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Prentice KR, Williams BA, True JM, Jones CH. Advancing health equity in the aftermath of COVID-19: Confronting intensifying racial disparities. iScience 2024; 27:110257. [PMID: 39027376 PMCID: PMC11255839 DOI: 10.1016/j.isci.2024.110257] [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] [Indexed: 07/20/2024] Open
Abstract
The COVID-19 pandemic has exposed and exacerbated the persistent racial and ethnic health disparities in the United States. The pandemic has also had profound spillover effects on other aspects of health and wellbeing, such as mental health, chronic diseases, education, and income, for marginalized groups. In this article, we provide a thorough analysis of the pandemic's impact on racial and ethnic health disproportionalities, highlighting the multifaceted and interrelated factors that contribute to these inequities. We also argue for a renewed focus on health equity in healthcare policy and practice, emphasizing the need for systemic changes that address both the immediate and long-term consequences of these imbalances. We propose a framework for achieving health equity that involves creating equitable systems, care, and outcomes for all individuals, regardless of their race or ethnicity.
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Affiliation(s)
| | | | - Jane M. True
- Pfizer Inc, 66 Hudson Boulevard, New York, NY 10001, USA
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2
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Smith DG, Smith CD, DeLeon JA, Sandoz JL, Ochoa CO, Pearson MP, Macena RHM. Factors influencing COVID-19 vaccine uptake among Latinos: A cross-sectional study. PLoS One 2024; 19:e0302332. [PMID: 38968176 PMCID: PMC11226026 DOI: 10.1371/journal.pone.0302332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 04/02/2024] [Indexed: 07/07/2024] Open
Abstract
Vaccination against COVID-19 can prevent severe illness and reduce hospitalizations and deaths. Understanding and addressing determinants contributing to vaccine uptake among high-risk groups, such as Latinos, are pivotal in ensuring equitable vaccine distribution, promoting health equity, and fostering community engagement to bridge the gap in vaccine acceptance and ultimately enhance public health. This study aimed to examine factors influencing vaccine uptake among Latinos. We conducted a cross-sectional study using an online platform (n = 242). The survey was administered using a multimodal approach. Strategies for recruitment included community outreach, social media, and targeting community networks serving Latinos. Descriptive statistics, chi-square, and multivariable analysis were performed. Overall, 81.4% of respondents had received at least one dose of the COVID-19 vaccine, with 77.0% recommending it and 70.6% believing it to be safe, 66.7% believing in its efficacy, 62.3% able to find trustful information in Spanish or Portuguese, and almost 40% who relied on health organizations as their primary resource for COVID-19 vaccine information. Factors significantly associated with vaccine uptake included higher education level (p<0.001), English level (p = 0.023), living in an urban area (p = 0.048), having insurance (p<0.001), and having a healthcare provider (p = 0.007). Furthermore, belief in vaccine safety and efficacy, trust in public health authorities, concerns about COVID-19, the ability to determine true/false vaccine information during the pandemic, and the availability of trustworthy information in Spanish/Portuguese had statistically significant associations (p<0.05) with COVID-19 vaccine uptake. COVID-19 vaccine uptake differed based on sociodemographic and other modifiable factors. Our findings emphasize the importance of implementing targeted interventions and culturally sensitive communication strategies to improve vaccination uptake among the Latino community in the United States.
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Affiliation(s)
- Deborah G Smith
- Department of Public Health, Louisiana State University Health Science Center Shreveport, Shreveport, Louisiana, United States of America
| | - Corey D Smith
- Department of Medicine, Louisiana State University Health Science Center Shreveport, Shreveport, Louisiana, United States of America
| | - Jennifer A DeLeon
- Department of Public Health, Louisiana State University Health Science Center Shreveport, Shreveport, Louisiana, United States of America
| | - Jillian L Sandoz
- Department of Medicine, Louisiana State University Health Science Center Shreveport, Shreveport, Louisiana, United States of America
| | - Carolina O Ochoa
- Department of Medicine, Louisiana State University Health Science Center Shreveport, Shreveport, Louisiana, United States of America
| | - Martha P Pearson
- Department of Nursing, Northwestern State University of Louisiana, Shreveport, Louisiana, United States of America
| | - Raimunda H M Macena
- Department of Medicine, Federal University of Ceara, Fortaleza, Ceara, Brazil
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Das J, Mallawaarachchi G, Grimshaw J, Jackson T, Talbot P, Sharaf N, Kalatha T, Lord L, Pace A, Mihalova T, Heal C, Rog D. Ethnicity and deprivation negatively impact the access to disease-modifying therapy for relapsing-remitting multiple sclerosis: a retrospective, single-centre study. J Neurol Neurosurg Psychiatry 2024:jnnp-2024-333338. [PMID: 38839276 DOI: 10.1136/jnnp-2024-333338] [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] [Received: 01/04/2024] [Accepted: 05/14/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND A growing body of evidence suggests inequitable access to disease-modifying therapies (DMTs) for multiple sclerosis (MS) in publicly funded healthcare systems. This retrospective study examined the impact of ethnicity and deprivation on the access to DMTs. METHODS All adults diagnosed with relapsing-remitting MS between 2010 and 2020 were included. The impact of ethnicity and deprivation on being offered and starting any DMTs and high-efficacy DMTs were measured using binary, multinomial logistic and Cox regression models. These analyses were adjusted for sex, age at diagnosis and year of diagnosis. RESULTS 164/1648 people with MS (PwMS) were from non-white ethnicities. 461/1648 who were living in the most deprived areas, were less likely to be offered DMTs, with an OR of 0.66 (95% CI 0.47 to 0.93), less likely to start high-efficacy DMTs with an OR of 0.67 (95% CI 0.48 to 0.93) and more likely to experience a delay in starting high-efficacy DMTs with an HR of 0.76 (95% CI 0.63 to 0.92), when also adjusted for ethnicity. Although the offer of DMTs did not depend on ethnicity, PwMS from non-white ethnicities were more likely to decline DMTs, less likely to start any DMTs and high-efficacy DMTs with ORs of 0.60 (95% CI 0.39 to 0.93) and 0.61 (95% CI 0.38 to 0.98), respectively, and more likely to experience a delay in starting DMTs with an HR of 0.79 (95% CI 0.66 to 0.95), when also adjusted for deprivation. CONCLUSIONS In a publicly funded healthcare system, the access to DMTs varied depending on ethnicities and levels of deprivation.
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Affiliation(s)
- Joyutpal Das
- Cardiovascular Department, The University of Manchester, Manchester, UK
- Neuroscience Department, Salford Royal Hospital Manchester Centre for Clinical Neurosciences, Salford, UK
| | | | | | | | - Paul Talbot
- Salford Royal Hospital Manchester Centre for Clinical Neurosciences, Salford, UK
| | - Nazar Sharaf
- Salford Royal Hospital Manchester Centre for Clinical Neurosciences, Salford, UK
| | - Thaleia Kalatha
- Salford Royal Hospital Manchester Centre for Clinical Neurosciences, Salford, UK
| | - Lindsay Lord
- Salford Royal Hospital Manchester Centre for Clinical Neurosciences, Salford, UK
| | - Adrian Pace
- Salford Royal Hospital Manchester Centre for Clinical Neurosciences, Salford, UK
- Gozo General Hospital, Victoria, Malta
| | - Tatiana Mihalova
- Salford Royal Hospital Manchester Centre for Clinical Neurosciences, Salford, UK
- Penta Hospitals, Bratislava, Poland
| | - Calvin Heal
- Centre for Biostatistics, University of Manchester, Manchester, UK
| | - David Rog
- Salford Royal Hospital Manchester Centre for Clinical Neurosciences, Salford, UK
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4
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Sentamilvannan M, Al-Dekany A, Eide HN, Lie AK. [Vaccine hesitancy during the COVID-19 pandemic among young people with an ethnic background in east Oslo – a qualitative study]. TIDSSKRIFT FOR DEN NORSKE LEGEFORENING 2024; 144:23-0690. [PMID: 38651718 DOI: 10.4045/tidsskr.23.0690] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024] Open
Abstract
Background Few studies have been conducted on young people's attitudes to the COVID-19 vaccine during the pandemic. We wished to examine how young people with an ethnic minority background decided whether to have the COVID-19 vaccine, based on the concept of vaccine hesitancy. Vaccine hesitancy involves uncertainty with regard to vaccination, irrespective of the decision taken. Material and method Fourteen qualitative in-depth interviews with young people aged 16-25 years with an ethnic minority background and from the east side of Oslo were analysed and categorised into main themes. The participants also had links to the Middle East, South Asia and Africa. Results Several of the study participants were hesitant to be vaccinated. Their hesitation was linked to the impression that the vaccine had been developed rapidly, false rumours, long travel times to vaccination centres and fear of adverse effects. A number called for better information. Vaccination through the school was described as a facilitating factor. Family and friends were less crucial in their assessment of whether to have the COVID-19 vaccine. The majority had trust in the authorities. Interpretation Insufficient knowledge about the vaccine and fear of adverse effects, as well as practical barriers associated with undergoing vaccination, appears to contribute to vaccine scepticism among young people with an ethnic minority background. The authorities and healthcare personnel should provide young people with better vaccine information. Information should be provided by personnel they already trust, such as the school nurse.
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Affiliation(s)
| | | | | | - Anne Kveim Lie
- Avdeling for samfunnsmedisin og global helse, Universitetet i Oslo
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Krasner H, Harmon N, Martin J, Olaco CA, Netski DM, Batra K. Community Level Correlates of COVID-19 Booster Vaccine Hesitancy in the United States: A Cross-Sectional Analysis. Vaccines (Basel) 2024; 12:167. [PMID: 38400150 PMCID: PMC10892894 DOI: 10.3390/vaccines12020167] [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: 12/05/2023] [Revised: 01/27/2024] [Accepted: 02/05/2024] [Indexed: 02/25/2024] Open
Abstract
Introduction: Evidence exists that individual-level sociodemographic factors contribute to vaccine hesitancy, but it is unknown how community-level factors affect COVID-19 booster dose hesitancy. The current study aims to fill this knowledge gap by comparing data from a nationwide survey on COVID-19 vaccine hesitancy with a community-level indicator, i.e., the Distressed Communities Index (DCI). Methods: Attitudes toward vaccinations, vaccine literacy, COVID-19 vaccine confidence index, and trust were measured using a 48-item, psychometrically valid and reliable survey tool. In this study, 2138 survey participants residing in the United States were divided into quintiles of varying community distress levels based on their zip codes using the DCI. Data were analyzed through Chi-square, one-way ANOVA, and post hoc analysis with Tukey's test. Results: A significantly higher proportion of participants from the distressed communities had lower trust than their prosperous counterparts (26.6% vs. 37.6%, p < 0.001). On the contrary, participants from the prosperous communities had significantly higher vaccine confidence index scores than those in distressed communities (2.22 ± 1.13 vs. 1.70 ± 1.01, p < 0.001). Conclusions: These findings affirm the importance of developing community-level interventions to promote trust in COVID-19 vaccinations and increase booster dose uptake. From these results, future studies can examine the efficacy of various community-level interventions.
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Affiliation(s)
- Henry Krasner
- Kirk Kerkorian School of Medicine at UNLV, University of Nevada, Las Vegas, NV 89102, USA; (J.M.); (C.-A.O.)
| | - Nicolette Harmon
- Department of Epidemiology and Biostatistics, School of Public Health, University of Nevada, Las Vegas, NV 89119, USA;
| | - Jeffrey Martin
- Kirk Kerkorian School of Medicine at UNLV, University of Nevada, Las Vegas, NV 89102, USA; (J.M.); (C.-A.O.)
| | - Crysty-Ann Olaco
- Kirk Kerkorian School of Medicine at UNLV, University of Nevada, Las Vegas, NV 89102, USA; (J.M.); (C.-A.O.)
| | - Dale M. Netski
- Office of Faculty Affairs, Kirk Kerkorian School of Medicine at UNLV, University of Nevada, Las Vegas, NV 89102, USA;
- Department of Medical Education, Kirk Kerkorian School of Medicine at UNLV, University of Nevada, Las Vegas, NV 89102, USA
| | - Kavita Batra
- Department of Medical Education, Kirk Kerkorian School of Medicine at UNLV, University of Nevada, Las Vegas, NV 89102, USA
- Office of Research, Kirk Kerkorian School of Medicine at UNLV, University of Nevada, Las Vegas, NV 89102, USA
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Benson BR, Rahman SA, Bleasdale J, Win S, Townsend-Kensinger K, Cole M, Jalal K, Yu J, Morse GD, Mohler JL, Ward RL. Trusted Information Sources About the COVID-19 Vaccine Vary in Underserved Communities. J Community Health 2024:10.1007/s10900-023-01319-0. [PMID: 38300477 DOI: 10.1007/s10900-023-01319-0] [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] [Accepted: 11/29/2023] [Indexed: 02/02/2024]
Abstract
The COVID-19 pandemic was one of the deadliest global public health events. In the United States, over 1.1 million individuals have died, and now COVID-19 is the third leading cause of death (CDC, 2023). Vaccine uptake has stalled among different demographics. Vaccine hesitancy, a delay in accepting or refusing vaccines, poses a significant challenge regardless of the availability of safe and effective COVID-19 vaccines. This study aimed to identify disparate COVID-19 vaccine uptake among individuals in Western New York. The primary objective was to identify the factors contributing to lower rates of COVID-19 vaccination within this population.Data were collected from 585 adults recruited from 20 Niagara and Erie Counties sites using a self-administered survey on vaccine hesitancy, vaccination status, and COVID-19-related characteristics. The survey included the adult Vaccine Hesitancy Scale (aVHS) and acquired information on demographic characteristics and COVID-19 impact, knowledge, and information sources. Data were analyzed using descriptive statistics, a chi-squared test, a Wilcoxon rank-sum test, and a logistic regression model.Findings suggest that unvaccinated participants (n = 35) were concerned about vaccine side effects (48.6%). For vaccinated/unboosted participants (n = 52), they (40.0%) reported clinical concerns. After adjusting for gender and age, healthcare provider guidance and family guidance remained significant predictors of vaccination status, while clinical research studies were significant predictors of booster status. Findings from this study suggest public health interventions that target vaccine education and facilitate well-informed decisions about COVID-19 vaccines lead to less vaccine hesitancy.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - James L Mohler
- Roswell Park Comprehensive Cancer Center (Urology, Pharmacology and Therapeutics), Buffalo, NY, USA
| | - Rolanda L Ward
- Department of Social Work, Niagara University, Niagara Falls, NY, USA.
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Kranzler EC, Ihongbe TO, Marshall MC, Denison B, Dahlen H, Hoffman B, Seserman K, Xie J, Hoffman L. Racial and ethnic differences in COVID-19 vaccine readiness among adults in the United States, January 2021-April 2023. Vaccine 2024; 42:410-414. [PMID: 38182461 DOI: 10.1016/j.vaccine.2023.12.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 12/21/2023] [Accepted: 12/23/2023] [Indexed: 01/07/2024]
Abstract
Racial and ethnic minority groups have been disproportionately affected by COVID-19 and have experienced systemic, attitudinal, and access-related barriers to COVID-19 vaccination. We examined differences in COVID-19 vaccine readiness-a composite measure of vaccination intention and behavior-between non-Hispanic White, non-Hispanic Black, Hispanic, non-Hispanic Asian American/Pacific Islander, and American Indian/Alaska Native U.S. adults. Using data from a cross-sectional survey administered to nationally representative samples of ∼ 5,000 U.S. adults each month from January 2021 to April 2023 (n = 135,989), we conducted weighted ttests comparing the monthly percentage of participants from racial/ethnic groups who were "Vaccine Ready." Initial racial/ethnic disparities in vaccine readiness were attenuated within a 7-month period, after which adults from most minority racial/ethnic groups became equally or more vaccine ready compared to non-Hispanic White adults (p < 0.05). Findings suggest that barriers to vaccine readiness that were more prevalent in non-White racial/ethnic groups may have largely been addressed.
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Affiliation(s)
| | | | | | - Benjamin Denison
- Fors Marsh, 4250 Fairfax Drive, Ste 520, Arlington, VA 22203, USA
| | - Heather Dahlen
- Fors Marsh, 4250 Fairfax Drive, Ste 520, Arlington, VA 22203, USA
| | - Blake Hoffman
- Fors Marsh, 4250 Fairfax Drive, Ste 520, Arlington, VA 22203, USA
| | - Kate Seserman
- Fors Marsh, 4250 Fairfax Drive, Ste 520, Arlington, VA 22203, USA
| | - Jingyuan Xie
- Fors Marsh, 4250 Fairfax Drive, Ste 520, Arlington, VA 22203, USA
| | - Leah Hoffman
- Fors Marsh, 4250 Fairfax Drive, Ste 520, Arlington, VA 22203, USA
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Albuquerque LH, Luckose AB, Joseph M, Mathews N, Devarayasamudram S, Mahon E. Original Research: Predictors of COVID-19 Vaccine Hesitancy Among Asian Indians in the United States: A Cross-Sectional Descriptive Study. Am J Nurs 2024; 124:20-27. [PMID: 38055842 DOI: 10.1097/01.naj.0000998220.62535.e4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/08/2023]
Abstract
BACKGROUND Although COVID-19 is a highly infectious disease, vaccine hesitancy remains a primary barrier to attaining full population inoculation. Numerous factors related to vaccine hesitancy have been identified. The aim of this study was to explore associations between select demographic variables and COVID-19 vaccine hesitancy among Asian Indians in the United States. METHODS The study used a cross-sectional, descriptive, correlational design. The sample consisted of 363 Asian Indians living in the United States who were 18 years of age or older and were literate in English. Vaccine hesitancy was assessed using an online survey. Both descriptive and inferential statistical analyses were conducted. Inferential tests included t tests, regression analyses, and analysis of variance (ANOVA) tests. RESULTS As participant age increased, there was a statistically significant proportionate increase in the total vaccine hesitancy score ( P = 0.01). There were also statistically significant differences in the vaccine hesitancy scores of participants with no more than a high school degree compared to those with associate or bachelor's degrees, although this finding was based on just six participants. Although most participants had already been vaccinated, many identified reasons for feeling some degree of vaccine hesitancy. CONCLUSIONS The reasons for vaccine hesitancy vary by individual and are often complex. The results of this study will help guide public health agencies and health care personnel in developing vaccination strategies tailored to the specific requirements of Asian Indians in the United States, which could reduce vaccine hesitancy in this population.
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Affiliation(s)
- Lydia Honorata Albuquerque
- Lydia Honorata Albuquerque and Maya Joseph are assistant professors in the School of Nursing, College of Science and Health, William Paterson University, Wayne, NJ. Anne B. Luckose is an NP at the Wellness Center at the Health Sciences Campus, Loyola University, Maywood, IL. Nisha Mathews is an assistant professor of nursing in the College of Human Sciences and Humanities, University of Houston-Clear Lake at Pearland, TX. Sujayalakshmi Devarayasamudram is an associate professor in the Department of Nursing, College of Health and Sciences, North Carolina Central University, Durham. Emily Mahon is an adjunct faculty member in the Department of Sociology and Criminal Justice, College of Arts, Humanities, and Social Sciences, William Paterson University. Contact author: Lydia Honorata Albuquerque, . The authors have disclosed no potential conflicts of interest, financial or otherwise
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Cacciani L, Cesaroni G, Calandrini E, Davoli M, Agabiti N. Covid-19 vaccination among migrants in Rome, Italy. Sci Rep 2023; 13:20890. [PMID: 38017018 PMCID: PMC10684578 DOI: 10.1038/s41598-023-48273-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 11/24/2023] [Indexed: 11/30/2023] Open
Abstract
Migrants may be susceptible to vaccine barriers and hesitancy. We evaluated the association between migrant status, as measured by the citizenship from a High Migratory Pressure Country (HMPC), and COVID-19 vaccination uptake in the resident population in Rome, Italy. We also investigated sex differences. We followed participants for vaccination against COVID-19 in 2021. We calculated crude- and adjusted-vaccination rates and Cox hazard ratios of vaccination for migrants compared to Italians. Among migrants from HMPCs, we estimated HRs for females compared to males, stratifying by geographical area of origin. Models were adjusted for age and deprivation index and stratified by infection history. In 2021, among 1,731,832 18-64-year-olds, migrants were 55% less likely to uptake at least one COVID-19 vaccine dose than their Italian counterpart. Past SARS-CoV-2 infection reduced the difference between migrants and Italians to 27%. Among migrants from HMPCs, we observed a slight excess of vaccination uptake among females compared to males. Focusing on geographical areas, we observed that only females from central-western Asia were 9% less likely to uptake vaccination than males. Health communication strategies oriented to migrants and considering their different languages, cultures, and health literacy should be adopted for prevention before emergencies.
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Affiliation(s)
- Laura Cacciani
- Department of Epidemiology of the Regional Health Service of Lazio, Asl Roma 1, Rome, Italy.
| | - Giulia Cesaroni
- Department of Epidemiology of the Regional Health Service of Lazio, Asl Roma 1, Rome, Italy
| | - Enrico Calandrini
- Department of Epidemiology of the Regional Health Service of Lazio, Asl Roma 1, Rome, Italy
| | - Marina Davoli
- Department of Epidemiology of the Regional Health Service of Lazio, Asl Roma 1, Rome, Italy
| | - Nera Agabiti
- Department of Epidemiology of the Regional Health Service of Lazio, Asl Roma 1, Rome, Italy
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Gibson A, Rand C, Olson-Chen C. Attitudes Toward COVID-19 Vaccination Among Pregnant Persons in Urban Hospital-Affiliated Practices: Exploring Themes in Vaccine Hesitancy. Matern Child Health J 2023; 27:1855-1863. [PMID: 37486448 DOI: 10.1007/s10995-023-03752-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2023] [Indexed: 07/25/2023]
Abstract
OBJECTIVE To explore beliefs and attitudes toward the COVID-19 vaccine among vaccinated and unvaccinated pregnant persons in order to identify reasons for both vaccine hesitancy and vaccine uptake. METHODS From June-August 2021, we conducted a qualitative study consisting of semi-structured interviews with pregnant persons (n = 30). Participants were recruited from university-owned obstetric practices during prenatal and ultrasound appointments. Interviews were audio recorded and transcribed; transcripts were coded and analyzed to identify themes and subthemes. RESULTS Of the participants, one-third (n = 10) had received the COVID-19 vaccine, while two-thirds (n = 20) were unvaccinated. Primary themes for unvaccinated participants were concern about the paucity of research on the vaccine in pregnancy and potential impact of the vaccine on both fetal development and maternal health. For vaccinated participants, main themes included potential maternal and fetal protection from COVID-19 and anticipated health complications from contracting COVID-19 as their motivations to get vaccinated. While most participants cited healthcare providers as the most trusted source of vaccine information, a majority reported that the internet was their primary source of vaccine information. Many participants wanted to learn more about the COVID-19 vaccine from their obstetric providers, and notably, most vaccinated participants reported the importance of their obstetrician in their vaccine decision-making process. CONCLUSIONS COVID-19 vaccine hesitancy is prevalent among pregnant persons, with concerns for vaccine safety for their fetus, as well as for themselves, being common. Obstetric providers must therefore be prepared to address common concerns with patients during prenatal appointments, taking the time to actively recommend vaccination.
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Affiliation(s)
- Anastasia Gibson
- School of Medicine & Dentistry, University of Rochester Medical Center, Rochester, NY, USA.
| | - Cynthia Rand
- Department of Pediatrics, University of Rochester Medical Center, Rochester, NY, USA
| | - Courtney Olson-Chen
- Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, NY, USA
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11
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Pan D, Tang JW. Four key problems that will need to be addressed during the next pandemic. Clin Med (Lond) 2023; 23:527-530. [PMID: 37775161 PMCID: PMC10541281 DOI: 10.7861/clinmed.2023-0283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/01/2023]
Abstract
In June 2023, the UK began official hearings for its independent investigation into pandemic preparedness. Thus far, the inquiry has been told that planning has been wholly inadequate and that a future outbreak is inevitable. We present here four key problems that contributed to significant morbidity and mortality during the Coronavirus 2019 (COVID-19) pandemic over the past 3 years in the UK - and which will contribute to excess morbidity and mortality in the next outbreak. First, there was misunderstanding about what procedures were deemed as aerosol generating. Aerosol transmission has always been a component of respiratory viruses; however, no specific aerosol-generating procedures are required to transmit any respiratory pathogens over long distances. Second, policy-makers were too binary in their answers to the public in terms of questions about severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2). This meant that, as evidence evolved and different conclusions were drawn, the public lost faith in both the UK Government and science. Third, public health guidance did not take into account that certain groups would be impacted differentially by public health guidelines and instead used a one-size-fits-all approach to non-pharmaceutical interventions. Finally, there was worsening of existing inequalities, especially in ethnic minority groups, that resulted in excessive numbers within certain cohorts becoming infected.
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Affiliation(s)
- Daniel Pan
- Leicester Biomedical Research Centre, Leicester, UK, honorary specialist registrar, University Hospitals of Leicester NHS Trust, Leicester, UK, and visiting academic, Li Ka Shing Institute of Health Information and Discovery, University of Oxford, Oxford, UK
| | - Julian W Tang
- University of Leicester, Leicester, UK and consultant in virology, University Hospitals of Leicester NHS Trust, Leicester, UK
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12
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Motilal S, Ward D, Mahabir K, Lopez T, Logan R, Maharaj S, Maloney J, Marson M, Marcelle C. COVID-19 Vaccine Hesitancy in Trinidad and Tobago: A Qualitative Study. Cureus 2023; 15:e43171. [PMID: 37560056 PMCID: PMC10409563 DOI: 10.7759/cureus.43171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2023] [Indexed: 08/11/2023] Open
Abstract
Background After three years of COVID-19, the WHO declared that the pandemic was no longer a global health emergency. Vaccination remains part of the management strategy, given the current phase of the pandemic. This study explored the reasons for COVID-19 vaccine hesitancy in Trinidad and Tobago (TT). Methodology A qualitative study of persons 18 years and over from the eastern, northwest, northcentral, and southwestern geographical areas of TT, who are unvaccinated and hesitant, was done by convenience sampling. Formal in-depth virtual interviews were done on a one-to-one basis using a semi-structured questionnaire. The interviews were recorded and transcribed using the principles of reflexive thematic analysis of participants' responses. Results From 25 participants' responses, the main themes for being vaccine-hesitant were fear, inefficacy, information inadequacy, perceived susceptibility, mistrust, herbal alternatives, and religious hesitations. Additionally, their motivations for receiving the vaccine in the future were surrounded by themes of necessity, perceived susceptibility, health benchmark, and assurance. Conclusion and recommendations This qualitative investigation identified traditional factors contributing to COVID-19 vaccine hesitancy and unique determinants such as herbal use and religious beliefs within the TT context. These insights could inform future research and facilitate the development of tailored strategies to address persistent vaccine hesitancy for COVID-19.
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Affiliation(s)
- Shastri Motilal
- Paraclinical Sciences, The University of the West Indies at St. Augustine, St. Augustine, TTO
| | - Daina Ward
- Paraclinical Sciences, The University of the West Indies at St. Augustine, St. Augustine, TTO
| | - Kymera Mahabir
- Paraclinical Sciences, The University of the West Indies at St. Augustine, St. Augustine, TTO
| | - Thea Lopez
- Paraclinical Sciences, The University of the West Indies at St. Augustine, St. Augustine, TTO
| | - Raesha Logan
- Paraclinical Sciences, The University of the West Indies at St. Augustine, St. Augustine, TTO
| | - Shastri Maharaj
- Paraclinical Sciences, The University of the West Indies at St. Augustine, St. Augustine, TTO
| | - Jenair Maloney
- Paraclinical Sciences, The University of the West Indies at St. Augustine, St. Augustine, TTO
| | - Monique Marson
- Paraclinical Sciences, The University of the West Indies at St. Augustine, St. Augustine, TTO
| | - Chadé Marcelle
- Paraclinical Sciences, The University of the West Indies at St. Augustine, St. Augustine, TTO
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Alcendor DJ, Matthews-Juarez P, Williams N, Wilus D, Tabatabai M, Hopkins E, George K, Leon AH, Santiago R, Lee A, Smoot D, Hildreth JEK, Juarez PD. COVID-19 Vaccine Hesitancy and Uptake among Minority Populations in Tennessee. Vaccines (Basel) 2023; 11:1073. [PMID: 37376464 PMCID: PMC10302928 DOI: 10.3390/vaccines11061073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 06/05/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023] Open
Abstract
COVID-19 vaccine hesitancy and uptake among Southern states in the US has been problematic throughout the pandemic. To characterize COVID-19 vaccine hesitancy and uptake among medically underserved communities in Tennessee. We surveyed 1482 individuals targeting minority communities in Tennessee from 2 October 2021 to 22 June 2022. Participants who indicated that they did not plan to receive or were unsure whether to receive the COVID-19 vaccine were considered vaccine-hesitant. Among participants, 79% had been vaccinated, with roughly 5.4% not likely at all to be vaccinated in the next three months from the date that the survey was conducted. When focusing particularly on Black/AA people and white people, our survey results revealed a significant association between race (Black/AA, white, or people of mixed Black/white ancestry) and vaccination status (vaccinated or unvaccinated) (p-value = 0.013). Approximately 79.1% of all participants received at least one dose of a COVID-19 vaccine. Individuals who were concerned with personal/family/community safety and/or wanted a return to normalcy were less likely to be hesitant. The study found that the major reasons cited for refusing the COVID-19 vaccines were distrust in vaccine safety, concerns about side effects, fear of needles, and vaccine efficacy.
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Affiliation(s)
- Donald J. Alcendor
- Department of Microbiology, Immunology and Physiology, School of Medicine, Meharry Medical College, 1005 Dr. D.B. Todd Jr. Blvd., Hubbard Hospital, 5th Floor, Rm. 5025, Nashville, TN 37208, USA
- Center for AIDS Health Disparities Research, Department of Microbiology, Immunology, and Physiology, School of Medicine, Meharry Medical College, 1005 Dr. D.B. Todd Jr. Blvd., Nashville, TN 37208, USA
| | - Patricia Matthews-Juarez
- Department of Family & Community Medicine, Meharry Medical College, 1005 D.B. Todd Jr. Blvd., Nashville, TN 37208, USA
| | - Neely Williams
- Community Partners’ Network, Nashville, TN 37208, USA (A.L.)
| | - Derek Wilus
- School of Graduate Studies, Meharry Medical College, 1005 D.B. Todd Jr. Blvd., Nashville, TN 37208, USA
| | - Mohammad Tabatabai
- School of Graduate Studies, Meharry Medical College, 1005 D.B. Todd Jr. Blvd., Nashville, TN 37208, USA
| | - Esarrah Hopkins
- Division of Public Health, Meharry Medical College, 1005 D.B. Todd Jr. Blvd., Nashville, TN 37208, USA
| | - Kirstyn George
- Division of Public Health, Meharry Medical College, 1005 D.B. Todd Jr. Blvd., Nashville, TN 37208, USA
| | - Ashley H. Leon
- Division of Public Health, Meharry Medical College, 1005 D.B. Todd Jr. Blvd., Nashville, TN 37208, USA
| | - Rafael Santiago
- Department of Family & Community Medicine, Meharry Medical College, 1005 D.B. Todd Jr. Blvd., Nashville, TN 37208, USA
| | - Arthur Lee
- Community Partners’ Network, Nashville, TN 37208, USA (A.L.)
| | - Duane Smoot
- Department of Internal Medicine, School of Medicine, Meharry Medical College, 1005 D.B. Todd Jr. Blvd., Nashville, TN 37208, USA
| | - James E. K. Hildreth
- Center for AIDS Health Disparities Research, Department of Microbiology, Immunology, and Physiology, School of Medicine, Meharry Medical College, 1005 Dr. D.B. Todd Jr. Blvd., Nashville, TN 37208, USA
| | - Paul D. Juarez
- Department of Family & Community Medicine, Meharry Medical College, 1005 D.B. Todd Jr. Blvd., Nashville, TN 37208, USA
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Sharma E, Mondal S, Das S, Vrana VG. Scale Development for COVID-19 Vaccine Hesitancy by Integration of Socio-Demographic and Psychological Factors. Vaccines (Basel) 2023; 11:1052. [PMID: 37376441 DOI: 10.3390/vaccines11061052] [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: 05/01/2023] [Revised: 05/27/2023] [Accepted: 05/29/2023] [Indexed: 06/29/2023] Open
Abstract
Vaccination is the most cost-effective way to maintain population health. However, it can only be effective if widespread acceptance is held. The efficacy of COVID-19 vaccines depends on their favor. When countries start to vaccinate their citizens, there is a certain level of skepticism about the effectiveness of the vaccines. The hesitancy study on vaccines has gained momentum following the pandemic. However, few studies have examined the link between the psychological and sociodemographic factors influencing the fit. This paper proposes integrating the concepts of the information systems success and stimulus-organism-response into a cognitive fit theory framework to explore the integration of psychological and sociodemographic factors in the receivers' reactions (n = 1510). This study analyses the factors that influence the hesitancy of vaccines and the public's refusal in Asia and Europe. Receivers' reactions were assessed to various stimuli and we explored the link between psychological and sociodemographic elements and the concept of fit. Two surveys were conducted following the scale development of Mackenzie. The first was to develop the fit scale, while the second was to validate the fit scale. The results of the second survey were analyzed using structural equation modelling. The results indicate that the scale's fit development is valid and reliable. The quality of the vaccine information, the psychological characteristics of the vaccine system, and vaccine receivers' satisfaction are also beneficial factors for emotional and cognitive fit. Maintaining the vaccines' quality and efficiency can help improve the fit between sociodemographic and psychological characteristics. It can also enhance receivers' satisfaction and encourage continued vaccine administration. This study is regarded as one of the first to examine and develop an emotional and cognitive fit scale for practitioners and researchers.
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Affiliation(s)
- Eliza Sharma
- Symbiosis Institute of Business Management Bengaluru, Symbiosis International (Deemed University), Karnataka 560100, India
| | - Subhra Mondal
- The Honors Programme, Department of Marketing, South Star Management Institute, Duy Tan University, Da Nang 550000, Vietnam
| | - Subhankar Das
- The Honors Programme, Department of Marketing, South Star Management Institute, Duy Tan University, Da Nang 550000, Vietnam
| | - Vasiliki G Vrana
- Department of Business Administration, School of Economics and Administration, The Campus of Serres, International Hellenic University, 62124 Serres, Greece
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Ekpor E, Akyirem S. Global acceptance of COVID-19 vaccine among persons with diabetes: A systematic review and meta-analysis. Diabetes Res Clin Pract 2023; 201:110731. [PMID: 37236364 DOI: 10.1016/j.diabres.2023.110731] [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] [Received: 04/22/2023] [Revised: 05/18/2023] [Accepted: 05/21/2023] [Indexed: 05/28/2023]
Abstract
AIM This review aimed to estimate the level of acceptance of COVID-19 vaccine among persons with diabetes. METHODS A systematic search was conducted on PubMed, MEDLINE, Embase, and CINAHL to identify relevant studies for this review. A random-effects meta-analysis was performed to generate an overall estimate of vaccine acceptance. The I2 statistic was used to quantify the degree of variation across studies, and subgroup analysis was conducted to identify the sources of heterogeneity. The review was conducted in line with the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA). RESULTS This review included 18 studies involving 11,292 diabetes patients. The pooled prevalence of COVID-19 vaccine acceptance among persons with diabetes was 76.1% (95% CI: 66.7% - 83.5%). The pooled prevalence across the continent ranged from 68.9% (95% CI: 47.8% - 84.3%) in Asia to 82.1% (95% CI: 80.2% - 83.8%) in Europe. Barriers to vaccine acceptance included misinformation, lack of information, mistrust, health concerns, and external influences. CONCLUSION The barriers to vaccine acceptance identified in this review, could inform the formulation of health policies and public health interventions that are specifically tailored to address the needs of persons with diabetes.
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Affiliation(s)
- Emmanuel Ekpor
- School of Nursing and Midwifery, University of Ghana, Legon, Accra, Ghana; Christian Health Association of Ghana, Accra, Ghana.
| | - Samuel Akyirem
- Yale School of Nursing, Yale University, New Haven, Connecticut, USA
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