a survey conducted on more than six thousand respondents from Bosnia-Herzegovina, Croatia, and Serbia, as well as a combination of public-health, economic, and sociodemographic data across more than five hundred municipalities in Croatia. Most notably, we find the political sources of vaccination hesitancy to be strongly related to people's support for the ideas of political parties committed to nationalist populism.
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Affiliation(s)
- Josip Glaurdić
- Institute of Political Science, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Christophe Lesschaeve
- Institute of Political Science, University of Luxembourg, Esch-sur-Alzette, Luxembourg
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Biederman CF, Pham MA, Jimoh L, Aguinaldo JL, Ramirez S, Alabadi-Bierman A, Yeganeh N. School-Located Vaccine Clinics: An Effective Strategy for Expanding Access to COVID-19 Vaccines in Los Angeles County. Public Health Rep 2024; 139:180-186. [PMID: 38111103 PMCID: PMC10851909 DOI: 10.1177/00333549231214784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2023] Open
Abstract
A key component of decreasing severe disease, hospitalizations, and death due to COVID-19 has been increasing vaccine accessibility to residents in communities where access to health care is poor and residents are at increased risk of poor health outcomes. Driven by the expansive geography and diverse population it serves, the Los Angeles County Department of Public Health built an extensive school vaccination network by partnering with the county's roughly 3000 schools and vaccine providers. We report on the process of building this network and its impact on vaccination coverage. We describe a unique equity metric (HPI+) that used a combination of the Healthy Places Index (HPI) and COVID-19 transmission and vaccination data to prioritize school-located vaccination efforts. More than 328 991 doses of COVID-19 vaccine were administered at 1050 schools in Los Angeles County from April 15, 2021, through June 18, 2022. Nearly 10% of all doses administered to children aged 5-11 years in Los Angeles County were at school-located vaccine clinics. Most vaccine clinic days (77.3%) were held at schools in HPI+ zip codes. Most doses (68.3%) were administered in HPI+ regions and to people aged ≥12 years (70.3%). Vaccinating the community at schools is an effective public health intervention; however, increased outreach efforts were required in HPI+ regions to ensure equitable access to vaccines. This case study can be used to replicate public health interventions using schools to support access to health care services for students and the surrounding community.
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Affiliation(s)
- Cassandra Fink Biederman
- Vaccine Preventable Disease Control Program, Los Angeles County Department of Public Health, Los Angeles, CA, USA
| | - Matthew A. Pham
- Office of Health Assessment and Epidemiology, Los Angeles County Department of Public Health, Los Angeles, CA, USA
| | - Lilly Jimoh
- Vaccine Preventable Disease Control Program, Los Angeles County Department of Public Health, Los Angeles, CA, USA
| | - Jeanne L. Aguinaldo
- Vaccine Preventable Disease Control Program, Los Angeles County Department of Public Health, Los Angeles, CA, USA
| | - Susana Ramirez
- Office of Health Assessment and Epidemiology, Los Angeles County Department of Public Health, Los Angeles, CA, USA
| | - Alaa Alabadi-Bierman
- Office of Health Assessment and Epidemiology, Los Angeles County Department of Public Health, Los Angeles, CA, USA
| | - Nava Yeganeh
- Vaccine Preventable Disease Control Program, Los Angeles County Department of Public Health, Los Angeles, CA, USA
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Bok S, Shum J, Lee M. Path analysis of perceived disease vulnerability, COVID-19 fear, and lower vaccine hesitancy within the context of protection motivation theory. Heliyon 2024; 10:e25889. [PMID: 38390175 PMCID: PMC10881856 DOI: 10.1016/j.heliyon.2024.e25889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 01/23/2024] [Accepted: 02/05/2024] [Indexed: 02/24/2024] Open
Abstract
COVID-19 vaccinations have demonstrated effectiveness in reducing severe infections. However, vaccine hesitancy posed a major public health hurdle to combat the COVID-19 pandemic. Online spread of vaccine conspiracy beliefs generated unwarranted mistrust and resistance to vaccines. While numerous studies have explored the factors influencing vaccine hesitancy, there remains a lack of comprehensive understanding regarding the interplay between perceived disease vulnerability, COVID-19 fear, and vaccine hesitancy. Protection motivation theory posits citizens will evaluate perceived threats and take actions to mitigate potential harm. With a large U.S. sample, path analysis demonstrated individuals' perceived disease vulnerability was associated with lower vaccine hesitancy. Greater perceived disease vulnerability was associated with higher COVID-19 fear. Greater COVID-19 fear was associated with lower vaccine hesitancy. Greater vaccine conspiracy beliefs associated with higher vaccine hesitancy. However, in the presence of perceived vulnerability to disease, vaccine conspiracy beliefs associated with higher fear of COVID-19 and thereby lower vaccine hesitancy. We found under circumstances of higher perceived vulnerability to disease and fear of COVID-19, vaccine conspiratorial believers were less vaccine hesitant. We discuss how public health messaging can highlight personal risks to contracting COVID-19 to appeal to those who self-identify as disease prone, but may have reservations about vaccines because of misinformation. Successfully combating diseases entails reaching and gaining cooperation from misbelievers because misinformation is expected to continue in the digital age. By understand individual differences to vaccine hesitancy, it can help increase vaccinations and prevent severe illnesses in the post COVID-19 pandemic era.
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Affiliation(s)
- Stephen Bok
- Department of Marketing, College of Business and Economics, California State University, East Bay, United States
| | - James Shum
- School of Accounting, Golden Gate University, San Francisco, United States
| | - Maria Lee
- Department of Urban Planning and Public Policy, University of California, Irvine, United States
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45
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Gupta D, Rudisill C. Timing of preventive behavior in the case of a new and evolving health risk: the case of COVID-19 vaccination. HEALTH ECONOMICS REVIEW 2024; 14:16. [PMID: 38411764 PMCID: PMC11344437 DOI: 10.1186/s13561-024-00484-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 02/01/2024] [Indexed: 02/28/2024]
Abstract
BACKGROUND Time preferences for preventive behavior under novel risks and uncertain contexts may differ from timing preferences related to familiar risks. Therefore, it is crucial to examine drivers of preventative health behavior timing in light of new health risks. Using the case of COVID-19, we examine factors affecting vaccination timing plans when vaccines were widely available in the European Union (EU). METHODS We use data from the Flash Eurobarometer 494 survey (May 21-26, 2021), which collected information on EU residents' attitudes towards COVID-19 vaccinations. We also use the 'Our World in Data' vaccination database for country-level COVID-19 vaccination rates. Probit regressions were conducted to determine how local vaccination rates, trust in information sources, social norms, vaccine safety beliefs, and risk understanding affected the probability of COVID-19 vaccination delay. RESULTS Of total participants (n = 26,106), 9,063 (34.7%) were vaccinated, 7,114 (27.3%) wanted to get vaccinated as soon as possible, 5,168 (19.8%) wanted to delay vaccination and 2,962 (11.4%) resisted vaccination. Participants were more likely to delay COVID-19 vaccination if they lived in a country with lower vaccination prevalence, trusted online social networks, family, friends, and colleagues for vaccination information, were eager to follow vaccination-related social norms, expressed vaccine safety concerns, and understood the risk of catching COVID-19 without a vaccine to be lower. CONCLUSIONS Results from the study contribute to understanding important factors that predict timing of vaccination plans. These findings can also contribute to the wider knowledge base about timing of preventive behavior uptake in novel risk contexts.
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Affiliation(s)
- Deeksha Gupta
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA.
| | - Caroline Rudisill
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
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46
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Qureshi NS, Miller LG, Judge SP, Tran NDT, Henderson SO. Characterizing predictors of COVID-19 vaccine refusal in an urban southern California jail population. Vaccine 2024; 42:777-781. [PMID: 38195263 DOI: 10.1016/j.vaccine.2024.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 12/28/2023] [Accepted: 01/03/2024] [Indexed: 01/11/2024]
Abstract
BACKGROUND Correctional populations have been disproportionately affected by COVID-19, and many large outbreaks have occurred in jails and prisons. Vaccination is a key strategy to reduce the SARS-CoV-2 transmission in carceral settings. Although implementation can be challenging due to vaccine hesitancy and medical mistrust, correctional settings provide largely equitable healthcare access and present a unique opportunity to identify potential predictors of vaccine hesitancy independent of access issues. METHODS We retrospectively analyzed electronic health record data for individuals offered COVID-19 vaccination at the Los Angeles County Jail between January 19, 2021, and January 31, 2023, and used multivariable logistic regression to determine predictors of COVID-19 vaccine refusal. RESULTS Of the 21,424 individuals offered COVID-19 vaccination, 2,060 (9.6 %) refused. Refusal was associated with male sex ([aOR] = 2.3, 95 % CI (1.9, 2.8)), age 18-34 ([aOR] = 1.2, 95 % CI (1.1, 1.4), referent group: age 45-54), Black race ([aOR] = 1.2, 95 % CI (1.1, 1.4)), reporting ever being houseless ([aOR] = 1.2, 95 % CI (1.1, 1.3)), and having a history of not receiving influenza vaccination while incarcerated ([aOR] = 2.4, 95 % CI (2.0, 2.8)). When analyzing male and female populations separately, male-specific trends reflected those seen in the overall population, whereas the only significant predictor of vaccine refusal in the female population was not receiving influenza vaccination while in custody ([aOR] = 6.5, 95 % CI (2.4, 17.6)). CONCLUSION Identifying predictors of vaccine refusal in correctional populations is an essential first step in the development and implementation of targeted interventions to mitigate vaccine hesitancy.
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Affiliation(s)
- Nazia S Qureshi
- Integrated Correctional Health Services-Los Angeles County Department of Health Services, 450 Bauchet St., Los Angeles, CA, USA.
| | - Loren G Miller
- Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA; David Geffen School of Medicine at UCLA, Los Angeles CA, USA; Harbor-UCLA Medical Center, 1000 West Carson Street, Box 466, Torrance, CA 90509, USA; Division of Infectious Diseases, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Stephen P Judge
- Integrated Correctional Health Services-Los Angeles County Department of Health Services, 450 Bauchet St., Los Angeles, CA, USA; Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA; David Geffen School of Medicine at UCLA, Los Angeles CA, USA; Harbor-UCLA Medical Center, 1000 West Carson Street, Box 466, Torrance, CA 90509, USA; Division of Infectious Diseases, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Ngoc Dung T Tran
- Integrated Correctional Health Services-Los Angeles County Department of Health Services, 450 Bauchet St., Los Angeles, CA, USA
| | - Sean O Henderson
- Integrated Correctional Health Services-Los Angeles County Department of Health Services, 450 Bauchet St., Los Angeles, CA, USA
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47
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Sileo KM, Hirani IM, Luttinen RL, Hayward M, Fleming PJ. A Scoping Review on Gender/Sex Differences in COVID-19 Vaccine Intentions and Uptake in the United States. Am J Health Promot 2024; 38:242-274. [PMID: 37847250 PMCID: PMC10802093 DOI: 10.1177/08901171231200778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
Abstract
OBJECTIVE To explore the empirical literature on gender/sex differences in vaccine acceptance among U.S.-based adults and adolescents in approximately the first 2 years of the pandemic. DATA SOURCE Embase, Medline, PsycINFO, EBSCO, CINAHL, Web of Science. STUDY INCLUSION AND EXCLUSION CRITERIA Peer-reviewed studies conducted in the U.S. with those aged 12 and older, published in English before January 12, 2022, examining the relationship between gender/sex on COVID-19 vaccine intentions and/or uptake. DATA EXTRACTION Three authors screened studies and extracted data. DATA SYNTHESIS Univariate and multivariate results are summarized. RESULTS A total of 53 studies met inclusion criteria (48 intentions, 7 uptake), using mostly cross-sectional designs (92.5%) and non-random sampling (83.0%). The majority of studies supported men's greater intentions to vaccinate compared to women, and men's greater vaccine uptake in univariate analyses, but most multivariate analyses supported no gender differences in uptake. Few studies examined gender beyond binary categories (women/men), highlighting a gap in the studies inclusive of transgender or gender-diverse populations in analyses. CONCLUSION Women may have been more hesitant to get the vaccine than men early in the pandemic, but these differences may not translate to actual behavior. Future research should include non-binary/transgender populations, explore the gender-specific reasons for hesitancy and differences by sub-populations, utilize more rigorous designs, and test gender-sensitive public health campaigns to mitigate vaccine concerns.
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Affiliation(s)
- Katelyn M. Sileo
- The Department of Public Health, College of Health, Community, and Policy, The University of Texas at San Antonio, San Antonio, TX, USA
| | - Inara M. Hirani
- The Department of Public Health, College of Health, Community, and Policy, The University of Texas at San Antonio, San Antonio, TX, USA
| | - Rebecca L. Luttinen
- The Department of Demography, College of Health, Community, and Policy, The University of Texas at San Antonio, San Antonio, TX, USA
| | - Matt Hayward
- The John Peace Library, The University of Texas at San Antonio, San Antonio, TX, USA
| | - Paul J. Fleming
- The Department of Health Behavior and Health Education, The School of Public Health at the University of Michigan, Ann Arbor, MI, USA
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48
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Leigh JP, FitzGerald EA, Moss SJ, Brundin-Mather R, Dodds A, Stelfox HT, Dubé È, Fiest KM, Halperin D, Ahmed SB, MacDonald SE, Straus SE, Manca T, Kamstra JN, Soo A, Longmore S, Kupsch S, Sept B, Halperin S. Factors affecting hesitancy toward COVID-19 vaccine booster doses in Canada: a cross-national survey. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2024; 115:26-39. [PMID: 37991692 PMCID: PMC10853155 DOI: 10.17269/s41997-023-00823-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 09/26/2023] [Indexed: 11/23/2023]
Abstract
OBJECTIVE COVID-19 transmission, emergence of variants of concern, and weakened immunity have led to recommended vaccine booster doses for COVID-19. Vaccine hesitancy challenges broad immunization coverage. We deployed a cross-national survey to investigate knowledge, beliefs, and behaviours toward continued COVID-19 vaccination. METHODS We administered a national, cross-sectional online survey among adults in Canada between March 16 and March 26, 2022. We utilized descriptive statistics to summarize our sample, and tested for demographic differences, perceptions of vaccine effectiveness, recommended doses, and trust in decisions, using the Rao-Scott correction for weighted chi-squared tests. Multivariable logistic regression was adjusted for relevant covariates to identify sociodemographic factors and beliefs associated with vaccine hesitancy. RESULTS We collected 2202 completed questionnaires. Lower education status (high school: odds ratio (OR) 1.90, 95% confidence interval (CI) 1.29, 2.81) and having children (OR 1.89, CI 1.39, 2.57) were associated with increased odds of experiencing hesitancy toward a booster dose, while higher income ($100,000-$149,999: OR 0.60, CI 0.39, 0.91; $150,000 or more: OR 0.49, CI 0.29, 0.82) was associated with decreased odds. Disbelief in vaccine effectiveness (against infection: OR 3.69, CI 1.98, 6.90; serious illness: OR 3.15, CI 1.69, 5.86), disagreeing with government decision-making (somewhat disagree: OR 2.70, CI 1.38, 5.29; strongly disagree: OR 4.62, CI 2.20, 9.7), and beliefs in over-vaccinating (OR 2.07, CI 1.53, 2.80) were found associated with booster dose hesitancy. CONCLUSION COVID-19 vaccine hesitancy may develop or increase regarding subsequent vaccines. Our findings indicate factors to consider when targeting vaccine-hesitant populations.
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Affiliation(s)
- Jeanna Parsons Leigh
- Faculty of Health, School of Health Administration, Dalhousie University, Halifax, NS, Canada.
- Department of Critical Care Medicine, Dalhousie University, Halifax, NS, Canada.
- Canadian Center for Vaccinology & IWK Health Centre, Halifax, NS, Canada.
| | - Emily A FitzGerald
- Faculty of Health, School of Health Administration, Dalhousie University, Halifax, NS, Canada
| | - Stephana J Moss
- Faculty of Health, School of Health Administration, Dalhousie University, Halifax, NS, Canada
- CRISMA Center, Department of Critical Care, University of Pittsburgh, Pittsburgh, USA
| | | | - Alexandra Dodds
- Faculty of Health, School of Health Administration, Dalhousie University, Halifax, NS, Canada
| | - Henry T Stelfox
- Department of Critical Care Medicine, University of Calgary, Calgary, AB, Canada
- O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
| | - Ève Dubé
- Centre de Recherche du CHU de Québec, Université Laval, Québec, Canada
- Institut National de Santé Publique du Québec, Québec, Canada
| | - Kirsten M Fiest
- Department of Critical Care Medicine, University of Calgary, Calgary, AB, Canada
- O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
- Department of Psychiatry & Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Donna Halperin
- Canadian Center for Vaccinology & IWK Health Centre, Halifax, NS, Canada
- Rankin School of Nursing, St. Francis Xavier University, Antigonish, NS, Canada
| | - Sofia B Ahmed
- O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
- Department of Medicine, University of Calgary, Calgary, AB, Canada
- Libin Cardiovascular Institute, University of Calgary, Calgary, AB, Canada
| | - Shannon E MacDonald
- School of Public Health, University of Alberta, Edmonton, AB, Canada
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Sharon E Straus
- Li Ka Shing Knowledge Institute of St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
- Department of Medicine, University of Toronto, Toronto, ON, Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Terra Manca
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
- Sociology and Social Anthropology, Dalhousie University, Halifax, NS, Canada
| | - Josh Ng Kamstra
- Department of Surgery, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA
- Department of Surgery, The Queen's Medical Center, Honolulu, HI, USA
| | - Andrea Soo
- Department of Critical Care Medicine, University of Calgary, Calgary, AB, Canada
- Alberta Health Services, Calgary, AB, Canada
| | - Shelly Longmore
- Department of Critical Care Medicine, University of Calgary, Calgary, AB, Canada
| | - Shelly Kupsch
- Department of Critical Care Medicine, University of Calgary, Calgary, AB, Canada
| | - Bonnie Sept
- Department of Critical Care Medicine, University of Calgary, Calgary, AB, Canada
| | - Scott Halperin
- Canadian Center for Vaccinology & IWK Health Centre, Halifax, NS, Canada
- Department of Pediatrics, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
- Department of Microbiology and Immunology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
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49
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Morales DX, Paat YF. Hesitancy or Resistance? Differential Changes in COVID-19 Vaccination Intention Between Black and White Americans. J Racial Ethn Health Disparities 2024; 11:23-35. [PMID: 36547772 PMCID: PMC9774084 DOI: 10.1007/s40615-022-01494-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 12/14/2022] [Accepted: 12/15/2022] [Indexed: 12/24/2022]
Abstract
The literature on COVID-19 vaccination has rarely taken a macro and longitudinal approach to investigate the nuanced racial and ethnic differences in vaccine hesitancy and refusal. To fill this gap, this study examines the relationships between race, time, and COVID-19 vaccine hesitancy and refusal using state-level data from the US Census Household Pulse Survey, 2020 US Decennial Census, and other sources (i.e., American Community Survey, Human Development Index database, and Centers for Disease Control and Prevention). Four longitudinal Generalized Estimating Equations (GEEs) were estimated to analyze how time-variant and time-invariant measures, and time itself influenced COVID-19 vaccine hesitancy and refusal rates, controlling for the effect of other relevant covariates. The results provide descriptive evidence that COVID-19 vaccine hesitancy had decreased in the USA, but vaccine refusal remained stable between January and October 2021. The GEEs further indicated that the proportion of the Black population was positively associated with both vaccine hesitancy and refusal rates, while the proportion of the White population was positively associated with the vaccine refusal rate but not associated with the vaccine hesitancy rate. In addition, over the 10-month period, COVID-19 vaccine hesitancy and refusal in the Black population declined rapidly, but vaccine refusal in the White population stayed fairly stable. More research and practical efforts are needed to understand and inform the public about these important but overlooked trends.
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Affiliation(s)
- Danielle Xiaodan Morales
- Department of Urban Studies, Worcester State University, 486 Chandler St, Worcester, MA, 01602, USA.
| | - Yok-Fong Paat
- Department of Social Work, The University of Texas at El Paso, El Paso, USA
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50
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Gonzalez VM, Stewart TJ. COVID-19 vaccine hesitancy among American Indian and Alaska native college students: the roles of discrimination, historical trauma, and healthcare system distrust. J Behav Med 2024; 47:123-134. [PMID: 37634151 DOI: 10.1007/s10865-023-00443-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 08/09/2023] [Indexed: 08/29/2023]
Abstract
For American Indians and Alaska Native (AIAN) and other communities of color, experiences with discrimination and historical trauma may contribute to healthcare system distrust and negatively affect health care decisions, including vaccination. A saturated path analysis was conducted to examine the direct and indirect associations of thoughts regarding historical losses (of culture, language, and traditional ways) and AIAN racial discrimination with historical loss associated distress, healthcare system distrust, and COVID-19 vaccine hesitancy among AIAN college students (N = 391). Historical loss thoughts and experiences with racial discrimination were strongly associated with each other, and both were uniquely associated with greater historical loss associated distress. In turn, historical loss associated distress was associated with greater healthcare system distrust, which in turn was associated with greater likelihood of being COVID-19 vaccine hesitant. While further research is needed, the findings suggest that to address health disparities for AIAN people it is necessary to consider how to best overcome healthcare system distrust and factors that contribute to it, including historical trauma and contemporary experiences with discrimination.
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Affiliation(s)
- Vivian M Gonzalez
- Department of Psychology, University of Alaska Anchorage, 3211 Providence Drive, Anchorage, AK, 4464, 99508, USA.
| | - Tracy J Stewart
- Department of Psychology, University of Alaska Anchorage, 3211 Providence Drive, Anchorage, AK, 4464, 99508, USA
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