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Weis KL, Trout KK, Cimiotti JP, Deupree JP, Killion C, Peter E, Polivka B, Shieh C. The nurse's role in a patient-centered approach for reducing COVID-19 vaccine hesitancy during pregnancy: An American Academy of Nursing consensus paper. Nurs Outlook 2024; 72:102196. [PMID: 38935987 DOI: 10.1016/j.outlook.2024.102196] [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: 01/02/2024] [Revised: 03/17/2024] [Accepted: 04/28/2024] [Indexed: 06/29/2024]
Abstract
The evidence shows that COVID-19 vaccines can reduce the risks of poor pregnancy outcomes. Yet, reluctance to vaccinate remains high in pregnant populations. In this paper, we take a precision health and patient-centered approach to vaccine hesitancy. We adopted the society-to-cells vaccine hesitancy framework to identify society, community, family, individual, and physiologic factors contributing to COVID-19 vaccine hesitancy in pregnancy. Nurses are particularly well-suited to impact the factors associated with vaccine hesitancy. Because of their proximity to the patient, nurses are positioned to provide individualized, timely health information, and clinical guidelines to assist patients with decision-making related to vaccinations. Recommendations are provided to bolster nurses' engagement in precision health and patient-centered models of care to mitigate COVID-19 vaccine hesitancy in pregnancy.
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Affiliation(s)
| | | | | | | | | | | | | | - Carol Shieh
- Maternal and Infant Health Expert Panel; Health Behaviors Expert Panel
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Hoffman E, Kahan T, Auerbach E, Brody H, Abramson NN, Haiken S, Shields D, Elyasi A, Ifrah S, Frenkel-Schick A, Zyskind I, Knoll M, Carmody E. Peer education as a strategy to promote vaccine acceptance: A randomized controlled trial within New York community healthcare practices. Vaccine 2024:S0264-410X(24)00654-6. [PMID: 38862308 DOI: 10.1016/j.vaccine.2024.05.076] [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: 03/07/2024] [Revised: 05/30/2024] [Accepted: 05/31/2024] [Indexed: 06/13/2024]
Abstract
BACKGROUND Effective strategies are needed to improve vaccine acceptance. This study sought to determine if a peer-led vaccine education intervention embedded within community medical practices increases parental acceptance of pediatric pneumococcal conjugate vaccination. METHODS From March 2022-July 2023, we conducted a randomized trial at three pediatric health practices in predominantly Hasidic Jewish neighborhoods in New York, where vaccine deferral is common. Parents of children up to 18 months due/overdue for routine pneumococcal vaccination were randomized (1:1) to receive routine care alone or routine care plus a peer educational intervention. Peer educators trained in motivational interviewing and vaccine science provided counseling at enrollment and follow-up telephone engagement in the intervention arm at day 30 and 60. Primary outcome was child's pneumococcal immunization status by allocation arm expressed as at least one dose received between enrollment and 90 days post-enrollment. RESULTS 144 parent-child dyads were eligible for outcome analysis. Participants in the group receiving routine care along with peer-led vaccine counseling were significantly more likely to have their child receive at least 1 vaccine dose between enrollment and 90 days compared to the group who received routine care alone (28.4 % vs 12.9 %, risk ratio [RR] 2.21, confidence interval [CI] 1.09-4.49, p = 0.022). The effect of peer education was greatest in dyads with children less than 1 year old at enrollment (34 % vs 12.7 %, RR 2.67, CI (1.22-5.86), p = 0.009). CONCLUSIONS Peer vaccine education can increase vaccine acceptance compared to routine care alone and may be particularly valuable in decreasing vaccination delays for younger infants. (Funded by EGL Charitable Foundation, ClinicalTrials.gov NCT05875779).
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Affiliation(s)
- Emily Hoffman
- Department of Medicine, Division of Infectious Diseases at NYU Grossman School of Medicine, 550 First Avenue, New York, NY, 10016, USA.
| | - Tamara Kahan
- NYU Grossman School of Medicine, 550 First Avenue, New York, NY, 10016, USA; Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, 02215, USA
| | - Esther Auerbach
- Jewish Orthodox Women's Medical Association, 350 Roselle Avenue, Cedarhurst, NY 11516, USA
| | - Heidi Brody
- Jewish Orthodox Women's Medical Association, 350 Roselle Avenue, Cedarhurst, NY 11516, USA
| | - Natalie Nesha Abramson
- Jewish Orthodox Women's Medical Association, 350 Roselle Avenue, Cedarhurst, NY 11516, USA
| | - Sarah Haiken
- NYU Langone Vaccine Center, 660 First Avenue 5(th) floor, New York, NY 10016, USA; The Hebrew University-Hadassah Braun School of Public Health and Community Medicine, Kalman Ya'akov Man Street, Jerusalem, Israel
| | - Danielle Shields
- NYU Grossman School of Medicine, 550 First Avenue, New York, NY, 10016, USA
| | - Ailin Elyasi
- Renaissance School of Medicine, Stony Brook University, 101 Nicolls Road, Stony Brook, NY 11794, USA
| | - Sheindel Ifrah
- Jewish Orthodox Women's Medical Association, 350 Roselle Avenue, Cedarhurst, NY 11516, USA; Touro College of Osteopathic Medicine, 230 West 125(th) Street, 3(rd) floor, New York, NY 10027, USA
| | | | - Israel Zyskind
- Department of Pediatrics at NYU Grossman School of Medicine, 145 East 32nd Street, 14th floor, New York, NY 10016, USA
| | - Miriam Knoll
- Jewish Orthodox Women's Medical Association, 350 Roselle Avenue, Cedarhurst, NY 11516, USA
| | - Ellie Carmody
- Department of Medicine, Division of Infectious Diseases at NYU Grossman School of Medicine, 550 First Avenue, New York, NY, 10016, USA
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Li Y, Li M, Yang L, Bressington D, Leung SF, Xie YJ, Qin J, Molasiotis A, Leung AYM. Are People Willing to Take Regular COVID-19 Vaccines? Prevalence and Determinants of Hesitancy for Regular COVID-19 Vaccination: A Random Population-Based Survey in Hong Kong. Vaccines (Basel) 2023; 11:1388. [PMID: 37631956 PMCID: PMC10459211 DOI: 10.3390/vaccines11081388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 08/10/2023] [Accepted: 08/18/2023] [Indexed: 08/29/2023] Open
Abstract
The emergence of new coronavirus variants and evidence of waning immunity offered by COVID-19 vaccines draw attention to the need for regular vaccination. Vaccine hesitancy is one of the top ten threats to global health. There is a dearth of knowledge on people's hesitancy to take regular COVID-19 vaccines. This study aimed to investigate the prevalence and determinants of hesitancy for regular COVID-19 vaccination. A population-based, random telephone survey was performed in Hong Kong in April 2022 (n = 1213). The age-standardized hesitancy rate for regular COVID-19 vaccines among Hong Kong adults was 39.4% (95% CI = 35.3-44.1%), exhibiting a sloping S-shape with age. Regression analyses revealed that females, young adults, self-perceived fair/bad health, low COVID-19 vaccine uptake, and believing there are better ways for prevention of infection were positive determinants of hesitancy for regular vaccination. Vaccine confidence, perceived severity and availability, trust in manufacturers and government, and civic duty inclination were negative determinants. Tailored vaccine promotions are needed for females, young adults, and people perceiving poor health and receiving fewer doses. Information on infection severity, vaccine availability, and trust in suppliers, products, and governments are key attitude-change facilitators to decrease hesitancy for regular COVID-19 vaccination and cope with future pandemics.
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Affiliation(s)
- Yan Li
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong 999077, China; (Y.L.); (L.Y.); (S.-F.L.); (Y.-J.X.); (J.Q.); (A.Y.M.L.)
| | - Mengqi Li
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong 999077, China; (Y.L.); (L.Y.); (S.-F.L.); (Y.-J.X.); (J.Q.); (A.Y.M.L.)
| | - Lin Yang
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong 999077, China; (Y.L.); (L.Y.); (S.-F.L.); (Y.-J.X.); (J.Q.); (A.Y.M.L.)
| | | | - Sau-Fong Leung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong 999077, China; (Y.L.); (L.Y.); (S.-F.L.); (Y.-J.X.); (J.Q.); (A.Y.M.L.)
| | - Yao-Jie Xie
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong 999077, China; (Y.L.); (L.Y.); (S.-F.L.); (Y.-J.X.); (J.Q.); (A.Y.M.L.)
| | - Jing Qin
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong 999077, China; (Y.L.); (L.Y.); (S.-F.L.); (Y.-J.X.); (J.Q.); (A.Y.M.L.)
| | - Alex Molasiotis
- College of Arts, Humanities and Education, University of Derby, Derby DE22 1GB, UK;
| | - Angela Y. M. Leung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong 999077, China; (Y.L.); (L.Y.); (S.-F.L.); (Y.-J.X.); (J.Q.); (A.Y.M.L.)
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Azhar S, Rahman R, Wernick LJ, Tripathi S, Cohen M, Maschi T. Race, masks, residency and concern regarding COVID-19 transmission. JOURNAL OF COMMUNITY PSYCHOLOGY 2023; 51:1716-1735. [PMID: 36256889 PMCID: PMC9874564 DOI: 10.1002/jcop.22953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 09/16/2022] [Accepted: 09/28/2022] [Indexed: 05/23/2023]
Abstract
To explore sociodemographic predictors for concern regarding COVID-19 transmission and how these factors interact with the identities of others, we conducted a web-based survey where we asked 568 respondents in the United States to indicate their level of COVID-19 concern in response to a series of images with short vignettes of masked and unmasked individuals of different racial/ethnic backgrounds. Using a linear mixed effects model, we found that regardless of the race of the image being presented in the vignette, concern regarding COVID-19 transmission was associated with respondents' older age (b = 0.029, p < 0.001), residing in NYC (b = 0.556, p = 0.009), being heterosexual (b = 1.075, p < 0.001), having higher levels of education, that is, completion of a Bachelor's degree (b = 1.10, p = 0.033) or graduate degree (b = 1.78, p < 0.001), and the person in the vignette being unmasked (b = 0.822, p < 0.001). Asian respondents were more likely than White respondents to be concerned regarding COVID-19. Individuals who self-reported themselves to be at high risk for COVID-19 were more likely to be concerned about COVID-19 over those who considered themselves to be low risk. These findings highlight the importance of acknowledging interactions between race, mask status, and residency in predicting COVID-19 concern.
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Affiliation(s)
- Sameena Azhar
- Graduate School of Social ServiceFordham UniversityNew YorkNew YorkUSA
| | - Rahbel Rahman
- Graduate School of Social ServiceFordham UniversityNew YorkNew YorkUSA
| | - Laura J. Wernick
- Graduate School of Social ServiceFordham UniversityNew YorkNew YorkUSA
| | - Saumya Tripathi
- Graduate School of Social ServiceFordham UniversityNew YorkNew YorkUSA
| | - Margaret Cohen
- Graduate School of Social ServiceFordham UniversityNew YorkNew YorkUSA
| | - Tina Maschi
- Graduate School of Social ServiceFordham UniversityNew YorkNew YorkUSA
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5
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Zalcberg Block S, Zalcberg S. Religious Minorities' Perceptions of Official COVID-19 Health Guidelines: The Case of Ultra-Orthodox Society in Israel. JOURNAL OF RELIGION AND HEALTH 2023; 62:408-427. [PMID: 36115890 PMCID: PMC9483401 DOI: 10.1007/s10943-022-01662-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/01/2022] [Indexed: 05/11/2023]
Abstract
This article focuses on perceptions of the Jewish ultra-Orthodox population in Israel-a religious minority-regarding guidelines enacted by the Israeli Ministry of Health (MOH) during the country's second wave of COVID-19, and ways the community coped with the pandemic. Semi-structured interviews with 30 ultra-Orthodox individuals revealed five major discourses reflecting participants' perceptions. Three discourses objected to MOH guidelines, while the other two aligned with them. The study's findings also indicate a lack of cooperation between the ultra-Orthodox population and state health authorities, emphasizing the need to implement culturally adapted health interventions. Study limitations are discussed, and future research recommendations are provided.
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Affiliation(s)
| | - Sara Zalcberg
- Hadassah Academic College, Jerusalem, Israel
- Religion Studies Tel Aviv University, Tel Aviv, Israel
- Shandong-Tel Aviv Joint Institute for Jewish and Israel Studies, Tel Aviv, Israel
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6
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Berger Lipsky T, Gabbay E. Sociocultural and Religious Perspectives Toward the COVID-19 Pandemic in the Haredi Jewish Community. JOURNAL OF RELIGION AND HEALTH 2023; 62:389-407. [PMID: 36115889 PMCID: PMC9483331 DOI: 10.1007/s10943-022-01667-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/06/2022] [Indexed: 06/15/2023]
Abstract
The Haredi Jewish community is centered around its religious life and commitment to Jewish law. Understanding aspects of the community's faith, as well as Jewish history and culture, are essential in examining the social determinants of health that affected the community's perspective in its response to the COVID-19 pandemic. The American Haredi community's trajectory throughout the pandemic was marked by high caseloads early on and throughout the pandemic, and a deep yearning to return to religious life. Some community members' non-adherence to public health guidelines led to public attention and scrutiny, which led many community members to feel unfairly targeted. This exacerbated feelings of dissonance toward the medical community, which to date has led to low communal vaccination rates. We examined religious texts, along with cultural factors and historical precedencies that contributed to the Haredi response to the COVID-19 pandemic. We offer guidance as to how understanding the religious and sociocultural makeup of the Haredi community could have resulted in a more effective and engaged pandemic response and provide a framework for creating a more beneficial alliance with the community in the future.
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Affiliation(s)
| | - Ezra Gabbay
- Weill Cornell Medicine, 1300 York Ave, New York, NY, 10065, USA
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7
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Corcoran KE, Stein RE, Colyer CJ, Guthrie SK, Mackay AM. Rituals of Contagion in Closed Religious Communities: A Case Study of Amish and Mennonite Communities in the USA During the Beginning of the COVID-19 Pandemic. JOURNAL OF RELIGION AND HEALTH 2022; 61:4260-4281. [PMID: 35882764 PMCID: PMC9321298 DOI: 10.1007/s10943-022-01615-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/12/2022] [Indexed: 06/02/2023]
Abstract
At the onset of the COVID-19 pandemic, government and medical guidelines emphasized social distancing to limit exposure. These guidelines significantly impacted closed religious communities, particularly those opposed to modern technologies, such as Amish and Mennonite communities. How did these religious communities respond to COVID-19 policies in the USA? We draw data from Ohio and Pennsylvania scribe entries published in an Amish/Mennonite correspondence newspaper. While some of these communities altered church rituals to comply with government directives, others maintained communal worship without disruption. Mennonite communities were more likely to conform to guidelines.
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Affiliation(s)
- Katie E Corcoran
- Department of Sociology and Anthropology, West Virginia University, PO Box 6326, Morgantown, WV, 26506-6326, USA.
| | - Rachel E Stein
- Department of Sociology and Anthropology, West Virginia University, PO Box 6326, Morgantown, WV, 26506-6326, USA
| | - Corey J Colyer
- Department of Sociology and Anthropology, West Virginia University, PO Box 6326, Morgantown, WV, 26506-6326, USA
| | - Sara K Guthrie
- Department of Sociology and Anthropology, West Virginia University, PO Box 6326, Morgantown, WV, 26506-6326, USA
| | - Annette M Mackay
- Department of Sociology and Anthropology, West Virginia University, PO Box 6326, Morgantown, WV, 26506-6326, USA
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8
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Marye S, Spencer G. A population study of the NYS measles epidemic: Lessons learned. Public Health Nurs 2022; 39:958-964. [PMID: 35452554 DOI: 10.1111/phn.13084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 03/01/2022] [Accepted: 04/08/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES In 2019 the United States experienced the largest outbreak of measles in 27 years, 19 years after the United States declared measles eliminated. The purpose of this paper was to present a population study of a measles outbreak within Orthodox Jewish communities in New York that led to the elimination of religious exemption for school mandated vaccines. METHODS Peer reviewed articles, news media, health department, and government resources were used to investigate environmental factors that led to this outbreak. State, county, and city immunization records were accessed to explore measles compliance rates before and after policy change. RESULTS Rockland County had low compliance rates compared to the rest of the state, and the elimination of religious exemptions raised compliance rate almost to state level. In all but one affected New York City zip codes, compliance following policy change rose to 97.95%-99.15%. CONCLUSIONS Overall, changes in measles compliance rates reflect policy goals, but localized differences imply a need for more customized interventions for each unique community. Public health planning to promote vaccination should be sensitive to the concerns and perceptions of each community in order for health interventions to have a positive effect.
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Affiliation(s)
- Stacey Marye
- Decker College of Nursing and Health Sciences, Binghamton University, Binghamton, New York
| | - Gale Spencer
- Decker College of Nursing and Health Sciences, Binghamton University, Binghamton, New York
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9
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Levin J, Bradshaw M. Determinants of COVID-19 skepticism and SARS-CoV-2 vaccine hesitancy: findings from a national population survey of U.S. adults. BMC Public Health 2022; 22:1047. [PMID: 35614396 PMCID: PMC9132354 DOI: 10.1186/s12889-022-13477-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 05/17/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The enduring presence of COVID-19 skepticism and SARS-CoV-2 vaccine hesitancy is an ongoing impediment to the global response effort to the current pandemic. This study seeks to identify determinants of skepticism and vaccine hesitancy in U.S. adults. METHODS Data are from the Values and Beliefs of the American Public Survey, conducted in 2021 by the Gallup Organization in conjunction with Baylor University. The survey used stratified random probability sampling of the U.S. adult population (N = 1222). Outcome measures were respective single items assessing COVID-19 skepticism and SARS-CoV-2 vaccine hesitancy. Exposure variables included political, religious, and sociodemographic indicators, and moderators assessed personal history of COVID-19 and losing a relative or close friend to COVID-19. RESULTS Skepticism and vaccine hesitancy were strongly associated with conservative and Republican political preference and conservative religious beliefs, and less so with socioeconomic status. Personal experience with COVID-19 did not mitigate the effect of politics on skepticism and barely reduced the odds for hesitancy. Results confirm that attitudes toward COVID-19 are politically and religiously conditioned, and are especially a product of conservative political preference. CONCLUSION Skepticism about COVID-19 and hesitancy regarding SARS-CoV-2 vaccination are highest among the political and religious right. Efforts to increase immunization through public education may be inadequate; resistance appears ideological. Other solutions may need to be considered, which risk widespread pushback both politically and religiously motivated.
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Affiliation(s)
- Jeff Levin
- Baylor University, One Bear Place # 97236, Waco, TX, 76798, USA.
| | - Matt Bradshaw
- Baylor University, One Bear Place # 97236, Waco, TX, 76798, USA
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10
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Kasstan B, Mounier-Jack S, Letley L, Gaskell KM, Roberts CH, Stone NRH, Lal S, Eggo RM, Marks M, Chantler T. Localising vaccination services: Qualitative insights on public health and minority group collaborations to co-deliver coronavirus vaccines. Vaccine 2022; 40:2226-2232. [PMID: 35216844 PMCID: PMC8849863 DOI: 10.1016/j.vaccine.2022.02.056] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 02/09/2022] [Accepted: 02/13/2022] [Indexed: 01/15/2023]
Abstract
Ethnic and religious minorities have been disproportionately affected by the SARS-CoV-2 pandemic and are less likely to accept coronavirus vaccinations. Orthodox (Haredi) Jewish neighbourhoods in England experienced high incidences of SARS-CoV-2 in 2020-21 and measles outbreaks (2018-19) due to suboptimal childhood vaccination coverage. The objective of our study was to explore how the coronavirus vaccination programme (CVP) was co-delivered between public health services and an Orthodox Jewish health organisation. Methods included 28 semi-structured interviews conducted virtually with public health professionals, community welfare and religious representatives, and household members. We examined CVP delivery from the perspectives of those involved in organising services and vaccine beneficiaries. Interview data was contextualised within debates of the CVP in Orthodox (Haredi) Jewish print and social media. Thematic analysis generated five considerations: i) Prior immunisation-related collaboration with public health services carved a role for Jewish health organisations to host and promote coronavirus vaccination sessions, distribute appointments, and administer vaccines ii) Public health services maintained responsibility for training, logistics, and maintaining vaccination records; iii) The localised approach to service delivery promoted vaccination in a minority with historically suboptimal levels of coverage; iv) Co-delivery promoted trust in the CVP, though a minority of participants maintained concerns around safety; v) Provision of CVP information and stakeholders' response to situated (context-specific) challenges and concerns. Drawing on this example of CVP co-delivery, we propose that a localised approach to delivering immunisation programmes could address service provision gaps in ways that involve trusted community organisations. Localisation of vaccination services can include communication or implementation strategies, but both approaches involve consideration of investment, engagement and coordination, which are not cost-neutral. Localising vaccination services in collaboration with welfare groups raises opportunities for the on-going CVP and other immunisation programmes, and constitutes an opportunity for ethnic and religious minorities to collaborate in safeguarding community health.
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Affiliation(s)
- Ben Kasstan
- Centre for Health, Law & Society, University of Bristol Law School, Bristol BS8 1RJ, UK; Department of Sociology & Anthropology, Hebrew University of Jerusalem, Har HaTzofim, Jerusalem 91905, Israel
| | - Sandra Mounier-Jack
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Louise Letley
- Immunisation and Countermeasures, National Infection Service, Public Health England, London, UK
| | - Katherine M Gaskell
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Chrissy H Roberts
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Neil R H Stone
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK; Hospital for Tropical Diseases, University College London Hospital NHS Foundation Trust, London, UK
| | - Sham Lal
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Rosalind M Eggo
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT UK
| | - Michael Marks
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK; Hospital for Tropical Diseases, University College London Hospital NHS Foundation Trust, London, UK; Division of Infection and Immunity, University College London, London, WC1E 6BT, UK
| | - Tracey Chantler
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK.
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Walter D, Ophir Y, Lokmanoglu AD, Pruden ML. Vaccine discourse in white nationalist online communication: A mixed-methods computational approach. Soc Sci Med 2022; 298:114859. [PMID: 35276624 DOI: 10.1016/j.socscimed.2022.114859] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 01/20/2022] [Accepted: 02/22/2022] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Research has indicated a growing resistance to vaccines among U.S. conservatives and Republicans. Following past successes of the far-right in mainstreaming health misinformation, this study tracks almost two decades of vaccine discourse on the extremist, white nationalist (WN) online message-board Stormfront. We examine the argumentative repertoire around vaccines on the forum, and whether it assimilated to or challenged common arguments for and against vaccines, or extended it in ways unique to the racist WN agenda. METHODS We use a mixed-methods approach, combining unsupervised machine learning of 8892 posts including the term "vaccin*", published on Stormfront between 2001 and 2017. We supplemented the computational analysis with a manual coding of randomly sampled 500 posts, evaluating the prevalence of pro- and anti-vaccine sentiment, previously identified pro- and anti-vaccine arguments, and WN-specific arguments. RESULTS Discourse was dynamic, increasing around specific events, such as outbreaks and following legal debates about vaccine mandates. We identified four themes: conspiracies, science, race and white innovation. The prominence of themes over time was relatively stable. Our manual coding identified levels of anti-vaccine sentiment that were much higher than found in the past on mainstream social media. Most anti-vaccine posts relied on common anti-vaccine tropes and not on WN conspiracy theories. Pro-vaccination posts, however, were supported by unique race-based arguments. CONCLUSION We find a high volume of anti-vaccine sentiment among WN on Stormfront, but also identify unique pro-vaccine arguments that echo the group's racist ideology. PUBLIC HEALTH IMPLICATION As with past health-related conspiracy theories, high levels of anti-vaccine sentiment in online far-right sociotechnical information systems could threaten public health, especially if it 'spills-over' to mainstream media. Many pro-vaccine arguments on the forum relied on racist, WN reasoning, thus preventing the authors from recommending the use of these unethical arguments in future public health communications.
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12
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Karafillakis E, Van Damme P, Hendrickx G, Larson HJ. COVID-19 in Europe: new challenges for addressing vaccine hesitancy. Lancet 2022; 399:699-701. [PMID: 35123665 PMCID: PMC8813064 DOI: 10.1016/s0140-6736(22)00150-7] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 01/10/2022] [Indexed: 01/03/2023]
Affiliation(s)
- Emilie Karafillakis
- Vaccine Confidence Project, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
| | - Pierre Van Damme
- Vaccine Confidence Project (European Regional Office), University of Antwerp, Antwerp, Belgium
| | - Greet Hendrickx
- Vaccine Confidence Project (European Regional Office), University of Antwerp, Antwerp, Belgium
| | - Heidi J Larson
- Vaccine Confidence Project, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK; Vaccine Confidence Project (European Regional Office), University of Antwerp, Antwerp, Belgium.
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13
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Wang Y, Liu Y. Multilevel determinants of COVID-19 vaccination hesitancy in the United States: A rapid systematic review. Prev Med Rep 2022; 25:101673. [PMID: 34934611 PMCID: PMC8675390 DOI: 10.1016/j.pmedr.2021.101673] [Citation(s) in RCA: 60] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 11/05/2021] [Accepted: 12/12/2021] [Indexed: 01/10/2023] Open
Abstract
Vaccine hesitancy is a challenge for the success and optimal implementation of COVID-19 immunization programs in the US. The objective of this study was to summarize multilevel determinants of COVID-19 vaccination intention in the US to inform future intervention opportunities. To this end, we conducted a rapid systematic review by searching published articles via PubMed published by October 5, 2021, following the PRISMA guidelines. One hundred and six articles were included. According to nationally representative studies, the overall COVID-19 acceptance rate ranges from 53.6% to 84.4%. Individual (demographics, health history, behaviors and health beliefs), interpersonal (having a close friend/family member impacted by COVID-19), healthcare and societal level factors (healthcare provider recommendations, source/credential of COVID-19 related information, and COVID-19 related conspiracy theories) all contributed to COVID-19 vaccine hesitancy in the US. This study demonstrates that the acceptance to COVID-19 vaccines is influenced by various factors, particularly the role of healthcare providers in enhancing public intent to vaccination. Potential interventions to mitigate people's concerns over the vaccines and address vaccine-related conspiracy/misinformation from social media are also critical to encourage vaccine uptake in the US.
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Affiliation(s)
- Ying Wang
- Department of Public Health Sciences, University of Rochester Medical Center, 265 Crittenden Blvd, BOX 420644, Rochester, NY 14642, USA
| | - Yu Liu
- Department of Public Health Sciences, University of Rochester Medical Center, 265 Crittenden Blvd, BOX 420644, Rochester, NY 14642, USA
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Norhayati MN, Che Yusof R, Azman YM. Systematic Review and Meta-Analysis of COVID-19 Vaccination Acceptance. Front Med (Lausanne) 2022; 8:783982. [PMID: 35155467 PMCID: PMC8828741 DOI: 10.3389/fmed.2021.783982] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 12/28/2021] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION Vaccination is an essential intervention to curb the coronavirus disease 2019 (COVID-19) pandemic. This review aimed to estimate the pooled proportion of COVID-19 vaccine acceptance worldwide. METHODS A systematic search of the MEDLINE (PubMed) database using "COVID-19," "vaccine" and "acceptance" to obtain original research articles published between 2020 and July 2021. Only studies with full text and that were published in English were included. The Joanna Briggs Institute meta-analysis was used to assess the data quality. The meta-analysis was performed using generic inverse variance with a random-effects model using the Review Manager software. RESULTS A total of 172 studies across 50 countries worldwide were included. Subgroup analyses were performed with regard to vaccine acceptance, regions, population, gender, vaccine effectiveness, and survey time. The pooled proportion of COVID-19 vaccine acceptance was 61% (95% CI: 59, 64). It was higher in Southeast Asia, among healthcare workers, in males, for vaccines with 95% effectiveness, and during the first survey. CONCLUSION COVID-19 vaccine acceptance needs to be increased to achieve herd immunity to protect the population from the disease. It is crucial to enhance public awareness of COVID-19 vaccination and improve access to vaccines. SYSTEMATIC REVIEW REGISTRATION PROSPERO 2021, identifier CRD42021268645.
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Affiliation(s)
- Mohd Noor Norhayati
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia
| | - Ruhana Che Yusof
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia
| | - Yacob Mohd Azman
- Medical Practice Division, Ministry of Health, Federal Government Administrative Centre, Putrajaya, Malaysia
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Promoting a Culturally Adapted Policy to Deal with the COVID-19 Crisis in the Haredi Population in Israel. J Racial Ethn Health Disparities 2022; 9:2508-2517. [PMID: 34791614 PMCID: PMC8597873 DOI: 10.1007/s40615-021-01186-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 10/29/2021] [Accepted: 11/02/2021] [Indexed: 12/29/2022]
Abstract
COVID-19 has caused high morbidity and mortality in Israel but, as in other countries, not all groups were equally affected. Haredi Jews (often called ultra-Orthodox), a religious minority, were disproportionately harmed by the pandemic. This group has distinctive cultural, lifestyle, and demographic characteristics, which may be related to these higher COVID-19 rates and call for policies specifically adapted for this community. This paper describes in detail the steps the Israeli Ministry of Health (MoH) took to try to improve the quality of care and prevent morbidity in the Haredi population through working in cooperation with the leadership and members of the Haredi community and strengthening mutual trust in order to increase adherence to government regulations and recommendations. This case study is based on the unique perspective of the two people who worked in the Israeli MoH and led the initiative as well as a review of relevant government documents and statistics. It discusses to what extent the initiative seemed to have been successful and what lessons can be learned not only for Haredim but for other religious and/or minority groups and closed communities in Israel and elsewhere.
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Yasmin F, Najeeb H, Moeed A, Naeem U, Asghar MS, Chughtai NU, Yousaf Z, Seboka BT, Ullah I, Lin CY, Pakpour AH. COVID-19 Vaccine Hesitancy in the United States: A Systematic Review. Front Public Health 2021; 9:770985. [PMID: 34888288 PMCID: PMC8650625 DOI: 10.3389/fpubh.2021.770985] [Citation(s) in RCA: 160] [Impact Index Per Article: 53.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 11/01/2021] [Indexed: 11/23/2022] Open
Abstract
Vaccine hesitancy in the US throughout the pandemic has revealed inconsistent results. This systematic review has compared COVID-19 vaccine uptake across US and investigated predictors of vaccine hesitancy and acceptance across different groups. A search of PUBMED database was conducted till 17th July, 2021. Articles that met the inclusion criteria were screened and 65 studies were selected for a quantitative analysis. The overall vaccine acceptance rate ranged from 12 to 91.4%, the willingness of studies using the 10-point scale ranged from 3.58 to 5.12. Increased unwillingness toward COVID-19 vaccine and Black/African Americans were found to be correlated. Sex, race, age, education level, and income status were identified as determining factors of having a low or high COVID-19 vaccine uptake. A change in vaccine acceptance in the US population was observed in two studies, an increase of 10.8 and 7.4%, respectively, between 2020 and 2021. Our results confirm that hesitancy exists in the US population, highest in Black/African Americans, pregnant or breastfeeding women, and low in the male sex. It is imperative for regulatory bodies to acknowledge these statistics and consequently, exert efforts to mitigate the burden of unvaccinated individuals and revise vaccine delivery plans, according to different vulnerable subgroups, across the country.
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Affiliation(s)
- Farah Yasmin
- Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Hala Najeeb
- Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Abdul Moeed
- Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Unaiza Naeem
- Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | | | - Najeeb Ullah Chughtai
- Department of General Surgery, Liaquat National Hospital and Medical College, Karachi, Pakistan
| | - Zohaib Yousaf
- Department of Internal Medicine, Hamad Medical Corporation, Doha, Qatar
| | | | - Irfan Ullah
- Department of Community Medicine, Kabir Medical College, Peshawar, Pakistan
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Amir H. Pakpour
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
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