Demographic, psychological, and experiential correlates of SARS-CoV-2 vaccination intentions in a sample of Canadian families

COVID-19 vaccine acceptance and uptake among caregivers of children aged 5-11 years in Ontario, Canada: A cross-sectional survey

INTRODUCTION

Although COVID-19 vaccine safety in 5-11-year-old children has been documented, half of Ontarian children this age remain unvaccinated. This study aimed to assess caregivers' vaccine acceptance for 5-11-year-old children and identify factors associated with vaccine non-acceptance.

METHODS

A multi-language self-administered survey was sent to caregivers of 5-11-year-old children through schools and community health centers within the Greater Toronto Area from April-July 2022. Sociodemographic characteristics and immunization behaviours were collected for caregivers, their 5-11-year-old children, and any older siblings. The primary outcome, COVID-19 vaccine acceptance, was previous uptake of COVID-19 vaccine or caregiver intent to vaccinate for their 5-11-year-old child. Data were analyzed using descriptive statistics and multivariable logistic regression.

RESULTS

In total, 807 caregivers were included in analysis. Although 93 % of caregivers had received two doses of COVID-19 vaccine, 77 % had a 5-11-year-old child who received at least one dose of vaccine. Caregivers age was associated with vaccine acceptance (vs. < 40 years; adjusted odds ratio [aOR] 2.1, 95 % confidence interval [CI] 1.4-3.1 for ages 40-49; aOR 2.8, 95 % CI 1.1-7.1 for ages ≥50 years). Immunization factors associated with vaccine acceptance included caregiver COVID-19 vaccination (aOR 38.1 vs. unvaccinated caregivers; 95 % CI 15.8-92.3), older siblings COVID-19 vaccination (aOR 49.2 vs. unvaccinated siblings; 95 % CI 18.3-132.3), and recent influenza vaccination for the child (aOR 6.9 vs. no influenza vaccine; 95 % CI 4.6-10.5). Among 189 caregivers with unvaccinated 5-11-year-old children, the most common reasons for non-acceptance were concerns about long-term side effects (59 %), lack of experience vaccinating children (41 %), and concerns that vaccines were developed too quickly (39 %).

CONCLUSION

Acceptance of COVID-19 vaccination for 5-11-year-old children were associated with caregiver vaccine behaviors and sociodemographic factors. These findings highlight groups of caregivers that can be targeted for educational interventions and concerns that may be addressed to increase vaccine confidence.

COVID-19 and COVID-19 vaccination experiences and perceptions among health workers during the pandemic in Ebonyi state, Nigeria: An analytical cross-sectional study

BACKGROUND

COVID-19 continues to be a disease of global public health importance and requires long-term management and control. Health workers' (previous) experiences and perceptions regarding the COVID-19 pandemic and COVID-19 vaccination/vaccination process will influence not only their subsequent use of control measures but also public experiences/perceptions. We explored the COVID-19 and COVID-19 vaccination and the vaccination process experiences and perceptions, and their predictors, among the health workers in Ebonyi state, Nigeria.

METHODS

We conducted an online-offline analytical cross-sectional survey between March 12 and May 9, 2022 among all categories of health workers (clinical/non-clinical, public/private) working/living in Ebonyi state who consented to participate and were selected by convenience/snowballing techniques. A structured electronic questionnaire was used to collect data: self-administered via WhatsApp and interviewer-administered via KoBoCollect for participants who did not have WhatsApp. Data was analysed using descriptive statistics and bivariate/multivariate generalized linear models.

RESULTS

Of the 1276 health workers surveyed: 55.8% had strong COVID-19 experience and perception, 80.7% had good COVID-19 vaccination expectation and perception, and 87.7% had positive COVID-19 vaccination process experience and perception. The most important predictors of the extent and level of COVID-19 and COVID-19 vaccination and the vaccination process experiences and perceptions were level of place of work (primary-secondary/tertiary), level of attitude towards COVID-19 (vaccination), and level of knowledge about COVID-19. Another important predictor was place of work (public/private).

CONCLUSIONS

The evidence indicate the factors that should guide subsequent policy actions in the strategies to enhance the COVID-19 and COVID-19 vaccination and the vaccination process experiences and perceptions of health workers (and their use of control measures) in Ebonyi state, Nigeria, and other similar contexts. It also indicate factors to be considered by future policy actions regarding similar diseases.

COVID-19 and COVID-19 vaccination experiences and perceptions and their predictors among community members during the COVID-19 pandemic in Ebonyi state, Nigeria: an analytical cross-sectional study

BACKGROUND

COVID-19 is still a disease of global public health importance which requires long term application of control measures as millions of new infections or re-infections and thousands of related deaths still occur worldwide and the risk of an upsurge from new strains of the virus continues to be a threat. The decrease in the use of and non-use of preventive public health measures are among the factors fuelling the disease. The (previous) experiences and perceptions of people regarding the COVID-19 pandemic, COVID-19 vaccination, and the vaccination process are factors that will influence subsequent use of preventive/control measures. We explored the COVID-19 and COVID-19 vaccination and the vaccination process experiences and perceptions, and their predictors, among the community members in Ebonyi state, Nigeria.

METHODS

We conducted an analytical cross-sectional study between March 12 and May 9, 2022 among all consenting/assenting community members aged 15 years and above in 28 randomly selected geographical clusters. A structured interviewer-administered electronic questionnaire in KoBoCollect installed in android devices was used to collect data which was analysed using descriptive statistics and bivariate and multivariate generalized estimating equations.

RESULTS

Of the 10,825 community members surveyed: only 31.6% had strong COVID-19 experience and perception, 72.2% had good COVID-19 vaccination expectation and perception, and only 54.2% had positive COVID-19 vaccination process experience and perception. The most important predictors of the extent/level of COVID-19 and COVID-19 vaccination and the vaccination process experiences and perceptions were level of attitude towards COVID-19 and COVID-19 vaccination and level of knowledge about COVID-19. Other important predictors were marital status, educational level, and main occupation.

CONCLUSIONS

This study's evidence, including the identified predictors, will inform subsequent policy actions regarding COVID-19 in the strategies to improve the COVID-19 and COVID-19 vaccination and the vaccination process experiences and perceptions of community members (and their use of preventive/control measures) in Ebonyi state and Nigeria, and other similar contexts. It will also inform future policy actions/strategies regarding similar diseases.

Ideological differences in COVID-19 vaccine intention: the effects of trust in the healthcare system, in complementary and alternative medicine, and perceived threat from the disease

Introduction

Politically left-leaning individuals are more likely to get vaccinated against COVID-19, although little is known about the mechanisms underlying the ideological differences in vaccination intentions. Understanding the extent to which trust in the healthcare system, in complementary and alternative medicine, and the perceived threat from the disease contribute to these disparities is crucial, as it could inform targeted interventions to address vaccine hesitancy across the political spectrum.

Methods

The present cross-sectional study conducted among adults living in Slovenia (n = 858) examined the mediating role of trust in the healthcare system, trust in complementary and alternative medicine (CAM), and the perceived threat from the virus on COVID-19 vaccination intention.

Results

We found that leftist ideology and trust in the healthcare system positively predicted vaccination intention, whereas CAM negatively predicted this intention. In addition, left-leaning individuals expressed greater trust in the healthcare system and lower trust in CAM, resulting in higher levels of COVID-19 vaccination intention. The serial mediation model confirmed that trust in CAM was a negative predictor, while trust in the healthcare system positively predicted perceived threat.

Discussion

When dealing with vaccine hesitancy among right-oriented individuals, strategies should focus on enhancing trust in the healthcare system and critically evaluating the reliance on CAM.

COVID-19 vaccination acceptance (uptake, hesitancy, intention to receive and timeliness of the intention to receive) and the determinants among health workers in Ebonyi state, Nigeria: an analytical cross-sectional study

OBJECTIVES

Health workers are at particular risk of contracting the COVID-19. However, non-acceptance of COVID-19 vaccination has been a noticeable challenge the world over and in Nigeria where supply constraints have also been an issue. We evaluated COVID-19 vaccination acceptance (the uptake, hesitancy, intention to receive and timeliness of the intention to receive) and the determinants, and the predictive power of acceptance factor compared with availability/access factor, among health workers in Ebonyi state.

METHODS

We conducted an online-offline survey, between 12 March 2022 and 9 May 2022, among all consenting health workers (clinical/non-clinical, public/private) working/living in Ebonyi state and who were selected by convenience and snowballing techniques. Data were collected using structured self-administered questionnaire distributed via WhatsApp and interviewer-administered questionnaire in KoBoCollect installed in android devices. Data were analysed using descriptive statistics and generalised linear models.

RESULTS

1276 health workers were surveyed. Uptake was 68.2% vaccinated, 47.4% fully vaccinated and 20.9% partially vaccinated. Hesitancy was 22.6% or 71.2% among the unvaccinated (76.3% of hesitancy due to refusal and 23.7% to delay). Intention to receive was 36.0% of which 55.1% gave the intended time (days) to receive with a median (IQR) of 30 days (7-133). The strongest and most important predictor of COVID-19 vaccination acceptance was COVID-19 vaccination expectations and perceptions. Other important predictors were COVID-19/COVID-19 vaccination process experiences and perceptions. Acceptance factor was a stronger predictor compared with availability/access factor.

CONCLUSION

The slow pace of COVID-19 vaccination coverage among the health workers in Ebonyi state/Nigeria may encounter a bottle-neck due to the high refusal rate among the unvaccinated. COVID-19 vaccination policy interventions in Nigeria and other similar settings should, in addition to sustaining availability and access, prioritise improvement of COVID-19 vaccination expectations and perceptions (regarding importance/safety/effectiveness) and COVID-19 risk communication among the health workers.

TRIAL REGISTRATION NUMBER

ISRCTN16735844.

Parents' perspectives on SARS-CoV-2 vaccinations for children: a qualitative analysis

BACKGROUND

Uptake of the SARS-CoV-2 vaccine for children aged 5-11 years has been lower than anticipated in Canada. Although research has explored parental intentions toward SARS-CoV-2 vaccination for children, parental decisions regarding vaccinations have not been studied in-depth. We sought to explore reasons why parents chose to vaccinate or not vaccinate their children against SARS-CoV-2 to better understand their decisions.

METHODS

We conducted a qualitative study involving in-depth individual interviews with a purposive sample of parents in the Greater Toronto Area, Ontario, Canada. We conducted interviews via telephone or video call from February to April 2022 and analyzed the data using reflexive thematic analysis.

RESULTS

We interviewed 20 parents. We found that parental attitudes toward SARS-CoV-2 vaccinations for their children represented a complex continuum of concern. We identified 4 cross-cutting themes: the newness of SARS-CoV-2 vaccines and the evidence supporting their use; the perceived politicization of guidance for SARS-CoV-2 vaccination; the social pressure surrounding SARS-CoV-2 vaccinations; and the weighing of individual versus collective benefits of vaccination. Parents found making a decision about vaccinating their child challenging and expressed difficulty sourcing and evaluating evidence, determining the trustworthiness of guidance, and balancing their own conceptions of health care decisions with societal expectations and political messaging.

INTERPRETATION

Parents' experiences making decisions regarding SARS-CoV-2 vaccination for their children were complex, even for those who were supportive of SARS-CoV-2 vaccinations. These findings provide some explanation for the current patterns of uptake of SARS-CoV-2 vaccination among children in Canada; health care providers and public health authorities can consider these insights when planning future vaccine rollouts.

Israeli parents` views on coronavirus (COVID-19) vaccinations for children: A cross-sectional study

BACKGROUND

Parents play the decisive role in children's vaccination. Our study aimed as assessing attitudes of parents toward the COVID-19 vaccine for children aged 5-18 and to define sources of influence on these attitudes, the barriers and reasons for hesitation.

METHODS

In this cross-sectional study, 138 Israeli parents of 5-18 aged children completed a self-administered structured questionnaire.

FINDINGS

More than a quarter of parents reported that they did not intend to vaccinate their children. Independent of other demographic characteristics, parents who do not vaccinate their children accordingly to the routine vaccinations have five-fold significant odds not to vaccinate with COVID-19 vaccine (OR = 4.8, 95% CI: 1.8-12.7). Greater social influence was significantly and negatively associated with intentions not to vaccinate a child. Among parents who do not intend to vaccinate their children, the most frequent reasons were fear of possible side effects (92%), vaccine novelty (92%) and lack of belief in its effectiveness (69%).

DISCUSSION

This study found that vaccination in the past as part of routine government immunization programs predict a tendency to vaccinate children during the pandemic. Among the factors associated with the intention not to vaccinate, concerns and uncertainty about the necessity of the vaccine, its side effects and reliability have been emphasized.

APPLICATION TO PRACTICE

Cultural-religious adjustments should be applied when implementing interventions aiming to promote vaccination in routines and emergencies. Social influence is important in adopting a positive attitude toward vaccines. Public health professionals should incorporate those parents who have vaccinated their children and have a positive attitude toward vaccination.

Influence of COVID-19 vaccination on the dynamics of new infected cases in the world

The initial COVID-19 vaccinations were created and distributed to the general population in 2020 thanks to emergency authorization and conditional approval. Consequently, numerous countries followed the process that is currently a global campaign. Taking into account the fact that people are being vaccinated, there are concerns about the effectiveness of that medical solution. Actually, this study is the first one focusing on how the number of vaccinated people might influence the spread of the pandemic in the world. From the Global Change Data Lab "Our World in Data", we were able to get data sets about the number of new cases and vaccinated people. This study is a longitudinal one from 14/12/2020 to 21/03/2021. In addition, we computed Generalized log-Linear Model on count time series (Negative Binomial distribution due to over dispersion in data) and implemented validation tests to confirm the robustness of our results. The findings revealed that when the number of vaccinated people increases by one new vaccination on a given day, the number of new cases decreases significantly two days after by one. The influence is not notable on the same day of vaccination. Authorities should increase the vaccination campaign to control well the pandemic. That solution has effectively started to reduce the spread of COVID-19 in the world.

COVID-19 vaccination acceptance among community members and health workers in Ebonyi state, Nigeria: study protocol for a concurrent-independent mixed method analyses of intention to receive, timeliness of the intention to receive, uptake and hesitancy to COVID-19 vaccination and the determinants

INTRODUCTION

The COVID-19 pandemic has gravely affected the lives and economies of the global population including Nigeria. The attainment of herd immunity through mass COVID-19 vaccination is the foremost control strategy, however, the deployments of COVID-19 vaccinations are facing challenges of non-acceptance. Despite the efforts of the Nigerian government and COVAX facility in making COVID-19 vaccination more available/accessible, the vaccination rate remains unexpectedly very low in Nigeria/Ebonyi state. Therefore, it is important to investigate the acceptability of COVID-19 vaccination to elucidate the explanations for the very low coverage rate. This study aims to evaluate/explore COVID-19 vaccination acceptance and the determinants among community members and health workers in Ebonyi state, Nigeria.

METHODS AND ANALYSES

The study is an analytical cross-sectional survey with a concurrent-independent mixed method design. Quantitative data will be collected from all consenting/assenting community members aged 15 years and above, in 28 randomly selected geographical clusters, through structured interviewer-administered questionnaire household survey using KoBoCollect installed in android devices. Quantitative data will be collected from all consenting health workers, selected via convenience and snowball techniques, through structured self-administered questionnaire survey distributed via WhatsApp and interviewer-administered survey using KoBoCollect installed in android devices. Qualitative data will be collected from purposively selected community members and health workers through focus group discussions. Quantitative analyses will involve descriptive statistics, generalised estimating equations (for community members data) and generalised linear model (for health workers data). Qualitative analyses will employ the thematic approach.

ETHICS AND DISSEMINATION

Ethical approval for this study was obtained from the Ebonyi State Health Research and Ethics Committee (EBSHREC/15/01/2022-02/01/2023) and Research and Ethics Committee of Alex Ekwueme Federal University Teaching Hospital Abakaliki (14/12/2021-17/02/2022), and verbal consent will be obtained from participants. Study findings will be reported at local, national and international levels as appropriate.

TRIAL REGISTRATION NUMBER

ISRCTN16735844.

Correlates and Patterns of COVID-19 Vaccination Intentions among Parents of Children with Type 1 Diabetes

Objective

To examine psychosocial, sociodemographic, medical, and coronavirus disease 2019 (COVID-19) experiences as correlates of COVID-19 vaccination intentions among parents of children with type 1 diabetes (T1D).

Methods

121 parents of children with T1D (Mchild age = 7.78 ± 1.70; MA1c = 8.3% ± 1.5%) in the mid-Atlantic and Southwest regions completed self-report measures in February to March 2021.

Results

Parents’ general vaccination behaviors and attitudes were associated with COVID-19 vaccination intentions. Child insurance type and social distancing adherence were associated with vaccination intention in the Southwest site. Higher A1c was associated with lower intention. Vaccine safety was the top reported concern.

Conclusions

COVID-19 vaccination intentions are important to address in parents of youth with health conditions.

Understanding national trends in COVID-19 vaccine hesitancy in Canada: results from five sequential cross-sectional representative surveys spanning April 2020-March 2021

OBJECTIVE

To examine rates of vaccine hesitancy and their correlates among Canadian adults between April 2020 and March 2021.

DESIGN

Five sequential cross-sectional age, sex and province-weighted population-based samples who completed online surveys.

SETTING

Canada.

PARTICIPANTS

A total of 15 019 Canadians aged 18 years and over were recruited through a recognised polling firm (Leger Opinion). Respondents were 51.5% female with a mean age of 48.1 (SD 17.2) years (range 18-95 years) and predominantly white (80.8%).

PRIMARY AND SECONDARY OUTCOME MEASURES

Rates of vaccine hesitancy over the five surveys (time points) and their sociodemographic, clinical and psychological correlates.

RESULTS

A total of 42.2% of respondents reported some degree of vaccine hesitancy, which was lowest during surveys 1 (April 2020) and 5 (March 2021) and highest during survey 3 (November 2020). Fully adjusted multivariate logistic regression analyses revealed that women, those aged 50 and younger, non-white, those with high school education or less, and those with annual household incomes below the poverty line in Canada were significantly more likely to report vaccine hesitancy, as were essential and healthcare workers, parents of children under the age of 18 and those who do not get regular influenza vaccines. Endorsing prevention behaviours as important for reducing virus transmission and high COVID-19 health concerns were associated with 77% and 54% reduction in vaccine hesitancy, respectively. Having high personal financial concerns was associated with 1.33 times increased odds of vaccine hesitancy.

CONCLUSIONS

Results highlight the importance of targeting vaccine efforts to specific groups by emphasising the outsized health benefits compared with risks of vaccination. Future research should monitor changes in vaccine intentions and behaviour to better understand underlying factors.

Using human-centred design to tackle COVID-19 vaccine hesitancy for children and youth: a protocol for a mixed-methods study in Montreal, Canada

INTRODUCTION

To successfully combat COVID-19 vaccine hesitancy and increase uptake, research has demonstrated that interventions are most effective when tailored to meet local needs through active engagement and co-development with communities. This mixed-methods project uses a human-centred design (HCD) approach to understand local perspectives of COVID-19 vaccine hesitancy and develop strategies to enhance vaccine confidence for children and adolescents.

METHODS AND ANALYSIS

Project ECHO (Étude Communautaire sur l'Hésitation vaccinale contre la COVID-19) combines population-based surveys of parents and adolescents with community-based participatory action research to design and pilot strategies to enhance COVID-19 vaccine confidence in two underserved and ethnoculturally diverse neighbourhoods of Montreal, Canada. Two surveys conducted 6 months apart through primary and secondary schools are used to monitor vaccine acceptance and its social determinants among children and youth. Analyses of survey data include descriptive and inferential statistical approaches. Community-led design teams of parents and youth from the two participating neighbourhoods, supported by academic researchers, design thinking experts and community partners, use an HCD approach to: (1) gather data to understand COVID-19 vaccine decision-making among parents and youth in their community and frame a design challenge (inspiration phase); (2) develop an intervention to address the design challenge (ideation phase) and (3) pilot the intervention (implementation phase). Strategies to evaluate the community-led interventions will be co-developed during the implementation phase.

ETHICS AND DISSEMINATION

This study has been approved by the research ethics boards of the Sainte-Justine University Hospital Centre and the University of Montreal. Community design teams will be involved in the dissemination of findings and the design of knowledge translation initiatives that foster dialogue related to COVID-19 vaccination for children and adolescents among community, school and public health stakeholders. Findings will be disseminated through peer-reviewed publications, conference presentations, community forums, policy briefs, and social media content.

How Implicit Attitudes toward Vaccination Affect Vaccine Hesitancy and Behaviour: Developing and Validating the V-IRAP

Vaccination is one of the most important ways of fighting infectious diseases, such as COVID-19. However, vaccine hesitancy and refusal can reduce adherence to vaccination campaigns, and therefore undermine their effectiveness. Although the scientific community has made great efforts to understand the psychological causes of vaccine hesitancy, studies on vaccine intention have usually relied on traditional detection techniques, such as questionnaires. Probing these constructs explicitly could be problematic due to defense mechanisms or social desirability. Thus, a measure capable of detecting implicit attitudes towards vaccination is needed. To achieve this aim, we designed and validated a new test called the Vaccine-IRAP, or V-IRAP, which is a modified version of the original Implicit Relational Assessment Procedure, or IRAP, task. The V-IRAP allows the unspoken reasons behind vaccine hesitancy to be investigated, and is able to distinguish between positive and negative beliefs on vaccination. The test was assessed in a sample of 151 participants. The V-IRAP showed good internal reliability and convergent validity, with meaningful correlational patterns with explicit measures. Moreover, it revealed incremental validity over such explicit measures. Lastly, the V-IRAP was able to shed light on the implicit attitudes involved in vaccine refusal, revealing negative attitudes relative to vaccine-related risks in non-vaccinated participants. Overall, these results support V-IRAP as a sensitive and reliable tool that could be used in future studies on implicit attitudes toward vaccination.

Parents' intention for their children to receive COVID-19 vaccine: Implications for vaccination program in Macao

INTRODUCTION

The decision about vaccinating children is subject to their parents' decision. To inform strategies that support full vaccination coverage, it is important to understand the parents' vaccination attitude and tendency to act. This study aims to investigate the intention and the factors affecting parents' decision-making about vaccinating their children.

METHODS

A cross-sectional, self-administered online questionnaire was completed by parents of children aged 3-12 yeas in Macao between 7 March and 17 April 2022. The survey tool was informed by the Theory of Planned Behavior (TPB) which composes of the variable "intention" and three TPB constructs (Attitude, Subjective Norm, and Perceived Behavioral Control). Respondents rated their level of agreement on the construct statements using a 5-point Likert scale. Multiple linear regression analysis was used to determine if the TPB constructs were predictors of parents' intention.

RESULTS

A total of 1,217 parents completed the questionnaire. The majority of participants were mothers (83.2%), aged 31-40 years (62.7%), having two or more children (74.1%), had at least one dose of COVID-19 vaccine (84.4%) and considered themselves knowledgeable about the vaccine (62.1%), all of which were significantly associated with the intention to vaccinate their children (all p < 0.05). Their intention varied from negative (19.1%), neutral (38.4%) to positive (42.5%). Respondents were mostly concerned about the serious side effects that the COVID-19 vaccine (mean = 3.96 ± 1.23), highly acknowledged the expectation by the school (mean = 3.94 ± 1.15) and the community (mean = 3.90 ± 1.19) of children vaccination, and rated highly the ease of making necessary arrangement (mean = 3.93 ± 1.25). In the multiple linear regression model which explained 63.5% of the variance in the intention-to-vaccinate their children, only Attitude (B = 0.52, p < 0.001) and Subjective Norm (B = 0.39, p < 0.001) were identified as strong predictors. The major reasons for not having intention were safety concerns (n = 646/699, 92.4%). Participants' most trusted local information sources were doctors (n = 682), government (n = 426) and healthcare professional organizations (n = 416).

CONCLUSIONS

Vaccinating children with COVID-19 vaccine is a complex decision-making for parents. A key to a successful COVID-19 vaccination program is effective communication about the safety profile and the usage experiences warranting the integration of reliable information sources across different healthcare sectors.

Social inequalities in COVID-19 vaccine acceptance and uptake for children and adolescents in Montreal, Canada

Background

The success of current and prospective COVID-19 vaccine campaigns for children and adolescents will in part depend on the willingness of parents to accept vaccination. This study examined social determinants of parental COVID-19 vaccine acceptance and uptake for children and adolescents.

Methods

We used cross-sectional data from an ongoing COVID-19 cohort study in Montreal, Canada and included all parents of 2 to 18-year-olds who completed an online questionnaire between May 18 and June 26, 2021 (n = 809). We calculated child age-adjusted prevalence estimates of vaccine acceptance by parental education, race/ethnicity, birthplace, household income, and neighbourhood, and used multinomial logistic regression to estimate adjusted prevalence differences (aPD) and ratios (aPR). Social determinants of vaccine uptake were examined for the vaccine-eligible sample of 12 to 18 year-olds (n = 306).

Results

Intention to vaccinate children against COVID-19 was high, with only 12.4% of parents unlikely to have their child vaccinated. Parents with younger children were less likely to accept vaccination, as were those from lower-income households, racialized groups, and those born outside Canada. Children from households with annual incomes <$100,000 had 18.4 percent lower prevalence of being vaccinated/very likely vaccinated compared to household incomes ≥$150,000 (95% CI: 10.1 to 26.7). Racialized parents reported greater unwillingness to vaccinate vs. White parents (aPD = 10.3; 95% CI: 1.5, 19.1). Vaccine-eligible adolescents from the most deprived neighbourhood were half as likely to be vaccinated compared to those from the least deprived neighbourhood (aPR = 0.48; 95% CI: 0.18 to 0.77).

Interpretation.

This study identified marked social inequalities in COVID-19 vaccine acceptance and uptake for children and adolescents. Efforts are needed to reach disadvantaged and marginalized populations with tailored strategies that promote informed decision making and facilitate access to vaccination.

Predictive Modeling of Vaccination Uptake in US Counties: A Machine Learning-Based Approach

BACKGROUND

Although the COVID-19 pandemic has left an unprecedented impact worldwide, countries such as the United States have reported the most substantial incidence of COVID-19 cases worldwide. Within the United States, various sociodemographic factors have played a role in the creation of regional disparities. Regional disparities have resulted in the unequal spread of disease between US counties, underscoring the need for efficient and accurate predictive modeling strategies to inform public health officials and reduce the burden on health care systems. Furthermore, despite the widespread accessibility of COVID-19 vaccines across the United States, vaccination rates have become stagnant, necessitating predictive modeling to identify important factors impacting vaccination uptake.

OBJECTIVE

This study aims to determine the association between sociodemographic factors and vaccine uptake across counties in the United States.

METHODS

Sociodemographic data on fully vaccinated and unvaccinated individuals were sourced from several online databases such as the US Centers for Disease Control and Prevention and the US Census Bureau COVID-19 Site. Machine learning analysis was performed using XGBoost and sociodemographic data.

RESULTS

Our model predicted COVID-19 vaccination uptake across US counties with 62% accuracy. In addition, it identified location, education, ethnicity, income, and household access to the internet as the most critical sociodemographic features in predicting vaccination uptake in US counties. Lastly, the model produced a choropleth demonstrating areas of low and high vaccination rates, which can be used by health care authorities in future pandemics to visualize and prioritize areas of low vaccination and design targeted vaccination campaigns.

CONCLUSIONS

Our study reveals that sociodemographic characteristics are predictors of vaccine uptake rates across counties in the United States and, if leveraged appropriately, can assist policy makers and public health officials to understand vaccine uptake rates and craft policies to improve them.

COVID-19 vaccination acceptability in the UK at the start of the vaccination programme: a nationally representative cross-sectional survey (CoVAccS - wave 2)

Objectives

Investigate factors associated with the intention to have the COVID-19 vaccination following initiation of the UK national vaccination programme.

Study design

An online cross-sectional survey completed by 1500 adults (13th–15th January 2021).

Methods

Linear regression analyses were used to investigate associations between intention to be vaccinated for COVID-19 and sociodemographic factors, previous influenza vaccination, attitudes and beliefs about COVID-19 and COVID-19 vaccination and vaccination in general. Participants’ main reasons for likely vaccination (non-)uptake were also solicited.

Results

73.5% of participants (95% CI 71.2%, 75.7%) reported being likely to be vaccinated against COVID-19, 17.3% (95% CI 15.4%, 19.3%) were unsure, and 9.3% (95% CI 7.9%, 10.8%) reported being unlikely to be vaccinated. The full regression model explained 69.8% of the variance in intention. Intention was associated with: having been/intending to be vaccinated for influenza last winter/this winter; stronger beliefs about social acceptability of a COVID-19 vaccine; the perceived need for vaccination; adequacy of information about the vaccine; and weaker beliefs that the vaccine is unsafe. Beliefs that only those at serious risk of illness should be vaccinated and that the vaccines are just a means for manufacturers to make money were negatively associated with vaccination intention.

Conclusions

Most participants reported being likely to get the COVID-19 vaccination. COVID-19 vaccination attitudes and beliefs are a crucial factor underpinning vaccine intention. Continued engagement with the public with a focus on the importance and safety of vaccination is recommended.

Canadian parents' perceptions of COVID-19 vaccination and intention to vaccinate their children: Results from a cross-sectional national survey

Background

Vaccinating children (≤17 years old) is important for controlling the COVID-19 pandemic. As parents are primary decision makers for their children, we aimed to assess parents’ perceptions and intentions regarding COVID-19 vaccination for their children, including for some underserved populations (e.g., newcomers, Indigenous peoples, and visible minority groups).

Methods

We conducted a cross-sectional national survey of Canadian parents in December 2020, just as COVID-19 vaccines were approved for adults, to assess intention to vaccinate their children (aged 0-17 years) against COVID-19, perceptions of COVID-19 disease and vaccines, previous uptake of influenza and routine vaccines, and sociodemographic characteristics. Binomial logistic regression was used to assess the association between parents' COVID-19 vaccination intention for their children and exposure variables.

Results

Sixty-three percent of parents (1074/1702) intended to vaccinate their children against COVID-19. Those employed part-time (compared to full-time) had lower intention to vaccinate their children (aOR=1.73, 95% CI: 1.06-2.84), while those who spoke languages other than English, French, or Indigenous languages were less likely to have low intention (aOR=0.55, 95% CI: 0.32-0.92). Low vaccination intention was also associated with children not receiving influenza vaccine pre-pandemic (aOR=1.51, 95% CI: 1.04-2.21), parents having low intention to vaccinate themselves against COVID-19 (aOR=9.22, 95% CI: 6.43-13.34), believing COVID-19 vaccination is unnecessary (aOR=2.59, 95% CI: 1.72-3.91) or unsafe (aOR=4.21, 95% CI: 2.96-5.99), and opposing COVID-19 vaccine use in children without prior testing (aOR=3.09, 95% CI: 1.87-5.24).

Interpretation

Parents’ COVID-19 vaccination intentions for their children are better predicted by previous decisions regarding influenza vaccination than routine childhood vaccines, and other perceptions of COVID-19 vaccine-related factors. Public communication should highlight the safety and necessity of COVID-19 vaccination in children to support a return to normal activities. Further research should assess actual COVID-19 vaccination uptake in children, particularly for underserved populations.

COVID-19 Vaccine Hesitancy in Delaware's Underserved Communities

BACKGROUND AND OBJECTIVE

Vaccine hesitancy may be one of the greatest challenges to conquering the COVID-19 pandemic. Underserved communities across the U.S. have been suffering from the pandemic in unique ways, and vaccine hesitancy may exacerbate or prolong these issues. However, the prevalence of vaccine uptake and hesitancy in these vulnerable populations is unknown. The present study aimed to investigate: (1) prevalence of COVID vaccine uptake and COVID vaccine hesitancy in Delaware's underserved communities; (2) factors (i.e., demographic, socioeconomic characteristics, as well as COVID-related behaviors) associated with vaccine hesitancy; and (3) specific concerns about COVID vaccines.

MATERIALS AND METHODS

Data were extracted from a survey conducted in Delaware's underserved communities from March 4, 2021 to May 25, 2021. Logistic regression analyses were used to assess factors associated with vaccine hesitancy.

RESULTS

Results from our survey indicated that vaccine uptake is lower in Delaware's underserved communities than Delaware overall and the national average. In addition, a considerable proportion of participants were categorized as vaccine hesitant. We also found that being black increased the likelihood of vaccine hesitancy for the COVID-19 vaccine, which is consistent with prior studies on vaccine hesitancy. Results also indicated that having been tested for COVID in the past decreased the odds of vaccine hesitancy. However, we did not find that demographic or socioeconomic characteristics played a role in vaccine hesitancy in Delaware's underserved communities.

CONCLUSION AND RELEVANCE

Our study represents a critial first step in understanding the determinants driving COVID vaccine uptake and hesitancy. Identifying key factors and causes for vaccine hesitancy may help in establishing novel strategies that counteract low vaccination rates in underserved communities.

Factors Affecting Hesitancy to mRNA and Viral Vector COVID-19 Vaccines among College Students in Italy

Vaccine hesitancy (VH) may be significant in jeopardizing efforts to mass containment of COVID-19. A cross-sectional survey was carried out on a sample of 2667 Italian college students, before the COVID-19 vaccines became available for this age group (from 7 May to 31 May 2021). An online survey was created to obtain information about socio-demographic, health-related, and psychological factors linked to mRNA and viral vector COVID-19 vaccines. Statistically significant higher VH (30.4%) and vaccine resistance (12.2%) rates were found for viral vector than mRNA COVID-19 vaccines (7.2% and 1.0%, respectively; p < 0.001). Factors related to viral vector VH were partially different from those related to mRNA VH. Students with greater endorsement on conspiracy statements and negative attitudes toward the vaccine had higher odds of being vaccine-hesitant or -resistant. Students who had received a previous COVID-19 test and who scored higher on the agreeableness personality dimension had lower odds to be vaccine-hesitant or -resistant. The willingness to choose the vaccine was related to the viral vector but not to the mRNA VH. Taking into consideration the factors involved in vaccine hesitancy/resistance in college students could represent a key public health strategy to increase vaccine coverage and reduce viral spreading.