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Howard MC. Vaccine hesitancy as indecision: Creation and evaluation of the Unidimensional Vaccine Hesitancy Scale. Br J Health Psychol 2024. [PMID: 39327232 DOI: 10.1111/bjhp.12753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 09/02/2024] [Indexed: 09/28/2024]
Abstract
BACKGROUND Several authors have argued that vaccine hesitancy should be conceptualized as indecision in the vaccination decision-making process, but no established measure with support for its psychometric properties and validity has been created from this operational definition. AIMS To resolve this tension, this article undergoes a four-study scale development process to create the 4-item Unidimensional Vaccine Hesitancy Scale (UVHS). MATERIALS AND METHODS We conduct four survey studies utilizing a total sample size of 884. RESULTS In Studies 1 (n = 297) and 2 (n = 298), we provide psychometric support for the measure via exploratory and confirmatory factor analysis. In Studies 3 (n = 193) and 4 (n = 106), we support the concurrent and discriminant validity of the measure by assessing its relations with relevant constructs, such as vaccination readiness and acceptance, and we also provide initial indicators of the scale's possible predictive qualities by testing its time-separated effects with vaccination willingness, receipt and word-of-mouth. DISCUSSION We leverage these results to provide a number of theoretical insights and suggestions for future practice. Of note, we highlight that different conceptualizations and operationalizations for the same construct can produce notably differing empirical findings, and vaccine hesitancy is no different. CONCLUSION Our cumulative efforts indicate that the UVHS is an appropriate measure to assess vaccine hesitancy as indecision.
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Affiliation(s)
- Matt C Howard
- The University of South Alabama, Mitchell College of Business, Mobile, Alabama, USA
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2
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Charles CM, Noles M, Munezero A, Gallardo N, Bahamondes L, Bento SF, de Pádua KS, Nhauche M, Metelus S, Cecatti JG, Souza RT, Pacagnella RC. Risk factors related to the SARS-CoV-2 vaccine additional doses hesitancy among pregnant and non-pregnant people of reproductive age and partners: A Brazilian cross-sectional study. Int J Gynaecol Obstet 2024; 166:1144-1160. [PMID: 38532554 DOI: 10.1002/ijgo.15512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 03/09/2024] [Accepted: 03/18/2024] [Indexed: 03/28/2024]
Abstract
OBJECTIVE The aim of this study was to assess the predictors of acceptance and hesitancy of additional doses of any SARS-CoV-2 (COVID-19) vaccine among pregnant or recently pregnant and non-pregnant people of reproductive age and partners in Brazil. METHODS We conducted an online cross-sectional study from June 2022 to April 2023 and invited women and partners between 18 and 49 years old to participate. We employed a snowball strategy to reach all potential eligible participants. Our primary outcome was the acceptance rate of the COVID-19 booster vaccine. We estimated the frequency and percentage for the three groups and compared categorical variables using the Chi-square test. Moreover, bivariate, backward stepwise regression, and subgroup analyses were performed to evaluate risk factors and predictors of COVID-19 vaccine booster hesitancy. We reported the effect size as OR with a 95% CI. RESULTS We included 1487 participants, and among them, 334 (22.5%) were pregnant or recently pregnant people, 905 (60.8%) were non-pregnant people, and 247 (16.6%) were male partners. Pregnant and recently pregnant people showed greater hesitancy for the COVID-19 vaccine booster than non-pregnant people (28% vs 15%, P < 0.001) and male partners (28% vs 16%, P < 0.001). Non-pregnant women accepted the COVID-19 vaccine more often than pregnant or recently pregnant people (OR 1.75; 95% CI: 1.13-2.70). The associated factors to the reduced COVID-19 vaccine booster acceptance were family income between US$ 566-945.00 (54%), evangelic religion (65%), concern about vaccine safety (80%) and perceived common vaccine importance (93%). CONCLUSION Pregnant people were more hesitant than non-pregnant people to accept the COVID-19 booster vaccine. Family income, religious beliefs, vaccine safety concerns, and perceived common vaccine importance were significant barriers to accepting COVID-19 booster vaccines. The impact of these factors was more evident among pregnant or recently pregnant people, emphasizing the harmful effect of misinformation among this vulnerable population.
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Affiliation(s)
- Charles M Charles
- Department of Obstetrics and Gynecology, Universidade Estadual de Campinas - (UNICAMP), Campinas, SP, Brazil
- Provincial Health Administration, DPS Manica, Chimoio, Mozambique
| | - Marcelo Noles
- Department of Obstetrics and Gynecology, Universidade Estadual de Campinas - (UNICAMP), Campinas, SP, Brazil
| | - Aline Munezero
- Department of Obstetrics and Gynecology, Universidade Estadual de Campinas - (UNICAMP), Campinas, SP, Brazil
| | - Negli Gallardo
- Department of Obstetrics and Gynecology, Universidade Estadual de Campinas - (UNICAMP), Campinas, SP, Brazil
| | - Luis Bahamondes
- Department of Obstetrics and Gynecology, Universidade Estadual de Campinas - (UNICAMP), Campinas, SP, Brazil
- Campinas Reproductive Health Research Center (CEMICAMP), Campinas, Brazil
| | - Silvana F Bento
- Campinas Reproductive Health Research Center (CEMICAMP), Campinas, Brazil
- Women's Hospital "Prof. Dr. José A Pinotti" - Center for Integral Attention to Women (CAISM), Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil
| | - Karla S de Pádua
- Campinas Reproductive Health Research Center (CEMICAMP), Campinas, Brazil
- Women's Hospital "Prof. Dr. José A Pinotti" - Center for Integral Attention to Women (CAISM), Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil
| | - Marta Nhauche
- Department of Obstetrics and Gynecology, Universidade Estadual de Campinas - (UNICAMP), Campinas, SP, Brazil
| | - Sherly Metelus
- Department of Obstetrics and Gynecology, Universidade Estadual de Campinas - (UNICAMP), Campinas, SP, Brazil
| | - José G Cecatti
- Department of Obstetrics and Gynecology, Universidade Estadual de Campinas - (UNICAMP), Campinas, SP, Brazil
- Campinas Reproductive Health Research Center (CEMICAMP), Campinas, Brazil
| | - Renato T Souza
- Department of Obstetrics and Gynecology, Universidade Estadual de Campinas - (UNICAMP), Campinas, SP, Brazil
- Campinas Reproductive Health Research Center (CEMICAMP), Campinas, Brazil
| | - Rodolfo C Pacagnella
- Department of Obstetrics and Gynecology, Universidade Estadual de Campinas - (UNICAMP), Campinas, SP, Brazil
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Kim JEC, Kranzler EC, Yu K, Denison B, Dahlen HM, Luchman JN, Ihongbe TO, Marshall MC, Hoffman B, Moffett K, Dupervil D, Margolis KA, Hoffman L. The Association Between the We Can Do This Campaign and Vaccination Beliefs in the United States, January 2021-March 2022. JOURNAL OF HEALTH COMMUNICATION 2024; 29:502-513. [PMID: 38958603 DOI: 10.1080/10810730.2024.2373159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/04/2024]
Abstract
Public health campaigns addressing COVID-19 vaccination beliefs may be effective in changing COVID-19 vaccination behaviors, particularly among people who remain vaccine hesitant. The "We Can Do This" COVID-19 public education campaign (the Campaign) was designed to increase COVID-19 vaccine confidence and uptake. This study aims to evaluate whether Campaign dose was associated with changes in vaccination beliefs related to COVID-19 vaccine concerns and perceived risks, the importance of COVID-19 vaccines, the perceived benefits of COVID-19 vaccination, normative beliefs about COVID-19 vaccination, and perceptions about general vaccine safety and effectiveness. The study linked data from four waves of a nationally representative longitudinal panel of U.S. adults (January 2021-March 2022) with Campaign paid digital media data (April 2021-May 2022). We used mixed-effects linear regressions to examine the association between Campaign paid digital impressions and changes in vaccination beliefs. The results provide evidence that Campaign digital impressions were significantly associated with changes in respondent beliefs regarding COVID-19 vaccine concerns and perceived risks, perceived benefits of COVID-19 vaccination, and perceptions about general vaccine safety and effectiveness. Findings suggest that public education campaigns may influence vaccine confidence and uptake by increasing positive vaccination beliefs and reducing vaccine concerns.
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Affiliation(s)
- Jae-Eun C Kim
- Communication Campaign Research & Evaluation, Fors Marsh, Arlington, Virginia
| | - Elissa C Kranzler
- Communication Campaign Research & Evaluation, Fors Marsh, Arlington, Virginia
| | - Kathleen Yu
- Center for Food Safety and Applied Nutrition, U.S. Department of Health and Human Services Office of the Assistant Secretary for Public Affairs, Washington, District of Columbia, United States
| | - Benjamin Denison
- Communication Campaign Research & Evaluation, Fors Marsh, Arlington, Virginia
| | - Heather M Dahlen
- Communication Campaign Research & Evaluation, Fors Marsh, Arlington, Virginia
| | - Joseph N Luchman
- Communication Campaign Research & Evaluation, Fors Marsh, Arlington, Virginia
| | - Timothy O Ihongbe
- Communication Campaign Research & Evaluation, Fors Marsh, Arlington, Virginia
| | - Michael C Marshall
- Communication Campaign Research & Evaluation, Fors Marsh, Arlington, Virginia
| | - Blake Hoffman
- Communication Campaign Research & Evaluation, Fors Marsh, Arlington, Virginia
| | - Kenneth Moffett
- Communication Campaign Research & Evaluation, Fors Marsh, Arlington, Virginia
| | - Daphney Dupervil
- Center for Food Safety and Applied Nutrition, U.S. Department of Health and Human Services Office of the Assistant Secretary for Public Affairs, Washington, District of Columbia, United States
| | - Katherine A Margolis
- Center for Food Safety and Applied Nutrition, U.S. Department of Health and Human Services Office of the Assistant Secretary for Public Affairs, Washington, District of Columbia, United States
| | - Leah Hoffman
- Communication Campaign Research & Evaluation, Fors Marsh, Arlington, Virginia
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4
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Stefkovics Á, Albert F, Ligeti AS, Dávid B, Rudas S, Koltai J. Vaccination homophily in ego contact networks during the COVID-19 pandemic. Sci Rep 2024; 14:15515. [PMID: 38969667 PMCID: PMC11226437 DOI: 10.1038/s41598-024-65986-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 06/26/2024] [Indexed: 07/07/2024] Open
Abstract
Vaccine hesitancy is an inevitable risk for societies as it contributes to outbreaks of diseases. Prior research suggests that vaccination decisions of individuals tend to spread within social networks, resulting in a tendency to vaccination homophily. The clustering of individuals resistant to vaccination can substantially make the threshold necessary to achieve herd immunity harder to reach. In this study, we examined the extent of vaccination homophily among social contacts and its association with vaccine uptake during the COVID-19 pandemic in Hungary using a contact diary approach in two cross-sectional surveys. The results indicate strong clustering among both vaccinated and unvaccinated groups. The most powerful predictor of vaccine uptake was the perceived vaccination rate within the egos' social contact network. Vaccination homophily and the role of the interpersonal contact network in vaccine uptake were particularly pronounced in the networks of close relationships, including family, kinship, and strong social ties of the ego. Our findings have important implications for understanding COVID-19 spread dynamics by showing that the strong clustering of unvaccinated individuals posed a great risk in preventing the spread of the disease.
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Affiliation(s)
- Ádám Stefkovics
- National Laboratory for Health Security, HUN-REN Centre for Social Sciences, Budapest, Hungary
- IQSS, Harvard University, Cambridge, MA, USA
| | - Fruzsina Albert
- Institute for Sociology, HUN-REN Centre for Social Sciences, Budapest, Hungary
- Institute of Mental Health, Semmelweis University, Budapest, Hungary
| | - Anna Sára Ligeti
- National Laboratory for Health Security, HUN-REN Centre for Social Sciences, Budapest, Hungary
| | - Beáta Dávid
- Institute for Sociology, HUN-REN Centre for Social Sciences, Budapest, Hungary
- Institute of Mental Health, Semmelweis University, Budapest, Hungary
| | - Szilvia Rudas
- National Laboratory for Health Security, HUN-REN Centre for Social Sciences, Budapest, Hungary
| | - Júlia Koltai
- National Laboratory for Health Security, HUN-REN Centre for Social Sciences, Budapest, Hungary.
- Department of Social Research Methodology, Faculty of Social Sciences, Eötvös Loránd University, Budapest, Hungary.
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Smith DG, Smith CD, DeLeon JA, Sandoz JL, Ochoa CO, Pearson MP, Macena RHM. Factors influencing COVID-19 vaccine uptake among Latinos: A cross-sectional study. PLoS One 2024; 19:e0302332. [PMID: 38968176 PMCID: PMC11226026 DOI: 10.1371/journal.pone.0302332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 04/02/2024] [Indexed: 07/07/2024] Open
Abstract
Vaccination against COVID-19 can prevent severe illness and reduce hospitalizations and deaths. Understanding and addressing determinants contributing to vaccine uptake among high-risk groups, such as Latinos, are pivotal in ensuring equitable vaccine distribution, promoting health equity, and fostering community engagement to bridge the gap in vaccine acceptance and ultimately enhance public health. This study aimed to examine factors influencing vaccine uptake among Latinos. We conducted a cross-sectional study using an online platform (n = 242). The survey was administered using a multimodal approach. Strategies for recruitment included community outreach, social media, and targeting community networks serving Latinos. Descriptive statistics, chi-square, and multivariable analysis were performed. Overall, 81.4% of respondents had received at least one dose of the COVID-19 vaccine, with 77.0% recommending it and 70.6% believing it to be safe, 66.7% believing in its efficacy, 62.3% able to find trustful information in Spanish or Portuguese, and almost 40% who relied on health organizations as their primary resource for COVID-19 vaccine information. Factors significantly associated with vaccine uptake included higher education level (p<0.001), English level (p = 0.023), living in an urban area (p = 0.048), having insurance (p<0.001), and having a healthcare provider (p = 0.007). Furthermore, belief in vaccine safety and efficacy, trust in public health authorities, concerns about COVID-19, the ability to determine true/false vaccine information during the pandemic, and the availability of trustworthy information in Spanish/Portuguese had statistically significant associations (p<0.05) with COVID-19 vaccine uptake. COVID-19 vaccine uptake differed based on sociodemographic and other modifiable factors. Our findings emphasize the importance of implementing targeted interventions and culturally sensitive communication strategies to improve vaccination uptake among the Latino community in the United States.
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Affiliation(s)
- Deborah G. Smith
- Department of Public Health, Louisiana State University Health Science Center Shreveport, Shreveport, Louisiana, United States of America
| | - Corey D. Smith
- Department of Medicine, Louisiana State University Health Science Center Shreveport, Shreveport, Louisiana, United States of America
| | - Jennifer A. DeLeon
- Department of Public Health, Louisiana State University Health Science Center Shreveport, Shreveport, Louisiana, United States of America
| | - Jillian L. Sandoz
- Department of Medicine, Louisiana State University Health Science Center Shreveport, Shreveport, Louisiana, United States of America
| | - Carolina O. Ochoa
- Department of Medicine, Louisiana State University Health Science Center Shreveport, Shreveport, Louisiana, United States of America
| | - Martha P. Pearson
- Department of Nursing, Northwestern State University of Louisiana, Shreveport, Louisiana, United States of America
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Hubin P, Van den Borre L, Braeye T, Cavillot L, Billuart M, Stouten V, Nasiadka L, Vermeiren E, Van Evercooren I, Devleesschauwer B, Catteau L, van Loenhout JA. Area and individual level analyses of demographic and socio-economic disparities in COVID-19 vaccination uptake in Belgium. Vaccine X 2024; 18:100496. [PMID: 38779406 PMCID: PMC11108972 DOI: 10.1016/j.jvacx.2024.100496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 04/27/2024] [Accepted: 05/02/2024] [Indexed: 05/25/2024] Open
Abstract
Vaccination has played a major role in overcoming the COVID-19 pandemic. However, vaccination status can be influenced by demographic and socio-economic factors at individual and area level. In the context of the LINK-VACC project, the Belgian vaccine register for the COVID-19 vaccination campaign was linked at individual level with other registers, notably the COVID-19 laboratory test results and demographic and socio-economic variables from the DEMOBEL database. The present article aims at investigating to which extent COVID-19 vaccination status is associated with area level and/or individual level demographic and socio-economic factors. From a sample of all individuals tested for SARS-CoV-2 (LINK-VACC sample) demographic and socio-economic indicators are derived and their impact on vaccination coverages at an aggregated geographical level (municipality) is quantified. The same indicators are calculated for the full Belgian population, allowing to assess the representativeness of the LINK-VACC sample with respect to the impact of demographic and socio-economic disparities on vaccination uptake. In a second step, hierarchical models are fitted to the individual level LINK-VACC data to disentangle the individual and municipality effects allowing to evaluate the added value of the availability of individual level data in this context. The most important effects observed at the individual level are reflected in the aggregated data at the municipality level. Multilevel analyses show that most of the demographic and socio-economic impacts on vaccination are captured at the individual level, although accounting for area level in individual level analyses improve the overall description.
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Affiliation(s)
- Pierre Hubin
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Laura Van den Borre
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
- Interface Demography, Department of Sociology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Toon Braeye
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Lisa Cavillot
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
- Research Institute of Health and Society, University of Louvain, Brussels, Belgium
| | - Matthieu Billuart
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Veerle Stouten
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Léonore Nasiadka
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Elias Vermeiren
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | | | - Brecht Devleesschauwer
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
- Department of Translational Physiology, Infectiology and Public Health, Ghent University, Merelbeke, Belgium
| | - Lucy Catteau
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
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Kalu K, Shah G, Tung HJ, Bland HW. Social and Structural Determinants of Health Associated with COVID-19 Vaccine Hesitancy among Older Adults in the United States. Vaccines (Basel) 2024; 12:521. [PMID: 38793773 PMCID: PMC11125749 DOI: 10.3390/vaccines12050521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 05/02/2024] [Accepted: 05/06/2024] [Indexed: 05/26/2024] Open
Abstract
State-level COVID-19 vaccination rates among older adults have been uneven in the United States. Due to the immunocompromised nature of older adults, vaccine hesitancy increases the risk of morbidity and mortality. This study aims to determine the association between the social determinants of health, the structural determinants of health, and COVID-19 vaccine hesitancy among older adults in the United States. Secondary data from the Health and Retirement Study (HRS) dataset were used. A descriptive analysis and multinomial multivariable logistic regression were performed to examine the association of the independent variables-gender, age, race, immigration status, marital status, broadband internet access, social security income, Medicare coverage, education, and frequency of religious service-with the dependent variable, vaccine hesitancy. Compared to the respondents with no vaccine hesitancy and without the specific predictor, the respondents who reported religious attendance at least once/week were more likely to be "somewhat hesitant", divorced respondents had higher odds of being "somewhat hesitant", and older adults aged 65-74 years were more likely to be "very hesitant" or "somewhat hesitant" about the COVID-19 vaccine. Compared to the respondents with no vaccine hesitancy and without the specific predictor, females had higher odds of being "very hesitant", "somewhat hesitant", or a "little hesitant", and African Americans were more likely to be "very hesitant", "somewhat hesitant", or a "little hesitant" about the COVID-19 vaccine. Addressing these factors may limit the barriers to vaccine uptake reported among older adults and improve herd immunity among the immunocompromised population.
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Affiliation(s)
| | - Gulzar Shah
- Jian-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA 30458, USA; (K.K.); (H.-J.T.); (H.W.B.)
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Yamamura E, Tsutsui Y, Ohtake F. Surname order and revaccination intentions during the COVID-19 pandemic. Sci Rep 2024; 14:4750. [PMID: 38413772 PMCID: PMC10899220 DOI: 10.1038/s41598-024-55543-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 02/24/2024] [Indexed: 02/29/2024] Open
Abstract
Teachers in Japanese schools employ alphabetical surname lists that call students sooner, with surnames appearing early on these lists. We conducted Internet surveys nearly every month from March 2020 to September 2022 with the same participants, wherein we asked participants where the alphabetical columns of their childhood and adult surnames were located. We aimed to identify how surname order is important for the formation of noncognitive skills. During the data collection period, the COVID-19 vaccines became available; Japanese people could receive their third dose starting in December 2021. The 19th wave of the survey was conducted in January 2022. Therefore, to examine how a surname's alphabetical order could influence intention to revaccinate, we used a subsample of data from December 2021 to September 2022. The major findings were as follows. Women with early surnames had an approximately 4% stronger likelihood of having such intentions than men with early surnames. Early name order was more strongly correlated with revaccination intention among women than among men. The surname effect for women was larger when a mixed-gender list was used compared with when it was not used. This effect was only observed for childhood surnames and not for adult surnames.
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Affiliation(s)
- Eiji Yamamura
- Department of Economics, Seinan Gakuin University, Fukuoka, Japan.
| | - Yoshiro Tsutsui
- Faculty of Social Relations, Kyoto Bunkyo University, Kyoto, Japan
| | - Fumio Ohtake
- Center for Infectious Disease Education and Research (CiDER), Osaka University, Osaka, Japan
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Are EB, Card KG, Colijn C. The role of vaccine status homophily in the COVID-19 pandemic: a cross-sectional survey with modelling. BMC Public Health 2024; 24:472. [PMID: 38355444 PMCID: PMC10868109 DOI: 10.1186/s12889-024-17957-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 02/01/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Vaccine homophily describes non-heterogeneous vaccine uptake within contact networks. This study was performed to determine observable patterns of vaccine homophily, as well as the impact of vaccine homophily on disease transmission within and between vaccination groups under conditions of high and low vaccine efficacy. METHODS Residents of British Columbia, Canada, aged ≥ 16 years, were recruited via online advertisements between February and March 2022, and provided information about vaccination status, perceived vaccination status of household and non-household contacts, compliance with COVID-19 prevention guidelines, and history of COVID-19. A deterministic mathematical model was used to assess transmission dynamics between vaccine status groups under conditions of high and low vaccine efficacy. RESULTS Vaccine homophily was observed among those with 0, 2, or 3 doses of the vaccine. Greater homophily was observed among those who had more doses of the vaccine (p < 0.0001). Those with fewer vaccine doses had larger contact networks (p < 0.0001), were more likely to report prior COVID-19 (p < 0.0001), and reported lower compliance with COVID-19 prevention guidelines (p < 0.0001). Mathematical modelling showed that vaccine homophily plays a considerable role in epidemic growth under conditions of high and low vaccine efficacy. Furthermore, vaccine homophily contributes to a high force of infection among unvaccinated individuals under conditions of high vaccine efficacy, as well as to an elevated force of infection from unvaccinated to suboptimally vaccinated individuals under conditions of low vaccine efficacy. INTERPRETATION The uneven uptake of COVID-19 vaccines and the nature of the contact network in the population play important roles in shaping COVID-19 transmission dynamics.
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Affiliation(s)
- Elisha B Are
- Mathematics, Simon Fraser University, Burnaby, BC, Canada.
- Pacific Institute On Pathogens, Pandemics and Society (PIPPS), Simon Fraser University, Burnaby, BC, Canada.
| | - Kiffer G Card
- Pacific Institute On Pathogens, Pandemics and Society (PIPPS), Simon Fraser University, Burnaby, BC, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
- Institute for Social Connection, Victoria, BC, Canada
| | - Caroline Colijn
- Mathematics, Simon Fraser University, Burnaby, BC, Canada
- Pacific Institute On Pathogens, Pandemics and Society (PIPPS), Simon Fraser University, Burnaby, BC, Canada
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10
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Hâncean MG, Lerner J, Perc M, Molina JL, Geantă M. Assortative mixing of opinions about COVID-19 vaccination in personal networks. Sci Rep 2024; 14:3385. [PMID: 38336858 PMCID: PMC10858210 DOI: 10.1038/s41598-024-53825-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 02/05/2024] [Indexed: 02/12/2024] Open
Abstract
Many countries worldwide had difficulties reaching a sufficiently high vaccination uptake during the COVID-19 pandemic. Given this context, we collected data from a panel of 30,000 individuals, which were representative of the population of Romania (a country in Eastern Europe with a low 42.6% vaccination rate) to determine whether people are more likely to be connected to peers displaying similar opinions about COVID-19 vaccination. We extracted 443 personal networks, amounting to 4430 alters. We estimated multilevel logistic regression models with random-ego-level intercepts to predict individual opinions about COVID-19 vaccination. Our evidence indicates positive opinions about the COVID-19 vaccination cluster. Namely, the likelihood of having a positive opinion about COVID-19 vaccination increases when peers have, on average, a more positive attitude than the rest of the nodes in the network (OR 1.31, p < 0.001). We also found that individuals with higher education and age are more likely to hold a positive opinion about COVID-19 vaccination. With the given empirical data, our study cannot reveal whether this assortative mixing of opinions is due to social influence or social selection. However, it may nevertheless have implications for public health interventions, especially in countries that strive to reach higher uptake rates. Understanding opinions about vaccination can act as an early warning system for potential outbreaks, inform predictions about vaccination uptake, or help supply chain management for vaccine distribution.
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Affiliation(s)
- Marian-Gabriel Hâncean
- Department of Sociology, University of Bucharest, Panduri, 90-92, 050663, Bucharest, Romania.
- The Research Institute of the University of Bucharest, University of Bucharest, Panduri, 90-92, 050663, Bucharest, Romania.
| | - Jürgen Lerner
- Department of Computer and Information Science, University of Konstanz, 78457, Konstanz, Germany
- Human Technology Center, RWTH Aachen University, 52062, Aachen, Germany
| | - Matjaž Perc
- Faculty of Natural Sciences and Mathematics, University of Maribor, Koroška Cesta 160, 2000, Maribor, Slovenia
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, 404332, Taiwan
- Community Healthcare Center Dr. Adolf Drolc Maribor, Vošnjakova Ulica 2, 2000, Maribor, Slovenia
- Complexity Science Hub Vienna, Josefstädterstraße 39, 1080, Vienna, Austria
- Department of Physics, Kyung Hee University, 26 Kyungheedae-Ro, Dongdaemun-Gu, Seoul, Republic of Korea
| | - José Luis Molina
- GRAFO - Department of Social and Cultural Anthtropology, Universitat Autònoma de Barcelona, 08193, Bellaterra (Cerdanyola del Vallès), Barcelona, Spain
| | - Marius Geantă
- Center for Innovation in Medicine, Th. Pallady 42J, 032266, Bucharest, Romania
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Misra R, Kirk B, Shawley-Brzoska S, Totzkay D, Morton C, Kuhn S, Harris M, McMillion M, Darling E. Educational Intervention to Increase COVID-19 Vaccine Uptake in Rural Patients with Chronic Diseases: Lessons Learned from An Innovative Academic-Community Partnership. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:71. [PMID: 38248535 PMCID: PMC10815710 DOI: 10.3390/ijerph21010071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/21/2023] [Accepted: 12/29/2023] [Indexed: 01/23/2024]
Abstract
BACKGROUND The pandemic has disproportionately impacted rural communities with a higher burden of chronic disease and COVID-19 infection. West Virginia is a rural state with a high rate of diabetes, hypertension, and COPD, which are known risk factors for severe COVID-19 and long COVID. Yet, there is a significant hesitancy regarding COVID-19 vaccination uptake in the state. The purpose of this study was to use an educational intervention to increase vaccine knowledge and vaccine acceptance in rural patients with chronic disease(s) in West Virginia. This project used an academic-community partnership comprised of researchers, practitioners, community organizations, community-engaged partners, and patient stakeholders to increase COVID-19 health literacy and increase vaccine acceptance among rural West Virginians with chronic conditions. MATERIALS AND METHODS A quasi-experimental study design was used to deliver an educational intervention by trained Health Navigators using short videos to increase COVID-19 health literacy and address participants' vaccine concerns. Eligibility included adults (18 years and older) who have at least one chronic condition. A statewide community advisory board (CAB) guided the development of the educational training curriculum and implementation strategies. An adapted version of the Exploration, Preparation, Implementation, Sustainment (EPIS) framework guided the development of the intervention. Health Navigators (n = 45) delivered the educational intervention in their local communities between November 2022 and October 2023 (project implementation is still ongoing). Intervention fidelity checks, an adaptable script, and a flow chart allowed tailoring of brief videos to address participants' specific COVID-19 questions and vaccine concerns. A validated online survey, monitored by an online Research Electronic Data Capture (REDCap) database, assessed participants' knowledge, perceived susceptibility, and vaccine intention. RESULTS Health Navigators delivered the intervention to 1368 West Virginians in 52 counties (59.2% women; 61.8% without a college degree). Participants reported living with an average of 2.1 ± 1.4 chronic conditions. The mean age was 43.5 ± 18.8 years. The majority of participants (81.2%) had received the primary vaccination series, and 63.1% had at least one booster. However, 18% were unvaccinated or did not complete the primary COVID-19 vaccine series. Discussions to improve vaccine literacy focused on how the vaccine was so quickly developed and protects against variants, addressing concerns related to the safety, short- and long-term side effects, and importance of vaccine uptake for immunocompromised individuals. Participants with higher concerns were more likely to be unvaccinated and to have not completed their primary series or boosters (p < 0.001). However, the educational intervention improved the willingness of individuals who were either unvaccinated or did not complete their primary vaccine series to get vaccinated (11.4%). DISCUSSION Our findings highlight the importance of vaccine literacy in increasing vaccination rates among rural patients with chronic diseases. Using the EPIS framework allowed us to reflect upon the challenges, ensure resilience during changing local contexts, and plan and implement a promising, cost-effective intervention in rural areas. CONCLUSIONS This study provides insights into the need for tailored educational interventions based on disease status, which has implications for public health and patient care in rural and underserved communities. Academic-community partnerships can be useful for successful knowledge transfer for vaccine acceptance to reduce rural health disparities.
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Affiliation(s)
- Ranjita Misra
- West Virginia University School of Public Health, Morgantown, WV 26505, USA; (B.K.); (S.S.-B.)
| | - Brenna Kirk
- West Virginia University School of Public Health, Morgantown, WV 26505, USA; (B.K.); (S.S.-B.)
| | | | - Daniel Totzkay
- Department of Communication Studies, Eberly College of Art and Sciences, West Virginia University, Morgantown, WV 26506, USA;
| | - Catherine Morton
- Health Sciences and Technology Academy, Morgantown, WV 26506, USA; (C.M.); (S.K.); (M.H.); (M.M.)
| | - Summer Kuhn
- Health Sciences and Technology Academy, Morgantown, WV 26506, USA; (C.M.); (S.K.); (M.H.); (M.M.)
| | - Misty Harris
- Health Sciences and Technology Academy, Morgantown, WV 26506, USA; (C.M.); (S.K.); (M.H.); (M.M.)
| | - Mary McMillion
- Health Sciences and Technology Academy, Morgantown, WV 26506, USA; (C.M.); (S.K.); (M.H.); (M.M.)
| | - Elaine Darling
- The Center for Rural Health Development Inc., 75 Chase Dr, Hurricane, WV 25526, USA;
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12
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Yuan J, Xu Y, Wong IOL, Lam WWT, Ni MY, Cowling BJ, Liao Q. Dynamic predictors of COVID-19 vaccination uptake and their interconnections over two years in Hong Kong. Nat Commun 2024; 15:290. [PMID: 38177142 PMCID: PMC10767005 DOI: 10.1038/s41467-023-44650-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 12/20/2023] [Indexed: 01/06/2024] Open
Abstract
The global rollout of COVID-19 vaccines faces a significant barrier in the form of vaccine hesitancy. This study adopts a dynamic and network perspective to explore the determinants of COVID-19 vaccine uptake in Hong Kong, focusing on multi-level determinants and their interconnections. Following the framework proposed by the Strategic Advisory Group of Experts (SAGE), the study used repeated cross-sectional surveys to map these determinants at multiple levels and investigates their interconnections simultaneously in a sample of 15,179 over two years. The results highlight the dynamic nature of COVID-19 vaccine hesitancy in an evolving pandemic. The findings suggest that vaccine confidence attitudes play crucial roles in vaccination uptake, with their importance shifting over time. The initial emphasis on vaccine safety gradually transitioned to heightened consideration of vaccine effectiveness at a later stage. The study also highlights the impact of chronic condition, age, COVID-19 case numbers, and non-pharmaceutical preventive behaviours on vaccine uptake. Higher educational attainment and being married were associated with primary and booster vaccine uptake and it may be possible to leverage these groups as early innovation adopters. Trust in government acts as a crucial bridging factor linking various variables in the networks with vaccine confidence attitudes, which subsequently closely linked to vaccine uptake. This study provides insights for designing future effective vaccination programmes for changing circumstances.
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Affiliation(s)
- Jiehu Yuan
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Yucan Xu
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Irene Oi Ling Wong
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Wendy Wing Tak Lam
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- Li Ka Shing Faculty of Medicine, Jocky Club Institute of Cancer Care, The University of Hong Kong, Hong Kong, China
| | - Michael Y Ni
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, China
- Urban Systems Institute, The University of Hong Kong, Hong Kong, China
| | - Benjamin J Cowling
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
- Laboratory of Data Discovery for Health Limited, Hong Kong Science and Technology Park, New Territories, Hong Kong, China.
| | - Qiuyan Liao
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
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13
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Rabin C. Longitudinal study of theory-based predictors of COVID-19 vaccination. PSYCHOL HEALTH MED 2024; 29:153-162. [PMID: 36602884 DOI: 10.1080/13548506.2022.2160873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 12/13/2022] [Indexed: 01/06/2023]
Abstract
Efforts to mitigate the impact of COVID-19 now focus primarily on encouraging vaccination. These efforts have been hampered, however, by vaccine hesitancy. A better understanding of the factors associated with vaccination may help identify those most likely to experience hesitancy and inform the content of public health outreach efforts. The aims of this study were to evaluate whether two theory-based factors (perceived vaccine efficacy and vaccination intention) and political party affiliation were associated with vaccination in the United States (US) and to provide descriptive analysis of factors shaping vaccination decisions. A longitudinal online survey was conducted with 108 adults in the US. Participants completed surveys in July 2020 (Time 1) and October 2021 (Time 2). As hypothesized, greater vaccination intention and perceived vaccine efficacy were significant predictors of vaccine uptake. The second hypothesis was also supported as political party affiliation was associated with vaccination (i.e. Democrats were more likely to vaccinate than Republicans). Descriptive data indicated that vaccinated participants (including those reluctant to vaccinate at Time 1) had been motivated by a desire to protect themselves and others from COVID-19. Participants who had chosen not to vaccinate were influenced by a variety of factors including concerns about vaccine safety and efficacy. Understanding the predictors of vaccination is critical to identifying those unlikely to vaccinate and creating effective interventions to encourage the uptake of this essential public health strategy. Messaging should emphasize the efficacy of COVID-19 vaccines and be delivered by those seen as trustworthy in communities prone to vaccine hesitancy.
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Affiliation(s)
- Carolyn Rabin
- Clinical Psychology Department, William James College, Newton, MA, USA
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14
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Hennessy M, Bleakley A, Langbaum JB. Tracking COVID-19 vaccination expectancies and vaccination refusal in the United States. PSYCHOL HEALTH MED 2024; 29:297-316. [PMID: 36809232 PMCID: PMC10440367 DOI: 10.1080/13548506.2023.2181977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 02/07/2023] [Indexed: 02/23/2023]
Abstract
To identify factors that predict COVID-19 vaccination refusal and show how expectancies affect vaccination acceptance for non-vaccinated adults, we used a monthly repeated cross-sectional sample from June/2021 to October/2021 to collect data on vaccination behaviors and predictor variables for 2,116 US adults over 50 years of age. Selection bias modeling - which is required when data availability is a result of behavioral choice - predicts two outcomes: (1) no vaccination vs. vaccination for the entire sample and (2) the effects of expectancy indices predicting vaccination Refuser vs. vaccination Accepters for the unvaccinated group. Vaccine refusers were younger and less educated, endorsed common misconceptions about the COVID-19 epidemic, and were Black. Vaccination expectancies were related to vaccination refusal in the unvaccinated eligible group: negative expectancies increased vaccine refusal, while positive expectancies decreased it. We conclude that behavior-related expectancies (as opposed to more stable psychological traits) are important to identify because they are often modifiable and provide a point of intervention, not just for COVID-19 vaccination acceptance but also for other positive health behaviors.
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Affiliation(s)
- Michael Hennessy
- Department of Communication, University of Delaware, Newark, DE, United States
| | - Amy Bleakley
- Department of Communication, University of Delaware, Newark, DE, United States
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15
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Newman PA, Dinh DA, Nyoni T, Allan K, Fantus S, Williams CC, Tepjan S, Reid L, Guta A. Covid-19 Vaccine Hesitancy and Under-Vaccination among Marginalized Populations in the United States and Canada: A Scoping Review. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01882-1. [PMID: 38117443 DOI: 10.1007/s40615-023-01882-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 11/20/2023] [Accepted: 11/27/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND Amid persistent disparities in Covid-19 vaccination and burgeoning research on vaccine hesitancy (VH), we conducted a scoping review to identify multilevel determinants of Covid-19 VH and under-vaccination among marginalized populations in the U.S. and Canada. METHODS Using the scoping review methodology developed by the Joanna Briggs Institute, we designed a search string and explored 7 databases to identify peer-reviewed articles published from January 1, 2020-October 25, 2022. We combine frequency analysis and narrative synthesis to describe factors influencing Covid-19 VH and under-vaccination among marginalized populations. RESULTS The search captured 11,374 non-duplicated records, scoped to 103 peer-reviewed articles. Among 14 marginalized populations identified, African American/Black, Latinx, LGBTQ+, American Indian/Indigenous, people with disabilities, and justice-involved people were the predominant focus. Thirty-two factors emerged as influencing Covid-19 VH, with structural racism/stigma and institutional mistrust (structural)(n = 71) most prevalent, followed by vaccine safety (vaccine-specific)(n = 62), side effects (vaccine-specific)(n = 50), trust in individual healthcare provider (social/community)(n = 38), and perceived risk of infection (individual)(n = 33). Structural factors predominated across populations, including structural racism/stigma and institutional mistrust, barriers to Covid-19 vaccine access due to limited supply/availability, distance/lack of transportation, no/low paid sick days, low internet/digital technology access, and lack of culturally- and linguistically-appropriate information. DISCUSSION We identified multilevel and complex drivers of Covid-19 under-vaccination among marginalized populations. Distinguishing vaccine-specific, individual, and social/community factors that may fuel decisional ambivalence, more appropriately defined as VH, from structural racism/structural stigma and systemic/institutional barriers to vaccination access may better support evidence-informed interventions to promote equity in access to vaccines and informed decision-making among marginalized populations.
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Affiliation(s)
- Peter A Newman
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada.
| | - Duy A Dinh
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
- Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
| | - Thabani Nyoni
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Kate Allan
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Sophia Fantus
- School of Social Work, University of Texas at Arlington, Arlington, TX, USA
| | - Charmaine C Williams
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | | | - Luke Reid
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Adrian Guta
- School of Social Work, University of Windsor, Windsor, ON, Canada
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16
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Pedersen B, Thompson G, Kouakou AY, Mujinga M, Nicholes S, Martinez A, Agha S, Thanel K, Ouattara ML, Gbeke D, Burke HM. Development and Assessment of a Six-Item Index to Gauge Motivation to Receive COVID-19 Vaccination. Vaccines (Basel) 2023; 12:6. [PMID: 38276665 PMCID: PMC10818755 DOI: 10.3390/vaccines12010006] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 12/12/2023] [Accepted: 12/16/2023] [Indexed: 01/27/2024] Open
Abstract
This study examined the factors influencing vaccine uptake using the Fogg Behavioral Model (FBM) and validated a multi-dimensional index for measuring a key construct in the FBM, motivation, using Confirmatory Factor Analysis (CFA) and Cronbach's alpha. The research was conducted in Yopougon Est, Côte d'Ivoire, and Kinshasa, Democratic Republic of Congo. We aimed to develop a motivation index for COVID-19 vaccination uptake informed by the FBM. The motivation index was developed and refined using interviews and cognitive testing, and then used in baseline and endline surveys to measure the motivation to uptake COVID-19 vaccination among 2173 respondents. The index was simplified to six items validated using Confirmatory Factor Analysis (CFA) and demonstrated strong internal reliability with Cronbach's alphas of 0.89 for the baseline and 0.77 for the endline. The study's findings indicate that this motivation index is a valid tool for measuring motivation to receive COVID-19 vaccination, with potential applications in other vaccination campaigns. However, further testing in diverse settings is needed to enhance generalizability, including in rural areas. This research provides valuable insights for designing effective behavior change interventions to increase COVID-19 vaccination rates.
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Affiliation(s)
- Brian Pedersen
- Department of Social and Behavior Change, FHI 360, Washington, DC 20009, USA;
| | - Gretchen Thompson
- Department of Behavioral, Epidemiological and Clinical Sciences, FHI 360, Durham, NC 27701, USA; (G.T.); (S.N.); (A.M.)
| | - Albert Yao Kouakou
- Independent Research Consultant, Abidjan 00225, Côte d’Ivoire; (A.Y.K.); (M.L.O.); (D.G.)
- Department of Social Sciences and Humanities, University of Jean Lorougnon Guédé of Daloa, Sassandra-Marahoué District, Daloa 150, Côte d’Ivoire
| | - Marie Mujinga
- Independent Research Consultant, Kinshasa 00243, Democratic Republic of the Congo;
| | - Samuel Nicholes
- Department of Behavioral, Epidemiological and Clinical Sciences, FHI 360, Durham, NC 27701, USA; (G.T.); (S.N.); (A.M.)
| | - Andres Martinez
- Department of Behavioral, Epidemiological and Clinical Sciences, FHI 360, Durham, NC 27701, USA; (G.T.); (S.N.); (A.M.)
| | - Sohail Agha
- Behavior Design Lab, Stanford University, Stanford, CA 94305, USA;
| | - Katherine Thanel
- Department of Social and Behavior Change, FHI 360, Washington, DC 20009, USA;
| | | | - Dorgeles Gbeke
- Independent Research Consultant, Abidjan 00225, Côte d’Ivoire; (A.Y.K.); (M.L.O.); (D.G.)
| | - Holly M. Burke
- Department of Reproductive, Maternal, Newborn and Child Health, FHI 360, Durham, NC 27701, USA;
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17
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Xu R, Shi G, Zheng S, Tung TH, Zhang M. COVID-19 vaccine hesitancy between family decision-makers and non-decision-makers among college teachers. Ann Med 2023; 55:292-304. [PMID: 36594480 PMCID: PMC9815219 DOI: 10.1080/07853890.2022.2162114] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Teachers with high educational levels significantly impact the health-related knowledge and attitudes of young students and their family members. This study aimed to investigate the coronavirus disease 2019 (COVID-19) vaccine hesitancy and associated factors, and compare the differences between decision-makers and non-decision-makers among college teachers. METHODS A cross-sectional online survey was administered across mainland China from 4 to 7 August 2021. Overall, 251 college teachers were included using snowball sampling. A multivariable logistic regression model was applied to explore the association between decision-makers and hesitancy to receive a COVID-19 vaccine. RESULTS Overall, 42.2% of the teachers were hesitant to being vaccinated against COVID-19. The hesitancy rate was lower among primary decision-makers than that among non-decision-makers (34.8% vs. 60.3%, p < .001). Primary decision-makers were less hesitant regarding COVID-19 vaccination than non-decision-makers (OR = 0.37, 95% CI 0.20-0.70); remarkably, whereas those engaged in nursing education versus non-medical related professional education (OR = 2.67, 95% CI 1.29-5.49), and partial versus full-course vaccination recipients (OR = 4.48, 95% CI: 1.76-11.42) were more likely to be hesitant regarding COVID-19 vaccination. CONCLUSION Our findings indicate that a high proportion of college teachers in China are hesitant to receiving COVID-19 vaccination, and that primary decision-makers are less likely to exhibit hesitancy to being vaccinated against COVID-19 than non-decision-makers in their family. Family decision-makers among teachers can be considered a priority for COVID-19 vaccine promotion, thereby enhancing vaccine acceptance among vulnerable populations-including older adults and children-and preventing adverse outcomes.KEY MESSAGESQuestion: How prevalent is COVID-19 vaccine hesitancy among college teachers? Do differences exist between decision-makers and non-decision-makers?Findings: We found that a substantial proportion of college teachers are hesitant to being vaccinated against COVID-19, and that family decision-makers exhibited a lower hesitancy rate than non-decision-makers.Meaning: Our findings indicate that distinguishing between family decision-makers and non-decision-makers is necessary to facilitate vaccination promotion interventions among college teachers.
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Affiliation(s)
- Rong Xu
- Department of Nursing, Xiamen Medical College, Xiamen, Fujian, China
| | - Guifeng Shi
- Department of Preventive Health Care, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, China
| | - Shuo Zheng
- Department of Nursing, Weifang Nursing Vocational College, Qingzhou, Shandong, China
| | - Tao-Hsin Tung
- Evidence-Based Medicine Center, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, China
| | - Meixian Zhang
- Evidence-Based Medicine Center, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, China
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18
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Okuhara T, Shirabe R, Kagawa Y, Okada H, Kiuchi T. Encouraging COVID-19 vaccination by focusing on anticipated affect: A scoping review. Heliyon 2023; 9:e22655. [PMID: 38076197 PMCID: PMC10709050 DOI: 10.1016/j.heliyon.2023.e22655] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 11/08/2023] [Accepted: 11/16/2023] [Indexed: 06/21/2024] Open
Abstract
OBJECTIVE This study reviewed studies of the anticipated affect related with COVID-19 vaccination to understand gaps in currently available studies and practice implications. METHODS We systematically searched MEDLINE, CINAHL, and other multiple databases for English language articles of studies that investigated COVID-19 vaccination related anticipated affects. RESULTS We identified seventeen studies. Thirteen studies focused anticipated regret from inaction (i.e., not vaccinated). Other studies focused anticipated regret from action (i.e., vaccinated), guilt from inaction, pride from action, and positive feelings from action. Eleven studies showed that anticipated regret from inaction was significantly associated with COVID-19 vaccination behavior or intention. Three of the 11 studies showed that anticipated regret from inaction was more strongly associated with vaccination behavior or intention than cognitive belief. CONCLUSION Most studies showed that positive associations between anticipated regret and COVID-19 vaccination outcomes. The use of messages that target cognitive beliefs as well as those that appeal to anticipated affect may be effective to promote COVID-19 vaccination. However, most studies employed a cross-sectional design and examined negative affect. Future studies should adopt an experimental design as well as examine positive affect.
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Affiliation(s)
- Tsuyoshi Okuhara
- Department of Health Communication, School of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Ritsuko Shirabe
- Department of Health Communication, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yumi Kagawa
- Department of Health Communication, School of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hiroko Okada
- Department of Health Communication, School of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takahiro Kiuchi
- Department of Health Communication, School of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Kyprianidou M, Konstantinou P, Alvarez-Galvez J, Ceccarelli L, Gruszczyńska E, Mierzejewska-Floreani D, Loumba N, Montagni I, Tavoschi L, Karekla M, Kassianos AP. Profiling Hesitancy to COVID-19 Vaccinations in Six European Countries: Behavioral, Attitudinal and Demographic Determinants. Behav Med 2023; 49:362-373. [PMID: 35546258 DOI: 10.1080/08964289.2022.2071198] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 04/06/2022] [Accepted: 04/22/2022] [Indexed: 11/02/2022]
Abstract
Vaccination hesitancy is an important barrier for the effective control of the COVID-19 pandemic. Identifying determinants of COVID-19 vaccination hesitancy is essential in order to reduce mortality rates. Further, given the variability of the factors and the different recommendations used in each country, it is important to conduct cross-country research to profile individuals who are hesitant toward COVID-19 vaccinations. This cross-sectional study aimed to examine cross-country differences and the behavioral, attitudinal and demographic characteristics of vaccine hesitant individuals. Adults living in six European countries (Cyprus, France, Germany, Italy, Poland, and Spain) were eligible to participate. A total of 832 individuals completed the online survey, with 17.9% reporting being hesitant to COVID-19 vaccination. Vaccine accepters were significantly older (M = 38.9, SD = 14.3), more educated (master/postgraduate studies) and lived in a place with a higher number of residents (>500,000 people) compared to those hesitant to COVID-19 vaccination. Discriminant analysis confirmed that the hesitant profile includes a person of younger age, living alone in smaller communities, and without children. Additionally, hesitant participants reported COVID-19-specific characteristics such as lower institutional trust, less adherence to COVID-19 protective behaviors and higher pandemic fatigue. When tackling COVID-19 vaccination hesitancy both socio-demographic and behavioral/attitudinal aspects should be taken into account. Stakeholders are advised to implement targeted vaccination programs while at the same time building trust with population illness cognitions addressed in order to reduce hesitancy rates. Further, stakeholders and public health authorities in each country are suggested to target interventions according to different population characteristics as behavioral and attitudinal determinants of COVID-19 vaccination hesitancy differed between countries.
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Affiliation(s)
| | | | - Javier Alvarez-Galvez
- Department of Biomedicine, Biotechnology and Public Health, University of Cadiz, Cadiz, Spain
| | - Luca Ceccarelli
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Ewa Gruszczyńska
- SWPS University of Social Sciences and Humanities, Warsaw, Poland
| | | | | | - Ilaria Montagni
- Bordeaux Population Health Research Center UMRS1219, University of Bordeaux - Inserm, Bordeaux, France
| | - Lara Tavoschi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Maria Karekla
- Department of Psychology, University of Cyprus, Nicosia, Cyprus
| | - Angelos P Kassianos
- Department of Psychology, University of Cyprus, Nicosia, Cyprus
- Department of Applied Health Research, UCL, London, UK
- Department of Nursing, Cyprus University of Technology, Limassol, Cyprus
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20
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Javanbakht M, Khan L, Mustanski B, Shoptaw S, Baum MK, Mehta SH, Kirk GD, Lai S, Moore R, Milloy MJ, Kipke M, Hayashi K, DeBeck K, Siminski S, White LM, Gorbach P. Substance use and other factors associated with COVID-19 vaccine uptake among people at risk for or living with HIV: Findings from the C3PNO consortium. Prev Med Rep 2023; 35:102300. [PMID: 37455759 PMCID: PMC10289823 DOI: 10.1016/j.pmedr.2023.102300] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 06/14/2023] [Accepted: 06/21/2023] [Indexed: 07/18/2023] Open
Abstract
Objective We describe the prevalence of COVID-19 vaccine uptake, substance use, and other factors associated with vaccine hesitancy among participants from nine North American cohort studies following a diverse group of individuals at risk for or living with HIV. Methods Between May 2021 and January 2022, participants completed a survey related to COVID-19 vaccination. Participants included those with and without substance use. Those responding as 'no' or 'undecided' to the question "Do you plan on getting the COVID-19 vaccine?" were categorized as vaccine hesitant. Differences between groups were evaluated using chi-square methods and multivariable log-binomial models were used to calculate prevalence ratios (PR) of COVID-19 vaccine hesitancy with separate models for each substance. Results Among 1,696 participants, COVID-19 vaccination was deferred or declined by 16%. Vaccine hesitant participants were younger, with a greater proportion unstably housed (14.8% vs. 10.0%; p = 0.02), and not living with HIV (48.% vs. 36.6%; p <.01). Vaccine hesitant participants were also more likely to report cannabis (50.0% vs. 42.4%; p = 0.03), methamphetamine (14.0% vs. 8.2%; p <.01), or fentanyl use (5.5% vs. 2.8%; p = 0.03). Based on multivariable analyses methamphetamine or fentanyl use remained associated with COVID-19 vaccine hesitancy (Adjusted PR = 1.4; 95% CI 1.1-1.9 and Adjusted PR = 1.6; 95% CI 1.0-2.6, respectively). Conclusion As new COVID-19 vaccines and booster schedules become necessary, people who use drugs (PWUD) may remain vaccine hesitant. Strategies to engage hesitant populations such as PWUD will need to be tailored to include special types of outreach such as integration with substance use programs such as safe injection sites or recovery programs.
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Affiliation(s)
- Marjan Javanbakht
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Lamia Khan
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Brian Mustanski
- Institute for Sexual and Gender Minority Health and Wellbeing and Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
| | - Steve Shoptaw
- Department of Family Medicine, Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Marianna K. Baum
- Department of Dietetics and Nutrition, Robert Stempel College of Public Health, Florida International University, Miami, FL, USA
| | - Shruti H. Mehta
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Gregory D. Kirk
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Shenghan Lai
- Department of Epidemiology and Public Health, School of Medicine, University of Maryland, Baltimore, MD, USA
| | - Richard Moore
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - M-J Milloy
- Department of Medicine, University of British Columbia, Vancouver, Canada
| | - Michele Kipke
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Kanna Hayashi
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - Kora DeBeck
- School of Public Policy, Simon Fraser University, Vancouver, Canada
| | | | - Lisa M White
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Pamina Gorbach
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
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21
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Powell N, Taylor B, Hotton A, Lamuda P, Flanagan E, Pyra M, Brewer R, Johnson O, Pollack HA, Schneider JA. The Relationship between Substance Use Stigma and COVID-19 Vaccine Hesitancy. Vaccines (Basel) 2023; 11:1194. [PMID: 37515010 PMCID: PMC10383134 DOI: 10.3390/vaccines11071194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 06/29/2023] [Accepted: 06/30/2023] [Indexed: 07/30/2023] Open
Abstract
Two parallel public health epidemics affecting the United States include the COVID-19 pandemic and a rise in substance use disorders (SUDs). Limited research has examined the potential relationship between these two epidemics. Our objective was therefore to perform an exploratory study in order to examine the association between public stigma toward people with a past history of opioid, methamphetamine, cocaine, and alcohol use disorder and COVID-19 vaccine hesitancy. A national sample of U.S. adults (N = 6515) completed a survey which assessed the degree of negative perceptions toward individuals with a past history of substance use disorders (referred to as substance use stigma) and COVID-19 vaccine hesitancy, along with variables such as racial prejudice, source of health news, and other demographics. We evaluated four multivariable logistic regression models to predict COVID-19 vaccine hesitancy, utilizing substance use stigma toward opioids, methamphetamine, cocaine, and alcohol use as independent variables. We found that COVID-19 vaccine hesitancy was positively associated with substance use stigma toward opioid (AOR = 1.34, p < 0.05), methamphetamine (AOR = 1.40, p < 0.01), and cocaine (AOR = 1.28, p < 0.05) use, but not alcohol use (AOR = 1.06, n.s.). Predictive models that incorporate substance use stigma may therefore improve our ability to identify individuals that may benefit from vaccine hesitancy interventions. Future research to understand the underlying reasons behind the association between substance use stigma and COVID-19 vaccine hesitancy may help us to construct combined interventions which address belief systems that promote both substance use stigma and vaccine hesitancy.
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Affiliation(s)
- Natasha Powell
- Pritzker School of Medicine, University of Chicago, Chicago, IL 60637, USA
| | - Bruce Taylor
- NORC at the University of Chicago, Chicago, IL 60637, USA
| | - Anna Hotton
- Departments of Medicine and Public Health, University of Chicago, Chicago, IL 60637, USA
| | - Phoebe Lamuda
- NORC at the University of Chicago, Chicago, IL 60637, USA
| | | | - Maria Pyra
- Department of Medical Social Sciences, Northwestern University, Evanston, IL 60201, USA
| | - Russell Brewer
- Department of Medicine, University of Chicago, Chicago, IL 60637, USA
| | - O'Dell Johnson
- Southern Public Health and Criminal Justice Research Center, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
| | - Harold A Pollack
- Crown Family School of Social Work, Policy, and Practice, University of Chicago, Chicago, IL 60637, USA
| | - John A Schneider
- Departments of Medicine and Public Health, University of Chicago, Chicago, IL 60637, USA
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22
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Visos-Varela I, Zapata-Cachafeiro M, Pintos-Rodríguez S, Bugarín-González R, González-Barcala FJ, Herdeiro MT, Piñeiro-Lamas M, Figueiras A, Salgado-Barreira Á. Outpatient atorvastatin use and severe COVID-19 outcomes: A population-based study. J Med Virol 2023; 95:e28971. [PMID: 37486310 DOI: 10.1002/jmv.28971] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 06/09/2023] [Accepted: 07/05/2023] [Indexed: 07/25/2023]
Abstract
Evidence of the effect of statins on patients with coronavirus disease (2019) COVID-19 is inconsistent. The aim of this study was to evaluate the association between chronic use of statins-both overall and by active ingredient-and severe outcomes of COVID-19 (risk of hospitalization and mortality), progression to severe outcomes, and susceptibility to the virus. We conducted a population-based case-control study with data from electronic records to assess the risk of (1) hospitalization: cases were patients admitted due to COVID-19 and controls were subjects without COVID-19; (2) mortality: cases were hospitalized patients who died due to COVID-19 and controls were subjects without COVID-19; (3) progression: cases were hospitalized COVID-19 subjects and controls were nonhospitalized COVID-19 patients; and (4) susceptibility: cases were patients with COVID-19 (both hospitalized and nonhospitalized) and controls were subjects without COVID-19. We collected data on 2821 hospitalized cases, 26 996 nonhospitalized cases, and 52 318 controls. Chronic use of atorvastatin was associated with a decreased risk of hospitalization (adjusted odds ratios [aOR] = 0.83; 95% confidence interval [CI]: 0.74-0.92) and mortality (aOR = 0.70; 95% CI: 0.53-0.93), attributable in part to a lower risk of susceptibility to the virus (aOR = 0.91; 95% CI: 0.86-0.96). Simvastatin was associated with a reduced risk of mortality (aOR = 0.59; 95% CI: 0.40-0.87). The wide degree of heterogeneity observed in the estimated odds ratios (ORs) of the different statins suggests that there is no class effect. The results of this real-world study suggest that chronic use of atorvastatin (and to a lesser degree, of simvastatin) is associated with a decrease in risk of severe COVID-19 outcomes.
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Affiliation(s)
- Irene Visos-Varela
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Maruxa Zapata-Cachafeiro
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
- Institute of Health Research of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Santiago de Compostela, Spain
| | - Samuel Pintos-Rodríguez
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Rosendo Bugarín-González
- Monforte de Lemos Health Center, Health Area of Lugo, A Mariña and Monforte de Lemos, SERGAS, Monforte de Lemos, Lugo, Spain
| | - Francisco Javier González-Barcala
- Spanish Biomedical Research Networking Centre-CIBERES, Santiago de Compostela, Spain
- Pneumoloxy Department, Santiago de Compostela University Hospital Complex, Santiago de Compostela, Spain
| | - Maria T Herdeiro
- Department of Medical Sciences, iBiMED-Institute of Biomedicine, University of Aveiro, Aveiro, Portugal
| | - María Piñeiro-Lamas
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Santiago de Compostela, Spain
| | - Adolfo Figueiras
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
- Institute of Health Research of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Santiago de Compostela, Spain
| | - Ángel Salgado-Barreira
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
- Institute of Health Research of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Santiago de Compostela, Spain
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23
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Zaildo T, Santino TA, Chaves G, da Silva BAK, Alchieri JC, Patino CM, Leite S, Luz KG, Guerra RO, da Penha THS, da Silva GR, Jácome AC, Monteiro KS, de Mendonça KMPP. Barriers to and facilitators of populational adherence to prevention and control measures of COVID-19 and other respiratory infectious diseases: a qualitative evidence synthesis. Eur Respir Rev 2023; 32:220238. [PMID: 37343960 DOI: 10.1183/16000617.0238-2022] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 04/03/2023] [Indexed: 06/23/2023] Open
Abstract
AIMS To summarise the evidence on barriers to and facilitators of population adherence to prevention and control measures for coronavirus disease 2019 (COVID-19) and other respiratory infectious diseases. METHODS A qualitative synthesis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis and the Cochrane Effective Practice and Organization of Care: Qualitative Evidence Synthesis. We performed an electronic search on MEDLINE, Embase and PsycINFO from their inception to March 2023. RESULTS We included 71 studies regarding COVID-19, pneumonia, tuberculosis, influenza, pertussis and H1N1, representing 5966 participants. The measures reported were vaccinations, physical distancing, stay-at-home policy, quarantine, self-isolation, facemasks, hand hygiene, contact investigation, lockdown, infection prevention and control guidelines, and treatment. Tuberculosis-related measures were access to care, diagnosis and treatment completion. Analysis of the included studies yielded 37 barriers and 23 facilitators. CONCLUSIONS This review suggests that financial and social support, assertive communication, trust in political authorities and greater regulation of social media enhance adherence to prevention and control measures for COVID-19 and infectious respiratory diseases. Designing and implementing effective educational public health interventions targeting the findings of barriers and facilitators highlighted in this review are key to reducing the impact of infectious respiratory diseases at the population level.
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Affiliation(s)
- Tácito Zaildo
- Department of Physical Therapy, Graduate Program in Physical Therapy, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Thayla Amorim Santino
- Department of Physical Therapy, State University of Paraiba, Campina Grande, PB, Brazil
| | | | | | - João Carlos Alchieri
- Department of Psychology, Graduate Program in Science, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Cecilia M Patino
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, CA, USA
| | - Sarah Leite
- Department of Physical Therapy, Graduate Program in Physical Therapy, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Kleber Giovanni Luz
- Department of Infectious Diseases, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Ricardo Oliveira Guerra
- Department of Physical Therapy, Graduate Program in Physical Therapy, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Tito Hugo Soares da Penha
- Department of Physical Therapy, Graduate Program in Physical Therapy, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Gabriel Rodrigues da Silva
- Department of Physical Therapy, Graduate Program in Physical Therapy, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Ada Cristina Jácome
- Public Health Department of the State of Rio Grande do Norte, Natal, RN, Brazil
| | - Karolinne Souza Monteiro
- Faculty of Health Sciences of Trairi, Federal University of Rio Grande do Norte, Natal, RN, Brazil
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24
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Pogue K, Altman JD, Lee AA, Miner DS, Skyles TJ, Bodily RJ, Crook TB, Nielson BU, Hinton K, Busacker L, Mecham ZE, Rose AM, Black S, Poole BD. Decrease in Overall Vaccine Hesitancy in College Students during the COVID-19 Pandemic. Vaccines (Basel) 2023; 11:1132. [PMID: 37514948 PMCID: PMC10384532 DOI: 10.3390/vaccines11071132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 06/08/2023] [Accepted: 06/20/2023] [Indexed: 07/30/2023] Open
Abstract
The COVID-19 pandemic changed our world as we know it and continues to be a global problem three years since the pandemic began. Several vaccines were produced, but there was a considerable amount of societal turmoil surrounding them that has affected the way people view not only COVID-19 vaccines but all vaccines. We used a survey to compare how attitudes towards vaccination have changed in college students during the pandemic. An initial survey was administered in 2021, then a follow-up in 2022. Out of 316 respondents who answered the first survey, 192 completed the follow-up. The survey was designed to measure trends in changes to vaccine attitudes since the COVID-19 pandemic began. By comparing the first survey in 2021 and the follow-up, we found that roughly 55% of respondents' vaccine attitudes did not change, roughly 44% of respondents' attitudes towards vaccines became more positive, and only about 1% of the respondents' vaccine attitudes became more negative. Improved view of vaccines was associated with political views and increased trust in medicine and the healthcare system. Worsened opinions of vaccines were associated with a belief that the COVID-19 vaccine affected fertility.
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Affiliation(s)
- Kendall Pogue
- Department of Microbiology and Molecular Biology, Brigham Young University, Provo, UT 84602, USA
| | - Jessica D Altman
- Department of Microbiology and Molecular Biology, Brigham Young University, Provo, UT 84602, USA
| | - Abigail A Lee
- Department of Microbiology and Molecular Biology, Brigham Young University, Provo, UT 84602, USA
| | - Dashiell S Miner
- Department of Microbiology and Molecular Biology, Brigham Young University, Provo, UT 84602, USA
| | - Ty J Skyles
- Department of Microbiology and Molecular Biology, Brigham Young University, Provo, UT 84602, USA
| | - Ruth J Bodily
- Department of Microbiology and Molecular Biology, Brigham Young University, Provo, UT 84602, USA
| | - Triston B Crook
- Department of Microbiology and Molecular Biology, Brigham Young University, Provo, UT 84602, USA
| | - Bryce U Nielson
- Department of Microbiology and Molecular Biology, Brigham Young University, Provo, UT 84602, USA
| | - Kaitlyn Hinton
- Department of Microbiology and Molecular Biology, Brigham Young University, Provo, UT 84602, USA
| | - Lydia Busacker
- Department of Microbiology and Molecular Biology, Brigham Young University, Provo, UT 84602, USA
| | - Zoe E Mecham
- Department of Microbiology and Molecular Biology, Brigham Young University, Provo, UT 84602, USA
| | - Agnes M Rose
- Department of Microbiology and Molecular Biology, Brigham Young University, Provo, UT 84602, USA
| | - Scott Black
- Department of English, University of Utah, Salt Lake City, UT 84112, USA
| | - Brian D Poole
- Department of Microbiology and Molecular Biology, Brigham Young University, Provo, UT 84602, USA
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25
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Carrieri V, Guthmuller S, Wübker A. Trust and COVID-19 vaccine hesitancy. Sci Rep 2023; 13:9245. [PMID: 37286569 DOI: 10.1038/s41598-023-35974-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 05/26/2023] [Indexed: 06/09/2023] Open
Abstract
This article uses novel data collected on a weekly basis covering more than 35,000 individuals in the EU to analyze the relationship between trust in various dimensions and COVID-19 vaccine hesitancy. We found that trust in science is negatively correlated, while trust in social media and the use of social media as the main source of information are positively associated with vaccine hesitancy. High trust in social media is found among adults aged 65+, financially distressed and unemployed individuals, and hesitancy is largely explained by conspiracy beliefs among them. Finally, we found that the temporary suspension of the AstraZeneca vaccine in March 2021 significantly increased vaccine hesitancy and especially among people with low trust in science, living in rural areas, females, and financially distressed. Our findings suggest that trust is a key determinant of vaccine hesitancy and that pro-vaccine campaigns could be successfully targeted toward groups at high risk of hesitancy.
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Affiliation(s)
- Vincenzo Carrieri
- Department of Political and Social Sciences, University of Calabria, Arcavacata di Rende (CS), Italy
- RWI-Leibniz Institute for Economic Research, Essen, Germany
- IZA, Bonn, Germany
| | - Sophie Guthmuller
- RWI-Leibniz Institute for Economic Research, Essen, Germany.
- Vienna University of Economics and Business, Vienna, Austria.
| | - Ansgar Wübker
- RWI-Leibniz Institute for Economic Research, Essen, Germany
- Hochschule Harz, Wernigerode, Germany
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26
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Datar RS, Fette LM, Hinkelman AN, Hammershaimb EA, Friedman-Klabanoff DJ, Mongraw-Chaffin M, Weintraub WS, Ahmed N, Gibbs MA, Runyon MS, Plumb ID, Thompson W, Saydah S, Edelstein SL, Berry AA. Factors associated with COVID-19 vaccination during June-October 2021: A multi-site prospective study. Vaccine 2023; 41:3204-3214. [PMID: 37069033 PMCID: PMC10063571 DOI: 10.1016/j.vaccine.2023.03.057] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 03/24/2023] [Accepted: 03/26/2023] [Indexed: 04/03/2023]
Abstract
INTRODUCTION Vaccine hesitancy presents a challenge to COVID-19 control efforts. To identify beliefs associated with delayed vaccine uptake, we developed and implemented a vaccine hesitancy survey for the COVID-19 Community Research Partnership. METHODS In June 2021, we assessed attitudes and beliefs associated with COVID-19 vaccination using an online survey. Self-reported vaccination data were requested daily through October 2021. We compared responses between vaccinated and unvaccinated respondents using absolute standardized mean differences (ASMD). We assessed validity and reliability using exploratory factor analysis and identified latent factors associated with a subset of survey items. Cox proportional hazards models and mediation analyses assessed predictors of subsequent vaccination among those initially unvaccinated. RESULTS In June 2021, 29,522 vaccinated and 1,272 unvaccinated participants completed surveys. Among those unvaccinated in June 2021, 559 (43.9 %) became vaccinated by October 31, 2021. In June, unvaccinated participants were less likely to feel "very concerned" about getting COVID-19 than vaccinated participants (10.6 % vs. 43.3 %, ASMD 0.792). Among those initially unvaccinated, greater intent to become vaccinated was associated with getting vaccinated and shorter time to vaccination. However, even among participants who reported no intention to become vaccinated, 28.5 % reported vaccination before study end. Two latent factors predicted subsequent vaccination-being 'more receptive' was derived from motivation to protect one's own or others' health and resume usual activities; being 'less receptive' was derived from concerns about COVID-19 vaccines. In a Cox model, both factors were partially mediated by vaccination intention. CONCLUSION This study characterizes vaccine hesitant individuals and identifies predictors of eventual COVID-19 vaccination through October 31, 2021. Even individuals with no intention to be vaccinated can shift to vaccine uptake. Our data suggest factors of perceived severity of COVID-19 disease, vaccine safety, and trust in the vaccine development process are predictive of vaccination and may be important opportunities for ongoing interventions.
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Affiliation(s)
- Reva S Datar
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Lida M Fette
- The Biostatistics Center, George Washington University, Rockville, MD, USA
| | - Amy N Hinkelman
- Jerry M. Wallace School of Osteopathic Medicine, Campbell University, Lillington, NC, USA
| | - E Adrianne Hammershaimb
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - DeAnna J Friedman-Klabanoff
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Morgana Mongraw-Chaffin
- Department of Epidemiology & Prevention, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - William S Weintraub
- MedStar Health Research Institute, Georgetown University, Washington, DC, USA
| | - Naheed Ahmed
- Center for Health Equity Research, MedStar Health Research Institute, Hyattsville, MD, USA
| | | | | | - Ian D Plumb
- Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - William Thompson
- Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Sharon Saydah
- Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Sharon L Edelstein
- The Biostatistics Center, George Washington University, Rockville, MD, USA
| | - Andrea A Berry
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD, USA.
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27
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Lee Y, Park K, Shin J, Oh J, Jang Y, You M. Factors Affecting the Public Intention to Repeat the COVID-19 Vaccination: Implications for Vaccine Communication. Healthcare (Basel) 2023; 11:healthcare11091235. [PMID: 37174775 PMCID: PMC10178399 DOI: 10.3390/healthcare11091235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 04/18/2023] [Accepted: 04/21/2023] [Indexed: 05/15/2023] Open
Abstract
Although most of the pandemic-related mandatory restrictions have been lifted or eased, vaccination is still recommended as an effective measure to minimize the damage from COVID-19 infection. Since COVID-19 eradication is unlikely, it is necessary to understand the factors affecting the public's vaccination intention when COVID-19 vaccination is continuously recommended. This study aims to explore the factors that affect the intention to repeat the COVID-19 vaccination in South Korea. An online survey was conducted in January 2022 with adults living in Gyeonggi-do, South Korea. In a hierarchical logistic regression analysis, sociodemographic factors, COVID-19 infection-related factors, COVID-19 vaccination-related factors, sociocultural factors, and communication factors were taken into account. In this study, more than three-quarters (78.1%) of Koreans were willing to repeat the COVID-19 vaccination. People who had high-risk perceptions, had been vaccinated against COVID-19 at least once, had more authoritarian attitudes, regarded the vaccination as a social responsibility, and had positive attitudes toward health authorities' regular briefings were more likely to repeat the vaccination. In contrast, those who directly or indirectly experienced COVID-19 vaccine side effects and who showed psychological reactance against the government's vaccination recommendation were less likely to repeat the vaccination. Our research indicates that empathetic communication, promotion of the prosocial aspect of vaccination, and regular and transparent provision of vaccine information are essential for promoting the intention to repeat the COVID-19 vaccination.
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Affiliation(s)
- Yubin Lee
- Department of Public Health, Graduate School of Public Health, Seoul National University, Seoul 08826, Republic of Korea
| | - Kunhee Park
- Gyeonggi Infectious Disease Control Center, Suwon 16508, Republic of Korea
| | - Jeonghoon Shin
- Department of Public Health, Graduate School of Public Health, Seoul National University, Seoul 08826, Republic of Korea
| | - Jeonghyeon Oh
- Gyeonggi Infectious Disease Control Center, Suwon 16508, Republic of Korea
| | - Yeongeun Jang
- Gyeonggi Infectious Disease Control Center, Suwon 16508, Republic of Korea
| | - Myoungsoon You
- Department of Public Health, Graduate School of Public Health, Seoul National University, Seoul 08826, Republic of Korea
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28
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Soorapanth S, Cheung R, Zhang X, Mokdad AH, Mensah GA. Rural-Urban Differences in Vaccination and Hesitancy Rates and Trust: US COVID-19 Trends and Impact Survey on a Social Media Platform, May 2021-April 2022. Am J Public Health 2023; 113:680-688. [PMID: 37053528 DOI: 10.2105/ajph.2023.307274] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/15/2023]
Abstract
Objectives. To analyze rural-urban differences in COVID-19 vaccination uptake, hesitancy, and trust in information sources in the United States. Methods. We used data from a large survey of Facebook users. We computed the vaccination, hesitancy, and decline rates and the trust proportions among individuals hesitant toward COVID-19 information sources for rural and urban regions in each state from May 2021 to April 2022. Results. In 48 states with adequate data, on average, two thirds of states showed statistically significant differences in monthly vaccination rates between rural and urban regions, with rural regions having a lower vaccination rate at all times. Far fewer states showed statistically significant differences when comparing monthly hesitancy and decline rates for urban versus rural regions. Doctors and health professionals received the highest level of trust. Friends and family were also among the most trusted sources in rural areas where the vaccination uptake was low. Conclusions. Rural-urban difference in hesitancy rates among those still unvaccinated was much smaller than the rural-urban difference in vaccination rates, suggesting that access to vaccines may be another contributor to the lower vaccination rates in rural areas. (Am J Public Health. Published online ahead of print April 13, 2023:e1-e9. https://doi.org/10.2105/AJPH.2023.307274).
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Affiliation(s)
- Sada Soorapanth
- Sada Soorapanth and Rex Cheung are with the Department of Decision Sciences, Lam Family College of Business, San Francisco State University, San Francisco, CA. Xinzhi Zhang and George A. Mensah are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD. Ali H. Mokdad is with the Institute for Health Metrics and Evaluation and the Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Rex Cheung
- Sada Soorapanth and Rex Cheung are with the Department of Decision Sciences, Lam Family College of Business, San Francisco State University, San Francisco, CA. Xinzhi Zhang and George A. Mensah are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD. Ali H. Mokdad is with the Institute for Health Metrics and Evaluation and the Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Xinzhi Zhang
- Sada Soorapanth and Rex Cheung are with the Department of Decision Sciences, Lam Family College of Business, San Francisco State University, San Francisco, CA. Xinzhi Zhang and George A. Mensah are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD. Ali H. Mokdad is with the Institute for Health Metrics and Evaluation and the Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Ali H Mokdad
- Sada Soorapanth and Rex Cheung are with the Department of Decision Sciences, Lam Family College of Business, San Francisco State University, San Francisco, CA. Xinzhi Zhang and George A. Mensah are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD. Ali H. Mokdad is with the Institute for Health Metrics and Evaluation and the Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - George A Mensah
- Sada Soorapanth and Rex Cheung are with the Department of Decision Sciences, Lam Family College of Business, San Francisco State University, San Francisco, CA. Xinzhi Zhang and George A. Mensah are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD. Ali H. Mokdad is with the Institute for Health Metrics and Evaluation and the Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
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29
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McCready JL, Nichol B, Steen M, Unsworth J, Comparcini D, Tomietto M. Understanding the barriers and facilitators of vaccine hesitancy towards the COVID-19 vaccine in healthcare workers and healthcare students worldwide: An Umbrella Review. PLoS One 2023; 18:e0280439. [PMID: 37043505 PMCID: PMC10096263 DOI: 10.1371/journal.pone.0280439] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 12/31/2022] [Indexed: 04/13/2023] Open
Abstract
BACKGROUND Healthcare workers (HCWs) and healthcare students display high levels of vaccine hesitancy with impact on healthcare provision, patient safety, and health promotion. The factors related to vaccine hesitancy have been reported in several systematic reviews. However, this evidence needs to be synthesised, as interventions to reduce vaccination hesitancy in this population are needed. METHODS This Umbrella Review aimed to explore the barriers and facilitators of vaccine hesitancy toward the COVID-19 vaccine for HCWs and healthcare students. The review was performed and reported in accordance with Joanna Briggs Institutes guidelines and the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. A protocol was preregistered on PROSPERO (CRD42022327354). Eight databases were searched from November 2019 to 23rd May 2022 to identify any systematic reviews that explored factors associated with hesitancy towards the COVID-19 vaccine for HCWs or healthcare students. RESULTS A total of 31 studies were included in the review. The majority of studies (71%) were appraised as strong or moderate quality and there was a slight degree of overlap (<5%) of primary studies between the reviews. Vaccine hesitancy was more common among HCWs and healthcare students in specific occupational roles (e.g. nurses) than others (e.g. physicians). Frequent reasons for hesitancy were related to sociodemographic factors (gender, age, ethnicity), occupational factors (COVID-19 exposure, perceived risk, mandatory vaccination), health factors (vaccination history), vaccine-related factors (concerns about safety, efficacy, side-effects, rapid development, testing, approval and distribution of the vaccine), social factors (social pressure, altruism and collective responsibility), distrust factors (key social actors, pandemic management), information factors (inadequate information and sources, exposure to misinformation). CONCLUSION The results from this Umbrella Review have wide-reaching implications for the research area, healthcare systems and institutions and governments worldwide. Designing tailored strategies for specific occupational groups is pivotal to increasing vaccine uptake and securing a safe healthcare provision worldwide.
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Affiliation(s)
- Jemma Louise McCready
- Department of Social Work, Education and Community Wellbeing, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Bethany Nichol
- Department of Social Work, Education and Community Wellbeing, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Mary Steen
- Department of Nursing, Midwifery and Health, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - John Unsworth
- Department of Nursing, Midwifery and Health, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | | | - Marco Tomietto
- Department of Nursing, Midwifery and Health, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland
- University of Bari “Aldo Moro”, Bari, Italy
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30
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Kowalska-Duplaga K, Duplaga M. The association of conspiracy beliefs and the uptake of COVID-19 vaccination: a cross-sectional study. BMC Public Health 2023; 23:672. [PMID: 37041546 PMCID: PMC10088115 DOI: 10.1186/s12889-023-15603-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Accepted: 04/04/2023] [Indexed: 04/13/2023] Open
Abstract
The COVID-19 pandemic revealed that health denialism might be an important determinant of adherence to preventive measures during epidemic challenges. Conspiracy beliefs seem to be one of the most visible manifestations of denialism in society. Despite intensive efforts to promote COVID-19 vaccinations, the number of citizens reluctant to get vaccinated was very large in many countries. The main aim of this study was the analysis of the association between the acceptance of the COVID-19 vaccination and conspiracy beliefs among adult Internet users in Poland. The analysis was based on data from a survey performed on a sample of 2008 respondents in October 2021. Uni- and multivariable logistic regression models were applied to evaluate the association between attitudes towards COVID-19 vaccination and generic conspiracist, vaccine-conspiracy, and COVID-19-related conspiracy beliefs. In the multivariable model, the effect of conspiracy beliefs was adjusted for the level of vaccine hesitancy, future anxiety, political sympathies, and socio-demographic variables. Univariate regression models showed that COVID-19 vaccination acceptance is significantly lower among respondents with higher levels of all three types of conspiracy beliefs. In the multivariable model, the effect of COVID-19-related and vaccine conspiracy beliefs, but not generic conspiracist beliefs, was maintained after adjusting for vaccine hesitancy. We conclude that conspiracy beliefs should be treated as a potential indicator of lower adherence to preventive measures during epidemic challenges. The respondents revealing a high level of conspirational thinking are a potential group for intensified actions which employ health educational and motivational interventions.
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Affiliation(s)
- Kinga Kowalska-Duplaga
- Department of Health Promotion and e-Health, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Skawinska Str. 8, Krakow, 30-611 Poland
| | - Mariusz Duplaga
- Department of Health Promotion and e-Health, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Skawinska Str. 8, Krakow, 30-611 Poland
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Limbu YB, Gautam RK. How Well the Constructs of Health Belief Model Predict Vaccination Intention: A Systematic Review on COVID-19 Primary Series and Booster Vaccines. Vaccines (Basel) 2023; 11:816. [PMID: 37112728 PMCID: PMC10141697 DOI: 10.3390/vaccines11040816] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 04/02/2023] [Accepted: 04/04/2023] [Indexed: 04/29/2023] Open
Abstract
This systematic review synthesizes the findings of quantitative studies examining the relationships between Health Belief Model (HBM) constructs and COVID-19 vaccination intention. We searched PubMed, Medline, CINAHL, Web of Science, and Scopus using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and identified 109 eligible studies. The overall vaccination intention rate was 68.19%. Perceived benefits, perceived barriers, and cues to action were the three most frequently demonstrated predictors of vaccination intention for both primary series and booster vaccines. For booster doses, the influence of susceptibility slightly increased, but the impact of severity, self-efficacy, and cues to action on vaccination intention declined. The impact of susceptibility increased, but severity's effect declined sharply from 2020 to 2022. The influence of barriers slightly declined from 2020 to 2021, but it skyrocketed in 2022. Conversely, the role of self-efficacy dipped in 2022. Susceptibility, severity, and barriers were dominant predictors in Saudi Arabia, but self-efficacy and cues to action had weaker effects in the USA. Susceptibility and severity had a lower impact on students, especially in North America, and barriers had a lower impact on health care workers. However, cues to action and self-efficacy had a dominant influence among parents. The most prevalent modifying variables were age, gender, education, income, and occupation. The results show that HBM is useful in predicting vaccine intention.
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Affiliation(s)
- Yam B. Limbu
- Feliciano School of Business, Montclair State University, 1 Normal Ave., Montclair, NJ 07043, USA
| | - Rajesh K. Gautam
- Department of Anthropology, Dr. Harisingh Gour Central University, Sagar 470003, MP, India;
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Repurposing selective serotonin reuptake inhibitors for severity of COVID-19: a population-based study. Eur Neuropsychopharmacol 2023; 71:96-108. [PMID: 37094487 PMCID: PMC10070770 DOI: 10.1016/j.euroneuro.2023.03.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 03/24/2023] [Accepted: 03/29/2023] [Indexed: 04/07/2023]
Abstract
The World Health Organization has proposed that a search be made for alternatives to vaccines for the prevention and treatment of COVID-19, with one such alternative being selective serotonin reuptake inhibitors (SSRIs). This study thus sought to assess: the impact of previous treatment with SSRI antidepressants on the severity of COVID-19 (risk of hospitalisation, admission to an intensive care unit [ICU], and mortality), its influence on susceptibility to SARS-CoV-2 and progression to severe COVID-19. We conducted a population-based multiple case-control study in a region in the north-west of Spain. Data were sourced from electronic health records. Adjusted odds ratios (aORs) and 95%CIs were calculated using multilevel logistic regression. We collected data from a total of 86 602 subjects: 3060 cases PCR+, 26 757 non-hospitalised cases PCR+ and 56 785 controls (without PCR+). Citalopram displayed a statistically significant decrease in the risk of hospitalisation (aOR=0.70; 95% CI 0.49-0.99, p=0.049) and progression to severe COVID-19 (aOR=0.64; 95% CI 0.43-0.96, p=0.032). Paroxetine was associated with a statistically significant decrease in risk of mortality (aOR=0.34; 95% CI 0.12 – 0.94, p=0.039). No class effect was observed for SSRIs overall, nor was any other effect found for the remaining SSRIs. The results of this large-scale, real-world data study indicate that, citalopram, could be a candidate drug for being repurposed as preventive treatment aimed at reducing COVID-19 patients’ risk of progressing to severe stages of the disease.
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Hajek A, Kretzler B, Orth B, Von Rüden U, König HH. Perceived Norms and Vaccination against COVID-19 among the General Adult Population in Germany: Results of a Nationally Representative Survey. Vaccines (Basel) 2023; 11:vaccines11040800. [PMID: 37112712 PMCID: PMC10146349 DOI: 10.3390/vaccines11040800] [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: 03/10/2023] [Revised: 03/30/2023] [Accepted: 03/31/2023] [Indexed: 04/29/2023] Open
Abstract
OBJECTIVE to examine whether perceived norms are associated with vaccination against COVID-19 (also stratified by age group). STUDY DESIGN nationally representative survey. METHODS Data were taken from a sample of the general adult population (n = 3829, 16 to 94 years). Data collection took place from early July to early August 2021, and 3 different groups (1: not yet vaccinated and no intention to vaccinate against COVID-19; 2: not yet, but intended to vaccinate against COVID-19; 3: yes, at least one vaccination against COVID-19) were distinguished in the analyses. Data were adjusted for several sociodemographic and health-related factors. Perceived norms served as key independent variables (1: number of important friends and relatives who would like me to get vaccinated; 2: number of important friends and relatives who already have been vaccinated or still want to do so; 3: how your general practitioner (GP) thinks about Corona vaccination). RESULTS Multiple logistic regression showed that, in particular, the number of important friends/relatives who would like an individual to get vaccinated is associated with the actual COVID-19 vaccination status among individuals aged 16 to 59 years. Interestingly, all 3 indicators for perceived norms are associated with the likelihood of COVID-19 vaccination status among individuals aged 60 years and over. CONCLUSIONS Our study adds to the understanding of the association between perceived norms and COVID-19 vaccination status. This highlights potential pathways to increase vaccination rates to further combat the later stages of the pandemic.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, 20246 Hamburg, Germany
| | - Benedikt Kretzler
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, 20246 Hamburg, Germany
| | - Boris Orth
- Federal Centre for Health Education (BZgA), Referat Q3-Evaluation, Methods, Research Data, 50825 Cologne, Germany
| | - Ursula Von Rüden
- Federal Centre for Health Education (BZgA), Referat Q3-Evaluation, Methods, Research Data, 50825 Cologne, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, 20246 Hamburg, Germany
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Peña JM, Schwartz MR, Hernandez-Vallant A, Sanchez GR. Social and structural determinants of COVID-19 vaccine uptake among racial and ethnic groups. J Behav Med 2023; 46:129-139. [PMID: 36652085 PMCID: PMC9846662 DOI: 10.1007/s10865-023-00393-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 01/04/2023] [Indexed: 01/19/2023]
Abstract
Latino, Black, American Indian/Alaska Native (AI/AN), and Native Hawaiian or Other Pacific Islander people have the highest hospitalizations and death rates from COVID-19. Social inequalities have exacerbated COVID-19 related health disparities. This study examines social and structural determinants of COVID-19 vaccine uptake. Results from logistic regressions suggest Latino and Black people were less likely to be vaccinated. People that did not have health insurance, a primary care doctor and were unemployed were more than 30% less likely to be vaccinated for COVID-19. Greater perceived health inequalities in one's neighborhood and perceived racial/ethnic discrimination were associated with a decreased odds in being vaccinated. People that suffered the loss of a household member from COVID-19 were three times more likely to have been vaccinated. Establishing policies that will increase access to health insurance and create jobs with living wages may have lasting impacts. Furthermore, collaboration with local and national community organizations can enhance the development of sustainable solutions.
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Affiliation(s)
- Juan M Peña
- Department of Psychology Albuquerque, The University of New Mexico, 2001 Redondo S Dr, Albuquerque, 87106, NM, USA
- Center for Social Policy, The University of New Mexico Albuquerque, Albuquerque, NM, USA
| | - Matthew R Schwartz
- Center for Social Policy, The University of New Mexico Albuquerque, Albuquerque, NM, USA
- Department of Internal Medicine, The University of New Mexico, Albuquerque, NM, USA
| | - Alexandra Hernandez-Vallant
- Department of Psychology Albuquerque, The University of New Mexico, 2001 Redondo S Dr, Albuquerque, 87106, NM, USA
- Center for Social Policy, The University of New Mexico Albuquerque, Albuquerque, NM, USA
- Center of Alcohol, The University of New Mexico, Substance Use, and Addictions, Albuquerque, NM, USA
| | - Gabriel R Sanchez
- Center for Social Policy, The University of New Mexico Albuquerque, Albuquerque, NM, USA
- Department of Political Science, The University of New Mexico, Albuquerque, NM, USA
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35
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Nowak GJ, Cacciatore MA. State of Vaccine Hesitancy in the United States. Pediatr Clin North Am 2023; 70:197-210. [PMID: 36841590 DOI: 10.1016/j.pcl.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
Although the term "vaccine hesitancy" has achieved great prominence, the extent to which US parents have reluctance, doubts, or indecision when it comes to vaccines recommended for children and how such hesitancy is manifest are unclear. A narrative review approach that placed emphasis on recent data and published work is used to surface evidence and insights into the current state of US parent vaccine hesitancy. The assessment finds evidence that ∼6% to 25% of parents may be vaccine hesitant, that hesitancy is higher for influenza and HPV vaccines, and there are indications that addressing parent hesitancy has become more challenging.
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Affiliation(s)
- Glen J Nowak
- Grady College of Journalism & Mass Communication, Grady Center for Health and Risk Communication, University of Georgia, 120 Hooper Street, Athens, GA 30602, USA.
| | - Michael A Cacciatore
- Grady College of Journalism & Mass Communication, Grady Center for Health and Risk Communication, University of Georgia, 120 Hooper Street, Athens, GA 30602, USA
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36
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Taylor BG, Mumford EA, Kaplan AM, Liu W. Concerns about COVID-19 Vaccine Hesitancy among Law Enforcement Officers: Prevalence and Risk Factor Data from a Nationally Representative Sample in the United States. Vaccines (Basel) 2023; 11:vaccines11040783. [PMID: 37112695 PMCID: PMC10144532 DOI: 10.3390/vaccines11040783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 03/29/2023] [Accepted: 03/30/2023] [Indexed: 04/05/2023] Open
Abstract
Scant research exists on COVID-19 vaccine hesitancy among law enforcement officers, hindering health messaging development for officers and, by extension, the communities they serve. This paper’s goal was to address this gap by providing the necessary data to better under hesitancy to guide training and policy interventions for officers. The objective was to conduct the first nationally representative survey of officers on COVID-19 vaccine hesitancy and its correlates. We collected data from February 2021 to March 2022 on officer COVID-19 vaccine hesitancy and examined their responses in terms of sociodemographic factors, health status, and job characteristics. We found that 40% of officers were COVID-19 vaccine hesitant. We found that officers with higher education, older officers, officers with more law enforcement experience, officers who received recent health checkups, and commanders (compared to line officers) were less likely to be COVID-19 vaccine hesitant. Critically, officers working in law enforcement agencies that provided masks for COVID-19 protection were less likely to be COVID-19 vaccine hesitant (compared to agencies not providing masks). Ongoing research is needed to understand how evolving attitudes and barriers toward vaccination change over time for officers and to test messaging to better align officers with health guidelines.
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Affiliation(s)
| | | | | | - Weiwei Liu
- NORC at the University of Chicago, Chicago, IL 60603, USA
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COVID-19 Vaccine Uptake Trends in SARS-CoV-2 Previously Infected Cancer Patients. Vaccine X 2023; 14:100289. [PMID: 37020982 PMCID: PMC10060025 DOI: 10.1016/j.jvacx.2023.100289] [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: 01/13/2023] [Revised: 03/21/2023] [Accepted: 03/23/2023] [Indexed: 03/31/2023] Open
Abstract
Purpose Cancer patients are at high risk of developing severe illness from SARS-CoV-2 infection, but risk is lowered with receipt of COVID-19 vaccine. COVID-19 vaccination uptake among previously infected cancer patients may be influenced by an assumption of natural immunity, predicted weak immune response, or concerns about vaccine safety. The objective of this study was to evaluate COVID-19 vaccine uptake trends in cancer patients previously infected with SARS-CoV-2. Materials and Methods Medical records of 579 sequential cancer patients undergoing active treatment at Levine Cancer Institute who tested positive for COVID-19 between January 2020 and January 2021 were evaluated. Patients who died prior to vaccine eligibility were excluded from the analysis. Demographic, clinical, and COVID-19 related characteristics were analyzed to identify prognostic factors for COVID-19 vaccine uptake as this information could be important for health policy design for future pandemics. Results Eighty-one patients died prior to the availability of COVID-19 vaccines. The acceptance rate of COVID-19 vaccination among 498 previously infected cancer patients was 54.6%. Of the patients with known vaccination dates, 76.8% received their first vaccine by April 17th, 2021. As of November 30, 2021, 23.7.% of eligible patients were boosted. In univariate models, older age, female sex, higher income, solid tumor cancer type, and hormone therapy were significantly associated with higher vaccine uptake, while Hispanic/Latino ethnicity was significantly associated with lower vaccine uptake. In a multivariable model, age (OR 1.18, 95% CI 1.10-1.28; p<0.001), female sex (OR 1.80, 95% CI 1.22-2.66; p=0.003), and higher income (OR 1.11, 95% CI 1.01-1.22; p=0.032), were predictive of COVID-19 vaccine uptake. Conclusions Overall, vaccine uptake was low among our cohort of previously infected cancer patients. Older age, female sex, and higher income were the only variables associated with COVID-19 vaccine uptake within this vulnerable patient population.
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Olivera-Figueroa LA, Unger A, Papastamatelou J, Zimbardo PG. A Time to Get Vaccinated? The Role of Time Perspective, Consideration of Future Consequences, Conspiracy Beliefs, Religious Faith, Gender, and Race on Intention to Vaccinate for COVID-19 in the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3625. [PMID: 36834320 PMCID: PMC9963941 DOI: 10.3390/ijerph20043625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 02/09/2023] [Accepted: 02/11/2023] [Indexed: 06/18/2023]
Abstract
The present study examined the predictability of Time Perspective (TP) tendencies (i.e., Past Positive, Past Negative, Present Hedonistic, Present Fatalistic, and Future), the Balanced Time Perspective (BTP) profile, the Consideration of Future Consequences-Immediate (CFC-I) factor, the Consideration of Future Consequences-Future (CFC-F) factor, conspiracy beliefs about COVID-19 being a hoax, religious faith, gender, and race on COVID-19 vaccination intention as a dependent variable. Participants were recruited in the United States through the online platforms Prolific and Google Forms. The final sample was n = 232 (n = 99 male, n = 129 female, and n = 2 other, Mage = 31). Outcome measures included sociodemographic questions, the Zimbardo Time Perspective Inventory-short version, the Consideration of Future Consequences (CFC) ultra-short scale, the COVID-19 Conspiracy Beliefs questionnaire, and the Santa Clara Strength of Religious Faith Questionnaire-brief version. Regression analyses revealed that vaccination intention was reduced by gender identification as woman, identification as multiracial or from mixed origin, Past Positive, Deviation from a BTP profile, belief in COVID-19 as hoax, and religious faith. Conversely, intention to vaccinate against COVID-19 was increased by Past Negative, CFC-I, and CFC-F. These findings could be beneficial for knowledge transfer to behavioral interventions aimed to promote vaccination against COVID-19, health promotion campaigns, and the public health field.
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Affiliation(s)
- Lening A. Olivera-Figueroa
- Department of Psychology, Golden Gate University, 536 Mission St., San Francisco, CA 94105, USA
- Family Medicine Residency Program, AltaMed Institute for Health Equity, AltaMed Health Services Corporation, 2040 Camfield Avenue, Los Angeles, CA 90040, USA
| | - Alexander Unger
- East-Asia Institute, Ludwigshafen University of Business and Society, Rheinpromenade 12, 67061 Ludwigshafen, Germany
| | - Julie Papastamatelou
- Study Program of Business Psychology, University of Applied Management Studies (HdWM), 68163 Mannheim, Germany
| | - Philip G. Zimbardo
- Department of Psychology, Stanford University, Jordan Hall 450 Jane Stanford Way, Building 420, Stanford, CA 94305, USA
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Meng L, Masters NB, Lu PJ, Singleton JA, Kriss JL, Zhou T, Weiss D, Black CL. Cluster analysis of adults unvaccinated for COVID-19 based on behavioral and social factors, National Immunization Survey-Adult COVID Module, United States. Prev Med 2023; 167:107415. [PMID: 36596324 PMCID: PMC9804852 DOI: 10.1016/j.ypmed.2022.107415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 12/24/2022] [Accepted: 12/28/2022] [Indexed: 01/02/2023]
Abstract
By the end of 2021, approximately 15% of U.S. adults remained unvaccinated against COVID-19, and vaccination initiation rates had stagnated. We used unsupervised machine learning (K-means clustering) to identify clusters of unvaccinated respondents based on Behavioral and Social Drivers (BeSD) of COVID-19 vaccination and compared these clusters to vaccinated participants to better understand social/behavioral factors of non-vaccination. The National Immunization Survey Adult COVID Module collects data on U.S. adults from September 26-December 31,2021 (n = 187,756). Among all participants, 51.6% were male, with a mean age of 61 years, and the majority were non-Hispanic White (62.2%), followed by Hispanic (17.2%), Black (11.9%), and others (8.7%). K-means clustering procedure was used to classify unvaccinated participants into three clusters based on 9 survey BeSD items, including items assessing COVID-19 risk perception, social norms, vaccine confidence, and practical issues. Among unvaccinated adults (N = 23,397), 3 clusters were identified: the "Reachable" (23%), "Less reachable" (27%), and the "Least reachable" (50%). The least reachable cluster reported the lowest concern about COVID-19, mask-wearing behavior, perceived vaccine confidence, and were more likely to be male, non-Hispanic White, with no health conditions, from rural counties, have previously had COVID-19, and have not received a COVID-19 vaccine recommendation from a healthcare provider. This study identified, described, and compared the characteristics of the three unvaccinated subgroups. Public health practitioners, healthcare providers and community leaders can use these characteristics to better tailor messaging for each sub-population. Our findings may also help inform decisionmakers exploring possible policy interventions.
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Affiliation(s)
- Lu Meng
- CDC COVID-19 Response Team; General Dynamics Information Technology Inc., Falls Church, VA, United States of America.
| | - Nina B Masters
- CDC COVID-19 Response Team; Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC; Epidemic Intelligence Service, CDC, Atlanta, GA, United States of America
| | - Peng-Jun Lu
- CDC COVID-19 Response Team; Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, GA, United States of America
| | - James A Singleton
- CDC COVID-19 Response Team; Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, GA, United States of America
| | - Jennifer L Kriss
- CDC COVID-19 Response Team; Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, GA, United States of America
| | - Tianyi Zhou
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, GA, United States of America; Leidos Inc., Atlanta, GA, United States of America
| | - Debora Weiss
- CDC COVID-19 Response Team; Division of State and Local Readiness, Center for Preparedness and Response, CDC
| | - Carla L Black
- CDC COVID-19 Response Team; Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, GA, United States of America
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Latkin C, Dayton L, Miller J, Eschliman E, Yang J, Jamison A, Kong X. Trusted information sources in the early months of the COVID-19 pandemic predict vaccination uptake over one year later. Vaccine 2023; 41:573-580. [PMID: 36513535 PMCID: PMC9722679 DOI: 10.1016/j.vaccine.2022.11.076] [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: 02/18/2022] [Revised: 09/28/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022]
Abstract
INTRODUCTION COVID-19 vaccine uptake has been a major barrier to stopping the pandemic in many countries with vaccine access. This longitudinal study examined the capability to predict vaccine uptake from data collected early in the pandemic before vaccines were available. METHODS 493 US respondents completed online surveys both at baseline (March 2020) and wave 6 (June 2021), while 390 respondents completed baseline and wave 7 (November 2021) surveys. The baseline survey assessed trust in sources of COVID-19 information, social norms, perceived risk of COVID-19, skepticism about the pandemic, prevention behaviors, and conspiracy beliefs. Multivariable logistic models examined factors associated with the receipt of at least one COVID-19 vaccine dose at the two follow-ups. RESULTS In the adjusted model of vaccination uptake at wave 6, older age (aOR = 1.02, 95 %CI = 1.00-1.04) and greater income (aOR = 1.69, 95 %CI = 1.04-2.73) was associated with positive vaccination status. High trust in state health departments and mainstream news outlets at baseline were positively associated with vaccination at wave 6, while high trust in the Whitehouse (aOR = 0.42, 95 %CI = 0.24-0.74) and belief that China purposely spread the virus (aOR = 0.66, 95 %CI = 0.46-0.96) at baseline reduced the odds of vaccination. In the adjusted model of vaccination uptake at wave 7, increased age was associated with positive vaccination status, and Black race (compared to white) was associated with negative vaccination status. High trust in the CDC and mainstream news outlets at baseline were both associated with being vaccinated at wave 7, while high trust in the Whitehouse (aOR = 0.24, 95 %CI = 0.11-0.51) and belief that the virus was spread purposefully by China (aOR = 0.60, 95 %CI = 0.39-0.93) were negatively associated with vaccination. CONCLUSIONS These findings indicated that vaccine uptake could be predicted over a year earlier. Trust in specific sources of COVID-19 information were strong predictors, suggesting that future pandemic preparedness plans should include forums for news media, public health officials, and diverse political leaders to meet and develop coherent plans to communicate to the public early in a pandemic so that antivaccine attitudes do not flourish and become reinforced.
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Affiliation(s)
- Carl Latkin
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, United States,Division of Infectious Diseases, Johns Hopkins University, School of Medicine, United States,Corresponding author at: Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, United States
| | - Lauren Dayton
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, United States
| | - Jacob Miller
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, United States
| | - Evan Eschliman
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, United States
| | - Jingyan Yang
- Department of Political Science, Columbia University, United States
| | - Amelia Jamison
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, United States
| | - Xiangrong Kong
- Wilmer Eye Institute, Johns Hopkins University, School of Medicine, United States
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Sandu D. Contextualising planned behaviours to the vaccination against COVID-19 in the European Union. INTERNATIONAL SOCIOLOGY : JOURNAL OF THE INTERNATIONAL SOCIOLOGICAL ASSOCIATION 2023; 38:22-45. [PMID: 38603452 PMCID: PMC9749066 DOI: 10.1177/02685809221137783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
The article targets the reasons that are behind behaviour orientation in the vaccination process against COVID-19. The data we are using come from the Flash Eurobarometer 494, collected in May 2021. The key dependent variable puts together vaccination intentions (soon, later on in 2021, undecided, later, never) and the fact of being vaccinated or not. A multivariate and multilevel analysis confirms the validity of an extended theory of planned behaviour in explaining the orientation to the vaccination against COVID-19. The space patterning of the behaviours is highly marked by differences among Old versus the New Member States of the European Union, clusters of countries, urban versus rural areas, and also by a function of trust in relevant institutions, and customs of using vaccination to cope with different diseases as an adult. New questions and hypotheses are generated by multiple comparisons.
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Kupferwasser D, Flores EA, Merino P, Phan Tran D, Bolaris M, Gonzales M, Nguyen MH, Balo A, Abueg A, Da Silva W, Astorga-Cook L, Liu H, Mason H, Freund D, Nightingale J, Orr J, Xie B, Miller LG. Characterization of COVID-19 Vaccine Hesitancy Among Essential Workforce Members of a Large Safety Net Urban Medical Center. J Prim Care Community Health 2023; 14:21501319231159814. [PMID: 36941757 PMCID: PMC10028456 DOI: 10.1177/21501319231159814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023] Open
Abstract
OBJECTIVES Vaccine hesitancy among essential workers remains a significant public health challenge. We examined psychological constructs of perceived susceptibility, threat, and self-efficacy and their associations with COVID-19 vaccine hesitancy among a racially and ethnically diverse essential workforce population. METHODS We performed a cross-sectional survey of essential workers from September-December 2020 at a large Los Angeles safety-net medical center as part of a program offering free COVID-19 serology testing. Program participants completed a standardized survey at the time of phlebotomy. Hierarchical logistic regression was utilized to determine factors independently associated with vaccine hesitancy. RESULTS Among 1327 persons who had serology testing, 1235 (93%) completed the survey. Of these, 958 (78%) were healthcare workers. Based on expressed intent, 22% were vaccine-hesitant 78% were vaccine acceptors. In our multivariate model, vaccine hesitancy was associated with female gender [aOR = 2.09; 95% CI (1.44-3.05)], African American race [aOR = 4.32; (2.16-8.62)], LatinX ethnicity [aOR = 2.47; 95% CI (1.51-4.05)] and history of not/sometimes receiving influenza vaccination [aOR = 4.39; 95% CI (2.98-6.48)]. Compared to nurses, vaccine hesitancy was lower among physicians [aOR = 0.09; 95% CI (0.04-0.23)], non-nursing/non-physician healthcare workers [aOR = 0.55; 95% CI (0.33-0.92)], and non-healthcare care workers [aOR = 0.53; 95% CI (0.36-0.78)]. CONCLUSIONS Among a racially/ethnically diverse group of safety net medical center essential workers, COVID-19 vaccine hesitancy was associated with racial/ethnic minority groups, employment type, and prior influenza vaccination hesitancy. Interestingly, we found no association with the Health Belief Model construct measures of perceived susceptibility, threat, and self-efficacy. Psychological constructs not assessed may be drivers of vaccine hesitancy in our population.
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Affiliation(s)
- Deborah Kupferwasser
- Harbor-UCLA Medical Center, Torrance, CA, USA
- Claremont Graduate University, Claremont, CA, USA
| | | | | | | | | | - Mildred Gonzales
- Los Angeles County College of Nursing and Allied Health, Los Angeles, CA, USA
| | | | - Arlene Balo
- Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Angel Abueg
- Harbor-UCLA Medical Center, Torrance, CA, USA
| | | | | | - Honghu Liu
- University of California, Los Angeles, Los Angeles CA, USA
| | - Holli Mason
- Harbor-UCLA Medical Center, Torrance, CA, USA
| | | | | | - Jay Orr
- Claremont Graduate University, Claremont, CA, USA
| | - Bin Xie
- Claremont Graduate University, Claremont, CA, USA
| | - Loren G Miller
- Harbor-UCLA Medical Center, Torrance, CA, USA
- University of California, Los Angeles, Los Angeles CA, USA
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Huang Q, Abad N, Bonner KE, Baack B, Petrin R, Hendrich MA, Lewis Z, Brewer NT. Explaining demographic differences in COVID-19 vaccination stage in the United States - April-May 2021. Prev Med 2023; 166:107341. [PMID: 36372280 PMCID: PMC9650505 DOI: 10.1016/j.ypmed.2022.107341] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 10/21/2022] [Accepted: 11/05/2022] [Indexed: 11/13/2022]
Abstract
COVID-19 vaccine coverage in the US has marked demographic and geographical disparities, but few explanations exist for them. Our paper aimed to identify behavioral and social drivers that explain these vaccination disparities. Participants were a national probability sample of 3562 American adults, recruited from the Ipsos KnowledgePanel. Participants completed an online survey in spring 2021, when COVD-19 vaccination was available for higher-risk groups but not yet available to all US adults. The survey assessed COVID-19 vaccination stage (intentions and vaccine uptake), constructs from the Increasing Vaccination Model (IVM) domains (thinking and feeling, social processes, and direct behavior change), self-reported exposure to COVID-19 vaccine information, and demographic characteristics. Analyses used multiple imputation to address item nonresponse and linear regressions to conduct mediation analyses. Higher COVID-19 vaccination stage was strongly associated with older age, liberal political ideology, and higher income in adjusted analyses (all p < .001). Vaccination stage was more modestly associated with urbanicity, white race, and Hispanic ethnicity (all p < .05). Some key mediators that explained more than one-third of demographic differences in vaccination stage were perceived vaccine effectiveness, social norms, and recommendations from family and friends across most demographic characteristics (all p < .05). Other mediators included safety concerns, trust, altruism, provider recommendation, and information seeking. Access to vaccination, barriers to vaccination, and self-efficacy explained few demographic differences. One of the most reliable explanations for demographic differences in COVID-19 vaccination stage is social processes, including social norms, recommendations, and altruism. Interventions to promote COVID-19 vaccination should address social processes and other domains in the IVM.
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Affiliation(s)
- Qian Huang
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
| | - Neetu Abad
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Brittney Baack
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | | | | | - Noel T Brewer
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
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Galanis P, Katsiroumpa A, Sourtzi P, Siskou O, Konstantakopoulou O, Katsoulas T, Kaitelidou D. COVID-19-Related Burnout and Intention of Fully Vaccinated Individuals to Get a Booster Dose: The Mediating Role of Resilience. Vaccines (Basel) 2022; 11:62. [PMID: 36679907 PMCID: PMC9860670 DOI: 10.3390/vaccines11010062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 12/23/2022] [Accepted: 12/24/2022] [Indexed: 12/29/2022] Open
Abstract
Because an annual COVID-19 booster vaccine appears to be required to control the pandemic, identifying the factors that influence individuals' decision to receive a booster dose is critical. Thus, our goal was to quantify the influence of COVID-19-related burnout on vaccination intention and to investigate the role of resilience in mediating the link between burnout and intention. We conducted a cross-sectional study with a convenience sample during October 2022. We used the COVID-19 burnout scale and the Brief Resilience Scale. The study sample included 1256 people who had received their primary COVID-19 vaccination. Among the participants, 34.1% reported being very likely to be vaccinated with a booster dose. COVID-19-related burnout was found to be inversely connected with vaccination intention. Moreover, our results suggested that resilience not only had a positive direct effect on vaccination intention but also mediated the relationship between burnout and vaccination intention. Although our study had limitations, such as a convenience sample and information bias, we demonstrate the critical role of resilience in reducing the impact of COVID-19-related burnout on the vaccination intention. Policymakers should develop and implement initiatives to address the issues of COVID-19-related burnout and enhance booster adoption by strengthening psychosocial resources such as resilience.
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Affiliation(s)
- Petros Galanis
- Clinical Epidemiology Laboratory, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Aglaia Katsiroumpa
- Clinical Epidemiology Laboratory, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Panayota Sourtzi
- Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Olga Siskou
- Department of Tourism Studies, University of Piraeus, 18534 Piraeus, Greece
| | - Olympia Konstantakopoulou
- Center for Health Services Management and Evaluation, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Theodoros Katsoulas
- Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Daphne Kaitelidou
- Center for Health Services Management and Evaluation, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece
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Fox A, Choi Y, Lanthorn H, Croke K. Does highlighting COVID-19 disparities reduce or increase vaccine intentions? evidence from a survey experiment in a diverse sample in New York State prior to vaccine roll-out. PLoS One 2022; 17:e0277043. [PMID: 36516173 PMCID: PMC9750017 DOI: 10.1371/journal.pone.0277043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 10/11/2022] [Indexed: 12/15/2022] Open
Abstract
Racial identity and political partisanship have emerged as two important social correlates of hesitancy towards COVID-19 vaccines in the United States. To examine the relationship of these factors with respondents' intention to vaccinate before the vaccine was available (November/December, 2020), we employed a multi-method approach: a survey experiment that randomized a vaccine-promotion message focused on racial equity in vaccine targeting, stepwise regression to identify predictors of hesitancy, and qualitative analysis of open-ended survey questions that capture how respondents reason about vaccination intentions. Experimental manipulation of a racial equity vaccine promotion message via an online survey experiment had no effect on intention-to-vaccinate in the full sample or in racial, ethnic and partisan subsamples. Descriptively, we find heightened hesitancy among non-Hispanic Black respondents (OR = 1.82, p<0.01), Hispanics (OR = 1.37, p<0.05), Trump voters (OR = 1.74, p<0.01) and non-Voters/vote Other (OR = 1.50, p<0.01) compared with non-Hispanic White respondents and Biden voters. Lower trust in institutions, individualism and alternative media use accounted for heightened hesitancy in Trump voters, but not non-Hispanic Blacks and Hispanics. Older age and female gender identity also persistently predicted lower vaccine intentions. Qualitatively, we find that most hesitant responders wanted to 'wait-and-see,' driven by generalized concerns about the speed of vaccine development, and potential vaccine side-effects, but little mention of conspiracy theories. Identity appears to be an important driver of vaccinate hesitancy that is not fully explained by underlying socioeconomic or attitudinal factors; furthermore, hesitancy was not significantly affected by racial equity messages in this setting.
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Affiliation(s)
- Ashley Fox
- Department of Public Administration and Policy, Rockefeller College of Public Affairs and Policy, University at Albany, State University of New York, Albany, NY, United States of America
- * E-mail:
| | - Yongjin Choi
- Department of Public Administration and Policy, Rockefeller College of Public Affairs and Policy, University at Albany, State University of New York, Albany, NY, United States of America
- Vaccine Confidence Project, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Laboratory of Data Discovery for Health, The University of Hong Kong, Hong Kong, China
| | | | - Kevin Croke
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
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Kjos N, Hendrix CL, Thomason ME. Perceived medical care quality during COVID-19 illness links socioeconomic disadvantage to vaccine hesitancy. Prev Med Rep 2022; 30:102020. [PMID: 36245805 PMCID: PMC9550282 DOI: 10.1016/j.pmedr.2022.102020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 09/10/2022] [Accepted: 10/09/2022] [Indexed: 11/27/2022] Open
Abstract
Maximizing vaccine uptake is critical for the optimal implementation of COVID-19 immunization programs. Indicators of socioeconomic status (SES) have been associated with variations in COVID-19 vaccine uptake in the United States. The present study investigates COVID-19 vaccination behavior in individuals with history of COVID-19 infection, with the specific goal of understanding whether experiences during illness explain socioeconomic disproportionalities in vaccine uptake. We leveraged a large sample of adults (n = 1584) infected with COVID-19 in NYC to examine this question, investigating whether specific experiences during illness explained the association between socioeconomic status and COVID-19 vaccine hesitancy. Data from this study were collected during February and March 2021. Principal component analysis was used to create three composite variables that measure distinct COVID-19 related experiences: infection-related health impacts, pandemic-related psychosocial disruption, and perceived quality of medical care during COVID-19 illness. Neither infection-related impacts nor psychosocial disruption were related to vaccine hesitancy after adjusting for related sociodemographic covariates. However, perceptions of higher quality care received during COVID-19 illness predicted decreased COVID-19 vaccine hesitancy. Furthermore, mediation analysis revealed that perceived care quality during COVID-19 illness mediate the relationship between objective socioeconomic risk and COVID-19 vaccine hesitancy. These findings highlight patient-reported care quality during illness as a novel target that may increase vaccine uptake among socioeconomically vulnerable populations.
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Affiliation(s)
- Nils Kjos
- Department of Child and Adolescent Psychiatry, New York University Grossman School of Medicine, United States
| | - Cassandra L. Hendrix
- Department of Child and Adolescent Psychiatry, New York University Grossman School of Medicine, United States
| | - Moriah E. Thomason
- Department of Child and Adolescent Psychiatry, New York University Grossman School of Medicine, United States
- Department of Population Health, New York University Grossman School of Medicine, United States
- Neuroscience Institute, New York University Grossman School of Medicine, United States
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Naveed Z, Li J, Spencer M, Wilton J, Naus M, García HAV, Otterstatter M, Janjua NZ. Observed versus expected rates of myocarditis after SARS-CoV-2 vaccination: a population-based cohort study. CMAJ 2022; 194:E1529-E1536. [PMID: 36410749 PMCID: PMC9828950 DOI: 10.1503/cmaj.220676] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Postmarketing evaluations have linked myocarditis to SARS-CoV-2 mRNA vaccines. We sought to estimate the incidence of myocarditis after mRNA vaccination against SARS-CoV-2, and to compare the incidence with expected rates based on historical background rates in British Columbia. METHODS We conducted an observational study using population health administrative data from the BC COVID-19 Cohort from Dec. 15, 2020, to Mar. 10, 2022. The primary exposure was any dose of an mRNA vaccine against SARS-CoV-2. The primary outcome was incidence of hospital admission or emergency department visit for myocarditis or myopericarditis within 7 and 21 days postvaccination, calculated as myocarditis rates per 100 000 mRNA vaccine doses, expected rates of myocarditis cases and observedto-expected ratios. We stratified analyses by age, sex, vaccine type and dose number. RESULTS We observed 99 incident cases of myocarditis within 7 days (0.97 cases per 100 000 vaccine doses; observed v. expected ratio 14.81, 95% confidence interval [CI] 10.83-16.55) and 141 cases within 21 days (1.37 cases per 100 000 vaccine doses; observed v. expected ratio 7.03, 95% CI 5.92-8.29) postvaccination. Cases of myocarditis per 100 000 vaccine doses were higher for people aged 12-17 years (2.64, 95% CI 1.54-4.22) and 18-29 years (2.63, 95% CI 1.94-3.50) than for older age groups, for males compared with females (1.64, 95% CI 1.30-2.04 v. 0.35, 95% CI 0.21-0.55), for those receiving a second dose compared with a third dose (1.90, 95% CI 1.50-2.39 v. 0.76, 95% CI 0.45-1.30) and for those who received the mRNA-1273 (Moderna) vaccine compared with the BNT162b2 (Pfizer-BioNTech) vaccine (1.44, 95% CI 1.06-1.91 v. 0.74, 95% CI 0.56-0.98). The highest observed-to-expected ratio was seen after the second dose among males aged 18-29 years who received the mRNA-1273 vaccine (148.32, 95% CI 95.03-220.69). INTERPRETATION Although absolute rates of myocarditis were low, vaccine type, age and sex are important factors to consider when strategizing vaccine administration to reduce the risk of postvaccination myocarditis. Our findings support the preferential use of the BNT162b2 vaccine over the mRNA-1273 vaccine for people aged 18-29 years.
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Affiliation(s)
- Zaeema Naveed
- School of Population and Public Health (Naveed), University of British Columbia; British Columbia Centre for Disease Control (Li, Spencer, Wilton, Naus, Velásquez García, Otterstatter, Janjua), Vancouver, BC
| | - Julia Li
- School of Population and Public Health (Naveed), University of British Columbia; British Columbia Centre for Disease Control (Li, Spencer, Wilton, Naus, Velásquez García, Otterstatter, Janjua), Vancouver, BC
| | - Michelle Spencer
- School of Population and Public Health (Naveed), University of British Columbia; British Columbia Centre for Disease Control (Li, Spencer, Wilton, Naus, Velásquez García, Otterstatter, Janjua), Vancouver, BC
| | - James Wilton
- School of Population and Public Health (Naveed), University of British Columbia; British Columbia Centre for Disease Control (Li, Spencer, Wilton, Naus, Velásquez García, Otterstatter, Janjua), Vancouver, BC
| | - Monika Naus
- School of Population and Public Health (Naveed), University of British Columbia; British Columbia Centre for Disease Control (Li, Spencer, Wilton, Naus, Velásquez García, Otterstatter, Janjua), Vancouver, BC
| | - Héctor Alexander Velásquez García
- School of Population and Public Health (Naveed), University of British Columbia; British Columbia Centre for Disease Control (Li, Spencer, Wilton, Naus, Velásquez García, Otterstatter, Janjua), Vancouver, BC
| | - Michael Otterstatter
- School of Population and Public Health (Naveed), University of British Columbia; British Columbia Centre for Disease Control (Li, Spencer, Wilton, Naus, Velásquez García, Otterstatter, Janjua), Vancouver, BC
| | - Naveed Zafar Janjua
- School of Population and Public Health (Naveed), University of British Columbia; British Columbia Centre for Disease Control (Li, Spencer, Wilton, Naus, Velásquez García, Otterstatter, Janjua), Vancouver, BC
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COVID-19 Vaccination Hesitancy in Mexico City among Healthy Adults and Adults with Chronic Diseases: A Survey of Complacency, Confidence, and Convenience Challenges in the Transition to Endemic Control. Vaccines (Basel) 2022; 10:vaccines10111944. [PMID: 36423039 PMCID: PMC9694314 DOI: 10.3390/vaccines10111944] [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: 09/21/2022] [Revised: 10/24/2022] [Accepted: 10/25/2022] [Indexed: 11/19/2022] Open
Abstract
Background. Monitoring of SARS-COV-2 vaccine hesitancy is important for epidemic control. We measured vaccine hesitancy among healthy adults and adults with chronic diseases after they had been offered the first dose of the vaccine in Mexico City. Methods. An observational cross-sectional study was undertaken among 185 healthy adults and 175 adults living with chronic diseases. Differences in means of variables for confidence, complacency, and convenience were analyzed. Aggregate indicators were constructed and their association with socioeconomic and demographic conditions and vaccination acceptance analyzed using multivariate analysis of variance and multivariate logistic analysis. Results. Up to 16.8% of healthy adults and 10.3% of sick adults reported not having received the SARS-COV-2 vaccine. Healthy adults were more complacent about COVID-19 risks than adults with chronic diseases, while no differences were found between the two groups regarding other hesitancy aggregate indicators. Among adults with chronic diseases, those with more education and enrolled with a social insurance institution were less complacent of COVID-19, while education was positively associated with convenience across both groups. Less complacency with COVID-19 and more confidence in the vaccine were associated with higher vaccine acceptance across both groups. Among adults living with chronic diseases, the odds ratios of vaccine acceptance were higher for less complacency (OR = 2.4, p = 0.007) than for confidence (OR = 2.0, p = 0.001). Odds ratios of vaccine acceptance in these two hesitancy indicators were similar among healthy adults (OR = 3.3, p = <0.005) and higher than for adults with comorbidities. Conclusions. Confidence in the vaccine and complacency regarding COVID-19 risks play an important role for vaccine acceptance in Mexico City, particularly among healthy adults. The perception of risk regarding COVID-19 is more important than confidence in vaccine safety and effectiveness. Promotion of COVID-19 vaccines needs to focus on decreasing complacency with COVID-19 and increasing vaccine confidence, particularly among healthy adults.
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Myroniuk TW, Schatz E, Teti M, Hermsen JM. Undergraduate Vaccine Hesitancy and the Influence of "Home" Locales. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14370. [PMID: 36361261 PMCID: PMC9653726 DOI: 10.3390/ijerph192114370] [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] [Received: 09/20/2022] [Revised: 10/27/2022] [Accepted: 11/01/2022] [Indexed: 06/16/2023]
Abstract
PURPOSE In the US, the COVID-19 pandemic has exposed deeply rooted resistance to public health. This has important consequences for SARS-CoV-2 variant spread and for future uptake of influenza and other vaccines. We examine these phenomena in Missouri, where its low vaccination rates, high levels of uninsured residents, predominance of conservative values, and stark rural-urban divides are intricately connected to public health resistance. The Socio-Ecological model guides our approach. METHODS We use data from the Fall 2020 Midwestern University (MWU-a pseudonym) Study of Seropositivity and Risk for SARS-CoV-2 and COVID-19 which are harmonized with the American Community Survey, Missouri County-Level Study, and the USDA Rural-Urban Continuum Codes to estimate multi-level regression models on the relationship between undergraduate students' "home" locales and their own COVID-19 and influenza vaccine hesitancy. FINDINGS The availability of primary care physicians, the prevalence of influenza vaccinations, and location type at the county level, as well as the percentage of residents without health insurance at the zip code level differentially predict COVID-19 and influenza vaccine hesitancy. CONCLUSIONS There is a link between county-level health and geographic characteristics, and individuals'-who were influenced by those counties because that is where their parents live-hesitancy towards vaccines. Identifying feasible, precise, local solutions to reducing vaccine hesitancy could take place if community members and other stakeholders would be open to changes in local-level health policy or practice.
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Affiliation(s)
- Tyler W. Myroniuk
- Department of Public Health, University of Missouri, Columbia, MO 65211, USA
| | - Enid Schatz
- Department of Public Health, University of Missouri, Columbia, MO 65211, USA
| | - Michelle Teti
- Department of Public Health, University of Missouri, Columbia, MO 65211, USA
| | - Joan M. Hermsen
- Department of Sociology, University of Missouri, Columbia, MO 65211, USA
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50
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Sahni LC, Price AM, Olson SM, Newhams MM, Pannaraj PS, Maddux AB, Halasa NB, Bline KE, Cameron MA, Schwartz SP, Walker TC, Irby K, Chiotos K, Nofziger RA, Mack EH, Smallcomb L, Bradford TT, Kamidani S, Tarquinio KM, Cvijanovich NZ, Schuster JE, Bhumbra SS, Levy ER, Hobbs CV, Cullimore ML, Coates BM, Heidemann SM, Gertz SJ, Kong M, Flori HR, Staat MA, Zinter MS, Hume JR, Chatani BM, Gaspers MG, Maamari M, Randolph AG, Patel MM, Boom JA. Factors Associated With COVID-19 Non-vaccination in Adolescents Hospitalized Without COVID-19. J Pediatric Infect Dis Soc 2022; 12:29-35. [PMID: 36309873 PMCID: PMC9620352 DOI: 10.1093/jpids/piac113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 10/28/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Pfizer-BioNTech COVID-19 vaccine received emergency use authorization for persons ≥ 16 years in December 2020 and for adolescents 12-15 years in May 2021. Despite the clear benefits and favorable safety profile, vaccine uptake in adolescents has been suboptimal. We sought to assess factors associated with COVID-19 non-vaccination in adolescents 12-18 years of age. METHODS Between June 1, 2021 and April 29, 2022, we assessed factors associated with COVID-19 non-vaccination in hospitalized adolescents ages 12-18 years enrolled in the Overcoming COVID-19 vaccine effectiveness network. Demographic characteristics and clinical information were captured through parent interviews and/or electronic medical record abstraction; COVID-19 vaccination was assessed through documented sources. We assessed associations between receipt of the COVID-19 vaccine and demographic and clinical factors using univariate and multivariable logistic regression and estimated adjusted odds ratios (aOR) for each factor associated with non-vaccination. RESULTS Among 1665 hospitalized adolescents without COVID-19, 56% were unvaccinated. Unvaccinated adolescents were younger (median age 15.1 years vs. 15.4 years, p < .01) and resided in areas with higher social vulnerability index (SVI) scores (median 0.6 vs 0.5, p < .001) than vaccinated adolescents. Residence in the Midwest [aOR 2.60 (95% CI: 1.80, 3.79)] or South [aOR 2.49 (95% CI: 1.77, 3.54)] US census regions, rarely or never receiving influenza vaccine [aOR 5.31 (95% CI: 3.81, 7.47)], and rarely or never taking precautions against COVID-19 [aOR 3.17 (95% CI: 1.94, 5.31)] were associated with non-vaccination against COVID-19. CONCLUSIONS Efforts to increase COVID-19 vaccination of adolescents should focus on persons with geographic, socioeconomic, and medical risk factors associated with non-vaccination.
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Affiliation(s)
- Leila C Sahni
- Corresponding author: Leila C. Sahni, PhD, MPH. Texas Children's Hospital, 1102 Bates Ave Ste 1550, Houston, TX 77030. Telephone: (832) 824-2057;
| | - Ashley M Price
- CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Samantha M Olson
- CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Margaret M Newhams
- Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children’s Hospital, Boston, MA 02115, USA
| | - Pia S Pannaraj
- Division of Infectious Diseases, Children’s Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles, CA 90027, USA
| | - Aline B Maddux
- Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO 80045, USA
| | - Natasha B Halasa
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Katherine E Bline
- Division of Pediatric Critical Care Medicine, Nationwide Children’s Hospital Columbus, OH 43205, USA
| | - Melissa A Cameron
- Division of Pediatric Hospital Medicine, UC San Diego-Rady Children’s Hospital, San Diego, CA 92123, USA
| | - Stephanie P Schwartz
- Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill, NC 27514, USA
| | - Tracie C Walker
- Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill, NC 27514, USA
| | - Katherine Irby
- Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock, AR 72202, USA
| | - Kathleen Chiotos
- Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Ryan A Nofziger
- Division of Critical Care Medicine, Department of Pediatrics, Akron Children’s Hospital, Akron, OH 44308, USA
| | - Elizabeth H Mack
- Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Laura Smallcomb
- Department of Pediatrics, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Tamara T Bradford
- Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children’s Hospital of New Orleans, New Orleans, LA 70118, USA
| | - Satoshi Kamidani
- The Center for Childhood Infections and Vaccines of Children’s Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Keiko M Tarquinio
- Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA 30322, USA
| | - Natalie Z Cvijanovich
- Division of Critical Care Medicine, UCSF Benioff Children's Hospital Oakland, CA 94609, USA
| | - Jennifer E Schuster
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Children’s Mercy Kansas City, Kansas City, MO 64108, USA
| | - Samina S Bhumbra
- The Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Emily R Levy
- Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Charlotte V Hobbs
- Department of Pediatrics, Department of Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - Melissa L Cullimore
- Division of Pediatric Critical Care, Department of Pediatrics, Children’s Hospital and Medical Center, Omaha, NE 68114, USA
| | - Bria M Coates
- Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL 60611, USA
| | - Sabrina M Heidemann
- Division of Pediatric Critical Care Medicine, Children’s Hospital of MI, Central Michigan University, Detroit, MI 48201, USA
| | - Shira J Gertz
- Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ 07039, USA
| | - Michele Kong
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Heidi R Flori
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children’s Hospital and University of Michigan, Ann Arbor, MI 48109, USA
| | - Mary A Staat
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 42559, USA
| | - Matt S Zinter
- Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California San Francisco, San Francisco, CA 94143, USA
| | - Janet R Hume
- Division of Pediatric Critical Care, University of Minnesota Masonic Children’s Hospital, Minneapolis, MN 55454, USA
| | - Brandon M Chatani
- Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth/Holtz Children's Hospital, Miami, FL 33136, USA
| | - Mary G Gaspers
- University of Arizona, Diamond Children’s Banner Children’s Medical Center, Tucson, AZ 85719, USA
| | - Mia Maamari
- Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center Dallas, TX 75235, USA
| | - Adrienne G Randolph
- Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children’s Hospital, Boston, MA 02115, USA,Departments of Anaesthesia and Pediatrics, Harvard Medical School, Boston, MA 02115, USA
| | - Manish M Patel
- CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Julie A Boom
- Alternate corresponding author: Julie A. Boom, MD, Texas Children's Hospital, 1102 Bates Ave Ste 1550, Houston, TX 77030. Telephone: (832) 822-3433;
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