Public trust, information sources and vaccine willingness related to the COVID-19 pandemic in Trinidad and Tobago: an online cross-sectional survey

Social media influence on COVID-19 vaccine perceptions among University students: a Malawi case study

INTRODUCTION

The global fight against the COVID-19 pandemic relies significantly on vaccination. The collective international effort has been massive, but the pace of vaccination finds hindrance due to supply and vaccine hesitancy factors. Understanding public perceptions, especially through the lens of social media, is important. This study investigates the influence of social media on COVID-19 vaccine perceptions among university students in Malawi.

METHODS

The study utilized a quantitative methodology and employed a cross-sectional study design to explore the relationship between social media dynamics and COVID-19 vaccine perceptions among 382 randomly sampled students at MUBAS. Data, collected by use of a Likert-scale questionnaire, was analyzed using IBM SPSS 20 for descriptive statistics and Pearson correlation tests.

RESULTS

The findings reveal crucial correlations. Specifically, trust in online vaccine information shows a positive correlation (r = 0.296, p < 0.01) with active engagement in social media discussions. Conversely, a negative correlation surfaces concerning individuals' reactions to vaccine availability in Malawi (r = -0.026, p > 0.05). The demographic overview highlights the prevalence of the 16 to 30 age group, representing 92.9% of respondents.

CONCLUSIONS

The identified correlations emphasize the need for careful communication strategies tailored to combat misinformation and enhance vaccine acceptance among the younger demographic in Malawi. The positive correlation between trust in online vaccine information and social media engagement underscores digital platforms' potential for disseminating accurate information. Conversely, the negative correlation with vaccine availability reactions suggest the presence of complex factors shaping public perceptions.

Fighting the infodemic: the 4 i Framework for Advancing Communication and Trust

BACKGROUND

The proliferation of false and misleading health claims poses a major threat to public health. This ongoing "infodemic" has prompted numerous organizations to develop tools and approaches to manage the spread of falsehoods and communicate more effectively in an environment of mistrust and misleading information. However, these tools and approaches have not been systematically characterized, limiting their utility. This analysis provides a characterization of the current ecosystem of infodemic management strategies, allowing public health practitioners, communicators, researchers, and policy makers to gain an understanding of the tools at their disposal.

METHODS

A multi-pronged search strategy was used to identify tools and approaches for combatting health-related misinformation and disinformation. The search strategy included a scoping review of academic literature; a review of gray literature from organizations involved in public health communications and misinformation/disinformation management; and a review of policies and infodemic management approaches from all U.S. state health departments and select local health departments. A team of annotators labelled the main feature(s) of each tool or approach using an iteratively developed list of tags.

RESULTS

We identified over 350 infodemic management tools and approaches. We introduce the 4 i Framework for Advancing Communication and Trust (4 i FACT), a modified social-ecological model, to characterize different levels of infodemic intervention: informational, individual, interpersonal, and institutional. Information-level strategies included those designed to amplify factual information, fill information voids, debunk false information, track circulating information, and verify, detect, or rate the credibility of information. Individual-level strategies included those designed to enhance information literacy and prebunking/inoculation tools. Strategies at the interpersonal/community level included resources for public health communicators and community engagement approaches. Institutional and structural approaches included resources for journalists and fact checkers, tools for managing academic/scientific literature, resources for infodemic researchers/research, resources for infodemic managers, social media regulation, and policy/legislation.

CONCLUSIONS

The 4 i FACT provides a useful way to characterize the current ecosystem of infodemic management strategies. Recognizing the complex and multifaceted nature of the ongoing infodemic, efforts should be taken to utilize and integrate strategies across all four levels of the modified social-ecological model.

Let's talk about COVID-19 vaccination: Relevance of conversations about COVID-19 vaccination and information sources on vaccination intention in Switzerland

BACKGROUND

COVID-19 vaccine hesitancy is known to be more pronounced among young people. However, there are a lack of studies examining determinants of COVID-19 vaccination intention in the general population in this young age-group in Switzerland, and in particular, studies investigating the influence of information sources and social networks on vaccination intention are missing.

METHODS

The cross-sectional study "COVIDisc - Discussion with young people about the corona pandemic" provided the opportunity to investigate COVID-19 vaccination intention in 893 individuals aged 15-34 years from the cantons of Zurich, Thurgau, and Ticino in Switzerland. An online survey was administered between 10 November 2020 and 5 January 2021. Associations of public information sources and conversations about COVID-19 with COVID-19 vaccination intention were analyzed with multivariable logistic regression and mediation analysis using generalized structural equation modeling.

RESULTS

51.5% of the participants intended or probably intended to get vaccinated once the vaccine would be available. Using print or online news (AOR 1.50, 95% CI 1.09-2.07) as an information source and having conversations about the COVID-19 vaccine (AOR 2.09, 95% CI 1.52-2.87) increased participants' COVID-19 vaccination intention. The effects of female gender (b = -0.267, p = 0.039) and risk perception (b = 0.163, p = 0.028) were partially mediated by having conversations about the COVID-19 vaccine. The effects of age (b = -0.036, p = 0.016), secondary educational level (b = 0.541, p = 0.010) and tertiary educational level (b = 0.726, p = 0.006) were fully mediated via having conversations about the COVID-19 vaccine.

CONCLUSIONS

Conversations and campaigns should start even before vaccines become available. Our data support interventions for young women and less educated people using social norms and supporting information seeking with news. Trust and risk perceptions are essential foundations for vaccine intentions.

COVID-19 Vaccine Hesitancy in Trinidad and Tobago: A Qualitative Study

Background After three years of COVID-19, the WHO declared that the pandemic was no longer a global health emergency. Vaccination remains part of the management strategy, given the current phase of the pandemic. This study explored the reasons for COVID-19 vaccine hesitancy in Trinidad and Tobago (TT). Methodology A qualitative study of persons 18 years and over from the eastern, northwest, northcentral, and southwestern geographical areas of TT, who are unvaccinated and hesitant, was done by convenience sampling. Formal in-depth virtual interviews were done on a one-to-one basis using a semi-structured questionnaire. The interviews were recorded and transcribed using the principles of reflexive thematic analysis of participants' responses.  Results From 25 participants' responses, the main themes for being vaccine-hesitant were fear, inefficacy, information inadequacy, perceived susceptibility, mistrust, herbal alternatives, and religious hesitations. Additionally, their motivations for receiving the vaccine in the future were surrounded by themes of necessity, perceived susceptibility, health benchmark, and assurance. Conclusion and recommendations This qualitative investigation identified traditional factors contributing to COVID-19 vaccine hesitancy and unique determinants such as herbal use and religious beliefs within the TT context. These insights could inform future research and facilitate the development of tailored strategies to address persistent vaccine hesitancy for COVID-19.

COVID-19 vaccine acceptance and associated factors among adult clients at public hospitals in eastern Ethiopia using the health belief model: multicentre cross-sectional study

OBJECTIVE

Immunization is still one of the best ways to reduce viral-related morbidity and mortality . Therefore, this study aimed to assess COVID-19 vaccine acceptance and associated factors among adult clients at public hospitals in Eastern Ethiopia.

METHOD

A multicentred facility-based cross-sectional study design was utilised. The systematic random sampling technique was used to select 420 study participants. The characteristics of individuals were described using descriptive statistical analysis such as frequency, median and IQR. Mean was used for health belief model components. The association was assessed using bivariate and multivariable logistic regression and described by the OR along with a 95% CI. Finally, a p-value<0.05 in the adjusted analysis was used to declare a significant association.

OUTCOME MEASURE

COVID-19 vaccine acceptance and associated factors.

RESULT

A total of 412 adult clients were interviewed, with a response rate of 98.1%. Of the total study participants, 225 (54.6%; 95% CI: 50.0% to -59.7%) were willing to accept the COVID-19 vaccine. Age≥46 (adjusted OR, AOR=3.64, 95% CI: 1.35- to 9.86), college and above level of education (AOR=2.50, 95% CI: 1.30- to 4.81), having health insurance (AOR=1.79, 95% CI: 1.11- to 2.87) and experiencing chronic disease (AOR=1.96, 95% CI: 1.02- to 3.77) were predictor variables. Also, components of the health belief model were significantly associated with COVID-19 vaccine acceptance.

CONCLUSION

COVID-19 vaccine acceptance among the adult population was low compared to other study. Factors associated with COVID-19 vaccine acceptance were age, college and above level of education, having a chronic disease, having health insurance, perceived susceptibility, perceived severity, perceived benefit and perceived barrier.Improving awareness about COVID-19 among all sections of the population is crucial to improving vaccine acceptability.

Correlates and Predictors of COVID-19 Vaccine Hesitancy Among Persons Living With HIV in Trinidad and Tobago

BACKGROUND

Persons living with HIV may be at risk of more severe forms of COVID-19 infection and minimizing health risks largely depends on their acceptance of the COVID-19 vaccinations.

OBJECTIVE

This study examined the correlates and predictors of COVID-19 vaccine hesitancy among persons living with HIV in Trinidad and Tobago.

METHODS

A cross-sectional survey using a structured interview was conducted. Data were compiled on patient socio-demographics, diagnosed chronic diseases, psychological factors, and decisions to take the COVID-19 vaccine. Pearson χ² tests examined the associations between study variables and COVID-19 vaccine hesitancy, and multivariable logistic regression analyses examined its predictors.

RESULTS

In this study, 84% were virally suppressed, i.e., HIV viral load <1000 copies/ml. COVID-19 vaccine hesitancy was found to be 39%. Univariate analysis showed that higher vaccine hesitancy was significantly associated with females (OR 2.02, 95% CI 1.23-3.33) and patients of mixed ethnicity (OR 1.84, 95% CI 1.07-3.15). In our multivariable analysis, psychological factors namely, confidence in the COVID-19 vaccine (OR 0.16, 95% CI 0.05-0.47), the perceived benefits of the vaccine (OR 0.54, 95% CI 0.37-0.79), and cues to action (OR 0.68, 95% CI 0.47-0.97) were observed as predictors of COVID-19 vaccine hesitancy.

CONCLUSION

Psychological factors such as confidence in the COVID-19 vaccine, perceived benefits of the vaccine, and cues to action were possible predictors of COVID-19 vaccine hesitancy. This study underscored the continued need for strategies to increase confidence and knowledge about the benefits of taking the COVID-19 vaccine among persons living with HIV.

The knowledge, attitudes, and perceptions toward the Oxford AstraZeneca COVID-19 vaccine amongst Primary Health care workers in North-Central Trinidad

Aim

To determine the effects of knowledge, attitudes, and perceptions of primary care health workers toward receiving the Oxford AstraZeneca vaccine in North Central, Trinidad.

Methods

A pretested de novo questionnaire containing forty-eight (48) closed ended questions and one (1) open ended question was used to gather data. Descriptive and inferential statistics were used to analyze the data obtained from the questionnaire. These included percentages, means and standard deviations for the descriptive aspect and the Chi-Square test to examine any significant associations. Analysis of Variance (ANOVA) was used to assess any significant differences in means among several categories and the independent samples t-test for assessing any significant difference in means between two categories.

Results

273 respondents completed the questionnaire. Most of the participants (72.2%) were female and within the age range 25-36 (56.0%). The mean knowledge score about the AstraZeneca vaccine was 16.28 (SD = 2.28) out of 19 with an overall correct response rate of 79%. 30.4% of participants had a good attitude score and 59.7% had a positive perception toward the AstraZeneca vaccine. There were significant associations between knowledge and marital status (p = 0.001), income level (p = 0.001), education level (p < 0.001), and length of employment (p = 0.041); attitudes and sex (p = 0.01), age (p = 0.04), marital status (p = 0.009), income level (p < 0.001), education level (p = 0.005) and category of staff (p < 0.001); perception and sex (p = 0.002), marital status (p = 0.027), income level (p < 0.001), and category of staff (p < 0.001).

Conclusions

The main contributors to vaccine hesitancy were inadequate duration of clinical trials and fear of adverse side effects. A significant number of participants (17%) were unwilling to get the vaccine due to lack of information.

COVID-19 vaccine hesitancy in a developing country: prevalence, explanatory factors and implications for the future

OBJECTIVES

Vaccine hesitancy is a public health challenge highlighted during the COVID-19 pandemic. This study sought to determine the prevalence and explanatory factors leading to COVID-19 vaccine hesitancy in the Jamaican population to inform vaccination strategies.

STUDY DESIGN

This was an exploratory cross-sectional study.

METHODS

An exploratory survey was distributed electronically between September and October 2021 to gather information on COVID-19 vaccination behaviour and beliefs among the Jamaican population. Data were expressed as frequencies and analysed using Chi-squared followed by multivariate logistic regressions. Significant analyses were determined at P < 0.05.

RESULTS

Of the 678 eligible responses, most were females (71.5%, n = 485), between ages 18-45 years (68.2%, n = 462), had tertiary education (83.4%, n = 564) and were employed (73.4%, n = 498), with 10.6% (n = 44) being healthcare workers. COVID-19 vaccine hesitancy was present in 29.8% (n = 202) of the survey population, mainly because of safety and efficacy concerns and a general lack of reliable information about the vaccines. The likelihood of hesitancy increased amongst respondents under 36 years (odds ratio [OR] 6.8, 95% confidence interval [CI] 3.6, 12.9), those who delayed initial acceptance of vaccines (OR 2.7, 95% CI 2.3, 3.1); parents for their children and with long waits at vaccination centres. Likelihood of hesitancy decreased for respondents over 36 years (OR 3.7, 95% CI 1.8, 7.8) and with vaccine support from pastors/religious leaders (OR 1.6, 95% CI 1.1, 2.4).

CONCLUSIONS

Vaccine hesitancy was more prevalent in younger respondents who were never exposed to the effects of vaccine-preventable diseases. Religious leaders had more influence than healthcare workers to increase vaccine uptake.

Global Predictors of COVID-19 Vaccine Hesitancy: A Systematic Review

Background: vaccine hesitancy is defined as a delay in the acceptance or refusal of vaccination, even though immunisation is a determinant in reducing the mortality and morbidity associated with Coronavirus Disease 2019 (COVID-19). Aim: to identify and analyse the predictors of COVID-19 vaccine acceptance and/or hesitancy. Methods: a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. Keywords: vaccine and (COVID or SARS) and (acceptance or acceptability or willingness or hesitancy or refusal) and (multivariate or regression) and (questionnaire or survey) and national. Databases/resources: PubMed, DOAJ, SciELO and b-on. Timeframe: March 2020–2022. Inclusion criteria: general population, questionnaire-based, calculation of a multivariate regression model and national studies. Quality assessment: application of the National Heart, Lung, and Blood institute (NHLBI) tool. Results: a total of 37 studies were selected, whose overall rate was fair. The most predominant predictors of vaccine hesitancy were a lower perceived risk of getting infected, a lower level of institutional trust, not being vaccinated against influenza, lower levels of perceived severity of COVID-19, or stronger beliefs that the vaccination would cause side effects or be unsafe. Discussion and conclusion: the identified predictors can be used to design tailored health policies and/or public health interventions, or to evaluate subjects’ vaccine hesitancy.

Infodemic, Institutional Trust, and COVID-19 Vaccine Hesitancy: A Cross-National Survey

The COVID-19 pandemic has been accompanied by a massive infodemic. Yet limited studies have quantified the impact of the COVID-19 infodemic on vaccine hesitancy. This study examined the effect of perceived information overload (IO) and misinformation on vaccine willingness and uptake within a cross-national context. It also investigated how trust in multiple institutions affected vaccine outcomes and moderated the relationship between the infodemic and vaccine attitude and behavior. A cross-national online survey of residents, representative of the general population aged ≥18 in six Asian and Western jurisdictions, was conducted in June 2021. The results showed that perceived IO was positively associated with COVID-19 vaccine willingness and uptake. Belief in misinformation was negatively associated with vaccine willingness and uptake. Institutional trust may increase vaccine willingness and uptake. Moreover, trust in the government and civil societies tended to strengthen the positive effect of IO and reduce the negative impact of misinformation on vaccine willingness and uptake. The relationship between belief in misinformation and getting vaccinated against COVID-19 was unexpectedly stronger among those with a higher level of trust in healthcare professionals. This study contributes to a better understanding of the main and interactive effect of the infodemic and institutional trust on vaccine outcomes during a pandemic.

Understanding and addressing COVID-19 vaccine hesitancy in low and middle income countries and in people with severe mental illness: Overview and recommendations for Latin America and the Caribbean

Despite the speedy development of vaccines for COVID-19, their rollout has posed a major public health challenge, as vaccine hesitancy (VH) and refusal are high. Addressing vaccine hesitancy is a multifactorial and context-dependent challenge. This perspective focuses on VH in the world region of Latin America and the Caribbean (LAC) and includes people suffering from severe mental illness, therefore covering populations and subpopulations often neglected in scientific literature. We present an overview of VH in LAC countries, discussing its global and historical context. Vaccine uptake has shown to widely vary across different subregions of LAC. Current data points to a possible correlation between societal polarization and vaccination, especially in countries going through political crises such as Brazil, Colombia, and Venezuela. Poor accessibility remains an additional important factor decreasing vaccination rollout in LAC countries and even further, in the whole Global South. Regarding patients with severe mental illness in LAC, and worldwide, it is paramount to include them in priority groups for immunization and monitor their vaccination coverage through public health indicators.

COVID-19 Vaccine Hesitancy and Emerging Variants: Evidence from Six Countries

As the world tries to cope with the devastating effects of the COVID-19 pandemic and emerging variants of the virus, COVID-19 vaccination has become an even more critical tool toward normalcy. The effectiveness of the vaccination program and specifically vaccine uptake and coverage, however, is a function of an individual's knowledge and individual opinion about the disease and available vaccines. This study investigated the knowledge, attitudes, and resulting community practice(s) associated with the new COVID-19 variants and vaccines in Bangladesh, Colombia, India, Malaysia, Zimbabwe, and the USA. A cross-sectional web-based Knowledge, Attitudes, and Practices (KAP) survey was administered to respondents living in six different countries using a structured and multi-item questionnaire. Survey questions were translated into English, Spanish, and Malay to accommodate the local language in each country. Associations between KAP and a range of explanatory variables were assessed using univariate and multiple logistic regression. A total of 781 responses were included in the final analysis. The Knowledge score mean was 24 (out of 46), Attitude score 28.9 (out of 55), and Practice score 7.3 (out of 11). Almost 65% of the respondents reported being knowledgeable about COVID-19 variants and vaccination, 55% reported a positive attitude toward available COVID-19 vaccines, and 85% reported engaging in practices that supported COVID-19 vaccination. From the multiple logistic models, we found post-graduate education (AOR = 1.83, 95% CI: 1.23-2.74) and an age range 45-54 years (AOR = 5.81, 95% CI: 2.30-14.69) to be significantly associated with reported COVID-19 knowledge. In addition, positive Attitude scores were associated with respondents living in Zimbabwe (AOR = 4.49, 95% CI: 2.04-9.90) and positive Practice scores were found to be associated with people from India (AOR = 3.68, 95% CI: 1.15-11.74) and high school education (AOR = 2.16, 95% CI: 1.07-4.38). This study contributes to the identification of socio-demographic factors associated with poor knowledge, attitudes, and practices relating to COVID-19 variants and vaccines. It presents an opportunity for collaboration with diverse communities to address COVID-19 misinformation and common sources of vaccine hesitancy (i.e., knowledge, attitudes, and practices).