Individual preferences for COVID-19 vaccination in China

Investigating the influencing factors of vaccination decisions for newly developed and established vaccines: a comparative study based on latent class logit models in China

Background

The factors influencing vaccination decision-making for newly developed vaccines may be similar to and different from those for established vaccines. Understanding these underlying differences and similarities is crucial for designing targeted measures to promote new vaccines against potential novel viruses.

Objective

This study aims to compare public vaccination decisions for newly developed and established vaccines and to identify the differences and similarities in the influencing factors.

Method

A discrete choice experiment (DCE) was conducted on 1,509 representatives of the general population in China to collect data on preferences for the coronavirus disease 2019 (COVID-19) and influenza vaccines, representing the newly developed and established vaccines, respectively. The latent class logit model was used to identify latent classes within the sample, allowing for an analysis of the factors distinctly influencing choices for both types of vaccines.

Result

Participants valued similar attributes for both vaccines. However, concerns about sequelae were more significant for the newly developed vaccine, while effectiveness was prioritized for the established vaccine. Class membership analysis revealed these differences and similarities were significantly correlated with age, health, yearly household income, acquaintances' vaccination status, and risk perception.

Conclusion

The study highlights the need for tailored communication strategies and targeted vaccination interventions. For the newly developed vaccines, addressing concerns about side effects is more crucial. For long-standing vaccines, emphasizing their effectiveness can enhance uptake more significantly. Engaging healthcare providers and community influencers is essential for both vaccines to increase public confidence and vaccination rates. Clear communication and community engagement are critical strategies for addressing public concerns and misinformation, particularly during periods of heightened concern.

Preferences and Willingness to Pay for Herpes Zoster Vaccination Among Chinese Adults: Discrete Choice Experiment

BACKGROUND

The incidence of herpes zoster (HZ) is rapidly increasing, causing both clinical and economic burdens in China. Very little is known about Chinese residents' HZ vaccine preferences and willingness to pay (WTP) for each vaccination attribute.

OBJECTIVE

This study aims to elicit the preferences of Chinese urban adults (aged 25 years or older) regarding HZ vaccination programs and to calculate WTP for each vaccination attribute.

METHODS

In this study, we interviewed 2864 residents in 9 cities in China. A discrete choice experiment was conducted to investigate the residents' preferences for HZ vaccination and to predict the uptake rate for different vaccine scenarios. A mixed logit model was used to estimate the preferences and WTP for each attribute. Seven attributes with different levels were included in the experiment, and we divided the coefficients of other attributes by the coefficient of price to measure WTP.

RESULTS

Vaccine effectiveness, protection duration, risk of side effects, place of origin, and cost were proven to influence Chinese adults' preferences for HZ vaccination. The effectiveness of the HZ vaccine was the attribute that had the most predominant impact on residents' preferences, followed by protection duration. The residents were willing to pay CN ¥974 (US $145) to increase the vaccine effectiveness from 45% to 90%, and they would barely pay to exchange the vaccination schedule from 2 doses to 1 dose. It is suggested that the expected uptake could be promoted the most (by 20.84%) with an increase in the protection rate from 45% to 90%.

CONCLUSIONS

Chinese urban adults made trade-offs between vaccine effectiveness, protection duration, place of origin, side effects, and cost of HZ vaccination. Vaccine effectiveness was the most important characteristic. The residents have the highest WTP (CN ¥974; US $145) for enhancing the effectiveness of vaccines. To maximize HZ vaccine uptake, health authorities should promote vaccine effectiveness.

Preferences for COVID-19 Vaccines: Systematic Literature Review of Discrete Choice Experiments

BACKGROUND

Vaccination can be viewed as comprising the most important defensive barriers to protect susceptible groups from infection. However, vaccine hesitancy for COVID-19 is widespread worldwide.

OBJECTIVE

We aimed to systematically review studies eliciting the COVID-19 vaccine preference using discrete choice experiments.

METHODS

A literature search was conducted in PubMed, Embase, Web of Science, Scopus, and CINAHL Plus platforms in April 2023. Search terms included discrete choice experiments, COVID-19, and vaccines and related synonyms. Descriptive statistics were used to summarize the study characteristics. Subgroup analyses were performed by factors such as high-income countries and low- and middle-income countries and study period (before, during, and after the pandemic wave). Quality appraisal was performed using the 5-item Purpose, Respondents, Explanation, Findings, and Significance checklist.

RESULTS

The search yield a total of 623 records, and 47 studies with 53 data points were finally included. Attributes were grouped into 4 categories: outcome, process, cost, and others. The vaccine effectiveness (21/53, 40%) and safety (7/53, 13%) were the most frequently reported and important attributes. Subgroup analyses showed that vaccine effectiveness was the most important attribute, although the preference varied by subgroups. Compared to high-income countries (3/29, 10%), a higher proportion of low- and middle-income countries (4/24, 17%) prioritized safety. As the pandemic progressed, the duration of protection (2/24, 8%) during the pandemic wave and COVID-19 mortality risk (5/25, 20%) after the pandemic wave emerged as 2 of the most important attributes.

CONCLUSIONS

Our review revealed the critical role of vaccine effectiveness and safety in COVID-19 vaccine preference. However, it should be noticed that preference heterogeneity was observed across subpopulations and may change over time.

TRIAL REGISTRATION

PROSPERO CRD42023422720; https://tinyurl.com/2etf7ny7.

Preferences regarding COVID-19 vaccination among 12,000 adults in China: A cross-sectional discrete choice experiment

Understanding public preferences concerning vaccination is critical to inform pandemic response strategies. To investigate Chinese adults' preferences regarding COVID-19 vaccine attributes, we conducted a cross-sectional online survey in 12,000 Chinese adults in June-July, 2021. Participants were requested to answer a series of discrete choice questions related to hypothetical COVID-19 vaccines. Using mixed logit models, our analysis revealed that participants had a higher preference for COVID-19 vaccines with longer duration of protection (coefficient: 1.272, 95% confidence interval [1.016 to 1.529]) and higher efficacy (coefficient: 1.063, [0.840, 1.287]). Conversely, participants demonstrated a lower preference associated with higher risk of rare but serious side-effects (coefficient: -1.158, [-1.359, -0.958]), oral administration (coefficient: -0.211, [-0.377, -0.046]), more doses (coefficient: -0.148, [-0.296, 0.000]) and imported origin (coefficient: -0.653, [-0.864, -0.443]). Moreover, preferences were heterogeneous by individual factors: highly educated participants were more sensitive to the negative vaccine attributes including price (coefficient -0.312, [-0.370, -0.253]) and imported vaccine (coefficient -0.941, [-1.186, -0.697]); there was also substantial heterogeneity in vaccine preferences with respect to age group, marital status, work status, income, chronic diagnosis history, COVID-19 vaccination history and geographic regions. As the first study of examining the public preferences for COVID-19 vaccine in China with a large nationwide sample of 12,000 adults, our results indicate that future vaccine should pose lower risk, possess longer protection period, have higher efficacy, be domestically produced, and have lower costs to increase the COVID-19 vaccination coverage. Our current study findings from this study provide insights and recommendations for not only COVID-19 vaccine design but also vaccine attribute preferences to increase vaccine uptake in potential future pandemics.

The effect of quarantine policy on pollution emission and the usage of private transportation in urban areas

Governmental policies, regulations, and responses to the pandemic can benefit from a better understanding of people's resulting behaviours before, during, and after COVID-19. To avoid the inelasticity and subjectivity of survey datasets, several studies have already used some objective variables like air pollutants to estimate the potential impacts of COVID-19 on the urban transportation system. However, the usage of reactant gases and a narrow time scale might weaken the results somehow. Here, both the objective passenger volume of public transport and the concentration of private traffic emitted black carbon (BC) from 2018 to 2023 were collected/calculated to decipher the potential relationship between public and private traffic during the COVID-19 period. Our results indicated that the commuting patterns of citizens show significant (p < 0.01) different patterns before, during, and after the pandemic. To be specific, public transportation showed a significant (p < 0.01) positive correlation with private transportation before the pandemic. This public transportation was significantly (p < 0.01) affected by the outbreaks of COVID-19, showing a significant (p < 0.01) negative correlation with private transportation. Such impacts of the virus and governmental policy would affect the long-term behaviour of individuals and even affect public transportation usage after the pandemic. Our results also indicated that such behaviour was mainly linked to the governmental restriction policy and would soon be neglected after the cancellation of the restriction policy in China.

Employees' seeking preference towards influenza vaccination in organization: A discrete choice experiment in China

To clarify the preferences of employees seeking influenza vaccination, a discrete choice experiment aims to understand the essential factors that close the gap between intention and behavior. A total of 866 employees with vaccination willingness willing to participated in a discrete choice experiment (DCE) between October 31st and December 6th, 2022 in China including the following attributes: price, vaccination setting, appointment mode, and service time. The data was analyzed using mixed logit models. Employees from smaller enterprises were more likely to get vaccinated collectively. For employees willing to get the influenza vaccine, 95.08 % of their choice was dominated by price. Employees' behavior varied according to their socioeconomic characteristics. Only female employees strongly favored work-site-based vaccination. Price was the primary factor considered by employees for getting the influenza vaccine. DCE would help to develop influenza vaccination intervention targeted at different groups in future studies.

Vaccinating without complete willingness against COVID-19: Personal and social aspects of Israeli nursing students and faculty members

Soon after the coronavirus disease 2019 (COVID-19) pandemic outbreak, it became clear that vaccination will be the most useful tool to combat the disease. Despite the apparent safety and efficacy of the developed anti-COVID-19 vaccines, relatively high percentages of the population worldwide refused to get vaccinated, including many health workers and health students. The present cross-sectional study examined the motives, attitudes, and personal characteristics of those who did not get vaccinated against COVID-19 or vaccinated without complete willingness among nursing students and nursing faculty members in Israel (n = 472). Results show that the vast majority of the study participants (97%) received at least one dose of the anti-COVID-19 vaccine. Nearly 37% of the participants indicated that they received the vaccine without complete willingness. As compared to faculty members, nursing students reported lower trust in the efficacy of the vaccine, perceived the COVID-19 pandemic as a health threat to a lesser extent, exhibited lower institutional and personal trust, and had higher levels of posttraumatic stress disorder symptoms. Non-Jewish participants were at risk of vaccinating without complete willingness. These findings underscore the need for developing evidence-based strategies to promote the safety and efficacy of the anti-COVID-19 vaccines in nursing schools.

Which factors drive the choice of the French-speaking Quebec population towards a COVID-19 vaccination programme: A discrete-choice experiment

OBJECTIVES

The aims of this study were to elicit preferences about the coronavirus disease 2019 (COVID-19) vaccine campaign in the general French-speaking adult Quebec population and to highlight the characteristics of the vaccine campaign that were of major importance.

METHODS

A discrete-choice experiment (DCE) was conducted between April and June 2021, in Quebec, Canada. A quota sampling method by age, gender and educational level was used to achieve a representative sample of the French-speaking adult population. The choice-based exercise was described by seven attributes within a vaccine campaign scenario. A mixed logit (MXL) model and a latent class logit (LCL) model were used to derive utility values. Age, gender, educational level, income and fear of COVID-19 were included as independent variables in the LCL.

RESULTS

A total of 1883 respondents were included for analysis, yielding 22,586 choices. From these choices, 3425 (15.16%) were refusals. In addition, 1159 (61.55%) individuals always accepted any of the vaccination campaigns, while 92 individuals (4.89%) always refused vaccine alternatives. According to the MXL, relative weight importance of attributes was effectiveness (32.50%), risk of side effects (24.76%), level of scientific evidence (22.51%), number of shots (15.73%), priority population (3.60%), type of vaccine (0.61%), and vaccination location (0.28%). Four classes were derived from the LCL model and attributes were more or less important according to them. Class 1 (19.8%) was more concerned about the effectiveness (27.99%), safety (24.22%) and the number of shots (21.82%), class 2 (55.3%) wanted a highly effective vaccine (40.16%) and class 3 (17.6%) gave high value to the scientific evidence (42.00%). Class 4 preferences (7.4%) were more balanced, with each attribute having a relative weight ranging from 1.84% (type of vaccine) to 21.32% (risk of side effects). Membership posterior probabilities to latent classes were found to be predicted by individual factors such as gender, annual income or fear of COVID-19.

CONCLUSIONS

Vaccination acceptance relies on multiple factors. This study allowed assessment of vaccination-specific issues through a choice-based exercise and description of factors influencing this choice by segmenting the sample and drawing profiles of individuals. Moreover, besides effectiveness and safety, a major point of this study was to show the importance given by the general population to the level of scientific evidence surrounding vaccines.

PATIENT OR PUBLIC CONTRIBUTION

A small group of citizens was involved in the conception, design and interpretation of data. Participants of the DCE were all from the general population.

Determining the coverage and efficacy of the COVID-19 vaccination program at the community level in children aged 12 to 17 in Tehran

Background

The vaccination is one of the acceptable and recomended solution to prevent and control of COVID-19. The aim of this study was to determine the efficacy of sinopharm vaccination in children aged 12-17 in Tehran.

Methods

The case population study was performed from October 2021 to March 2022 among 1,500 children with positive PCR test reffered in Mofid Children's Hospital in Tehran. 64 children aged 12-17 years were included. The data were collected by the hospital information system (HIS), vaccination information registration systems and questionnaire with their families. The coverage and efficacy of vaccination determined with equels commented by WHO.

Results

Out of 64 children, 52 children were 12 to 15 years old (13.35±1.08), 12 children were 16 to 17 years old (16.55±0.52). 48.4% had received two doses of vaccine. The highest rate of positive PCR was observed in February 2022. Sinopharm vaccine coverage in this age group was 93.6% for the first dose and 81.1% for the second dose. Based on this information, 48.4% children in this study have received two complete doses of the COVID-19 vaccine. The efficacy of the vaccine was estimated as 94.4% (95% CI 90.2 to 97.7).

Conclusion

It seems the coverage of Sinopharm vaccination in the age group of 12-17 years in Tehran is favorable and has high efficacy in this age group. In order to obtain more accurate and comprehensive estimation, it is recommended to take a sample on a wider level of the community.

Global COVID-19 vaccine acceptance level and its determinants: an umbrella review

BACKGROUND

The COVID-19 vaccination is essential for reducing disease burden on a worldwide scale. The success of this strategy will largely depend on how well vaccines are received. Previous reviews had produced contradictory results, and there had been no umbrella review. Therefore, the objective of this umbrella review was to combine the contradictory data regarding the COVID-19 vaccination's global acceptance rate and its contributing factors.

METHODS

Using PRISMA guideline, PubMed, Embase, Scopus, Web of Sciences, Cochrane Database of Systematic Reviews, Scopus and Google Scholar which reported COVID-19 vaccine acceptance and/or its determinants were searched. The quality of the included studies was assessed using Assessment of Multiple Systematic Reviews (AMSTAR). A weighted inverse variance random-effects model was applied to find the pooled estimates. The subgroup analysis, heterogeneity, publication bias and sensitivity analysis were also assessed.

RESULT

Twenty-two SRM with 10,433,306 study participants were included. The pooled COVID-19 vaccine acceptance rate globally is found to be 60.23 (95% CI: 58.27, 62.18). In low-income countries, the pooled level of COVID-19 vaccine acceptance was found to be 54.07(50.31, 57.83) while this magnitude is 64.32 (62.24,66.40) among studies across the globe. Higher level of education (AOR =1.96; 95% CI:1.20, 2.73), good level of knowledge (2.20; 95% CI:1.36, 3.03), favourable attitude (AOR =4.50; 95% CI:2.89, 6.12), previous history of COVID-19 infection (AOR =3.41; 95% CI:1.77, 5.06), male sex (AOR =1.62; 95% CI:1.47, 1.77), and chronic disease (AOR =1.54; 95% CI:1.18, 1.90) were predictors of COVID-19 vaccine acceptance.

CONCLUSION

The pooled level of COVID-19 vaccine acceptance highly varied and found to be unacceptably low particularly in low-income countries. Higher level of education, good level of knowledge, favourable attitude, previous history of COVID-19, male sex, and chronic disease were factors of COVID-19 vaccine acceptance rate. A collaborative effort of stakeholders such as policymakers, and vaccine campaign program planners is needed to improve the acceptance rate of COVID-19 vaccine.

Incentivizing COVID-19 Vaccination in a Polarized and Partisan United States

CONTEXT

As COVID-19 vaccines were rolled out in early 2021, governments at all levels in the United States experienced significant difficulty in consistently and efficiently administering injections in the face of vaccination resistance among a public increasingly politically polarized on vaccination preferences before the beginning of mass vaccinations.

METHODS

Using an original conjoint experiment fielded to a nationally representative sample before the mass proliferation of COVID-19 vaccines, the authors examined how different incentives (e.g., employer mandates, state-organized or health care provider-organized vaccination clinics, and financial incentives) affect the public's preference to get vaccinated. They also tested how financial incentive preferences correlated with self-reported vaccination intention using observational data from the June 2021 Kaiser Family Foundation Health Tracking Poll.

FINDINGS

The authors found financial incentives positively influenced vaccine preferences among the mass public and all partisan groups, including Republicans who were initially "unlikely" to be vaccinated. The authors used the observational data to replicate their experimental findings, showing positive financial incentive attitudes positively correlated with self-reported vaccination disclosures.

CONCLUSIONS

These results provide support for direct financial incentives, rather than other incentives, as being a valuable tool for policy makers tasked with alleviating vaccination resistance among a US mass public increasingly polarized along partisan lines.

Factors associated with COVID-19 booster vaccine hesitancy: a nationwide, cross-sectional survey in Japan

OBJECTIVES

COVID-19 vaccine hesitancy/fatigue is increasing as the pandemic enters the endemic phase. The present study aimed to explore current perceptions about COVID-19 booster vaccination among the Japanese public.

STUDY DESIGN

This was a cross-sectional study.

METHODS

This cross-sectional study used data from the Japan COVID-19 and Society Internet Survey conducted in September 2021 and September 2022. The public's perceptions of COVID-19 vaccination and factors associated with COVID-19 booster vaccine hesitancy were analyzed.

RESULTS

In total, 56,735 respondents were included. In the Japan COVID-19 and Society Internet Survey 2021, 75.1% of the participants (21,126/28,118) had completed the primary vaccination series. In the 2022 survey, 74.1% of the respondents (21,216/28,617) completed the primary series of vaccination with booster doses. The proportion of fear toward COVID-19 and obtaining information about COVID-19 has decreased from 2021 to 2022. Factors independently associated with booster vaccine hesitancy were young age (range: 18-29 years; adjusted odds ratio [aOR]: 6.56), history of COVID-19 (aOR: 1.82), distrust of the Japanese government's COVID-19 prevention measures (aOR: 1.55), lack of confidence in COVID-19 vaccine efficacy (aOR: 1.30), lack of confidence in COVID-19 vaccine safety (aOR: 1.62), low reliance on the COVID-19 vaccine (aOR: 1.92), and belief in COVID-19 conspiracy theories (aOR: 1.77).

CONCLUSIONS

Providing clear and trustworthy information is critically important, especially targeted and tailored messages for the young generation, to promoting COVID-19 booster vaccination. Policymakers should therefore develop consistent and transparent communication strategies and the ability to respond promptly and flexibly to mitigate the negative impact of COVID-19 on the public while preparing for the next pandemic.

Role of Trust, Risk Perception, and Perceived Benefit in COVID-19 Vaccination Intention of the Public

COVID-19 vaccination is an effective method for dealing with the COVID-19 pandemic. This study proposed and validated a theoretical intention model for explaining the COVID-19 vaccination intention (CVI) of the public. The theoretical intention model incorporated trust in vaccines, two types of risk perception (risk perception of COVID-19 and risk perception of COVID-19 vaccination), and perceived benefit into a theory of planned behavior (TPB). Structural equation modeling was utilized to test the theoretical intention model with data collected from 816 Chinese adults in China. The results confirmed the crucial role of trust in vaccines, risk perception, and perceived benefit in shaping the CVI of the public. In addition, TPB was found to be applicable in a research context. The theoretical intention model accounted for 78.8% of the variance in CVI. Based on the findings, several practical recommendations for improving COVID-19 vaccination rates were discussed.

Evolution of preferences for COVID-19 vaccine throughout the pandemic - The choice experiment approach

In this study, we employ a choice experiment to study individual preferences for COVID-19 vaccines in the US. A unique characteristic of the microdata (N = 5671) is that the survey was conducted in five distinct waves from October 2020 to October 2021. Because of this dynamic feature, it is possible to control for evolving pandemic conditions such as the number of COVID-19 active cases, vaccination uptake, and the frequency of Google searches related to the vaccines. Furthermore, we employ a hybrid choice model to incorporate respondents' attitudes related to their perceived vulnerability to diseases, as well as their perceived health status. The hybrid choice model was extended to incorporate latent classes as well as random effects. We find that the rate of vaccinated individuals in the population actually increases the probability of vaccine hesitancy, and therefore may discourage people to get vaccinated. This may be evidence of free-riding behavior. On the other hand, the number of COVID-19 cases has a positive effect on the probability of getting vaccinated, suggesting that individuals react to the pandemic conditions by taking some protective measures. Google trend data do not seem to have a straightforward effect on the vaccination demand, but it increases consumers' willingness to pay for several vaccine characteristics. With respect to the analyzed attitudes, we find that perceived uninfectability is a significant driver of vaccine hesitancy, probably related to the frequent "natural immunity" argument. In turn, germ aversion has a positive effect on the probability of getting vaccinated as well as on the marginal willingness to pay. Finally, health status has a limited effect on whether the individual will decide to vaccinate or not.

Inactivated SARS-CoV-2 vaccination does not disturb the clinical course of Graves' disease: An observational cohort study

SARS-CoV-2 vaccination has been reported to be associated with the induction of thyroid disorders. To investigate the influence of SARS-CoV-2 vaccination on the disease course of patients who were undergoing treatment for Graves' disease (GD), a total of 651 consecutive GD patients who attended follow-up visits in Jiangyuan Hospital were enrolled in this retrospective study, including 443 inactivated SARS-CoV-2 vaccine recipients and 208 unvaccinated participants. The changes in serum levels of free triiodothyronine (fT3), free thyroxine (fT4), thyroid stimulating hormone (TSH) and TSH receptor antibody (TRAb) were analyzed. Crude and adjusted hazard ratios (HRs) were estimated using Cox regression models to investigate the risks in incident TRAb positivity and hyperthyroidism recurrence following vaccination. The median levels of TRAb and fT3 significantly decreased in both vaccinated and unvaccinated groups during the GD hyperthyroidism treatment. The fT4 levels of both groups were well within normal limits and presented downward trends simultaneously. Although the present study observed an increasing trend of TSH level during follow-up, significant difference was not seen in both vaccinated and unvaccinated groups. Except for newly diagnosed GD patients, vaccinated participants had significantly lower risks of incident TRAb positivity (adjusted HR = 0.22; 95%CI: 0.10-0.48, P < 0.001) after adjusted for sex, age, disease duration and MMI dose at baseline. Besides, vaccination was unlikely to serve as a risk factor for hyperthyroidism recurrence (adjusted HR = 1.20; 95%CI: 0.51-2.83, P = 0.678). Notably, newly diagnosed patients who received vaccination were just as likely to achieve remission of thyrotoxicosis as those not receiving the vaccination at any time. Our results concluded that inactivated SARS-CoV-2 vaccination would not disturb the treatment course among GD hyperthyroidism patients.

Application of Protection Motivation Theory to COVID-19 vaccination among a predominantly Hispanic sample of adolescents

Despite the efficacy and widespread availability of COVID-19 vaccines, vaccine uptake has been relatively low in U.S. Hispanic communities, especially among adolescents. This study examined vaccination status among 444 high school students in predominantly Hispanic neighborhoods of Los Angeles County, California in May-June 2022 (mean age = 15.74 years, 55% female, 93% Hispanic). Guided by Protection Motivation Theory, we hypothesized that the odds of being fully vaccinated (at least 2 vaccine doses) would be significantly associated with higher levels of perceived severity, perceived vulnerability, response efficacy, and self-efficacy. 79% of the respondents were fully vaccinated. Binary logistic regression analyses found that response efficacy (belief in the effectiveness of the COVID-19 vaccine) and self-efficacy to get vaccinated were significantly associated with the likelihood of being fully vaccinated. Perceived severity of COVID-19 and perceived vulnerability to COVID-19 were not associated with the likelihood of being fully vaccinated. Results indicate that health communications are needed to convince Hispanic adolescents and their parents that the COVID-19 vaccine is effective, and outreach efforts are needed to remove barriers to vaccination among this population.

Preference of young adults for COVID-19 vaccination in the United Kingdom: a discrete choice experiment

OBJECTIVES

To determine preferences for COVID-19 vaccinations in the young adult population in the United Kingdom (UK).

METHOD

A discrete choice experiment survey was conducted in UK young adults. Participants were asked to choose between two hypothetical vaccines the one they preferred the most. Vaccines were defined by five attributes (effectiveness, risk of side effects, duration of protection, number of doses, confidence in available evidence), identified following a systematic literature review and qualitative interviews with 13 young adults. A random parameters logit model, a latent class model, and subgroup analyses were used to identify preferences.

RESULTS

One hundred and forty-nine respondents were included (70% women, mean age 23 years). All five attributes significantly influenced respondents' vaccination decisions. Respondents valued higher effectiveness, lower risk of side effects, longer protection duration, and a smaller number of doses. Based on the range of levels of each attribute, vaccine effectiveness was the most important attribute (relative importance 34%), followed by risk of side effects (32%), and duration of vaccine protection (22%).

CONCLUSIONS

The five investigated vaccine attributes appear to play an important role in young adults' decision-making process. Results of this study may help health authorities designing appropriate strategies in future vaccines campaigns in the younger UK population.

COVID-19 vaccination in the mass vaccination center: clinical practice and effectiveness analysis

Objectives

Mass vaccination campaigns can rapidly increase the vaccination rate for the COVID-19 vaccine, the establishment of mass vaccination centers is indispensable. At the beginning of March 2021, China began to carry out COVID-19 vaccination activities nationwide. Here, we aimed to evaluate the criteria established by mass vaccination centers, COVID-19 vaccination experience, the incidence of adverse events following immunization and opinions.

Methods

We describe the layout and functioning of Nan'an District mass vaccination center, the working mechanism, experience and effectiveness. Distribution of COVID-19 vaccine vaccination and adverse events following immunization reported in the mass vaccination center of Nan'an District were evaluated.

Results

From March 26, 2021 to April 28, 2022, the mass vaccination center has inoculated about 381,364 doses of COVID-19 vaccine to the population. The study found that the incidence of adverse events following immunization (AEFI) was very low (1.04/100000). The chances of having AEFI were significantly higher in COVID-19 vaccine (CHO cell) than COVID-19 vaccine (Vero cell).

Conclusion

The mass vaccination center was running successfully. It was effective and safe, providing vaccination services and increasing COVID-19 vaccination rates among the population. The experience of the mass vaccination center for COVID-19 in China can provide a reference for other countries and regions to carry out COVID-19 vaccination.

Boosting COVID-19 vaccine inoculation and booster shots: a systematic review and meta-analysis of factors that influence Coronavirus vaccine uptake in practice

Introduction

Vaccines alone do not control pandemics, but vaccinations. The hope of COVID-19 pandemic control is hinged on vaccinations and other public health measures. This systematic review/meta-analysis (SR/MA) investigated the factors that inform coronavirus vaccine uptake globally in an attempt to improve COVID-19 immunization.

Method

The PRISMA 2020 methodology was used for this review. A total of 2902 articles were identified from electronic databases and other sources. After screening, 33 articles were included in the review and quantitative meta-analysis. Comprehensive meta-analysis software version 3 was used for the meta-analysis.

Results

We observed that vaccine effectiveness, side effects and the proportion of acquaintances vaccinated significantly influenced respondents' COVID-19 immunization decision. Also, associations of vaccine effectiveness, smaller risks to serious side effects, free and voluntary vaccinations and fewer vaccine doses, and longer duration to wanning were observed. We also observed variations in vaccine hesitancy trends in studies carried out in Asia, Europe, America, and Africa.

Conclusion

Wanning and acquaintance's vaccination status as factors to vaccination are insights the present paper is bringing to the limelight. Health promotion and COVID-19 vaccination planning are crucial for enhancing vaccine uptake.

Investigating preferences of the covid-19 vaccine among individuals in Iran: Discrete choice experiment analysis

Background and Aims

This study aimed to estimate the preferences for COVID-19 vaccines among a sample of Iranian adults and to understand the sources of preference heterogeneity.

Methods

A web-based survey was conducted from April to July 2021; out of 1747 participants, 678 completed the survey. Seven key attributes were selected, namely effectiveness, risk of severe side effects, risk of mild side effects, number of doses, duration of protection, location of manufacture, and price. Additionally, conditional logit and mixed logit models were used to analyze the data.

Results

The results of this study indicate that vaccine effectiveness, protective duration, the risk of side effects, and price are the most important factors that influence vaccine preferences. Furthermore, we identified heterogeneity in preferences, indicating that not all individuals respond in the same way to vaccine attributes.

Conclusion

The majority of Iranians prefer to get the Covid-19 vaccine. Policymakers should consider these findings when implementing successful programs. This study contributes to the literature by estimating Iranian respondents' preferences for the Covid-19 vaccine and identifying the heterogeneity in their preferences for vaccine attributes. The findings may also inform future research and policies related to Covid-19 vaccination programs in Iran.

Understanding the role of personal experiences and contextual variables in shaping risk reduction preferences

This article explores how preferences for risk reduction during the COVID-19 pandemic are influenced by personal experiences and contextual variables such as having a close friend or relative who has been infected by the virus (closeness), the severity of the illness (severity), people's own perceptions of being in a risky group (risk group), change in employment status due to the pandemic (employment situation), and vaccination status (vaccination status and altruistic vaccination). We conducted a choice experiment (CE) in Chile, Colombia, and Costa Rica. The attributes of the experiment were risk reduction, latency, and cost. Then, we estimated a mixed logit model to capture preference heterogeneity across the countries. The attributes presented in the CE were statistically significant, with the expected sign in each country. The variables closeness and employment situation presented homogeneous behavior in each country; however, severity, risk group, and vaccination status showed mixed results. We found that preferences were more heterogeneous for the attributes of the CE than for the personal experiences and contextual variables. Understanding the impact of these variables is essential for generating more effective risk reduction policies. For instance, methodologies such as the value of statistical life base their calculations on society's valuation of risk reduction. We provide evidence that the preferences for risk reduction vary due to the everyday situations that individuals face in the context of the pandemic. The latter may cause distortions in the values used to evaluate policies aimed at mitigating the outbreak.

Determinants of COVID-19 vaccination decision among Filipino adults

BACKGROUND

With a number of vaccines against COVID-19 now widely available globally, it is opportune to determine what tips the decision to get vaccinated. In most countries like the Philippines where the government provides these vaccines for free to all its citizens, their COVID-19 vaccine awareness and COVID-19 information sources as well as their socio-demographic profile were considered as primary factors that could possibly affect vaccination decisions. Participants' income level was considered as a possible financial consideration that can affect vaccination decision as transport to vaccination sites might entail costs to them.

METHODS

This study used a cross sectional survey design wherein participants came from all regions of the Philippines. An online questionnaire was voluntarily answered by Filipinos aged 18-80 years of age.

RESULTS

A total of 2,268 participated in the survey with 1,462 having complete responses which were included in the analysis. Those who are younger, with higher educational attainment, with public health insurance, with employers requiring vaccination, high awareness about COVID-19 vaccination, and high vaccine confidence are more likely to get vaccinated. On the other hand, those with long-standing illness and those residing outside the national capital region are less likely to get vaccinated.

CONCLUSION

Vaccination decisions among Filipinos are determined by their age, educational attainment, health insurance, employer requirement, high awareness of the disease, and a high level of vaccine confidence.

COVID-19 Vaccine-Related Information on the WeChat Public Platform: Topic Modeling and Content Analysis

BACKGROUND

The COVID-19 vaccine is an effective tool in the fight against the COVID-19 outbreak. As the main channel of information dissemination in the context of the epidemic, social media influences public trust and acceptance of the vaccine. The rational application of health behavior theory is a guarantee of effective public health information dissemination. However, little is known about the application of health behavior theory in web-based COVID-19 vaccine messages, especially from Chinese social media posts.

OBJECTIVE

This study aimed to understand the main topics and communication characteristics of hot papers related to COVID-19 vaccine on the WeChat platform and assess the health behavior theory application with the aid of health belief model (HBM).

METHODS

A systematic search was conducted on the Chinese social media platform WeChat to identify COVID-19 vaccine-related papers. A coding scheme was established based on the HBM, and the sample was managed and coded using NVivo 12 (QSR International) to assess the application of health behavior theory. The main topics of the papers were extracted through the Latent Dirichlet Allocation algorithm. Finally, temporal analysis was used to explore trends in the evolution of themes and health belief structures in the papers.

RESULTS

A total of 757 papers were analyzed. Almost all (671/757, 89%) of the papers did not have an original logo. By topic modeling, 5 topics were identified, which were vaccine development and effectiveness (267/757, 35%), disease infection and protection (197/757, 26%), vaccine safety and adverse reactions (52/757, 7%), vaccine access (136/757, 18%), and vaccination science popularization (105/757, 14%). All papers identified at least one structure in the extended HBM, but only 29 papers included all of the structures. Descriptions of solutions to obstacles (585/757, 77%) and benefit (468/757, 62%) were the most emphasized components in all samples. Relatively few elements of susceptibility (208/757, 27%) and the least were descriptions of severity (135/757, 18%). Heat map visualization revealed the change in health belief structure before and after vaccine entry into the market.

CONCLUSIONS

To the best of our knowledge, this is the first study to assess the structural expression of health beliefs in information related to the COVID-19 vaccine on the WeChat public platform based on an HBM. The study also identified topics and communication characteristics before and after the market entry of vaccines. Our findings can inform customized education and communication strategies to promote vaccination not only in this pandemic but also in future pandemics.

The COVID-19 vaccination decision-making preferences of elderly people: a discrete choice experiment

COVID-19 is a continuing threat to global public health security. For elderly people, timely and effective vaccination reduces infection rates in this group and safeguards their health. This paper adopted an offline Discrete Choice Experiment (DCE) to research the preference for COVID-19 vaccination amongst Chinese adults aged 50 years and above. Through multinomial logistic regression analysis, our DCE leverages five attributes-the risk of adverse reactions, protective duration, injection doses, injection period, and effectiveness-each of which is split into three to four levels. The risk of adverse reaction and the protective duration were demonstrated to be determinants of vaccination preference. Moreover, it was found that socio demographic factors like region, self-health assessment and the number of vaccinated household members can strengthen or weaken the effects of vaccine attributes. In conclusion, the preferences of the elderly population should be considered when developing COVID-19 vaccination programs for this population in China. Accordingly, the results may provide useful information for policymakers to develop tailored, effectively vaccination strategies.

Assessment of knowledge, attitudes, practices, and risk perceptions regarding COVID-19: a cross-sectional study from China

Aim

To analyze the level of knowledge, attitudes, practices, and risk perception regarding COVID-19 among Chinese residents 1.5 years after the pandemic.

Subject and methods

A cross-sectional study was carried out with both online and paper questionnaires. We included a variety of covariates that were characteristic-related factors such as age, gender, education level, and retirement status, as well as those closely associated with risk perception regarding COVID-19.

Results

Participants (n = 3588), 53.49 ± 18.88 years old, from two provinces of China, of which 44.7% were male and 52.03% had a high school or greater level of education, answered the questions. More than 90% of participants had adequate background knowledge about COVID-19 and agreed or even strongly agreed with many attitude items related to the government's role in diagnosis, treatment, and dealing with COVID-19 infections. About three fifths of the participants reported fear of contracting COVID-19, but only a minority (18.63%) felt they were more susceptible than others. Respondents aged 45 years or younger were more likely to fear contracting the virus than those older than 45 years (adjusted OR = 1.464, 95% CI 1.196 to 1.794, P = 0.0002). High education level (adjusted OR = 1.503, 95% CI 1.187 to 1.904, P = 0.0007) and non-retired status (adjusted OR = 1.679, 95% CI 1.354 to 2.083, P < 0.0001) were associated with a higher perception of susceptibility to infection than others. Moreover, respondents who were not retired had a significantly reduced practice score (adjusted OR = 1.554, 95% CI 1.261 to 1.916, P < 0.0001). Age, retirement status, and education level were also associated with knowledge, attitude, and practice level.

Conclusion

Our findings suggest that the public generally has trust in the COVID-19 vaccine and the government with regard to COVID-19 in China. We recommend that high-risk groups of communities, such as elders and patients with chronic diseases, be given greater consideration in the outbreaks. Health education campaigns combined with workplace preventive intervention should be aimed at improving COVID-19 knowledge and beliefs in order to encourage more optimistic attitudes and to maintain safe practices.

Covid-19 Vaccine Side Effects and Its Associated Factors Among Healthcare Workers at Dessie Hospital, Ethiopia

Background

Vaccines are a powerful choice to stop disease outbreaks, including covid-19. However, people are hesitant to take vaccinations due to uncertainty about side effects. So, this study aimed to assess covid-19 vaccine side-effect and its associated factors among healthcare workers in Dessie comprehensive specialized hospital, in Ethiopia.

Methods

An institution-based cross-sectional study was conducted at Dessie Comprehensive and Specialized Hospital among 351 vaccinated healthcare workers from April 25 to May 25, 2021. Self-administrated questionnaires were used by consented health workers. Variance inflation factor (VIF) was used to assess the multicollinearity of independent variables. Bivariable and multivariable binary logistic regression were used to identify significant factors of vaccine side effects. The adjusted odds ratio (AOR) with a 95% confidence interval (CI) was reported as the effect size. Statistical significance was considered at p-value <0.05.

Results

Overall, of vaccinated healthcare workers, 56.98% (95% CI, 50.86-61.26%) experienced at least one side effect. The majority of the side effects were fever (44.44%), headache (39.03%), fatigue (27.35%), injection site pain (25.93%), and nausea (24.22%). Healthcare workers with (≥10 years) of work experience (AOR: 3.74, 95% CI, 1.32-10.59), Hesitancy to take the first dose of the Covid-19 vaccine (AOR: 3.01, 95% CI, 1.82-4.99), underlying chronic disease (AOR: 14.41, 95% CI, (5.07-40.92)), being on antihypertensive medication (AOR: 0.15; 95% CI (0.02-0.93)), and unsafe perception of vaccine safety (AOR:3.50; 95% CI, 1.43-8.57) were independent factors of Covax vaccine side effect development.

Conclusion

Overall, common vaccine side effects were identified in healthcare workers who have taken the Covax vaccine. Healthcare workers with (≥10 years) of work experience, Hesitancy to take the first dose, unsafe perception of vaccine safety, and underlined chronic disease were predictors of vaccine side effect occurrence. So, providing vaccine-related information to the community to be vaccinated is mandatory to reduce hesitancy and flaws regarding vaccine safety.

Loss-framing of information and pre-vaccination consultation improve COVID-19 vaccine acceptance: A survey experiment

Backgrounds

Vaccination remains one of the most effective ways to protect populations from COVID-19 infection, severe conditions, and death. This study aims to examine whether the gain/loss-framing of information, provision of subsidized pre-vaccination physician consultation, and cash incentives can improve COVID-19 acceptance amongst adults.

Methods

A survey experiment was conducted within a broader cross-sectional survey of people aged 18-64 years in Hong Kong, China. The participants were randomly assigned to one of the eight groups derived from full-factorial design of the three strategies with stratification by age and sex. The vaccine acceptance rate was compared between people with and without any of the strategies. The heterogeneous effects of these strategies were identified for those with different perceptions of the pandemics and vaccine in multiple logistic regressions.

Results

The survey experiment collected 1,000 valid responses. It found that loss-framed information and provision of subsidized physician consultation to assess suitability to be vaccinated, can improve vaccine acceptance, while cash incentives did not make a difference. The improvement effect of loss-framing information and physician consultation is stronger among those with higher perceived infection risk and severity of condition, as well as unvaccinated people with lower confidence in vaccine safety.

Conclusions

The findings indicated that individualized loss-framing messages and equitable provision of subsidized pre-vaccination physician consultations can be incorporated in efforts to promote vaccine acceptance and vaccination roll-out speed. However, it remains inconclusive whether and how universal cash incentives may be deployed to support vaccination promotion.

What attributes influence rural household's willingness to get vaccinated for COVID-19? Perspectives from six Chinese townships

Since the onset of the COVID-19 pandemic, vaccinations have been identified as the most effective mitigation strategy against the deadly virus. This has led developed nations to accelerate research and shorten the licensure process for COVID-19 vaccines, but these changes have caused widespread concerns about vaccine safety. Research literature has long indicated that citizens' perceptions of protective actions will determine their behaviors, and thus, the relationship between vaccine perception and vaccination intention needs to be assessed. To better understand vaccination willingness, especially in rural populations, this study surveyed 492 households from six townships in the Ya'an region of China's Sichuan Province in November 2020. The survey followed the Protective Action Decision Model (PADM) framework for collecting perceptions about the influenza and COVID-19 vaccines as protective actions, information sources, emergency preparedness, emotional response, and demographic characteristics. The results showed that influenza vaccine perceptions significantly affected people's COVID-19 vaccination perceptions and intentions. Unlike previous vaccination willingness and other COVID-19 studies, this study found that perceptions of resource-related attributes and health-related attributes both affected COVID-19 vaccination intentions, but the former were slightly stronger than the latter. Moreover, these effects were strongest among respondents who had the most positive perceptions of their influenza vaccine experience. This study's findings will benefit local authorities in designing appropriate policies and measures (e.g., hazard education, risk communication, vaccination convenience enhancement) for increasing vaccination compliance for the current and future pandemics.

In or Out? Identifying the Factors Playing a Role in Covid-19 Decision Making in Turkiye

OBJECTIVE

The study aimed at investigating the social, demographic, and economic factors affecting Covid-19 vaccine decisions before the vaccination started in Turkey. The study also aimed to understand the attitudes towards Covid-19 vaccines.

METHODS

The study was conducted by exploiting the data of 693 individuals living in Turkey. The data was collected via a virtually applied questionnaire according to snowball sampling in late 2020 when the vaccination program had not started in Turkey yet. Multinomial logistic regression design was used to identify the factors affecting Covid-19 vaccine decisions.

RESULTS

It was observed that Covid-19 vaccine acceptance was notably low before the vaccination started in Turkey. Further, almost 50% of the participants were indecisive about getting vaccinated. It was identified that age, gender, educational status, and residential status, as well as occupational status, the number of dependents, smoking, and the vaccination of governmental authorities, have associations with Covid-19 vaccination decisions.

CONCLUSIONS

Covid-19 vaccine acceptance is generally low, although it is relatively high among vulnerable groups (i.e., the elderly and smokers), and among those who are unable to isolate themselves. In addition, the vaccination of governmental authorities is remarkably effective on Covid-19 vaccine acceptance in Turkey.

Factors related to COVID-19 vaccine hesitancy in Denmark: A national study in the autumn of 2021

AIMS

The novelty of the COVID-19 pandemic and fast-developed vaccines may increase concerns about the safety and effectiveness of the COVID-19 vaccine and thereby influence vaccine hesitancy. The aims of this study were to examine (a) the main reasons for COVID-19 vaccine hesitancy and (b) factors associated with COVID-19 vaccine hesitancy.

METHODS

A nationwide survey was conducted in the autumn of 2021 when most Danes had received at least one dose of a COVID-19 vaccine. The sample (N=13,570) was based on a random selection of individuals (⩾15 years), and data were collected via self-administered mailed questionnaires (digital and physical). The participants were asked whether they had been vaccinated against COVID-19, and if they had not, they were asked about their reasons for vaccine hesitancy. Logistic regression models were used to determine factors associated with vaccine hesitancy.

RESULTS

In all, 5,384 (39.7%) individuals completed the questionnaire. The main reasons for vaccine hesitancy were worries about adverse effects (57.6%) and the belief that natural immunity is better than vaccination (43.8%). Factors associated with vaccine hesitancy included female sex, younger age, being divorced, a country of origin other than Denmark, lower educational level, being unemployed, previously infected with COVID-19 and being worried to a greater extent about oneself and others getting infected. Mental health indicators were not associated with vaccine hesitancy.

CONCLUSIONS

COVID-19 vaccine hesitancy is likely to pose a challenge for population immunity. To reduce vaccine hesitancy and increase vaccination uptake, future vaccination programmes should focus on specific socio-demographic subgroups identified in this study.

Population preferences for non-pharmaceutical interventions to control the SARS-CoV-2 pandemic: trade-offs among public health, individual rights, and economics

PROBLEM

Policymakers must decide on interventions to control the pandemic. These decisions are driven by weighing the risks and benefits of various non-pharmaceutical intervention alternatives. Due to the nature of the pandemic, these decisions are not based on sufficient evidence regarding the effects, nor are decision-makers informed about the willingness of populations to accept the economic and health risks associated with different policy options. This empirical study seeks to reduce uncertainty by measuring population preferences for non-pharmaceutical interventions.

METHODS

An online-based discrete choice experiment (DCE) was conducted to elicit population preferences. Respondents were asked to choose between three pandemic scenarios with different interventions and impacts of the Corona pandemic. In addition, Best-worst scaling (BWS) was used to analyze the impact of the duration of individual interventions on people's acceptance. The marginal rate of substitution was applied to estimate willingness-to-accept (WTA) for each intervention and effect by risk of infection.

RESULTS

Data from 3006 respondents were included in the analysis. The DCE showed, economic effect of non-pharmaceutical measures had a large impact on choice decisions for or against specific lockdown scenarios. Individual income decreases had the most impact. Excess mortality and individual risk of infection were also important factors influencing choice decisions. Curfews, contact restrictions, facility closures, personal data transmissions, and mandatory masking in public had a lesser impact. However, significant standard deviations in the random parameter logit model (RPL) indicated heterogeneities in the study population. The BWS results showed that short-term restrictions were more likely to be accepted than long-term restrictions. According to WTA estimates, people would be willing to accept a greater risk of infection to avoid loss of income.

DISCUSSION

The results can be used to determine which consequences of pandemic measures would be more severe for the population. For example, the results show that citizens want to limit the decline in individual income during pandemic measures. Participation in preference studies can also inform citizens about potential tradeoffs that decision-makers face in current and future decisions during a pandemic. Knowledge of the population's preferences will help inform decisions that consider people's perspectives and expectations for the future. Survey results can inform decision-makers about the extent to which the population is willing to accept certain lockdown measures, such as curfews, contact restrictions, lockdowns, or mandatory masks.

Trust is the common denominator for COVID-19 vaccine acceptance: A literature review

Vaccine hesitancy and refusal to be vaccinated are major reasons why mass vaccination strategies do not reach the intended coverage, even if adequate vaccine supply has been achieved. The main objective of this study is to explore the role and contribution of trust in public willingness to accept COVID-19 vaccinations. The study utilised a qualitative synthesis of literature around hesitancy, willingness to accept vaccination, and the role of trust. Data were extracted from the literature and first categorised using a deductive approach, and later analysed in QSR NVivo using a mix of deductive and inductive approaches. The impact of trust was mostly borne out in the willingness to accept a vaccine, but details on what trust is, how and why it affects willingness or lack of it, was not frequently reported. Three types of trust were identified: 1) Trust in the quality and safety of vaccines; 2) Institutional trust; and 3) Interpersonal trust in the professionals who communicate about and administer the vaccine. Trust in the vaccines' quality and safety, and institutional affiliation significantly contributed towards willingness to be vaccinated. The bulk of the literature focused on how interpersonal trust and personal attributes of potential vaccinees affected the willingness to accept the vaccine. This complex relationship included a fragility of beliefs and perceptions at an individual level, with a bidirectional relationship to societal perceptions. Perceptions of vaccines had a predominant role in decision-making, in contrast to more science-based decision-making. Although globally, the perceptions and beliefs contributing to trust had commonalities and relevance, trust was often found to be dependent on factors embedded in local social, cultural, institutional, and individual attributes and experiences. Understanding different types of trust offers potential approaches to motivate undecided people to receive vaccine; and vaccine refusers to revisit their decisions.

Stated choice analysis of preferences for COVID-19 vaccines using the Choquet integral

We investigate preferences for COVID-19 vaccines using data from a stated choice survey conducted in the US in March 2021. To analyse the data, we embed the Choquet integral, a flexible aggregation operator for capturing attribute interactions under monotonicity constraints, into a mixed logit model. We find that effectiveness is the most important vaccine attribute, followed by risk of severe side effects and protection period. The attribute interactions reveal that non-pecuniary vaccine attributes are synergistic. Out-of-pocket costs are independent of effectiveness, incubation period, and mild side effects but exhibit moderate synergistic interactions with other attributes. Vaccine adoption is significantly more likely among individuals who identify as male, have obtained a bachelor's degree or a higher level of education, have a high household income, support the democratic party, had COVID-19, got vaccinated against the flu in winter 2020/21, and have an underlying health condition.

Association between health and safety perceptions of COVID-19 vaccine and its uptake in Ghana

Background

Attitudes towards vaccines have affected COVID-19 vaccination programs in many countries. This study sought to evaluate the effects of general perceptions on the safety and health concerns and the confidence in COVID-19 vaccines on its uptake in Ghana.

Methods

A cross-sectional online survey was conducted between January and March 2021. The outcome variables for this study were "Taking mandatory COVID-19 vaccine" and "Taking voluntary COVID-19 vaccine". The data were subjected to both descriptive (frequency, percentages, and chi-square tests) and inferential (complementary log-log logistic regression) analyses.

Results

Out of 620 Ghanians who participated in the survey, about 80% of the participants believed that vaccines were good for one's health and 73% had confidence on COVID-19 vaccine safety; although 81% of the respondents were particularly concerned about the source of the vaccine. 79% and 71% of respondents indicated their willingness for mandatory and voluntary COVID-19 vaccination, respectively. In all operationalized regression models, Ghanaians who believed that vaccines are healthy (OR = 1.998, Cl = 1.345-2.968; OR = 1.652, Cl = 1.050-2.601) and those who had confidence in a COVID-19 vaccine safety (OR = 4.405, Cl = 3.136-6.188; OR = 8.340, Cl = 5.471-12.713) were more likely to take a mandatory or voluntary COVID-19 vaccine compared to those who thought and believed otherwise. Individual preferences and/or intentions towards COVID-19 vaccine uptake and uptake route (i.e., mandatory, voluntary) were influenced by multifaceted determinants: biosocial (age, marital status, education), socio-cultural (religion, source of vaccine as a concern), and location (geographical zone) factors.

Conclusion

To consolidate and possibly increase vaccine uptake in response to the COVID-19 pandemic in Ghana, health education and promotion programs should aim at creating awareness on the benefits of vaccine uptake while addressing the health and safety concerns on the potential side effects through evidence-based community messaging from credible sources. It is important to show specific commitment to transparency and reliable information to build public trust by decision-makers.

A study on the willingness and influencing factors of novel coronavirus vaccination among medical personnel in North China

Aim

To understand the awareness of the willingness to be vaccinated and influencing factors of the new coronavirus vaccine (neo-crown vaccine) among medical personnel in North China and to provide a theoretical basis and application guidelines for the feasibility of coronavirus vaccination by medical personnel to guide the public to actively be vaccinated by taking initiative and obtaining a coronavirus vaccination as soon as possible.

Methods

From April 2021 to June 2021, medical staff in North China were selected to complete an online questionnaire survey using Questionnaire Star to analyze the willingness rate to be vaccinated with the new coronavirus vaccine, and the influencing factors were analyzed using binary logistic regression.

Results

Among 621 respondents, 85.7% were willing to be vaccinated after the launch of the new vaccine. In the questionnaire, respondents were asked to answer questions such as “Do you think it is better to receive as few vaccines as possible at the same time?,” “If I get the new coronavirus vaccine, I may have serious side effects.,” “The new coronavirus vaccine is safe.,” “Specifically, for the new coronavirus vaccine, do you think it is safe?,” and “Specifically, for the new coronavirus vaccine, do you think it is easy to administer?.” These beliefs have an important influence on the vaccination of medical staff with the new coronavirus vaccine in Northern China (OR = 1.610,95% CI: 1.055 ~ 2.456; OR = 1.715,95% CI: 1.164 ~ 2.526; OR = 0.401, 95% CI: 0.212 ~ 0.760; OR = 0.352,95% CI: 0.147 ~ 0.843; OR = 3.688,95% CI: 1.281 ~ 10.502, respectively; All P values < .05).

Conclusions

Medical staff have a high willingness to be vaccinated with the new coronavirus vaccine, which plays a positive role in the publicity of the vaccine.

Parental refusal and hesitancy of vaccinating children against COVID-19: Findings from a nationally representative sample of parents in the U.S

The uptake rate of COVID-19 vaccines among children remains low in the U.S. This study aims to 1) identify sociodemographic and behavioral factors influencing parental refusal of vaccinating children, and 2) quantify the relative importance of vaccine characteristics in parental hesitancy of vaccinating children. An online survey was conducted from October to November 2021 among a probability-based, representative sample of 1456 parents with children under age 18. The survey included a discrete choice experiment asking parents to choose between two hypothetical COVID-19 vaccine alternatives with varying levels of characteristics in 10 hypothetical scenarios. Logistic regressions were used to estimate parental refusal (refused to choose any vaccine alternatives in all hypothetical scenarios) and random parameter logit regressions were used to estimate parental hesitancy (choice of vaccine alternatives depended on vaccine characteristics) of vaccinating children. About 20% parents refused to vaccinate children. The refusal is predicted by parents' sociodemographic characteristics, political orientation, vaccination status, and parents' and children's previous exposure with COVID-19. Among parents who were willing to consider vaccinating children, the most important vaccine characteristics are risk of severe side effects (31.2% relative importance) and effectiveness (30.7%), followed by protection duration (22.6%), local coverage (9.4%), and hospitalization rate of unvaccinated children (6.1%). Our findings imply that policymakers and public health professionals could develop outreach programs at community level to encourage specific subgroups and focus on vaccination depoliticization. Effectively communicating the low risk of severe side effects and high effectiveness of the vaccines may relieve some of the parental hesitancy.

Perception of human papilloma virus (HPV) vaccination during the COVID-19 pandemic

The COVID 19 pandemic is far from over, and vaccines remain important tool for fighting the disease. As the preventive effects of the COVID-19 vaccine emerges, it is likely that the perception of importance and safety of vaccines have a positive effect on the acceptance of other vaccines. However, it is still unclear how COVID-19 pandemic has affected the general vaccination perception and acceptance. Therefore, the objective of this study was to investigate the impact of the COVID-19 pandemic on the perception of HPV vaccination. This study involved an offline survey of 161 women aged between 20 and 49 years who visited the gynecologic clinic at Chung-nam National University Sejong Hospital from January 2021 to June 2021. The questionnaire consists of items related to experience and knowledge of COVID-19 and HPV viruses, as well as attitudes toward HPV vaccination. Knowledge about COVID-19 virus and HPV correlated positively with their experiences (P = .011 and P = .045, respectively). Positive attitude was increased, and negative attitude was reduced toward HPV vaccination in the COVID-19 pandemic era. Participants stated that accurate information and cost reduction about HPV vaccine was needed to increase the HPV vaccination rate. During the COVID-19 pandemic era, positive attitudes towards HPV vaccination have tended to increase. To increase the HPV vaccination rate, public efforts are needed for further information and cost reduction.

Trade-Off between COVID-19 Pandemic Prevention and Control and Economic Stimulus

The coronavirus disease 2019 (COVID-19) pandemic has posed a severe threat to public health and economic activity. Governments all around the world have taken positive measures to, on the one hand, contain the epidemic spread and, on the other hand, stimulate the economy. Without question, tightened anti-epidemic policy measures restrain people's mobility and deteriorate the levels of social and economic activity. Meanwhile, loose policy measures bring little harm to the economy temporarily but could accelerate the transmission of the virus and ultimately wreck social and economic development. Therefore, these two kinds of governmental decision-making behaviors usually conflict with each other. With the purpose of realizing optimal socio-economic benefit over the full duration of the epidemic and to provide a helpful suggestion for the government, a trade-off is explored in this paper between the prevention and control of the epidemic, and economic stimulus. First, the susceptible-infectious-recovered (SIR) model is introduced to simulate the epidemic dynamics. Second, a state equation is constructed to describe the system state variable-the level of socio-economic activity dominated by two control variables. Specifically, these two variables are the strengths of the measures taken for pandemic prevention and control, and economic stimulus. Then, the objective function used to maximize the total socio-economic benefit over the epidemic's duration is defined, and an optimal control problem is developed. The statistical data of the COVID-19 epidemic in Wuhan are used to validate the SIR model, and a COVID-19 epidemic scenario is used to evaluate the proposed method. The solution is discussed in both static and dynamic strategies, according to the knowledge of the epidemic's duration. In the static strategy, two scenarios with different strengths (in terms of anti-epidemic and economic stimulus measures) are analyzed and compared. In the dynamic strategy, two global optimization algorithms, including the dynamic programming (DP) and Pontryagin's minimum principle (PMP), respectively, are used to acquire the solutions. Moreover, a sensitivity analysis of model parameters is conducted. The results demonstrate that the static strategy, which is independent of the epidemic's duration and can be easily solved, is capable of finding the optimal strengths of both policy measures. Meanwhile, the dynamic strategy, which generates global optimal trajectories of the control variables, can provide the path that leads to attaining the optimal total socio-economic benefit. The results reveal that the optimal total socio-economic benefit of the dynamic strategy is slightly higher than that of the static strategy.

The Willingness of Parents to Vaccinate Their Children Aged from Five to under Twelve Years with COVID-19 Vaccines between February and March 2022 in Vietnam

The current study used data surveyed with 5357 parents/guardians (parents would be used to represent both 'parents' and 'guardians' hereafter) between February and March 2022 in Vietnam to examine their willingness to vaccinate their children with current COVID-19 vaccines. It applied the multinomial logistic regression model to examine the association between the willingness of parents and selected influential factors. In addition, the reasons that made parent hesitant or unwilling to vaccinate their children were investigated. Moreover, it identified parents' preferences for vaccine origins. Approximately, 75.4% of the parents were willing, 21.3% were hesitant and 3.3% were unwilling to vaccinate their children. The most common reasons that made the parents hesitant or unwilling to vaccinate their children were their concerns about the vaccine safety, efficacy and immunity. The most and the second most preferred vaccines were those developed/originated in the US and EU, respectively. Parents who were more likely to vaccinate their children included those whose children were insured, who regularly vaccinated their children, who belonged to the vaccine priority groups, who possessed sufficient knowledge about the ways to prevent the virus or about the herd immunity, and who perceived that their children might be infected with the virus and whose children were afraid of needles. Parents who were less likely to vaccinate their children included those who were the family main income source, who had savings, and who had tertiary education or higher.

The effect of vaccination beliefs regarding vaccination benefits and COVID-19 fear on the number of vaccination injections

The Coronavirus disease pandemic of 2019 is a vast worldwide public health hazard, impacting people of all ages and socioeconomic statuses. Vaccination is one of the most effective methods of controlling a pandemic like COVID-19. This study aims to investigate the relationship between the number of vaccination injections and fear of COVID-19 and test whether beliefs benefit from vaccination COVID-19 mediate the effect of fear of COVID-19 on the number of vaccination injections. A total of 649 Vietnamese adults were enrolled online to finish answering, including scales The Health Belief Model (HBM) and The Fear of COVID-19 (FCV-19S), consisting of 340 (52.4%) males and 309 (47.6%) females. The data were analyzed using variance, regression, and a simple mediation model. The total score of COVID-19 fear was M = 22.26, SD = 5.49. Vietnamese fear of COVID-19 was at a medium level. Our results suggest that 18- to 20-year-olds are more fearful of COVID-19 than others. People who received the first dosage exhibited a greater fear of COVID-19 than those who received the second dose and were not inoculated. Additionally, the beliefs benefit of vaccination COVID-19 has a role in the relationship between the number of vaccination injections and fear of COVID-19. During the pandemic, adults in Vietnam are more afraid of COVID-19 than during prior outbreaks. Besides, the Vietnamese populace demonstrated a considerable demand for and high acceptability of the COVID-19 vaccine. The current study indicates that psychological counselors and therapists should counsel clients on the value of vaccination and address the fear of COVID-19 as public understanding of the benefits of vaccines increases. To further clarify the effect of this issue on the correlation between fear of COVID-19 and the number of vaccinations, the results of this study indicate that the existing vaccine communication factor for COVID-19 vaccination should be modified to increase confidence in the benefits of immunization.

Student COVID-19 vaccination preferences in China: A discrete choice experiment

Objective

This study uses a discrete choice experiment (DCE) questionnaire to investigate student vaccination preferences for both intrinsic and extrinsic attributes.

Methods

A two-part DCE questionnaire was distributed to 1,138 students through face-to-face interviews at vaccination centers in Qingdao, China. Conditional logit models were used to understand student preference trade-offs. Mixed logit models (MLM) and sub-group analysis were conducted to understanding student preference heterogeneity.

Results

We found that students preferred vaccines with fewer side effects (β = 0.845; 95% CI, 0.779-0.911), administered through third level health facilities (β = 0.170; 95% CI, 0.110-0.230), and had at least 1 year duration of protection (β = 0.396; 95% CI, 0.332-0.461. Higher perception of COVID-19 risks (β = 0.492; 95% CI, 0.432-0.552) increased the likelihood of student vaccination uptake. Surprisingly, vaccine effectiveness (60%) and percentages of acquaintances vaccinated (60%) reduced vaccination utility, which points to free-rider problems. In addition, we find that student study majors did not contribute to preference heterogeneity, and the main disparities in preferences were attributed to student risk tolerances.

Conclusion

Both intrinsic and extrinsic attributes were influential factors shaping student preferences for COVID-19 vaccines. Our results inform universities and local governments across China on targeting their vaccination programs.

COVID-19 Vaccines on TikTok: A Big-Data Analysis of Entangled Discourses

Focusing on social media affordances and China's social/political context, the present study analyzed the digital communication practices about COVID-19 vaccines on a popular social media platform-TikTok-which is called DouYin in China. Overall, this study identified five major forces partaking in constructing the discourses, with government agencies and state media being the dominant contributors. Furthermore, video posters demonstrated different patterns of utilizing social media affordances (e.g., hashtags) in disseminating their messages. The top hashtags adopted by state media were more representative of international relations and Taiwan; those by government agencies were of updates on pandemic outbreaks; those by individual accounts were of mainstream values and health education; those by commercial media were of celebrities and health education; those by enterprise accounts were of TikTok built-in marketing hashtags. The posted videos elicited both cognitive and affective feedback from online viewers. Implications of the findings were discussed in the context of health communication and global recovery against the backdrop of the COVID-19 pandemic and Chinese culture.

Malaysian public preferences and decision making for COVID-19 vaccination: A discrete choice experiment

BACKGROUND

Low vaccine uptake has the potential to seriously undermine COVID-19 vaccination programs, as very high coverage levels are likely to be needed for virus suppression to return life to normal. We aimed to determine the influence of vaccine attributes (including access costs) on COVID-19 vaccination preferences among the Malaysian public to improve national uptake.

METHODS

An online Discrete Choice Experiment (DCE) was conducted on a representative sample of 2028 Malaysians. Respondents were asked to make vaccination decisions in a series of hypothetical scenarios. A nested, mixed logit model was used to estimate the preferences for vaccination over vaccine refusal and for how those preferences varied between different sub-populations. The attributes were the risk of developing severe side effects of the vaccine, vaccine effectiveness, vaccine content, vaccination schedule, and distance from home to vaccination centre.

FINDINGS

Reported public uptake of COVID-19 vaccination was primarily influenced by the risk of developing severe side effects (b = -1·747, 95% CI = -2·269, -1·225), vaccine effectiveness (b = 3·061, 95% CI = 2·628, 3·494) and its Halal status (b = 3·722, 95% CI = 3·152, 4·292). Other factors such as appointment timing and travel distance to the vaccination centre also had an effect on vaccine uptake. There was substantial heterogeneity in preferences between different populations, particularly for age groups, ethnicity, regions, and underlying health conditions.

INTERPRETATION

Perceived effectiveness and side effects are likely to affect COVID-19 vaccine uptake in Malaysia. Halal content is critical to Malays' vaccination choices. Reducing the physical distance to vaccination centres, particularly in rural areas where uptake is lower, is likely to improve uptake.

FUNDING

Ministry of Health Research Grant from the Malaysian government [NIH/800-3/2/1 Jld.7(46), grant reference no: 57377 and warrant no: 91000776].

Does COVID-19 have an impact on influenza vaccine knowledge, attitude and practice among medical students: a 2-year prospective cohort study

OBJECTIVES

To explore the main factors affecting the knowledge, attitude and practice about influenza and influenza vaccine as well as the intention to receive influenza vaccination among the same group of medical students before (2019) and after (2021) the COVID-19 outbreak.

DESIGN

A population-based prospective cohort study.

SETTING

A longitudinal cohort study of a selected medical school in Chongqing, China, which ran from 2019 to 2021.

PARTICIPANTS

A total of 803 medical students participated in the study in 2019 and only 484 students responded in 2021. The response rate for our survey was only 60.27% due to graduation, emails being abandoned, etc. RESULTS: The influenza vaccination rate of students at this medical school was 6.7% in 2019, compared with 25.8% in 2021. The awareness rate of medical students about influenza and influenza vaccine was 82.8% in 2019 and 86% in 2021, and there was no significantly statistical difference between the 2 years (p=0.134); the number of medical students with supportive attitude towards influenza vaccine was 95.1% in 2019 and 97.1% in 2021, and there was no statistically significant difference between the 2 years (p=0.078); the number of students who actively learnt about knowledge related to influenza vaccine rose from 183 (22.8%) in 2019 to 195 (40.3%) in 2021.

CONCLUSIONS

The COVID-19 outbreak prompted an increase in influenza vaccination rates among medical students in Chongqing, with almost all students (96.0%) believing that the spread of COVID-19 promoted their knowledge about influenza and influenza vaccine, and the vast majority (74.8%) believing that the spread of COVID-19 promoted their willingness to receive influenza vaccine.

Applications of discrete choice experiments in COVID-19 research: Disparity in survey qualities between health and transport fields

Published choice experiments linked to various aspects of the COVID-19 pandemic are analysed in a rapid review. The aim is to (i) document the diversity of topics as well as their temporal and geographical patterns of emergence, (ii) compare various elements of design quality across different sectors of applied economics, and (iii) identify potential signs of convergent validity across findings of comparable experiments. Of the N = 43 published choice experiments during the first two years of the pandemic, the majority identifies with health applications (n = 30), followed by transport-related applications (n = 10). Nearly 100,000 people across the world responded to pandemic-related discrete choice surveys. Within health applications, while the dominant theme, up until June 2020, was lockdown relaxation and tracing measures, the focus shifted abruptly to vaccine preference since then. Geographical origins of the health surveys were not diverse. Nearly 50% of all health surveys were conducted in only three countries, namely US, China and The Netherlands. Health applications exhibited stronger pre-testing and larger sample sizes compared to transport applications. Limited signs of convergent validity were identifiable. Within some applications, issues of temporal instability as well as hypothetical bias attributable to social desirability, protest response or policy consequentiality seemed likely to have affected the findings. Nevertheless, very few of the experiments implemented measures of hypothetical bias mitigation and those were limited to health studies. Our main conclusion is that swift administration of pandemic-related choice experiments has overall resulted in certain degrees of compromise in study quality, but this has been more so the case in relation to transport topics than health topics.

Public Preferences and Willingness to Pay for a COVID-19 Vaccine in Iran: A Discrete Choice Experiment

BACKGROUND AND OBJECTIVE

The coronavirus disease 2019 (COVID-19) pandemic is a major international threat and vaccination is the most robust strategy to terminate this crisis. It is helpful for policymakers to be aware of community preferences about vaccines. The present study aims to investigate the public's preferences and willingness to pay for the COVID-19 vaccine in Iran.

METHODS

This research is a cross-sectional study performed using a discrete choice experiment for a sample of the public population of several provinces of Iran in 2021. The samples were divided into two groups: one group expressed their preferences regarding the vaccine's attributes, and another group expressed their preferences regarding prioritizing individuals to get the vaccine. The discrete choice experiment design included five attributes including effectiveness, risk of severe complications, price, location of vaccine production, and duration of protection related to preferences for vaccine selection and six attributes including age, underlying diseases, employment in the healthcare sector, the rate of virus spread, the necessary job, and cost to the community related to preferences for prioritizing individuals to get the vaccine. A total of 715 individuals completed the questionnaire. The conditional logit regression model was used to analyze the discrete choice experiment data. Willingness to pay for each attribute was also calculated.

RESULTS

The willingness to pay for the COVID-19 vaccine with 90% (70%) efficacy, the risk of severe complications for 1 (5) person per one million people, imported (domestic) vaccine, and 24-month (12-month) duration of protection attributes was about US$71 (US$37). The preference for vaccination for respondents was enhanced by increasing the efficacy and the duration of vaccine protection and decreasing complications and costs. The likelihood of prioritizing individuals to get a vaccination was increased for a person with an underlying disease, employment in the healthcare sector, the necessary job for the community, the high potential for virus spread in the community, and the high cost of death to the community. The age variable was not statistically significant for prioritizing individuals to get the vaccine.

CONCLUSIONS

In the setting of the COVID-19 vaccination program, the public's preferences identified in this study should be considered. The obtained results provide useful information for policymakers to identify individual and social values for an appropriate vaccination strategy.

A Systematic Investigation of American Vaccination Preference via Historical Data

While COVID-19 vaccines are generally available, not all people receive vaccines. To reach herd immunity, most of a population must be vaccinated. It is, thus, important to identify factors influencing people’s vaccination preferences, as knowledge of these preferences allows for governments and health programs to increase their vaccine coverage more effectively. Fortunately, vaccination data were collected by U.S. Census Bureau in partnership with the CDC via the Household Pulse Survey (HPS) for Americans. This study presents the first analysis of the 24 vaccination datasets collected by the HPS from January 2021 to May 2022 for 250 million respondents of different ages, genders, sexual orientations, races, education statuses, marital statuses, household sizes, household income levels, and resources used for spending needs, and with different reasons for not receiving or planning to receive a vaccine. Statistical analysis techniques, including an analysis of variance (ANOVA), Tukey multiple comparisons test, and hierarchical clustering (HC), were implemented to analyze the HPS vaccination data in the R language. It was found that sexual orientation, gender, age, and education had statistically significant influences on the vaccination rates. In particular, the gay/lesbian group showed a higher vaccination rate than the straight group; the transgender group had a lower vaccination rate than either the female or the male groups; older respondents showed greater preference for vaccination; respondents with higher education levels also preferred vaccination. As for the other factors that were not significant enough to influence vaccinations in the ANOVA, notable trends were found. Asian Americans had higher vaccination rates than other races; respondents from larger household sizes had a lower chance of getting vaccinated; the unmarried group showed the lowed vaccination rate in the marital category; the respondents depending on borrowed money from the Supplemental Nutrition Assistance Program (SNAP) showed a lower vaccination rate than people with regular incomes. Concerns regarding the side-effects and the safety of the vaccines were the two major reasons for vaccination hesitance at the beginning of the pandemic, while having no trust in the vaccines and no trust in the government became more common in the later stage of the pandemic. The findings in this study can be used by governments or organizations to improve their vaccination campaigns or methods of combating future pandemics.

Childhood COVID-19 vaccine acceptance and preference from caregivers and healthcare workers in China: A survey experiment

With approval of more COVID-19 vaccines for children, vaccine attributes may influence parental acceptance and choices. We aimed to assess effects of vaccine attributes and information on herd immunity on childhood COVID-19 vaccine acceptance. A survey experiment was conducted with caregivers of children aged 6 months to 11 years old and health care workers (HCWs) in China from September 14 to November 18, 2021. Respondents were randomly assigned to receive differing information on herd immunity (> 80% of the entire population must be vaccinated; or no information). Respondents then completed eight discrete choice tasks to assess vaccine acceptance based on attributes. 2331 (90.07%) of 2588 surveyed caregivers and 1576 (92.71%) of 1700 surveyed HCWs would accept COVID-19 vaccination for children, respectively. High Odds Ratios (OR) were found for acceptance of a vaccine with 90% over 50% efficacy (OR 6.70 [95% CI 6.11-7.35] for caregivers; 11.44 [10.12-12.95] for HCWs); and risk of adverse reactions to be 1 over 10 in 10,000 (3.96 [3.72-4.22] for caregivers; 2.98 [2.76-3.22] for HCWs). To achieve herd immunity target (> 80% vaccination coverage), vaccine efficacy should reach over 70% and risk of adverse reactions lower than 1 in 10,000. Knowledge on herd immunity target increased the odds of vaccine acceptance (1.82 [1.34-2.46] for caregivers; 2.42 [1.58-3.72] for HCWs). Childhood COVID-19 vaccine acceptance was high in China, independent of child's age, and depended on vaccine attributes.

Public Preferences for Policies to Promote COVID-19 Vaccination Uptake: A Discrete Choice Experiment in The Netherlands

OBJECTIVES

The COVID-19 pandemic forms an unprecedented public health, economic, and social crisis. Uptake of vaccination is critical for controlling the pandemic. Nevertheless, vaccination hesitancy is considerable, requiring policies to promote uptake. We investigate Dutch citizens' preferences for policies that aim to promote vaccination through facilitating choice of vaccination, profiling it as the norm, making vaccination more attractive through rewards, or punishing people who reject vaccination.

METHODS

We conducted a discrete choice experiment in which 747 respondents were asked to choose between policies to promote vaccination uptake and their impacts on the number of deaths, people with permanent health problems, households with income loss, and a tax increase.

RESULTS

Respondents generally had a negative preference for policies that promote vaccination. They particularly disliked policies that punish those who reject the vaccine and were more favorable toward policies that reward vaccination, such as awarding additional rights to vaccinated individuals through vaccination passports. Respondents who reject vaccination were in general much more negative about the policy options than respondents who consider accepting the vaccine. Nevertheless, vaccination passports are supported by both respondents who accept the vaccine, those who reject vaccination, and those who are unsure about vaccination.

CONCLUSIONS

This study provides concrete directions for governments attempting to increase the vaccination uptake in ways that are supported by the public. Our results could encourage policy makers to focus on policy options that make vaccination easier and reward people who take the vaccine, as especially the implementation of vaccination passports was supported.