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Garnier S, Then C, de St Aubin M, Cadavid Restrepo A, Mayfield HJ, Dumas D, Duke W, Peña F, Kucharski AJ, Skewes R, Zielinski Gutiérrez E, Coyoli J, Etienne MC, Lau CL, Vázquez M, Nilles E. Trust and COVID-19 vaccine hesitancy in the Dominican Republic: a national cross-sectional household survey, June-October 2021. BMJ Open 2024; 14:e081523. [PMID: 38803259 DOI: 10.1136/bmjopen-2023-081523] [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] [Indexed: 05/29/2024] Open
Abstract
OBJECTIVE This study investigates the role of trust in shaping COVID-19 vaccine acceptance in the Dominican Republic (DR) during the COVID-19 pandemic. DESIGN Cross-sectional household survey. SETTING Randomly selected households across 134 clusters in the DR, from 30 June 2021 to 12 October 2021. PARTICIPANTS 5999 participants ≥16 years of age were enrolled. OUTCOME MEASURES COVID-19 vaccine hesitancy (CVH) data were collected from participants ≥16 years of age and analysed as both an ordinal and binary variable. RESULTS Overall, CVH was low (5.2% (95% CI 4.6% to 5.8%)), but more common among younger individuals, women and individuals of Mestizo ethnicity. Higher trust in local government, national government, scientists and local doctors (considered official sources) was associated with lower odds of CVH (OR 0.89 (95% CI 0.72 to 0.88), 0.89 (95% CI 0.81 to 0.98), 0.87 (95% CI 0.80 to 0.94) and 0.70 (95% CI 0.62 to 0.80), respectively). Higher trust in religious leaders, social media and traditional media (considered unofficial sources) was associated with higher odds of CVH, with respective ORs of 1.32 (95% CI 1.18 to 1.47), 1.30 (95% CI 1.19 to 1.41) and 1.08 (95% CI 0.97 to 1.22). CONCLUSION We report findings on CVH from a national household survey in the DR and identify overall low rates of CVH but marked heterogeneity by age, gender and ethnicity. Trust in unofficial versus official sources of information is associated with increased CVH. These findings highlight and quantify the importance of trust as a key parameter when considering public health communication strategies.
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Affiliation(s)
- Salomé Garnier
- EHESP French School of Public Health, Paris, France
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Harvard Humanitarian Initiative, Cambridge, Massachusetts, USA
| | - Cecilia Then
- Dirección General de Epidemiología, Santo Domingo, Dominican Republic
| | - Michael de St Aubin
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Harvard Humanitarian Initiative, Cambridge, Massachusetts, USA
| | | | - Helen J Mayfield
- School of Public Health, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Devan Dumas
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Harvard Humanitarian Initiative, Cambridge, Massachusetts, USA
| | - William Duke
- Universidad Nacional Pedro Henríquez Ureña, Santo Domingo, Dominican Republic
| | - Farah Peña
- Dirección General de Epidemiología, Santo Domingo, Dominican Republic
| | | | - Ronald Skewes
- Dirección General de Epidemiología, Santo Domingo, Dominican Republic
| | - Emily Zielinski Gutiérrez
- Central America Regional Office, Centers for Disease Control and Prevention, Guatemala City, Guatemala
| | - Julia Coyoli
- Department of Government, Harvard University Faculty of Arts and Sciences, Cambridge, Massachusetts, USA
| | - Marie Caroline Etienne
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Colleen L Lau
- School of Public Health, The University of Queensland, Saint Lucia, Queensland, Australia
| | | | - Eric Nilles
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Harvard Humanitarian Initiative, Cambridge, Massachusetts, USA
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Slavec A, Iwanowska M, Bałandynowicz-Panfil K, Olah Ș, Zvonar MŠ, Štebe J, Łosiewicz M. Determinants of COVID-19 vaccination intention in Central and Eastern Europe: A cross-sectional study in Poland, Romania, and Slovenia. Arch Public Health 2024; 82:60. [PMID: 38689314 PMCID: PMC11061955 DOI: 10.1186/s13690-024-01261-0] [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] [Received: 12/29/2022] [Accepted: 02/28/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Identifying predictors of vaccination intention is critical to developing appropriate programs and campaigns targeting groups reluctant to be vaccinated. This study aimed to identify the determinants of vaccination intention at the beginning of the COVID-19 pandemic in three Central and Eastern European (CEE) countries: Poland, Romania, and Slovenia. METHODS In this cross-sectional study, a sample of unvaccinated 1723 Poles, Romanians, and Slovenians completed an online survey (April 2021). Questions included measures of vaccination intention, attitudes towards vaccines, conspiracy mindset, preference for a type of vaccine, and trust in information sources. RESULTS The results showed that mistrust of vaccine benefits and concerns about commercial profiteering negatively predicted vaccination intention. Conversely, trust in information from medical professionals and scientists, official sources, and traditional media was positively related to vaccination intention, while trust in digital media was negatively related to vaccination intention. In addition, preference for mRNA vaccine type was a positive significant predictor of vaccination intention. The differences between countries are discussed. CONCLUSIONS The study results deliver suggestions for developing appropriate vaccine uptake programs and campaigns that should consider presenting the positive outcomes of vaccines via official sources and traditional media based on scientific evidence and medical professionals' knowledge.
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Affiliation(s)
- Ana Slavec
- InnoRenew CoE, Izola, Slovenia and Faculty of Mathematics, Natural Sciences and Information Technologies, University of Primorska, Koper, Slovenia
| | - Magdalena Iwanowska
- Institute of Psychology, Faculty of Social Sciences, University of Gdańsk, Gdańsk, Poland.
| | | | - Șerban Olah
- Department of Sociology and Social Work, University of Oradea, Oradea, Romania
| | | | - Janez Štebe
- Social Science Data Archives (ADP), Faculty of Social Sciences, University of Ljubljana, Ljubljana, Slovenia
| | - Małgorzata Łosiewicz
- Institute of Media, Journalism and Social Communication, Faculty of Social Sciences, University of Gdańsk, Gdańsk, Poland
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Dang JHT, Gori A, Rios L, Rolon AM, Zhang J, Chen MS. "You Don't Know If It's the Truth or a Lie": Exploring Human Papillomavirus (HPV) Vaccine Hesitancy among Communities with Low HPV Vaccine Uptake in Northern California. Vaccines (Basel) 2024; 12:372. [PMID: 38675754 PMCID: PMC11053910 DOI: 10.3390/vaccines12040372] [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: 02/26/2024] [Revised: 03/25/2024] [Accepted: 03/29/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Vaccine hesitancy, delaying or refusing to vaccinate despite the availability of vaccines, impedes the progress of achieving optimal HPV vaccine coverage. Little is known about the sources of human papillomavirus (HPV) vaccine hesitancy among racially/ethnically and geographically diverse communities. The purpose of this paper is to explore HPV vaccine hesitancy among rural, Slavic, and Latino communities that reside in counties with low HPV vaccine uptake rates. METHODS Key informant interviews and focus groups were conducted with rural, Slavic, and Latino communities that reside within counties in California that have low HPV vaccine up to date rates (16-25%). Qualitative data were transcribed verbatim and analyzed using inductive and deductive thematic analysis. RESULTS A total of seven focus groups and 14 key informant interviews were conducted with 39 individuals from seven California counties. Salient themes that contributed to HPV vaccine hesitancy included the following: social media and the anti-vaccination movement; a strong belief in acquiring immunity naturally; prior vaccine experiences; and vaccine timing concerns. Participants suggested the provision of culturally appropriate, in-language, in-person easy to understand HPV vaccine education to mitigate HPV vaccine hesitancy. CONCLUSIONS Our findings can inform future interventions to increase HPV vaccine uptake among hesitant communities.
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Affiliation(s)
- Julie H. T. Dang
- Division of Health Policy and Management, Department of Public Health Sciences, School of Medicine, University of California, Davis, CA 95816, USA
| | - Alexandra Gori
- Comprehensive Cancer Center, University of California, Davis, CA 95816, USA; (A.G.); (A.M.R.)
| | - Lucy Rios
- Division of Hematology and Oncology, Department of Internal Medicine, School of Medicine, University of California, Davis, CA 95817, USA; (L.R.); (M.S.C.J.)
- Department of Public Health Sciences, University of California, Davis, CA 95817, USA
| | - Angelica M. Rolon
- Comprehensive Cancer Center, University of California, Davis, CA 95816, USA; (A.G.); (A.M.R.)
| | - Jingwen Zhang
- Department of Communication, Department of Public Health Sciences, University of California, Davis, CA 95616, USA;
| | - Moon S. Chen
- Division of Hematology and Oncology, Department of Internal Medicine, School of Medicine, University of California, Davis, CA 95817, USA; (L.R.); (M.S.C.J.)
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4
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Liu Shiu Cheong D, Tran J, Chong W, May S, Carlson SJ, Salter SM, Attwell K. Attitudes, perceptions, and experiences of Western Australians towards vaccine safety surveillance systems following COVID-19 vaccines: A qualitative descriptive study. Aust N Z J Public Health 2024; 48:100108. [PMID: 38141591 DOI: 10.1016/j.anzjph.2023.100108] [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: 01/16/2023] [Revised: 07/27/2023] [Accepted: 11/07/2023] [Indexed: 12/25/2023] Open
Abstract
OBJECTIVE Concerns regarding adverse events following immunisation are a barrier to vaccine uptake. Health professionals use vaccine safety surveillance systems (VSSSs) to monitor vaccines and inform the public of safety data. With little known about public attitudes, perceptions, and experiences with VSSS, we examined them in the context of COVID-19 vaccinations in Western Australia. METHODS Researchers conducted 158 qualitative interviews between March 2021 and May 2022 within the broader [name redacted] project. Data regarding VSSS were coded in NVivo using the deductive and inductive methods. RESULTS Despite some not knowing about VSSS, participants expected follow-up post COVID-19 vaccination. Vaccine hesitant or refusing participants knew about VSSS and regarded these systems positively. Additional considerations concerned the reliability of data collected by VSSS. CONCLUSION Perceptions of VSSS signal a lack of understanding about how these systems work. Future studies should further explore the public's understanding of VSSS, whether VSSS improves vaccine confidence, and how governments can better communicate to the public about VSSS. IMPLICATIONS FOR PUBLIC HEALTH Lack of understanding of how VSSS operate may be stymying attempts to build public vaccine confidence. Healthcare providers and governments could build public knowledge and understanding of VSSS to mitigate concerns of adverse events following immunisation.
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Affiliation(s)
- Denis Liu Shiu Cheong
- School of Allied Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Jayden Tran
- School of Allied Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Wyitt Chong
- School of Allied Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Scott May
- School of Allied Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Samantha J Carlson
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia; School of Social Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - Sandra M Salter
- School of Allied Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Katie Attwell
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia; School of Social Sciences, University of Western Australia, Perth, Western Australia, Australia.
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Shin H, Shah P, Preston SD. The Reasoning through Evidence versus Advice (EvA) Scale: Scale Development and Validation. J Pers Assess 2024:1-15. [PMID: 38271474 DOI: 10.1080/00223891.2023.2297266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 11/28/2023] [Indexed: 01/27/2024]
Abstract
Our well-being can improve when people heed evidence rather than simply follow familiar or charismatic advisors who neglect evidence. We developed the Reasoning through Evidence versus Advice (EvA) scale to measure individual differences in reasoning through evidence like science and statistics versus following advisors such as politicians and celebrities. No existing scales directly measure these tendencies; moreover, it was theoretically unknown whether they reflect a single dimension (from evidence- to advice-based) or distinct tendencies to value or distrust each. Our scale validation process included qualitative interviews and four studies that involved 1583 respondents (753 college graduates, 830 non-college graduates) in which we conducted exploratory and confirmatory factor analyses and tests of convergent validity, discriminant validity, and measurement invariance by gender and education. This process yielded a 16-item EvA scale with four dimensions: Pro-evidence, Anti-evidence, Pro-advice, and Anti-advice. In assessing criterion validity, these tendencies identified individual differences in important, real-world attitudes and behaviors, including susceptibility to health misinformation, adherence to CDC guidelines on social distancing, confidence in the COVID vaccine, science curiosity, and religiosity. The EvA scale extends our understanding of individual differences in reasoning tendencies that shape critical attitudes, decisions, and behaviors and can help promote informed decisions.
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Affiliation(s)
- Hwayong Shin
- Department of Political Science, University of Michigan, Ann Arbor, Michigan
| | - Priti Shah
- Department of Psychology, University of Michigan, Ann Arbor, Michigan
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Dimitrova V, Stoitsova S, Rangelov V, Raycheva R, Martinova M, Nenova G, Iakimova M, Georgieva I, Georgiev I, Krumova S, Minkova A, Vladimirova N, Nikolaeva-Glomb L. High vaccine confidence and strong approval of the mandatory immunization schedule among Bulgarian general practitioners in 2022. Hum Vaccin Immunother 2023; 19:2265640. [PMID: 37846744 PMCID: PMC10583620 DOI: 10.1080/21645515.2023.2265640] [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: 07/18/2023] [Accepted: 09/28/2023] [Indexed: 10/18/2023] Open
Abstract
In a context of recently decreasing childhood immunization coverage and low uptake of COVID-19 vaccines in Bulgaria, this study measures vaccine hesitancy among general practitioners (GPs) in the country, as they are central to forming patients' attitudes. In 2022, a face-to-face survey was conducted through a simple random sample from an exhaustive national database of Bulgarian GPs. This study measured attitudes on vaccine importance, safety, and effectiveness, and attitudes toward the Bulgarian immunization schedule. Information was collected on demographic and GP practice characteristics and possible predictors of vaccine confidence in order to test for associations with attitudes toward immunization. GP attitudes toward vaccines and the immunization schedule in Bulgaria were generally positive. Among 358 respondents, 351 (98%,95%CI96-99%) strongly agreed/agreed that vaccines are important, 352 (98%,95%CI96-99%) that vaccines are effective, and 341 (95%,95%CI93-97%) that vaccines are safe. 347 respondents (97%,95%CI95-98%) affirmed that "it's good that vaccines from the children's immunization schedule are mandatory", and 331 (92%,95%CI89-95%) agreed with the statement "Bulgaria's childhood immunization has my approval". Trust in information from official institutions was among the strongest predictors of vaccine confidence. Respondents' vaccine confidence levels are within the ranges reported by GPs in other European countries and above those reported within the general Bulgarian population. GPs' vaccine confidence is highly associated with trust in official institutions. It is important to maintain trust in official institutions and to support GPs in communicating vaccine knowledge with patients so that vaccine hesitancy in the general population is countered.
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Affiliation(s)
- Veronika Dimitrova
- Department of Sociology, Sofia University “St. Kliment Ohridski”, Sofia, Bulgaria
| | - Savina Stoitsova
- Department of Epidemiology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Vanya Rangelov
- Department of Epidemiology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
- Department of Epidemiology and Disaster Medicine, Medical University Plovdiv, Plovdiv, Bulgaria
| | - Ralitsa Raycheva
- Department of Social Medicine and Public Health, Medical University Plovdiv, Plovdiv, Bulgaria
| | - Maria Martinova
- Communities and Identities Department, Bulgarian Academy of Sciences, Sofia, Bulgaria
| | - Gergana Nenova
- Department of Sociology, Sofia University “St. Kliment Ohridski”, Sofia, Bulgaria
| | - Milena Iakimova
- Department of Sociology, Sofia University “St. Kliment Ohridski”, Sofia, Bulgaria
| | - Irina Georgieva
- Department of Virology, National Center for Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Ivo Georgiev
- Department of Epidemiology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Stefka Krumova
- Department of Virology, National Center for Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Antoaneta Minkova
- Department of Epidemiology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Nadezhda Vladimirova
- Department of Epidemiology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
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Carrico S, Zitta JP, Stevens E, Jenkins R, Mortiboy M, Jenks JD. Mpox Vaccination and the Role of Social Vulnerability in Durham County, North Carolina, USA. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01827-8. [PMID: 37831364 DOI: 10.1007/s40615-023-01827-8] [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: 06/26/2023] [Revised: 09/13/2023] [Accepted: 10/03/2023] [Indexed: 10/14/2023]
Abstract
BACKGROUND Disparities in vaccine coverage among groups in the USA is common, possibly due to higher vaccine hesitancy in certain populations, difficulty accessing vaccines, and underlying social vulnerability. METHODS The aim of this study was to investigate the association between mpox vaccine administration, social determinants of health, and social vulnerability index (SVI) in Durham County, North Carolina, USA. Random forest regression (RFE) and min-max scaling preprocessing were used to predict mpox vaccinations in Durham County at the census tract level. The top eleven most influential features and their correlations with mpox vaccination were calculated. RESULTS Non-Hispanic white individuals, males, and those between the ages of 20 and 40 years were overrepresented in mpox vaccine reception in Durham County. Surprisingly, lacking a high school diploma, lacking health insurance, lacking a household vehicle, and living below the poverty line were all positively associated with receiving the mpox vaccine. Being a Black or African American and Hispanic or Latino individual was also positively associated with receiving the mpox vaccine. DISCUSSION Vaccine outreach efforts in Durham County, North Carolina, had success in reaching at-risk individuals, including socially vulnerable individuals. Future research should focus more specifically on how social vulnerability relates to vaccine reception for vaccine-preventable diseases.
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Affiliation(s)
- Savannah Carrico
- Durham County Department of Public Health, 414 East Main Street, Durham, NC, USA.
| | - John-Paul Zitta
- Durham County Department of Public Health, 414 East Main Street, Durham, NC, USA
| | - Elizabeth Stevens
- Durham County Department of Public Health, 414 East Main Street, Durham, NC, USA
| | - Rodney Jenkins
- Durham County Department of Public Health, 414 East Main Street, Durham, NC, USA
| | - Marissa Mortiboy
- Durham County Department of Public Health, 414 East Main Street, Durham, NC, USA
| | - Jeffrey D Jenks
- Durham County Department of Public Health, 414 East Main Street, Durham, NC, USA.
- Division of Infectious Diseases, Department of Medicine, Duke University, Durham, NC, USA.
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Metta E, Shayo EH, Ngalesoni F, Kalolo A, Nyamuryekung'e K, Mboya IB, Ndumwa HP, Njiro BJ, Amour MA. The role of trust in the implementation and uptake of COVID-19 response measures: a qualitative study of health professionals' experiences in Tanzania. BMC Health Serv Res 2023; 23:1077. [PMID: 37817175 PMCID: PMC10566036 DOI: 10.1186/s12913-023-10043-3] [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: 03/02/2023] [Accepted: 09/17/2023] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND Even though trust is placed at the central point in ensuring proper functioning of the health systems, studies remain scant on how it affects both the implementation and uptake of COVID-19 response measures in low- and middle-income countries such as Tanzania. This study, therefore, explored the role of trust in the implementation and uptake of recommended COVID-19 response measures including vaccines from the perspective of health professionals in Tanzania. METHODS This cross-sectional qualitative study was implemented in four of Tanzania's thirty-one regions. Qualitative data was collected through 26 in-depth interviews held with regional and district disease outbreak response teams, district cold chain co-ordinators and health facility in-charges. In addition, five focus group discussions and seven group interviews were conducted with healthcare workers from the lower-level health facilities. Thematic analysis was conducted and applied the trust constructs. RESULTS Interpersonal trust and health system trust emerged as two major themes in the study. Interpersonal trust was reported to stem from lack of transparency that instigated fear, worries, and confusion regarding the implementation and uptake of the recommended response measures. The distrust was mainly between health professionals in health facilities and those assigned to isolation centres as well as between patients and community members. On the other hand, the health system trust was shaped by mixed feelings regarding COVID-19 vaccine national decisions, and conflicting messages from national officials, politicians and religious leaders on COVID-19 responses, safety, and effectiveness of the vaccines. Questions surrounding the short duration of clinical trials, indeterminate post-vaccination protection duration, impotence-linked beliefs, freemasonry notion and unclear vaccinated cards information are other reported contributory factors to mistrust in the health system. However, after a comprehensive health education and experience in COVID-19 vaccination administration most professionals affirmed the effectiveness of the vaccines in limiting infections and its severe consequences. CONCLUSION Participants indicated limited trust at both interpersonal and health system levels aggravated by lack of transparency, unclear and conflicting messages on COVID-19 infections and response measures. Enforced transparency on pandemics alongside standardised messages from the reliable sources is crucial in enhancing trust in implementation and uptake of the recommended response measures.
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Affiliation(s)
- Emmy Metta
- Department of Behavioral Sciences, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania.
| | - Elizabeth H Shayo
- National Institute for Medical Research, P.O. Box 9653, Dar es Salaam, Tanzania
| | - Frida Ngalesoni
- AMREF Health Africa in Tanzania, P.O. Box 2773, Dar es Salaam, Tanzania
| | - Albino Kalolo
- Department of Public Health, St. Francis University College of Health, and Allied Sciences, P.O. Box 175, Morogoro, Tanzania
| | - Kasusu Nyamuryekung'e
- Department of Community Dentistry, School of Dentistry, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania
| | - Innocent B Mboya
- Department of Epidemiology and Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College, P.O. Box 2240, Moshi, Tanzania
- Department of Translational Medicine, Lund University, 202 13 Malmö, P.O. Box 50332, Malmö, Sweden
| | - Harrieth P Ndumwa
- Department of Community Health, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania
| | - Belinda J Njiro
- Department of Community Health, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania
| | - Maryam A Amour
- Department of Community Health, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania
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Zastawna B, Milewska A, Załuska R, Kozłowski R, Zastawna M, Marczak M. Analysis of Parents' Attitudes and Knowledge toward Immunization and How These Factors Influence Their Decisions to Vaccinate Their Children against Human Papilloma Virus (HPV). MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1755. [PMID: 37893473 PMCID: PMC10608555 DOI: 10.3390/medicina59101755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 09/22/2023] [Accepted: 09/28/2023] [Indexed: 10/29/2023]
Abstract
Background and objectives: Vaccination hesitancy is a growing problem associated with decreasing chances for the elimination of vaccine-preventable diseases through immunization. This research was conducted to learn about parents' attitudes toward vaccination, particularly against HPV, in the context of their beliefs and fears regarding immunization and the impact of these views on their children's vaccination decisions. An additional goal was to determine what views or convictions most often lead to the phenomenon of delaying or refusing vaccinations, especially HPV vaccines, in the surveyed community. Materials and Methods: An online questionnaire was conducted in which parents marked how they vaccinated their children with mandatory vaccinations and whether they took the opportunity to protect their children with additional vaccinations, including HPV and COVID-19. Respondents also marked the extent to which they agreed with the statements, regarding the safety of vaccinations, doubts about them, as well as popular anti-vaccine myths. Results: A total of 250 questionnaires were collected with data on the immunization of 425 children. Associations between specific beliefs and vaccine abstention were established. The most motivating factor for vaccination against HPV was the parent's awareness that the virus HP is the cause of cancer. The most inhibiting factor was respondent's compliance with the opinion that HPV vaccines can affect the child's sexual activity. Conclusions: The results indicate that information campaigns are needed, especially focusing on vaccine safety and the regularity and transparency of monitoring adverse effects. The obtained results will be used to create educational interventions against vaccination hesitancy more adapted to local conditions.
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Affiliation(s)
- Beata Zastawna
- Department of Management and Logistics in Health Care, Medical University of Lodz, 90-131 Lodz, Poland; (R.Z.); (R.K.)
| | - Anna Milewska
- Department of Statistics and Medical Informatics, Medical University of Bialystok, 15-089 Bialystok, Poland;
| | - Roman Załuska
- Department of Management and Logistics in Health Care, Medical University of Lodz, 90-131 Lodz, Poland; (R.Z.); (R.K.)
| | - Remigiusz Kozłowski
- Department of Management and Logistics in Health Care, Medical University of Lodz, 90-131 Lodz, Poland; (R.Z.); (R.K.)
| | - Martyna Zastawna
- Department of Psychology, SWPS University of Social Sciences and Humanities, 03-815 Warsaw, Poland;
| | - Michał Marczak
- Collegium of Management, WSB University in Warsaw, 03-204 Warsaw, Poland
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10
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Fasce A, Schmid P, Holford DL, Bates L, Gurevych I, Lewandowsky S. A taxonomy of anti-vaccination arguments from a systematic literature review and text modelling. Nat Hum Behav 2023; 7:1462-1480. [PMID: 37460761 DOI: 10.1038/s41562-023-01644-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 05/25/2023] [Indexed: 09/23/2023]
Abstract
The proliferation of anti-vaccination arguments is a threat to the success of many immunization programmes. Effective rebuttal of contrarian arguments requires an approach that goes beyond addressing flaws in the arguments, by also considering the attitude roots-that is, the underlying psychological attributes driving a person's belief-of opposition to vaccines. Here, through a pre-registered systematic literature review of 152 scientific articles and thematic analysis of anti-vaccination arguments, we developed a hierarchical taxonomy that relates common arguments and themes to 11 attitude roots that explain why an individual might express opposition to vaccination. We further validated our taxonomy on coronavirus disease 2019 anti-vaccination misinformation, through a combination of human coding and machine learning using natural language processing algorithms. Overall, the taxonomy serves as a theoretical framework to link expressed opposition of vaccines to their underlying psychological processes. This enables future work to develop targeted rebuttals and other interventions that address the underlying motives of anti-vaccination arguments.
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Affiliation(s)
- Angelo Fasce
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
| | - Philipp Schmid
- Institute for Planetary Health Behaviour, University of Erfurt, Erfurt, Germany
- Department of Implementation Research, Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany
| | - Dawn L Holford
- School of Psychological Science, University of Bristol, Bristol, UK
- Department of Psychology, University of Essex, Colchester, UK
| | - Luke Bates
- Ubiquitous Knowledge Processing Lab/Department of Computer Science and Hessian Center for AI (hessian.AI), Technical University of Darmstadt, Darmstadt, Germany
| | - Iryna Gurevych
- Ubiquitous Knowledge Processing Lab/Department of Computer Science and Hessian Center for AI (hessian.AI), Technical University of Darmstadt, Darmstadt, Germany
| | - Stephan Lewandowsky
- School of Psychological Science, University of Bristol, Bristol, UK
- School of Psychological Science, University of Western Australia, Perth, Western Australia, Australia
- Department of Psychology, University of Potsdam, Potsdam, Germany
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11
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Tolley AJ, Scott VC, Mitsdarffer ML, Scaccia JP. The Moderating Effect of Vaccine Hesitancy on the Relationship between the COVID-19 Vaccine Coverage Index and Vaccine Coverage. Vaccines (Basel) 2023; 11:1231. [PMID: 37515046 PMCID: PMC10386611 DOI: 10.3390/vaccines11071231] [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: 05/26/2023] [Revised: 07/05/2023] [Accepted: 07/07/2023] [Indexed: 07/30/2023] Open
Abstract
To examine COVID-19 vaccination barriers in the US, this study drew on publicly available county-level data (n = 3130) to investigate the impact of vaccine hesitancy on the relationship between county-level social/structural barriers and vaccine coverage. A hierarchical regression was performed to establish the relationship between the COVID-19 Vaccine Coverage Index (CVAC) and vaccine coverage, assess the moderating effect of vaccine hesitancy on this relationship, and explore the influence of ethno-racial composition on vaccine coverage. A significant, negative relationship (r2 = 0.11, f2 = 0.12) between CVAC and vaccine coverage by county was established (step 1). When vaccine hesitancy was introduced as a moderator (step 2), the model significantly explained additional variance in vaccine coverage (r2 = 0.21, f2 = 0.27). Simple slopes analysis indicated a significant interaction effect, whereby the CVAC-vaccine coverage relationship was stronger in low hesitancy counties as compared with high hesitancy counties. Counties with low social/structural barriers (CVAC) but high hesitancy were projected to have 14% lower vaccine coverage. When county-level ethno-racial composition was introduced (step 3), higher proportions of white residents in a county predicted decreased vaccination rates (p < 0.05). Findings indicate that CVAC should be paired with vaccine hesitancy measures to better predict vaccine uptake. Moreover, counties with higher proportions of white residents led to decreases in vaccine uptake, suggesting that future intervention strategies should also target whites to reach herd immunity. We conclude that public health leaders and practitioners should address both social/structural and psychological barriers to vaccination to maximize vaccine coverage, with a particular focus on vaccine hesitancy in communities with minimal social/structural barriers.
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Affiliation(s)
- Annalise Julia Tolley
- Department of Psychology, Health Psychology, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223, USA
| | - Victoria C Scott
- Department of Psychology, Health Psychology, Faculty of Psychological Science and Public Health Science, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223, USA
| | - Mary Louise Mitsdarffer
- Biden School of Public Policy & Administration, Research Faculty in the Center for Community Research and Service, University of Delaware, Newark, DE 19716, USA
| | - Jonathan P Scaccia
- Dawn Chorus Group, 342 N. Queen Street, Candy Factory Warehouse D, Lancaster, PA 17603, USA
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12
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Masoud D, Pierz A, Rauh L, Cruz AK, Palmedo C, Ratzan S. Vaccine Trust Gauge: Mixed methods research to measure and understand vaccine trust. Vaccine 2023:S0264-410X(23)00690-4. [PMID: 37336659 DOI: 10.1016/j.vaccine.2023.06.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 05/15/2023] [Accepted: 06/06/2023] [Indexed: 06/21/2023]
Abstract
INTRODUCTION While trust in vaccination is one factor in the ecosystem that surrounds vaccine decision-making and acceptance, understanding its role may provide insights into effective and tailored approaches to help build individual-level vaccine confidence. The authors developed the Vaccine Trust Gauge (VTG), a scale used to measure trust in vaccines, and conducted mixed methods research to provide an in-depth understanding of the various factors shaping vaccine trust in the United States. MATERIALS AND METHODS The VTG instrument was developed from previous and scoping research of questionnaires (Larson et al., 2018; Palmedo et al., 2021) and fielded in the US to n = 3026 adults ages ≥18. Based on survey responses, participants were segmented by vaccine trust level (low, medium, or high) through an aggregated scoring system constructed from the VTG. 65 respondents were recruited to participate in in-depth interviews or focus groups conducted by phone or video conference. A conceptual definition of vaccine trust was developed using components of the VTG scale. RESULTS Multivariate regressions found that higher levels of vaccine trust measured by the VTG are closely associated with trust in healthcare providers and trust in government. College or higher degree, Democrats, and those aged 55+ were more likely to have higher trust in vaccines compared to Black/African Americans, and those experiencing discrimination in the healthcare system. The qualitative analysis allowed the authors to add diverse, contextual elements to the vaccine trust levels summarized here. DISCUSSION These mixed methods findings suggest future implications for research and practice. Ideas for potential communication, policy, and public health strategies are offered to build vaccine confidence and advance uptake for COVID-19 and other vaccines. CONCLUSIONS There are diverse underlying factors that influence an individual's trust in vaccines, which means trust categories and demographic characteristics cannot be used as monolithic identifiers. Assessing vaccine trust provides insights into a foundation for engagement to promote individual-level vaccine acceptance. The authors present recommendations for the use of the VTG, future implications for research and practice, and potential strategies to build vaccine confidence.
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Affiliation(s)
- Dima Masoud
- City University of New York Graduate School of Public Health and Health Policy, United States.
| | - Amanda Pierz
- City University of New York Graduate School of Public Health and Health Policy, United States
| | - Lauren Rauh
- City University of New York Graduate School of Public Health and Health Policy, United States
| | - Alanna Kate Cruz
- City University of New York Graduate School of Public Health and Health Policy, United States
| | - Chris Palmedo
- City University of New York Graduate School of Public Health and Health Policy, United States
| | - Scott Ratzan
- City University of New York Graduate School of Public Health and Health Policy, United States
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13
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Li M, Luo Y, Watson R, Zheng Y, Ren J, Tang J, Chen Y. Healthcare workers' (HCWs) attitudes and related factors towards COVID-19 vaccination: a rapid systematic review. Postgrad Med J 2023; 99:520-528. [PMID: 37319159 DOI: 10.1136/postgradmedj-2021-140195] [Citation(s) in RCA: 122] [Impact Index Per Article: 122.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 05/29/2021] [Indexed: 01/24/2023]
Abstract
Herd immunity through vaccination is a key measure to control COVID-19 pandemic. However, vaccine hesitancy remains a public health threat, which is still common among healthcare workers (HCWs). This systematic review aimed to synthesise evidence on HCWs' attitudes towards COVID-19 vaccination and analyse associated factors to provide information for vaccine policy development and practice. We searched PubMed, Embase, ScienceDirect, Web of Science and three Chinese databases for literature published on 12 February 2021. Two researchers screened the literature independently, and 13 studies were included in the systematic review. Vaccine acceptance varied widely and ranged from 27.7% to 77.3%. HCWs had positive attitudes towards future COVID-19 vaccines, while vaccine hesitancy was still common. Demographic variables such as men, older age and physicians were positive predictive factors. Women and nurses had more vaccine hesitancy. Previous influenza vaccination and self-perceived risk were facilitators. Concerns for safety, efficacy and effectiveness and distrust of the government were barriers. Influences of direct (COVID-19) patient care towards vaccination intention were less conclusive. Tailored communication strategies were needed to increase the uptake rate of COVID-19 vaccines among HCWs. More importantly, more data and information on the safety and efficacy of vaccines should be provided with transparency.
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Affiliation(s)
- Mei Li
- School of Nursing, Southwest Medical University, Luzhou, Sichuan, China
| | - Yue Luo
- School of Nursing, Southwest Medical University, Luzhou, Sichuan, China
| | - Roger Watson
- Health and Social Care Faculty, University of Hull, Hull, UK
| | - Yu Zheng
- Department of Rheumatism and Immunology, the Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Jianlan Ren
- Department of Anesthesiology, the Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Jian Tang
- Department of Central Sterile Supply, the Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Yanhua Chen
- Department of Nursing, the Affiliated Hospital of Southwest Medical University, Luzhou, China
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14
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Malo B, Labbé F, Meyer SB, Filice E, Graham JE, MacDonald NE, Bettinger JA, Greyson D, MacDonald SE, Driedger SM, Kawchuk G, Dubé E. "I Want People to Be Able to Make an Informed Choice": How Quebec naturopaths discuss vaccination in their practice. Vaccine 2023:S0264-410X(23)00553-4. [PMID: 37210310 DOI: 10.1016/j.vaccine.2023.05.026] [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: 11/25/2022] [Revised: 03/22/2023] [Accepted: 05/09/2023] [Indexed: 05/22/2023]
Abstract
Health care providers' recommendations can play an important role in individuals' vaccination decisions. Despite being one of the most popular complementary and alternative medicine (CAM), naturopathy is understudied in relation to vaccination decisions. We sought to address this gap through this study of vaccination perspectives of naturopathy practitioners in the province of Quebec, Canada. We conducted in-depth interviews with 30 naturopaths. Thematic analysis was conducted. Main themes were developed deductively (i.e., based on prior literature) and expanded through inductive coding of the data. Participants noted that they discuss vaccination in their practice, but only when clients asked questions or wanted advice. Naturopaths described refraining from explicitly recommending for or against vaccination. Instead, they focus on empowering their clients to make their own informed decision regarding vaccination. Most participants noted that they direct clients towards sources of information so that clients could decide for themselves, but some mentioned they discussed with clients what they considered to be risks associated with vaccination, as well as its benefits. These discussions were framed through a personalized and individual approach with clients.
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Affiliation(s)
- Benjamin Malo
- Axe Maladies infectieuses et immunitaires, Centre de recherche du CHU de Québec-Université Laval, Québec, Canada; Département d'anthropologie, Université Laval, Québec, Canada
| | - Fabienne Labbé
- Axe Santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec-Université Laval, Québec, Canada
| | - Samantha B Meyer
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Eric Filice
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Janice E Graham
- Department of Pediatrics, Dalhousie University, Halifax, Canada
| | | | - Julie A Bettinger
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, University of British Columbia, Vancouver, Canada
| | - Devon Greyson
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, University of British Columbia, Vancouver, Canada
| | | | - S Michelle Driedger
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Gregory Kawchuk
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | - Eve Dubé
- Axe Maladies infectieuses et immunitaires, Centre de recherche du CHU de Québec-Université Laval, Québec, Canada; Département d'anthropologie, Université Laval, Québec, Canada; Direction des risques biologiques et de la santé au travail, Institut national de santé publique du Québec, Québec, Canada.
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15
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Novilla MLB, Goates MC, Redelfs AH, Quenzer M, Novilla LKB, Leffler T, Holt CA, Doria RB, Dang MT, Hewitt M, Lind E, Prickett E, Aldridge K. Why Parents Say No to Having Their Children Vaccinated against Measles: A Systematic Review of the Social Determinants of Parental Perceptions on MMR Vaccine Hesitancy. Vaccines (Basel) 2023; 11:vaccines11050926. [PMID: 37243030 DOI: 10.3390/vaccines11050926] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/20/2023] [Accepted: 04/24/2023] [Indexed: 05/28/2023] Open
Abstract
Ongoing outbreaks of measles threaten its elimination status in the United States. Its resurgence points to lower parental vaccine confidence and local pockets of unvaccinated and undervaccinated individuals. The geographic clustering of hesitancy to MMR indicates the presence of social drivers that shape parental perceptions and decisions on immunization. Through a qualitative systematic review of published literature (n = 115 articles; 7 databases), we determined major themes regarding parental reasons for MMR vaccine hesitancy, social context of MMR vaccine hesitancy, and trustworthy vaccine information sources. Fear of autism was the most cited reason for MMR hesitancy. The social drivers of vaccine hesitancy included primary care/healthcare, education, economy, and government/policy factors. Social factors, such as income and education, exerted a bidirectional influence, which facilitated or hindered vaccine compliance depending on how the social determinant was experienced. Fear of autism was the most cited reason for MMR hesitancy. Vaccine hesitancy to MMR and other childhood vaccines clustered in middle- to high-income areas among mothers with a college-level education or higher who preferred internet/social media narratives over physician-based vaccine information. They had low parental trust, low perceived disease susceptibility, and were skeptical of vaccine safety and benefits. Combating MMR vaccine misinformation and hesitancy requires intersectoral and multifaceted approaches at various socioecological levels to address the social drivers of vaccine behavior.
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Affiliation(s)
| | - Michael C Goates
- Harold B. Lee Library, Brigham Young University, Provo, UT 84602, USA
| | - Alisha H Redelfs
- Department of Public Health, Brigham Young University, Provo, UT 84602, USA
| | - Mallory Quenzer
- Department of Public Health, Brigham Young University, Provo, UT 84602, USA
| | | | - Tyler Leffler
- Department of Public Health, Brigham Young University, Provo, UT 84602, USA
| | - Christian A Holt
- Department of Public Health, Brigham Young University, Provo, UT 84602, USA
| | - Russell B Doria
- School of Osteopathic Medicine, Campbell University, Lillington, NC 27546, USA
| | - Michael T Dang
- School of Osteopathic Medicine, Campbell University, Lillington, NC 27546, USA
| | - Melissa Hewitt
- Department of Public Health, Brigham Young University, Provo, UT 84602, USA
| | - Emma Lind
- Department of Public Health, Brigham Young University, Provo, UT 84602, USA
| | - Elizabeth Prickett
- Department of Public Health, Brigham Young University, Provo, UT 84602, USA
| | - Katelyn Aldridge
- Department of Public Health, Brigham Young University, Provo, UT 84602, USA
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16
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Viskupič F, Wiltse DL. Political Partisanship and Trust in Government Predict Popular Support for COVID-19 Vaccine Mandates for Various Professions and Demographic Groups: A Research Note. AMERICAN POLITICS RESEARCH 2023; 51:139-146. [PMID: 38603210 PMCID: PMC9364069 DOI: 10.1177/1532673x221118888] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
Due to the slow rate of COVID-19 vaccine uptake and the spread of the highly contagious Omicron variant, governments are considering mandating COVID-19 vaccination for specific professions and demographic groups. This study evaluates popular attitudes toward such policies. We fielded a survey of 535 registered voters in South Dakota to examine popular attitudes towards vaccine mandates for five groups-children 12 and older, K-12 teachers, medical staff, nursing homes staff, and police personnel. We estimated a series of logistic regression models and presented predicted probabilities to find the primary determinants of these attitudes. Results revealed that political partisanship and trust in government are strong predictors of support for vaccine mandates across all models. Should government and public health officials wish to increase the proportion of people vaccinated for COVID-19, they must recognize the limitations of current public health campaigns, and reshape their efforts in congruence with scientific findings.
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17
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Durmuş Sarıkahya S, Güden E, Sümeyye Yorulmaz D. Childhood vaccine hesitancy in two regions with different socioeconomic backgrounds in Turkey. ZEITSCHRIFT FUR GESUNDHEITSWISSENSCHAFTEN = JOURNAL OF PUBLIC HEALTH 2023:1-10. [PMID: 36855466 PMCID: PMC9948781 DOI: 10.1007/s10389-023-01854-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 02/10/2023] [Indexed: 02/25/2023]
Abstract
Aim This study investigated childhood vaccine hesitancy in two regions with different socioeconomic backgrounds in Kayseri, Turkey. Subject and methods The study population consisted of all people over 18 years of age admitted to two family health centers (No 65 and 103) in a city center for any reason. Results Participants living in the high socioeconomic status (SES) region had a significantly lower mean rating on the CVHQ (Childhood Vaccine Hesitancy Questionnaire - see below) than those living in the low SES region. Conclusion Vaccine hesitancy is the main reason for vaccine refusal. Therefore, authorities should provide adequate and accurate information about the significance of vaccines to raise public awareness.
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Affiliation(s)
| | - Emel Güden
- Kayseri Provincial Health Directorate, AR-GE Project Management and Consultancy Unit, Kayseri, Türkiye
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18
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Vaccine Communication: Appeals and Messengers Most Effective for COVID-19 Vaccine Uptake in Ukraine. Vaccines (Basel) 2023; 11:vaccines11020279. [PMID: 36851156 PMCID: PMC9967207 DOI: 10.3390/vaccines11020279] [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: 12/24/2022] [Revised: 01/20/2023] [Accepted: 01/24/2023] [Indexed: 01/31/2023] Open
Abstract
Throughout the COVID-19 pandemic, vaccine communication has been a challenge, particularly as some populations may be highly distrustful of information from public health or government institutions. To better understand the different communication needs in Ukraine, an online survey panel of 168 Ukrainian participants viewed six COVID-19 vaccination ads with three variations on vaccine messaging appeals (potential economic impacts of COVID-19 infection COVID-19 disease outcomes, and social norms related to vaccination) and two different messengers (a peer or a health provider). The ad featuring a health outcome appeal delivered by a healthcare provider was most favored (n = 53, 31.6%); however, across demographic categories, including vaccine hesitancy categories, participants expressed high levels of approval for all six variations of the COVID-19 vaccine ads. When participants ranked reasons why someone may not accept the COVID-19 vaccine, the most prevalent beliefs identified were that the vaccine was not safe, and that the vaccine was not effective. Findings from this study suggest that vaccine appeals focused on health outcomes delivered by healthcare providers are preferred by most individuals in Ukraine; however, individuals are motivated by a myriad of factors suggesting that for vaccine messaging to be most effective, communication should be varied in both appeal and messenger.
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19
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Pavlovic D, Sahoo P, Larson HJ, Karafillakis E. Factors influencing healthcare professionals' confidence in vaccination in Europe: a literature review. Hum Vaccin Immunother 2022; 18:2041360. [PMID: 35290160 PMCID: PMC9009961 DOI: 10.1080/21645515.2022.2041360] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Health-care professionals (HCPs) have a fundamental role in vaccination, their own beliefs and attitudes affecting both their uptake and recommendation of vaccines. This literature review (n = 89) summarises evidence on HCPs’ perceptions of the risks and benefits of vaccination, trust, and perceptions of mandatory vaccination in Europe. HCPs across studies believed that vaccination is important to protect themselves and their patients. However, beliefs that some diseases such as influenza are less risky were reported by some HCPs as a reason for not getting vaccinated. Concerns about both short- and long-term side effects were identified among HCPs in most studies, such as those affecting the immune or neurological system. Mistrust toward health authorities and pharmaceutical industry was reported in some studies. The question of mandatory vaccination revealed mixed opinions, with some favoring self-determination and others viewing vaccination as a duty. This review highlights key factors influencing HCPs’ confidence in vaccination in Europe.
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Affiliation(s)
- D Pavlovic
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - P Sahoo
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - H J Larson
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.,Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Zagreb, Croatia
| | - E Karafillakis
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Zagreb, Croatia
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20
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Choi Y, Fox AM. Mistrust in public health institutions is a stronger predictor of vaccine hesitancy and uptake than Trust in Trump. Soc Sci Med 2022; 314:115440. [PMID: 36332532 PMCID: PMC9557136 DOI: 10.1016/j.socscimed.2022.115440] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 07/27/2022] [Accepted: 10/07/2022] [Indexed: 11/18/2022]
Abstract
STUDY GOAL This study examines the sources of COVID-19 vaccine hesitancy and refusal in Americans by decomposing different forms of government trust/mistrust including trust in Trump and mistrust in public health institutions. METHODS Using linear panel regression models with data from 5,446 US adults (37,761 responses) from the Understanding America Survey, the likelihoods of vaccine hesitancy, uptake, and trust in various information sources were examined. RESULTS AND CONCLUSION We find that the likelihoods of hesitancy and having negative perceptions of COVID-19 vaccines were consistently much higher among PHI mistrusters, showing even a stronger hesitancy than Trump trusters. This tendency has persisted over time, resulting in only 49% of PHI mistrusters having been vaccinated in the most recent survey wave. However, a large portion of PHI mistrusters still trusted physicians, family, and friends. These findings suggest that mistrust in PHIs is a salient predictor of vaccine hesitancy and reduced uptake on its own, which is compounded by trust in Trump.
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Affiliation(s)
- Yongjin Choi
- Corresponding author. 135 Western Avenue, Albany, NY, 12203, USA
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21
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Frew PM, Schamel JT, Randall LA, King AR, Spaulding AC, Wu E, Holloway IW. Vaccine confidence among people who use drugs: A cross-sectional survey. Hum Vaccin Immunother 2022; 18:2123201. [PMID: 36170655 DOI: 10.1080/21645515.2022.2123201] [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: 12/15/2022] Open
Abstract
Adult immunization coverage remains low in the US, particularly for people who use drugs (PWUD), a population that experiences a disproportionate burden of vaccine-preventable diseases. The extent of and characteristics associated with vaccine confidence (VC) held by PWUD is poorly understood. As VC strongly correlates with vaccine uptake, this cross-sectional study identifies mutable factors associated with VC and quantifies its relationship to immunization status within a highly vulnerable, underimmunized population of PWUD. Using a community-engaged research strategy with select partner organizations hosting syringe exchange programs in Atlanta, Los Angeles, and Las Vegas, USA, we surveyed participants ages 18-69 years served by these organizations from 2019 to 2020. Survey measures included sociodemographics, health behavior including immunization receipt, and vaccine confidence in adult vaccinations using a modified Emory Vaccine Confidence Index (EVCI). The findings reflect relatively low VC among the 1,127 recruited participants, with 56% expressing low VC (EVCI 0-12), 35% medium (EVCI 13-20) and 10% high (EVCI 21-24). EVCI varied by city, with lowest confidence in Atlanta and highest in Las Vegas. VC was associated with past receipt of specific vaccines, including hepatitis A, MMR, Tdap, and influenza. VC varied by specific sociodemographic correlates such as housing insecurity (reduced confidence) and receipt of public benefits or disability (increased confidence). This study identified correlates associated with VC based on site and sociodemographic characteristics for this priority population, highlighting the need for specific interventions to raise VC among PWUD, especially among those experiencing housing insecurity and without public benefits.
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Affiliation(s)
- Paula M Frew
- Schools of Public Health, Medicine, and Integrated Health Sciences, University of Nevada, Las Vegas, NV, USA.,Population Health & Health Equity Initiative, University of Nevada, Las Vegas, NV, USA
| | - Jay T Schamel
- Schools of Public Health, Medicine, and Integrated Health Sciences, University of Nevada, Las Vegas, NV, USA.,Population Health & Health Equity Initiative, University of Nevada, Las Vegas, NV, USA
| | - Laura A Randall
- Schools of Public Health, Medicine, and Integrated Health Sciences, University of Nevada, Las Vegas, NV, USA.,Population Health & Health Equity Initiative, University of Nevada, Las Vegas, NV, USA
| | - Adrian R King
- Schools of Public Health, Medicine, and Integrated Health Sciences, University of Nevada, Las Vegas, NV, USA.,Population Health & Health Equity Initiative, University of Nevada, Las Vegas, NV, USA
| | - Anne C Spaulding
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.,Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA, USA
| | - Elizabeth Wu
- Department of Social Welfare, UCLA Luskin School of Public Affairs, Los Angeles, CA, USA.,Southern California HIV/AIDS Policy Research Center, UCLA Luskin School of Public Affairs, Los Angeles, CA, USA.,UCLA Hub for Health Intervention, Policy, and Practice, UCLA Luskin School of Public Affairs, Los Angeles, CA, USA
| | - Ian W Holloway
- Department of Social Welfare, UCLA Luskin School of Public Affairs, Los Angeles, CA, USA.,Southern California HIV/AIDS Policy Research Center, UCLA Luskin School of Public Affairs, Los Angeles, CA, USA.,UCLA Hub for Health Intervention, Policy, and Practice, UCLA Luskin School of Public Affairs, Los Angeles, CA, USA
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22
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Goren T, Vashdi DR, Beeri I. Count on trust: the indirect effect of trust in government on policy compliance with health behavior instructions. POLICY SCIENCES 2022; 55:593-630. [PMID: 36405103 PMCID: PMC9665042 DOI: 10.1007/s11077-022-09481-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 10/29/2022] [Indexed: 06/16/2023]
Abstract
Trust in government is considered a prominent factor for enhancing public compliance with government policies and instructions. The Coronavirus pandemic demonstrates the crucial role public compliance with governmentally issued health guidelines has in mitigating the pandemic. However, the mechanism explaining the trust-compliance association, particularly in regard to health-behavior compliance, is unclear. This article develops a new theoretical model, the Mediated Trust Model (MTM), for explaining the relationship between trust in government and public compliance with health instructions. The model extends the classic Health Belief Model for predicting health behavior by claiming that the perceptions regarding the instructions' costs, benefits and one's ability to perform them are affected by trust in government and mediate the trust-compliance association. The MTM was tested in four cross-sectional studies performed during the first 20 months of the Coronavirus pandemic in Israel on 3732 participants, for various health instructions. Implications for public health literature, policy compliance theory and policy makers are discussed.
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Affiliation(s)
- Talia Goren
- Division of Public Administration and Policy, School of Political Sciences, University of Haifa, 31905 Mount Carmel, Israel
| | - Dana R. Vashdi
- Division of Public Administration and Policy, School of Political Sciences, University of Haifa, 31905 Mount Carmel, Israel
| | - Itai Beeri
- Division of Public Administration and Policy, School of Political Sciences, University of Haifa, 31905 Mount Carmel, Israel
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23
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Wróblewski M, Meler A, Stankowska J, Kawiak-Jawor E. An Analysis of Factors Shaping Vaccine Attitudes and Behaviours in a Low-Trust Society Based on Structural Equation Modelling-The Case of Poland's Vaccination Programme against COVID-19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14655. [PMID: 36429367 PMCID: PMC9690255 DOI: 10.3390/ijerph192214655] [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: 10/05/2022] [Revised: 10/28/2022] [Accepted: 11/04/2022] [Indexed: 06/16/2023]
Abstract
This study focuses on factors that shape vaccine attitudes and behaviours in the context of a low-trust society. Our analysis focuses on the Polish vaccination programme against COVID-19, primarily on (1) the evaluation of the information campaign, (2) trust in the institutions, (3) trust in other people, (4) attitudes toward vaccine safety and efficacy, (5) attitudes toward restrictions related to vaccination (e.g., restricted access to certain services for unvaccinated persons) and the introduction of mandatory vaccination, (6) the evaluation of the government's actions during the pandemic, and (7) political preferences. The study was conducted with a sample of 1143 adult residents in Poland (CATI). The explanation of the factors determining the COVID-19 vaccine was based on structural equation modelling (SEM). The model showed that the declared fact of vaccination was largely determined by a positive attitude toward restrictions related to vaccination and trust in vaccines. The formation of the provaccine attitude was to an extent determined by the assessment of the government's campaign and actions during pandemic. While institutional trust had a positive effect on support for the ruling coalition (0.56), the latter on its own had the opposite effect (-0.61) on the formation of provaccine attitude. In the group who both trust institutions and support the parties currently in power, there are more of those who simultaneously reject the restrictions and mandatory vaccination and remain sceptical about the safety and efficacy of COVID-19 vaccines than those who both trust in the vaccine safety and efficacy and accept the restrictions and mandatory vaccination. This indicates that in the context of strong political polarisation, ideological affiliations may play a greater role in shaping vaccine attitudes and behaviours than institutional trust.
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Affiliation(s)
- Michał Wróblewski
- Institute of Sociology, Nicolaus Copernicus University, 87-100 Toruń, Poland
- The Łukasiewicz Research Network Institute of Organisation and Management in Industry, 00-879 Warszawa, Poland
| | - Andrzej Meler
- Institute of Sociology, Nicolaus Copernicus University, 87-100 Toruń, Poland
| | - Joanna Stankowska
- Institute of Sociology, Nicolaus Copernicus University, 87-100 Toruń, Poland
| | - Ewa Kawiak-Jawor
- The Łukasiewicz Research Network Institute of Organisation and Management in Industry, 00-879 Warszawa, Poland
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Romer D, Jamieson KH. Conspiratorial thinking as a precursor to opposition to COVID-19 vaccination in the US: a multi-year study from 2018 to 2021. Sci Rep 2022; 12:18632. [PMID: 36329136 PMCID: PMC9633026 DOI: 10.1038/s41598-022-22014-5] [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: 08/19/2022] [Accepted: 10/07/2022] [Indexed: 11/06/2022] Open
Abstract
Despite widespread availability of safe and effective COVID-19 vaccines in the US, only about 66% of the eligible US population had taken the recommended initial doses of the COVID-19 vaccines as of April 2022. Explanations for this hesitancy have focused on misinformation about the vaccines, lack of trust in health authorities, and acceptance of conspiracy theories about the pandemic. Here we test whether those with a conspiratorial mindset, which distrusts a wide range of institutions, were poised to reject COVID vaccines before the pandemic even began. To answer that question, we reinterviewed members of a national US panel that we had previously surveyed beginning in 2018. As hypothesized, having a conspiratorial mindset in 2019 predicted COVID-vaccination hesitancy in 2021 better than prior trust in health authorities or acceptance of vaccine misinformation. Those with the mindset were also more likely to consume media that bolstered belief in pandemic conspiracies. Research is needed on the determinants of conspiratorial mindset and ways to minimize the likelihood that consequential health decisions will be influenced by it.
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Affiliation(s)
- Daniel Romer
- grid.25879.310000 0004 1936 8972Annenberg Public Policy Center, University of Pennsylvania, 202 S. 36th ST, Philadelphia, PA 19104 USA
| | - Kathleen Hall Jamieson
- grid.25879.310000 0004 1936 8972Annenberg Public Policy Center, University of Pennsylvania, 202 S. 36th ST, Philadelphia, PA 19104 USA
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Marlowe E, Pranikoff S, Borsheim B, Salafian K, Halvorson EE, Kram DE. Pilot study to determine effect of an altruism intervention focusing on herd immunity to enhance influenza vaccination rates. Vaccine 2022; 40:6625-6630. [PMID: 36210252 DOI: 10.1016/j.vaccine.2022.09.074] [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: 06/28/2022] [Revised: 09/16/2022] [Accepted: 09/26/2022] [Indexed: 01/27/2023]
Abstract
OBJECTIVE A prospective, single-arm clinical trial was conducted to evaluate an altruism-tailored educational intervention to improve parental attitudes and vaccine uptake in vaccine-hesitant parents. METHODS Vaccine-hesitant parents at two primary care sites, spanning two influenza seasons from 2020 to 2021 were provided an intervention (spoken and written communication) which highlighted altruistic benefits of accepting the seasonal influenza vaccine to optimize herd immunity to help protect pediatric cancer patients. Eligible parents included those with children eligible for the seasonal influenza vaccine, those who were proficient in English, and those with scores on the adjusted Vaccine Hesitancy Scale (aVHS) suggesting vaccine hesitancy (score ≥ 3). Enrollees completed a demographic questionnaire, underwent the educational intervention, and repeated the aVHS. Vaccination status at that visit was assessed. The primary outcome was change in aVHS scores obtained pre- and post-intervention. Influenza vaccine acceptance, along with demographic information, were also analyzed. RESULTS We enrolled 510 parents of influenza vaccine eligible children and identified 73 vaccine-hesitant parents. There was an overall trend toward lower aVHS score, with a mean change in hesitancy score of -0.4 (P < 0.01). 43/73 (58.9 %) of the cohort experienced a positive effect toward a lower aVHS score, and 27/73 (37.0 %) of vaccine hesitant subjects became non-hesitant on the aVHS. Several demographic characteristics were associated with vaccine hesitancy in the screening population: educational level lower than bachelor's degree (p = 0.03), household income < 400 % of federal poverty level (p < 0.01), unmarried (p = 0.02), and identifying with a political affiliation other than Democrat (p < 0.01). However, no demographic characteristics were significantly associated with an individual becoming non-hesitant. Our altruism-tailored communication approach carried the largest positive impact on the altruism-specific question on the aVHS, decreasing the post-intervention response value by nearly 25 % (P < 0.01). CONCLUSIONS Our altruism-tailored communication approach significantly improved attitudes regarding childhood influenza vaccine among vaccine-hesitant parents. CLINICALTRIALS gov Identifier: NCT04568590.
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Affiliation(s)
- Elizabeth Marlowe
- Department of Pediatrics, Wake Forest School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157, USA
| | - Sarah Pranikoff
- Department of Pediatrics, Wake Forest School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157, USA
| | - Briana Borsheim
- Department of Pediatrics, Northwestern Feinberg School of Medicine, 225 E Chicago Ave, Chicago, IL 60611, USA
| | - Kiarash Salafian
- Department of Medicine, University of Virginia School of Medicine, 1215 Lee St, Charlottesville, VA 22903, USA
| | - Elizabeth E Halvorson
- Department of Pediatrics, Wake Forest School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157, USA
| | - David E Kram
- Section of Pediatric Hematology/Oncology, Department of Pediatrics, University of North Carolina School of Medicine, 170 Manning Drive, Chapel Hill, NC 27599, USA.
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Herman HS, Rosenthaler MP, Elhassan N, Weinberg JM, Satyam VR, Wasan SK. COVID-19 Vaccine Hesitancy Among Patients with Inflammatory Bowel Diseases at a Diverse Safety Net Hospital. Dig Dis Sci 2022; 67:5029-5033. [PMID: 35175432 PMCID: PMC8853212 DOI: 10.1007/s10620-022-07413-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 01/25/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND AND AIMS Patients with inflammatory bowel disease (IBD) and underrepresented minorities (URMs) historically have below average vaccination rates. URMs have increased morbidity and mortality from COVID-19. We surveyed IBD patients to assess COVID vaccination attitudes, particularly among URMs. METHODS In May and June 2021, all 822 adult patients with IBD, medically homed at a tertiary IBD referral center and safety net hospital, and with access to the electronic patient portal, were sent an electronic survey assessing their attitudes regarding COVID-19 vaccination. An additional 115 without access to the patient portal were contacted by phone. Demographic and clinical data were recorded. The primary outcome was vaccination hesitancy, defined as: likely will become vaccinated later this year, but not immediately; unsure if they will get the vaccine; or do not want the vaccine. Multivariable logistic regression was used to calculate adjusted odds ratios (aOR) of factors associated with vaccination intent. RESULTS The mean age was 46.6 years (SD 15.1). 210/1029 patients responded to the survey: 150/822 (18.2%) electronically and 60/115 (52.2%) by phone. Overall vaccine hesitancy rate was 11.9%, significantly higher in younger (aOR for 10-year increments, 0.64; 95% confidence interval [CI], 0.46-0.90, p = 0.011), Hispanic (aOR, 7.67; 95% CI, 2.99-21.3, p < 0.0002), and Black patients (aOR, 3.52; 95% CI 1.11-11.1, p = 0.050). Safety concerns were the most cited reasons for vaccine hesitancy. CONCLUSIONS URM patients were more vaccine hesitant. Future studies should further explore factors leading to lower vaccination rates among these groups and strategies to improve COVID-19 vaccination rates.
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Affiliation(s)
| | | | - Noon Elhassan
- Department of Biostatistics, Boston University School of Public Health, Boston, MA USA
| | - Janice M. Weinberg
- Department of Biostatistics, Boston University School of Public Health, Boston, MA USA
| | - Venkata R. Satyam
- Section of Gastroenterology, Department of Medicine, Boston Medical Center, Boston, MA USA
| | - Sharmeel K. Wasan
- Section of Gastroenterology, Department of Medicine, Boston Medical Center, Boston, MA USA
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Romer D, Winneg KM, Jamieson PE, Brensinger C, Jamieson KH. Misinformation about vaccine safety and uptake of COVID-19 vaccines among adults and 5-11-year-olds in the United States. Vaccine 2022; 40:6463-6470. [PMID: 36192273 PMCID: PMC9492517 DOI: 10.1016/j.vaccine.2022.09.046] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 09/12/2022] [Accepted: 09/15/2022] [Indexed: 01/27/2023]
Abstract
Despite increasing rates of vaccination for COVID-19 in the US, hesitancy continues to be a barrier to the full immunization of the eligible population. Hesitancy appears to be particularly pronounced among adults deciding whether to recommend that children be vaccinated against COVID-19. In this research, we tested whether embrace of misinformation about the safety of vaccination is associated with hesitancy to vaccinate oneself and to recommend vaccination of a 5-11-year-old child for COVID-19. In a national probability panel created in April 2021, we assessed belief in both general vaccination misinformation and misinformation about COVID-19 vaccines, in particular. As hypothesized, belief in general vaccination misinformation predicted the uptake in reported vaccination among adults through September 2021, and likelihood to recommend COVID-19 vaccination of children aged 5-11 in January 2022, three months after the approval of that vaccine. In addition, misinformation about COVID-19 vaccines that arose over time correlated highly with more general vaccination misinformation. For both outcomes, general vaccine misinformation predicted vaccination hesitancy beyond concerns about the health risks of contracting COVID-19 for one's family and children ages 5-11. The findings indicate that continued efforts are needed to bolster beliefs about the safety of authorized and approved vaccines of many types and not just those for COVID-19. Some strategies to achieve this objective are suggested.
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Affiliation(s)
- Daniel Romer
- Annenberg Public Policy Center, University of Pennsylvania, United States,Corresponding author at: Annenberg Public Policy Center, 202 S. 36 ST, Philadelphia, PA, United States
| | - Kenneth M. Winneg
- Annenberg Public Policy Center, University of Pennsylvania, United States
| | | | - Colleen Brensinger
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, United States
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Freeman D, Loe BS, Chadwick A, Vaccari C, Waite F, Rosebrock L, Jenner L, Petit A, Lewandowsky S, Vanderslott S, Innocenti S, Larkin M, Giubilini A, Yu LM, McShane H, Pollard AJ, Lambe S. COVID-19 vaccine hesitancy in the UK: the Oxford coronavirus explanations, attitudes, and narratives survey (Oceans) II. Psychol Med 2022; 52:3127-3141. [PMID: 33305716 PMCID: PMC7804077 DOI: 10.1017/s0033291720005188] [Citation(s) in RCA: 407] [Impact Index Per Article: 203.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 12/07/2020] [Accepted: 12/08/2020] [Indexed: 01/05/2023]
Abstract
BACKGROUND Our aim was to estimate provisional willingness to receive a coronavirus 2019 (COVID-19) vaccine, identify predictive socio-demographic factors, and, principally, determine potential causes in order to guide information provision. METHODS A non-probability online survey was conducted (24th September-17th October 2020) with 5,114 UK adults, quota sampled to match the population for age, gender, ethnicity, income, and region. The Oxford COVID-19 vaccine hesitancy scale assessed intent to take an approved vaccine. Structural equation modelling estimated explanatory factor relationships. RESULTS 71.7% (n=3,667) were willing to be vaccinated, 16.6% (n=849) were very unsure, and 11.7% (n=598) were strongly hesitant. An excellent model fit (RMSEA=0.05/CFI=0.97/TLI=0.97), explaining 86% of variance in hesitancy, was provided by beliefs about the collective importance, efficacy, side-effects, and speed of development of a COVID-19 vaccine. A second model, with reasonable fit (RMSEA=0.03/CFI=0.93/TLI=0.92), explaining 32% of variance, highlighted two higher-order explanatory factors: 'excessive mistrust' (r=0.51), including conspiracy beliefs, negative views of doctors, and need for chaos, and 'positive healthcare experiences' (r=-0.48), including supportive doctor interactions and good NHS care. Hesitancy was associated with younger age, female gender, lower income, and ethnicity, but socio-demographic information explained little variance (9.8%). Hesitancy was associated with lower adherence to social distancing guidelines. CONCLUSIONS COVID-19 vaccine hesitancy is relatively evenly spread across the population. Willingness to take a vaccine is closely bound to recognition of the collective importance. Vaccine public information that highlights prosocial benefits may be especially effective. Factors such as conspiracy beliefs that foster mistrust and erode social cohesion will lower vaccine up-take.
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Affiliation(s)
- Daniel Freeman
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - Bao S. Loe
- The Psychometrics Centre, University of Cambridge, Cambridge, UK
| | - Andrew Chadwick
- Online Civic Culture Centre, Department of Communication and Media, Loughborough University, Loughborough, UK
| | - Cristian Vaccari
- Online Civic Culture Centre, Department of Communication and Media, Loughborough University, Loughborough, UK
| | - Felicity Waite
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - Laina Rosebrock
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - Lucy Jenner
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - Ariane Petit
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | | | - Samantha Vanderslott
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK
| | - Stefania Innocenti
- Smith School of Enterprise and the Environment, University of Oxford, Oxford, UK
| | - Michael Larkin
- Department of Psychology, Life and Health Sciences, Aston University, Birmingham, UK
| | - Alberto Giubilini
- Oxford Uehiro Centre for Practical Ethics, University of Oxford, Oxford, UK
| | - Ly-Mee Yu
- Nuffield Department of Primary Care, University of Oxford, Oxford, UK
| | - Helen McShane
- Nuffield Department of Medicine, The Jenner Institute, University of Oxford, Oxford, UK
| | - Andrew J. Pollard
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK
| | - Sinéad Lambe
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
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29
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Abstract
Vaccine hesitancy is a growing complex and multifaceted phenomenon. It encompasses a wide spectrum of context-dependent attitudes and beliefs. Multiple factors influence parental decision-making including knowledge, sources of information, risk perception, trust, and individual experiences among others. This review focuses on describing the most common reasons that contribute to vaccine hesitancy among parents. Social media and the Internet have been described as major elements that can negatively influence parental decision-making regarding vaccines. The next focus is describing effective interventions that clinical providers can apply. Nonconfrontational and open discussions along with trusting and strong relationships between parents and providers seem to create a solid foundation toward vaccine acceptance. In addition, motivational interviewing is a helpful tool that has proven to be effective during these discussions. Ultimately, an individualized approach tailored to a specific community will likely be most effective in addressing vaccine hesitancy.
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Affiliation(s)
- Andrea Lafnitzegger
- Pediatrics, University of South Florida Morsani College of Medicine, 2 Tampa General Circle, Tampa, FL 33606, USA
| | - Claudia Gaviria-Agudelo
- Pediatric Infectious Diseases, University of South Florida Morsani College of Medicine, 2 Tampa General Circle, Tampa, FL 33606, USA.
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30
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Abstract
From vaccination refusal to climate change denial, antiscience views are threatening humanity. When different individuals are provided with the same piece of scientific evidence, why do some accept whereas others dismiss it? Building on various emerging data and models that have explored the psychology of being antiscience, we specify four core bases of key principles driving antiscience attitudes. These principles are grounded in decades of research on attitudes, persuasion, social influence, social identity, and information processing. They apply across diverse domains of antiscience phenomena. Specifically, antiscience attitudes are more likely to emerge when a scientific message comes from sources perceived as lacking credibility; when the recipients embrace the social membership or identity of groups with antiscience attitudes; when the scientific message itself contradicts what recipients consider true, favorable, valuable, or moral; or when there is a mismatch between the delivery of the scientific message and the epistemic style of the recipient. Politics triggers or amplifies many principles across all four bases, making it a particularly potent force in antiscience attitudes. Guided by the key principles, we describe evidence-based counteractive strategies for increasing public acceptance of science.
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Anti-Vaccine Attitudes among Adults in the U.S. during the COVID-19 Pandemic after Vaccine Rollout. Vaccines (Basel) 2022; 10:vaccines10060933. [PMID: 35746539 PMCID: PMC9228411 DOI: 10.3390/vaccines10060933] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/24/2022] [Accepted: 06/03/2022] [Indexed: 02/01/2023] Open
Abstract
Even though vaccination is the most effective measure against COVID-19 infections, vaccine rollout efforts have been hampered by growing anti-vaccine attitudes. Based on current knowledge, we identified three domains (beliefs, discrimination, and news) as our correlates of primary interest to examine the association with anti-vaccine attitudes. This is one of the first studies to examine key correlates of anti-vaccine attitudes during the critical early stages of vaccine implementation in the United States. An online survey was administered in May 2021 to a non-representative, nationally based sample of adults (N = 789). Using multivariable logistic regression analysis, we found that individuals who expressed worry about COVID-19 (OR = 0.34, 95% CI 0.21, 0.55) and had greater knowledge of COVID-19 (OR = 0.50, 95% CI 0.25, 0.99) were less likely to hold anti-vaccine attitudes. Conversely, individuals who held stigmatizing views of COVID-19 (OR = 2.47, 95% CI 1.53, 3.99), had experienced racial discrimination (OR = 2.14, 95% CI 1.25, 3.67) and discrimination related to COVID-19 (OR = 2.84, 95% CI 1.54, 5.24), and who had been watching Fox News (OR = 3.95, 95% CI 2.61, 5.97) were more likely to hold anti-vaccine attitudes. These findings suggest COVID-19 beliefs, experiences of discrimination, and news sources should be considered when designing targeted approaches to address the anti-vaccine movement.
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Wright D, Rune KT. Underlying Motivators for Anti-Vaccination Attitudes Among Regional Sunshine Coast Parents in Australia. Health Promot J Austr 2022; 34:579-586. [PMID: 35504853 DOI: 10.1002/hpja.612] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 04/27/2022] [Accepted: 04/27/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The Immunisation Register of Australia reports that childhood vaccination rates in some regional areas are below herd immunity levels. This is a concern for the health and well-being of society, as regions with low vaccination rates have an increased risk of disease outbreaks. OBJECTIVE This study explored psychological motivators as predictors of anti-vaccination attitudes among parents living on the Sunshine Coast (Queensland), Australia. METHODS A cross-sectional survey design explored anti-vaccination attitudes, conspiratorial thinking, psychological reactance, trust in government, and magical beliefs about health in 1,050 parents (968 mothers). RESULTS The predictor variables significantly accounted for 42% of the variance in parental anti-vaccination attitudes. The strongest predictor of anti-vaccination attitudes was trust in government. CONCLUSION The findings contribute to understanding of psychological factors motivating anti-vaccine attitudes in Australian parents. The findings may help inform health communication campaign effectiveness in their alignment with individual underlying motivations.
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Affiliation(s)
- Daniel Wright
- School of Health and Behavioural Sciences, University of the Sunshine Coast
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33
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Carey JM, Keirns T, Loewen PJ, Merkley E, Nyhan B, Phillips JB, Rees JR, Reifler J. Minimal effects from injunctive norm and contentiousness treatments on COVID-19 vaccine intentions: evidence from 3 countries. PNAS NEXUS 2022; 1:pgac031. [PMID: 36713316 PMCID: PMC9802041 DOI: 10.1093/pnasnexus/pgac031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Indexed: 02/01/2023]
Abstract
Does information about how other people feel about COVID-19 vaccination affect immunization intentions? We conducted preregistered survey experiments in Great Britain (5,456 respondents across 3 survey waves from September 2020 to February 2021), Canada (1,315 respondents in February 2021), and the state of New Hampshire in the United States (1,315 respondents in January 2021). The experiments examine the effects of providing accurate public opinion information to people about either public support for COVID-19 vaccination (an injunctive norm) or public beliefs that the issue is contentious. Across all 3 countries, exposure to this information had minimal effects on vaccination intentions even among people who previously held inaccurate beliefs about support for COVID-19 vaccination or its perceived contentiousness. These results suggest that providing information on public opinion about COVID vaccination has limited additional effect on people's behavioral intentions when public discussion of vaccine uptake and intentions is highly salient.
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Affiliation(s)
- John M Carey
- Department of Government, Dartmouth College, Hanover, NH 03755, USA
| | - Tracy Keirns
- UNH Survey Center, University of New Hampshire, Durham, NH 03823, USA
| | - Peter John Loewen
- Department of Political Science, University of Toronto, Toronto, ONT M5S 3G3, Canada
| | - Eric Merkley
- Department of Political Science, University of Toronto, Toronto, ONT M5S 3G3, Canada
| | - Brendan Nyhan
- Department of Government, Dartmouth College, Hanover, NH 03755, USA
| | | | - Judy R Rees
- Geisel School of Medicine, Dartmouth College, Hanover, NH 03755, USA
| | - Jason Reifler
- Department of Politics, University of Exeter, Amory Building, Exeter EX4 4RJ, UK
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Walsh JC, Comar M, Folan J, Williams S, Kola-Palmer S. The psychological and behavioural correlates of COVID-19 vaccine hesitancy and resistance in Ireland and the UK. Acta Psychol (Amst) 2022; 225:103550. [PMID: 35259642 PMCID: PMC8882412 DOI: 10.1016/j.actpsy.2022.103550] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 02/18/2022] [Accepted: 02/21/2022] [Indexed: 11/16/2022] Open
Abstract
Background The successful control of the COVID-19 pandemic depends largely on the acceptance and uptake of a COVID-19 vaccine among the public. Thus, formative research aiming to understand and determine the causes of weak and/or positive vaccination intentions is vital in order to ensure the success of future and current vaccination programmes through the provision of effective, evidence-based health messaging. Methods A cross-sectional survey was completed by a sample of Irish (N = 500) and UK (N = 579) citizens using the online platform ‘Qualtrics’. Participants completed a questionnaire battery comprised of health, attitudes/beliefs, influences, and behavioural intention measures. Demographic information was also assessed. Results Results highlighted similar rates of vaccine intention among both samples; where a total of 76.8% Irish respondents, and 73.7% of UK respondents indicated that they intended to be immunized if the government advised them to take the COVID-19 vaccine. Overall, 23.2% of Irish respondents reported being vaccine hesitant or vaccine resistant, while a rate of 26.3% of UK respondents reported vaccine hesitancy or resistance. Univariate analysis highlighted that both gender and age played a significant role in vaccine intention, with women under age 30 reporting higher rate of vaccine hesitancy. Multivariate analysis revealed that significant correlates of vaccine acceptance included peer influence, GP influence, civic responsibility, perceived benefit, and positive vaccination attitudes. Those who reported vaccine resistance and hesitancy were more likely to have less positive vaccination attitudes and perceive higher vaccination risk. Discussion The current sociodemographic and psychological profiles of vaccine resistant and hesitant individuals provide a useful resource for informing health practitioners in the UK and Ireland with the means of enhancing pro-vaccine attitudes and promoting vaccination uptake. The current research shows indications of associations between distrust in the vaccine itself and vaccine hesitancy and resistance. Thus, to effectively design and deliver public health messages that ensures the success of vaccination uptake, it is likely that governments and public health officials will need to take actions to garner trust in the safety of the vaccine itself. Additionally, campaigns to decrease hesitancy and resistance in the COVID-19 vaccine may benefit in targeting altruism to increase willingness to get vaccinated against COVID-19.
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Affiliation(s)
- Jane C Walsh
- School of Psychology, National University of Ireland, Galway, Ireland.
| | - Miranda Comar
- School of Psychology, National University of Ireland, Galway, Ireland
| | - Joy Folan
- School of Psychology, National University of Ireland, Galway, Ireland
| | - Samantha Williams
- Department of Psychology, University of Huddersfield, United Kingdom of Great Britain and Northern Ireland
| | - Susanna Kola-Palmer
- Department of Psychology, University of Huddersfield, United Kingdom of Great Britain and Northern Ireland
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35
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Viskupič F, Wiltse DL, Meyer BA. Trust in physicians and trust in government predict COVID-19 vaccine uptake. SOCIAL SCIENCE QUARTERLY 2022; 103:509-520. [PMID: 35600052 PMCID: PMC9115527 DOI: 10.1111/ssqu.13147] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 03/07/2022] [Accepted: 03/20/2022] [Indexed: 05/07/2023]
Abstract
OBJECTIVE We consider how trust in government, trust in physicians, and interpersonal trust affect the likelihood of COVID-19 vaccine uptake. METHODS A survey of 3057 registered South Dakota voters was fielded in April 2021 that measured COVID-19 vaccine uptake, three aspects of trust, and several other factors related to vaccine hesitancy. Logistic regression was utilized to analyze the responses. RESULTS We found positive, statistically significant, and substantively impactful effects for trust in government and trust in physicians on the likelihood of COVID-19 vaccine uptake, and null results for interpersonal trust. CONCLUSIONS Our findings provide a more nuanced understanding of the relationship between trust and COVID-19 vaccine uptake, and suggest that public health official as well as physicians should strive to increase the public's trust in the medical community.
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Affiliation(s)
- Filip Viskupič
- The SDSU Poll, School of American and Global StudiesSouth Dakota State UniversityBrookingsSouth DakotaUSA
| | - David L. Wiltse
- The SDSU Poll, School of American and Global StudiesSouth Dakota State UniversityBrookingsSouth DakotaUSA
| | - Brittney A. Meyer
- College of Pharmacy and Allied Health ProfessionsSouth Dakota State UniversityBrookingsSouth DakotaUSA
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36
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Exploring the Association between Misinformation Endorsement, Opinions on the Government Response, Risk Perception, and COVID-19 Vaccine Hesitancy in the US, Canada, and Italy. Vaccines (Basel) 2022; 10:vaccines10050671. [PMID: 35632427 PMCID: PMC9147457 DOI: 10.3390/vaccines10050671] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 04/14/2022] [Accepted: 04/16/2022] [Indexed: 02/06/2023] Open
Abstract
The COVID-19 pandemic has highlighted the adverse consequences created by an infodemic, specifically bringing attention to compliance with public health guidance and vaccine uptake. COVID-19 vaccine hesitancy is a complex construct that is related to health beliefs, misinformation exposure, and perceptions of governmental institutions. This study draws on theoretical models and current data on the COVID-19 infodemic to explore the association between the perceived risk of COVID-19, level of misinformation endorsement, and opinions about the government response on vaccine uptake. We surveyed a sample of 2697 respondents from the US, Canada, and Italy using a mobile platform between 21–28 May 2021. Using multivariate regression, we found that country of residence, risk perception of contracting and spreading COVID-19, perception of government response and transparency, and misinformation endorsement were associated with the odds of vaccine hesitancy. Higher perceived risk was associated with lower odds of hesitancy, while lower perceptions of government response and higher misinformation endorsement were associated with higher hesitancy.
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Hussain B, Latif A, Timmons S, Nkhoma K, Nellums LB. Overcoming COVID-19 vaccine hesitancy among ethnic minorities: A systematic review of UK studies. Vaccine 2022; 40:3413-3432. [PMID: 35534309 PMCID: PMC9046074 DOI: 10.1016/j.vaccine.2022.04.030] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 03/09/2022] [Accepted: 04/06/2022] [Indexed: 12/31/2022]
Abstract
Ethnic minority communities in the UK have been disproportionately affected by the pandemic, with increased risks of infection, severe disease, and death. Hesitancy around the COVID-19 vaccine may be contributing to disparities in vaccine delivery to ethnic minority communities. This systematic review aims to strengthen understanding of COVID-19 vaccine concerns among ethnic minorities in the UK. Five databases were searched in February 2022, yielding 24 peer-reviewed studies reporting on vaccine hesitancy or acceptance in ethnic minority groups. Data were extracted using a standardised form, and quality assessment was carried out using the Standard Quality Criteria. There were three key themes: (1). Prevalence of vaccine hesitancy; (2). Reasons for vaccine hesitancy and acceptance; and (3). Recommendations to address vaccine concerns. Vaccine hesitancy, which was more common among some ethnic minority groups, is a complex phenomenon, driven by misinformation, mistrust, concerns about safety and efficacy, and structural and systemic inequities. Community engagement and tailored communication may help to address vaccine concerns. Robust data disaggregated by ethnicities are needed to better understand barriers and facilitators for COVID-19 vaccine delivery in ethnic minority communities. Strategies to address structural disadvantage need to be inclusive, comprehensive, and behaviorally informed and foster confidence in healthcare systems and governments. Community leaders and health care practitioners may prove to be the most important agents in creating an environment of trust within ethnic minority groups.
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Recio-Román A, Recio-Menéndez M, Román-González MV. Political Populism, Institutional Distrust and Vaccination Uptake: A Mediation Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063265. [PMID: 35328952 PMCID: PMC8955402 DOI: 10.3390/ijerph19063265] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 03/04/2022] [Accepted: 03/08/2022] [Indexed: 11/16/2022]
Abstract
Politics is ubiquitous in public health, but vaccines had never been weaponized to instill distrust to gain political advantage. In pandemic and post-pandemic scenarios, populist political parties could use vaccine-related issues to generate distrust in evidence-based knowledge. Therefore, some questions arise. What impact could populist political parties impinge on vaccination uptake rates through sowing political discontent? What could the medical institutions do to avoid the adverse effects that these political strategies could infringe? For answering these research questions, we first hypothesized that vaccine uptake was negatively associated with distrust in the institutions. Furthermore, we analyzed whether populism mediates this relationship. In doing so, we hypothesized a positive association between distrust and populism, because populists, mainly fueled by politically discontent citizens, offer hope of a better future, blaming their misfortune on the actions of the elite. Additionally, we hypothesized that those citizens with a higher level of political dissatisfaction, following the claims of the populist political parties, will have lower vaccine uptake results, because they will be discouraged from making the efforts to counter the pandemic. Based on a survey carried out by the European Commission that covered 27 E.U. + U.K. countries (totaling 27,524 respondents), this paper proves that an individual’s political discontent fully mediates the relationship between distrust in institutions and vaccine uptake. Targeting the vaccine-hesitant population is quite convenient for populists because they only need to convince a minority of citizens not to be vaccinated to achieve their destabilizing goals. New outbreaks will appear if the minimum herd immunity coverage is not reached, reinforcing a vicious circle of distrust in elites, in consequence. For tackling this matter, recommendations are given to institutional managers from a social marketing standpoint.
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Rozbroj T, Lyons A, Lucke J. Understanding how the Australian vaccine-refusal movement perceives itself. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:695-705. [PMID: 33002263 DOI: 10.1111/hsc.13182] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 07/20/2020] [Accepted: 08/28/2020] [Indexed: 06/11/2023]
Abstract
Public health responses to the vaccine-refusal (VR) movement are hindered by inadequate research about the movement's aims, identity and perceived value for its members. This study examined how members of the VR movement in Australia described the movement and what being part of it meant to them. Descriptions of the VR movement by 696 members from across Australia were collected between January and May in 2017 via an online survey. The data were analysed using thematic discourse analysis. Members' understandings of the movement and the beliefs underpinning these understandings were examined. Vaccine refusal was underpinned by distinct epistemic beliefs. Participants believed that mainstream vaccine promotion relies on dishonest communication of compromised research. They saw the VR movement as a science-based movement, researching both 'mainstream' and 'hidden' knowledge, promoting scientific values and advocating for better vaccine studies. Participants believed responsible parenting requires personally researching healthcare choices. Participants constructed the movement's identity in relation to common criticisms of vaccine refusal. These were discredited and repurposed to portray the movement as being brave and righteous. Participants believed people in the movement are astute, informed, responsible and courageous. They believed many members were impacted by vaccine-related harms, from which the movement now saves others. They saw themselves as fighting for an inconvenient truth that the mainstream ignores. Vaccine promotion needs to address the epistemic beliefs associated with vaccine refusal, yet these have been inadequately understood. Our findings contribute to understanding these beliefs. Furthermore, our findings suggest what messages targeting vaccine-refusing people should focus on. This may include acknowledging the significant effort that vaccine-refusing people invest in trying to protect their children, catering to vaccine-refusing people's high engagement and desire for detailed information, and avoiding stigmatising or confrontational vaccine-promotion strategies.
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Affiliation(s)
- Tomas Rozbroj
- Australian Research Centre in Sex, Health and Society, La Trobe University, Bundoora, VIC, Australia
- Monash Department of Clinical Epidemiology, Cabrini Institute, Malvern, VIC, Australia
| | - Anthony Lyons
- Australian Research Centre in Sex, Health and Society, La Trobe University, Bundoora, VIC, Australia
| | - Jayne Lucke
- Australian Research Centre in Sex, Health and Society, La Trobe University, Bundoora, VIC, Australia
- School of Public Health, The University of Queensland, St Lucia, QLD, Australia
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40
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Shanka MS, Menebo MM. When and How Trust in Government Leads to Compliance with COVID-19 Precautionary Measures. JOURNAL OF BUSINESS RESEARCH 2022; 139:1275-1283. [PMID: 34744211 PMCID: PMC8559780 DOI: 10.1016/j.jbusres.2021.10.036] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 10/13/2021] [Accepted: 10/16/2021] [Indexed: 06/13/2023]
Abstract
Despite the risks of COVID-19, some people ignore the COVID-19 precautionary measures, endangering public health. We aimed to investigate how and in what conditions trust in government and health authorities encourage individuals to comply with COVID-19 precautionary measures. Based on a sample of 664 respondents, we found that an increase in the level of trust in government is associated with higher compliance with COVID-19 precautionary measures. We also found that problem awareness mediates the effect of trust in government on compliance with COVID-19 precautionary measures. In addition, we examined whether individualistic orientation moderates the mediating effect of problem awareness. We found that individualistic orientation mitigates the mediating effect of problem awareness in the relationship between trust in government and compliance behavior. The findings of this study have the potential to inform policy and practice by addressing the ways in which compliance with COVID-19 precautionary measures can be improved.
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Ledford CJW, Cafferty LA, Moore JX, Roberts C, Whisenant EB, Garcia Rychtarikova A, Seehusen DA. The dynamics of trust and communication in COVID-19 vaccine decision making: A qualitative inquiry. JOURNAL OF HEALTH COMMUNICATION 2022; 27:17-26. [PMID: 35220915 DOI: 10.1080/10810730.2022.2028943] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
In response to the COVID-19 pandemic, scientists coordinated a complex immunization effort that developed and distributed vaccines by December 2020. This study aimed to explain COVID-19 vaccination decision-making process to inform vaccine communication with patients and the public. Building on quantitative research on COVID-19 vaccine hesitancy, we conducted a grounded theory study, collecting 30 qualitative interviews with employees at a U.S. university that provided vaccine eligibility in December 2020. Analysis followed the Sort and Sift, Think and Shift method. Participants who had chosen to receive the vaccine and those who had not both described five factors that impacted their decision-making: emotional response, understanding, personal values, culture, and social norms. Across these factors, we identified three cross-cutting themes: time, trust, and communication tactics. In a time of emerging science and changing answers, the constant introduction of new information created information overload for participants. COVID-19 vaccine development was a "grand experiment globally," which required trust, not only knowledge, to overcome hesitancy. The complex information environment surrounding COVID-19 vaccination requires multi-level intervention that cannot rely on knowledge translation alone. We need to help patients build trusting relationships with experts that can create scaffolding for future information processing.
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Affiliation(s)
- Christy J W Ledford
- Department of Family Medicine, Medical College of Georgia, Augusta University, Augusta, Georgia, USA
| | - Lauren A Cafferty
- Military Primary Care Research Network, Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Justin X Moore
- Cancer Prevention, Control, & Population Health, Department of Medicine, Georgia Cancer Center, Augusta University, USA
| | - Courtney Roberts
- Department of Family Medicine, Medical College of Georgia, Augusta University, Augusta, Georgia, USA
| | - Ebony B Whisenant
- Department of Family Medicine, Medical College of Georgia, Augusta University, Augusta, Georgia, USA
| | | | - Dean A Seehusen
- Department of Family Medicine, Medical College of Georgia, Augusta University, Augusta, Georgia, USA
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42
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Alqahtani YS. Acceptability of the COVID-19 Vaccine among Adults in Saudi Arabia: A Cross-Sectional Study of the General Population in the Southern Region of Saudi Arabia. Vaccines (Basel) 2021; 10:41. [PMID: 35062702 PMCID: PMC8777608 DOI: 10.3390/vaccines10010041] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 12/01/2021] [Accepted: 12/06/2021] [Indexed: 01/06/2023] Open
Abstract
Vaccines afford protection against infectious diseases. However, a sizeable part of the population refuse vaccinations and continue to dispute the evidence supporting vaccinations. The objective of this study was to determine the prevalence of COVID-19 vaccination uptake and its determinants among the Saudi population in the southern region of Saudi Arabia. A cross-sectional survey studied COVID-19 vaccine acceptance in adults in Saudi Arabia, targeting the general population in the southwestern region. Data were collected through an online survey questionnaire tool. All data were analysed using SPSS version 23.0. The majority (57.29%) of the participants were willing to receive the new COVID-19 vaccine, whereas almost 64% believed it is necessary to take the COVID-19 vaccine to protect oneself and that the vaccine is safe, efficient and effective. The data showed that perceived risk of COVID-19 (p = 0.015), history of previous vaccination against seasonal influenza (p = 0.000), and trust in the healthcare system (p = 0.025) were significant predictors for COVID-19 vaccine acceptance. We conclude that participants' trust in the healthcare system, perceived risk of contracting COVID-19, and history of previous vaccination against seasonal influenza were significant predictors for COVID-19 vaccine acceptance. Knowing the acceptance rates for the COVID-19 vaccination can aid state agencies, medical practitioners, and other entities in reducing the impact of vaccine avoidance.
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Affiliation(s)
- Yahya S Alqahtani
- Department of Pharmaceutical Chemistry, College of Pharmacy, Najran University, Najran 66462, Saudi Arabia
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43
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Restrepo N, Krouse HJ. COVID-19 Disparities and Vaccine Hesitancy in Black Americans: What Ethical Lessons Can Be Learned? Otolaryngol Head Neck Surg 2021; 166:1147-1160. [PMID: 34905417 DOI: 10.1177/01945998211065410] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE This state of the art review focuses on bioethical questions and considerations from research findings and methodological issues, including design and recruitment of participants, in studies related to COVID-19 vaccine hesitation in Black individuals. Ethical concerns identified were applied to otolaryngology with recommendations for improving health inequities within subspecialties. DATA SOURCES An internet search through PubMed, CINAHL, and socINDEX was conducted to identify articles on COVID-19 vaccine hesitation among the Black population between 2020 and 2021. REVIEW METHODS A systematic review approach was taken to search and analyze the research on this topic, which was coupled with expert analysis in identifying and classifying vital ethical considerations. CONCLUSIONS The most common COVID-19 vaccine hesitation factors were related to the development of the vaccine, mistrust toward government agencies, and misconceptions about safety and side effects. These findings raised bioethical concerns around mistrust of information, low health literacy, insufficient numbers of Black participants in medical research, and the unique positions of health professionals as trusted sources. These bioethical considerations can be applied in otolaryngology and other health-related areas to aid the public in making informed medical decisions regarding treatments, which may reduce health inequalities among Black Americans and other racial and ethnic minority groups. IMPLICATIONS FOR PRACTICE Addressing ethical questions by decreasing mistrust, tailoring information for specific populations, increasing minority representation in research, and using health professionals as primary sources for communicating health information and recommendations may improve relationships with Black communities and increase acceptance of new knowledge and therapies such as COVID-19 vaccination.
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Affiliation(s)
- Nicolas Restrepo
- Baylor College of Medicine, School of Medicine, Houston, Texas, USA
| | - Helene J Krouse
- Department of Internal Medicine, School of Medicine, University of Texas Rio Grande Valley, Edinburg, Texas, USA
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44
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Lau JFW, Woon YL, Leong CT, Teh HS. Factors influencing acceptance of the COVID-19 vaccine in Malaysia: a web-based survey. Osong Public Health Res Perspect 2021; 12:361-373. [PMID: 34818501 PMCID: PMC8721269 DOI: 10.24171/j.phrp.2021.0085] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 11/07/2021] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE The coronavirus disease 2019 (COVID-19) pandemic has set a precedent for the fastest-produced vaccine as a result of global collaboration and outreach. This study explored Malaysians' acceptance of the COVID-19 vaccine and its associated factors. METHODS A cross-sectional anonymous web-based survey was disseminated to Malaysian adults aged ≥18 years old via social media platforms between July 10, 2020 and August 31, 2020. RESULTS In the analysis of 4,164 complete responses, 93.2% of participants indicated that they would accept the COVID-19 vaccine if it was offered for free by the Malaysian government. The median out-of-pocket cost that participants were willing to pay for a COVID-19 vaccine was Malaysian ringgit (MYR) 100 (interquartile range [IQR], 100) if it was readily available and MYR 150 (IQR, 200) if the supply was limited. Respondents with a low likelihood of vaccine hesitancy had 13 times higher odds of accepting the COVID-19 vaccine (95% confidence interval [CI], 8.69 to 19.13). High perceived risk and severity were also associated with willingness to be vaccinated, with adjusted odds ratios of 2.22 (95% CI, 1.44 to 3.41) and 2.76 (95% CI, 1.87 to 4.09), respectively. Age and ethnicity were the only independent demographic characteristics that predicted vaccine uptake. CONCLUSION Public health strategies targeting perceived risk, perceived susceptibility and vaccine hesitancy could be effective in enhancing vaccine uptake.
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Affiliation(s)
- June Fei Wen Lau
- Centre for Clinical Epidemiology, Institute for Clinical Research, National Institutes of Health, Ministry of Health, Shah Alam, Malaysia
| | - Yuan Liang Woon
- Centre for Clinical Epidemiology, Institute for Clinical Research, National Institutes of Health, Ministry of Health, Shah Alam, Malaysia
| | - Chin Tho Leong
- Centre for Clinical Epidemiology, Institute for Clinical Research, National Institutes of Health, Ministry of Health, Shah Alam, Malaysia
| | - Hoon Shien Teh
- Centre for Clinical Epidemiology, Institute for Clinical Research, National Institutes of Health, Ministry of Health, Shah Alam, Malaysia
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45
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Al-Hasan A, Khuntia J, Yim D. Does Seeing What Others Do Through Social Media Influence Vaccine Uptake and Help in the Herd Immunity Through Vaccination? A Cross-Sectional Analysis. Front Public Health 2021; 9:715931. [PMID: 34796158 PMCID: PMC8592939 DOI: 10.3389/fpubh.2021.715931] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 10/08/2021] [Indexed: 12/01/2022] Open
Abstract
Widespread acceptance of COVID-19 vaccination is the next major step in fighting the pandemic. However, significant variations are observed in the willingness to take the vaccination by citizens across different countries. Arguably, differences in vaccination intentions will be influenced by beliefs around vaccines to influence health. Often perceptions of what others are doing and the information available guide individuals' behaviors for vaccination. This is more so in the digital age with the influence of the internet and media. This study aims to determine the factors that impact willingness to vaccinate for COVID-19. We examined factors associated with acceptance of vaccine based on (1) constructs of the Health Belief Model (HBM), (2) sources of information, (3) social media usage, (4) knowledge of COVID-19 treatment, and (5) perception of government's efforts for mitigation. Randomly sampled online survey data was collected by a global firm between December 2020 and January 2021 from 372 citizens (with a response rate of 96.6%) from multiple regions, including North America, the Middle East, Europe, and Asia. Ordered probit regression suggests that the health belief model constructs hold. Perceived severity of COVID-19 (P < 0.001) and action cues of others taking the vaccine positively influences a subject's vaccine intent (P < 0.001), perceived benefits and perceived efficacy of the vaccine positively influences a subject's vaccine intent (P < 0.001). Perceived barriers negatively influence vaccine intent (P < 0.001). Interestingly as for media usage, mainstream media (e.g., TV, newspaper) (P = 0.006) and social media (P = 0.013) both negatively influence a subject's vaccine intent. Social media platforms that are more entertainment and social-based, such as Whatsapp, Instagram, and YouTube, have a negative and significant influence on vaccine intent (P = 0.061), compared to other more information-based social media platforms (e.g., Twitter, LinkedIn). Knowledge of COVID-19 treatment positively influences vaccine intent (P = 0.023). Lastly, governmental efforts' perceived reliability in mitigation strategy (P = 0.028) and response efforts (P = 0.004) negatively influence vaccine intent. The study highlights the "wait-and-see" action cue from others and leaders in the community. It also informs the importance of shaping media information for vaccination through informative media and social media outlets to counteract any misinformation.
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Affiliation(s)
- Abrar Al-Hasan
- College of Business Administration, Kuwait University, AlShadadiyah City, Kuwait
| | - Jiban Khuntia
- CU Denver Business School, Information Systems Department, University of Colorado, Denver, CO, United States
| | - Dobin Yim
- Sellinger School of Business, Information Systems Law and Operations Department, Loyola University Maryland, Baltimore, MD, United States
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46
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Hwang SE, Kim WH, Heo J. Socio-demographic, psychological, and experiential predictors of COVID-19 vaccine hesitancy in South Korea, October-December 2020. Hum Vaccin Immunother 2021; 18:1-8. [PMID: 34614382 PMCID: PMC8920123 DOI: 10.1080/21645515.2021.1983389] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Vaccine hesitancy is the primary barrier to controlling the COVID-19 pandemic in South Korea. We used logistic multivariate regression modeling to investigate (1) the prevalence and reasons for COVID-19 vaccine hesitancy, (2) sub-groups that had higher rates of vaccine hesitancy, and (3) vaccine hesitancy predictors. We used a national survey of representatively sampled households (n = 13,021 adults) from October to December 2020. A self-report questionnaire asked about vaccination intention and reasons for hesitancy and gathered data on socio-demographic, demographic, psychological, and experiential factors. Our study indicated that 39.8% of the participants answered that they hesitated or refused to be vaccinated. The most common reason for vaccine hesitancy was a lack of confidence in the COVID-19 vaccine (77.9%). Less or no fear of COVID-19 (OR = 2.08, 95% CI = 1.92–2.26; OR = 1.79, 95% CI = 1.54–2.08), unstable job status (OR = 1.42, 95% CI = 1.18–1.70), decreased family income (OR = 1.40, 95% CI = 1.21–1.61), and worsening health status (OR = 1.38, 95% CI = 1.13–1.68) were predictors of vaccine hesitancy. Younger age, no religious affiliation, political conservatism, and lower family income were also significantly associated with vaccine hesitancy. Effective health communication and policies need to consider the target subgroup population and predictors of vaccine hesitancy to attain herd immunity at an early stage.
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Affiliation(s)
- Seo Eun Hwang
- Department of Family Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Republic of Korea.,Department of Medicine, Seoul National University Graduate School of Medicine, Seoul, Republic of Korea
| | - Woong-Han Kim
- JW LEE Center for Global Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jongho Heo
- JW LEE Center for Global Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.,Quality of Life Group, National Assembly Futures Institute, Seoul, Republic of Korea
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47
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Dudley MZ, Bernier R, Brewer J, Salmon DA. Walking the Tightrope: Reevaluating science communication in the era of COVID-19 vaccines. Vaccine 2021; 39:5453-5455. [PMID: 34446317 DOI: 10.1016/j.vaccine.2021.08.037] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 08/09/2021] [Accepted: 08/10/2021] [Indexed: 11/18/2022]
Abstract
Scientists are trained to be skeptical and not overstate the existing evidence. This cautiousness is a valuable asset when working in scientific research, where the goal is the pursuit of knowledge and truth. It becomes a handicap when scientists are asked to communicate to the public about pressing topics such as COVID-19 vaccines. Often in such contexts, immediate recommendations are sought, and decisions must be made even when complete evidence is lacking. For scientists to be effective public communicators, they must adjust their mindset and embrace brevity, clarity, and other principles of effective communication. Focusing messages on what is known fosters public confidence in taking needed actions, whereas focusing on what is still unknown fosters inaction and seeds doubt. The implementation of principles of effective communication does not inherently conflict with maintaining scientific accuracy and acknowledging uncertainty, but it does require additional care, effort, and training.
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Affiliation(s)
- Matthew Z Dudley
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA; Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA.
| | - Roger Bernier
- Senior Epidemiologist Editor, The Epidemiology Monitor, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA
| | - Janesse Brewer
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA; Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA
| | - Daniel A Salmon
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA; Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA
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48
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Moore JX, Gilbert KL, Lively KL, Laurent C, Chawla R, Li C, Johnson R, Petcu R, Mehra M, Spooner A, Kolhe R, Ledford CJW. Correlates of COVID-19 Vaccine Hesitancy among a Community Sample of African Americans Living in the Southern United States. Vaccines (Basel) 2021; 9:vaccines9080879. [PMID: 34452004 PMCID: PMC8402307 DOI: 10.3390/vaccines9080879] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 08/03/2021] [Accepted: 08/04/2021] [Indexed: 12/23/2022] Open
Abstract
In the United States, African Americans (AAs) have been disproportionately affected by COVID-19 mortality. However, AAs are more likely to be hesitant in receiving COVID-19 vaccinations when compared to non-Hispanic Whites. We examined factors associated with vaccine hesitancy among a predominant AA community sample. We performed a cross-sectional analysis on data collected from a convenience sample of 257 community-dwelling participants in the Central Savannah River Area from 5 December 2020, through 17 April 2021. Vaccine hesitancy was categorized as resistant, hesitant, and acceptant. We estimated relative odds of vaccine resistance and vaccine hesitancy using polytomous logistic regression models. Nearly one-third of the participants were either hesitant (n = 40, 15.6%) or resistant (n = 42, 16.3%) to receiving a COVID-19 vaccination. Vaccine-resistant participants were more likely to be younger and were more likely to have experienced housing insecurity due to COVID-19 when compared to both acceptant and hesitant participants, respectively. Age accounted for nearly 25% of the variation in vaccine resistance, with 21-fold increased odds (OR: 21.93, 95% CI: 8.97-5.26-91.43) of vaccine resistance in participants aged 18 to 29 compared to 50 and older adults. Housing insecurity accounted for 8% of the variation in vaccine resistance and was associated with 7-fold increased odds of vaccine resistance (AOR: 7.35, 95% CI: 1.99-27.10). In this sample, AAs under the age of 30 and those experiencing housing insecurity because of the COVID-19 pandemic were more likely to be resistant to receiving a free COVID-19 vaccination.
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Affiliation(s)
- Justin Xavier Moore
- Division of Epidemiology, Department of Population Health Sciences, Augusta University, Augusta, GA 30912, USA; (K.L.L.); (C.L.); (R.C.); (C.L.); (R.J.); (R.P.); (M.M.); (A.S.)
- Cancer Prevention, Control, & Population Health Program, Department of Medicine, Augusta University, Augusta, GA 30912, USA
- Institute of Preventive and Public Health, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
- Correspondence: ; Tel.: +1-706-721-4621
| | - Keon L. Gilbert
- Department of Behavioral Science and Health Education, Saint Louis University, St. Louis, MO 63103, USA;
| | - Katie L. Lively
- Division of Epidemiology, Department of Population Health Sciences, Augusta University, Augusta, GA 30912, USA; (K.L.L.); (C.L.); (R.C.); (C.L.); (R.J.); (R.P.); (M.M.); (A.S.)
| | - Christian Laurent
- Division of Epidemiology, Department of Population Health Sciences, Augusta University, Augusta, GA 30912, USA; (K.L.L.); (C.L.); (R.C.); (C.L.); (R.J.); (R.P.); (M.M.); (A.S.)
| | - Rishab Chawla
- Division of Epidemiology, Department of Population Health Sciences, Augusta University, Augusta, GA 30912, USA; (K.L.L.); (C.L.); (R.C.); (C.L.); (R.J.); (R.P.); (M.M.); (A.S.)
| | - Cynthia Li
- Division of Epidemiology, Department of Population Health Sciences, Augusta University, Augusta, GA 30912, USA; (K.L.L.); (C.L.); (R.C.); (C.L.); (R.J.); (R.P.); (M.M.); (A.S.)
| | - Ryan Johnson
- Division of Epidemiology, Department of Population Health Sciences, Augusta University, Augusta, GA 30912, USA; (K.L.L.); (C.L.); (R.C.); (C.L.); (R.J.); (R.P.); (M.M.); (A.S.)
| | - Robert Petcu
- Division of Epidemiology, Department of Population Health Sciences, Augusta University, Augusta, GA 30912, USA; (K.L.L.); (C.L.); (R.C.); (C.L.); (R.J.); (R.P.); (M.M.); (A.S.)
| | - Mehul Mehra
- Division of Epidemiology, Department of Population Health Sciences, Augusta University, Augusta, GA 30912, USA; (K.L.L.); (C.L.); (R.C.); (C.L.); (R.J.); (R.P.); (M.M.); (A.S.)
| | - Antron Spooner
- Division of Epidemiology, Department of Population Health Sciences, Augusta University, Augusta, GA 30912, USA; (K.L.L.); (C.L.); (R.C.); (C.L.); (R.J.); (R.P.); (M.M.); (A.S.)
| | - Ravindra Kolhe
- Department of Pathology, Section of Anatomic Pathology, Augusta University, Augusta, GA 30912, USA;
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Berg MB, Lin L. Predictors of COVID-19 vaccine intentions in the United States: the role of psychosocial health constructs and demographic factors. Transl Behav Med 2021; 11:1782-1788. [PMID: 34293163 PMCID: PMC8344533 DOI: 10.1093/tbm/ibab102] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background On December 21, 2020, a study was conducted to investigate a range of psychosocial health constructs and demographic variables potentially associated with intentions toward accepting or forgoing the coronavirus (COVID-19) vaccine. Purpose The goal of the study was to identify predictors of forgoing COVID-19 vaccination at the time of the initial rollout. Methods A cross-sectional, representative online survey of 350 U.S. residents was conducted using the online crowdsourcing site Prolific to assess vaccine intentions, health attitudes, and demographic information. Variables examined included demographic factors and health constructs corresponding to each of the elements of the health belief model (perceived severity, susceptibility, benefits, barriers, and cues to action), the theory of planned behavior (attitudes, subjective norms, and perceived behavioral control), attitudes toward vaccines in general, and trust in the COVID-19 vaccine approval process. Results After using hierarchical linear regression to control for demographics, the health constructs uniquely associated with the likelihood to forgo vaccination were perceived barriers, general attitudes toward the COVID-19 vaccine, subjective norms, and trust in the vaccine approval process. Significant demographic predictors of vaccine reluctance included being female, politically conservative, and more religious. Conclusions The current research identified three demographic factors and four health constructs uniquely associated with vaccine acceptance. These findings reveal that the constructs contained within the health belief model and theory of planned behavior can be used to predict COVID-19 vaccination intentions, and can be supplemented with an assessment of general vaccine attitudes and attitudes toward the vaccine approval process.
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Affiliation(s)
- Michael B Berg
- Department of Psychology, Wheaton College, Norton, MA, USA
| | - Linda Lin
- Department of Psychology, Emmanuel College, Boston, MA, USA
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Halbrook M, Gadoth A, Martin-Blais R, Gray AN, Kashani S, Kazan C, Kane B, Tobin NH, Ferbas KG, Aldrovandi GM, Rimoin AW. Longitudinal assessment of COVID-19 vaccine acceptance and uptake among frontline medical workers in Los Angeles, California. Clin Infect Dis 2021; 74:1166-1173. [PMID: 34292319 DOI: 10.1093/cid/ciab614] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Sentiments of vaccine hesitancy and distrust in public health institutions have complicated the government-led COVID-19 vaccine control strategy in the United States. As the first to receive the vaccine, COVID-19 vaccine attitudes among front line workers are consequential for COVID-19 control and public opinion of the vaccine. METHODS This study employed a repeated cross-sectional survey administered at three time points between September 24 - February 6, 2021 to a cohort of employees of University of California, Los Angeles (UCLA) Health and the Los Angeles County Fire Department (LACoFD). The primary outcome of interest was COVID-19 vaccination intent and vaccine uptake. RESULTS Confidence in COVID-19 vaccines and vaccine uptake rose significantly over time. At Survey 1, confidence in vaccine protection was 46.4% among healthcare workers (HCW) and 34.6% among first responders (FR); by Survey 3, this had risen to 90.0% and 75.7%, respectively. At Survey 1, about one-third of participants intended to receive a vaccine as soon as possible. By Survey 3, 96.0% of HCW and 87.5% of FR had received a COVID-19 vaccine. CONCLUSIONS Attitudes towards vaccine uptake increased over the study period, likely a result of increased public confidence in COVID-19 vaccines, targeted communications, a COVID-19 winter surge in LA County, and ease of access from employer-sponsored vaccine distribution.
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Affiliation(s)
- Megan Halbrook
- Department of Epidemiology, Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, USA
| | - Adva Gadoth
- Department of Epidemiology, Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, USA
| | - Rachel Martin-Blais
- Department of Pediatrics, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA, USA
| | - Ashley N Gray
- Division of Pediatric Hematology/Oncology, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA, USA
| | - Saman Kashani
- Los Angeles County Fire Department, Los Angeles CA, USA
| | - Clayton Kazan
- Los Angeles County Fire Department, Los Angeles CA, USA
| | - Brian Kane
- Los Angeles County Fire Department, Los Angeles CA, USA
| | - Nicole H Tobin
- Department of Pediatrics, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA, USA
| | - Kathie G Ferbas
- David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA, USA
| | - Grace M Aldrovandi
- David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA, USA
| | - Anne W Rimoin
- Department of Epidemiology, Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, USA
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