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Chicoine N, Schnipper N, Griffin J. The role of hesitancy and infrastructure in the equity and efficiency of COVID-19 vaccine administration. PLoS One 2024; 19:e0304416. [PMID: 38875217 PMCID: PMC11178164 DOI: 10.1371/journal.pone.0304416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 05/12/2024] [Indexed: 06/16/2024] Open
Abstract
After the first COVID-19 vaccines received emergency use authorization from the U.S. FDA in December 2020, U.S. states employed vaccine eligibility and administration plans (VEAPs) that determined when subgroups of residents would become eligible to receive the vaccine while the vaccine supply was still limited. During the implementation of these plans, public concern grew over whether the VEAPs and vaccine allocations from the federal government were resulting in an equitable and efficient vaccine distribution. In this study, we collected data on five states' VEAPs, federal vaccine allocations, vaccine administration, and vaccine hesitancy to assess the equity of vaccine access and vaccine administration efficiency that manifested during the campaign. Our results suggest that residents in states which opened eligibility to the vaccine sooner had more competition among residents to receive the vaccine than occurred in other states. Regardless of states' VEAPs, there was a consistent inefficiency in vaccine administration among all five states that could be attributed to both state and federal infrastructure deficits. A closer examination revealed a misalignment between federal vaccine allocations and the total eligible population in the states throughout the campaign, even when accounting for hesitancy. We conclude that in order to maximize the efficiency of future mass-vaccination campaigns, the federal and state governments should design adaptable allocation policies and eligibility plans that better match the true, real-time supply and demand for vaccines by accounting for vaccine hesitancy and manufacturing capacity. Further, we discuss the challenges of implementing such strategies.
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Affiliation(s)
- Noah Chicoine
- Department of Mechanical and Industrial Engineering, Northeastern University, Boston, MA, United States of America
| | - Noah Schnipper
- Division of Engineering, Lafayette College, Easton, PA, United States of America
| | - Jacqueline Griffin
- Department of Mechanical and Industrial Engineering, Northeastern University, Boston, MA, United States of America
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Marinthe G, Brown G, Cristea M, Kutlaca M. Predicting vaccination hesitancy: The role of basic needs satisfaction and institutional trust. Vaccine 2024; 42:3592-3600. [PMID: 38704252 DOI: 10.1016/j.vaccine.2024.04.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 01/15/2024] [Accepted: 04/23/2024] [Indexed: 05/06/2024]
Abstract
Autonomous motivation is considered a powerful driver of health behaviour, but less is known about the specific roles played by basic needs. Drawing on the context of the COVID-19 pandemic, this research examined basic needs as a motivational determinant of vaccination. We hypothesized that satisfaction of basic needs (autonomy, competence, relatedness) has both a direct and an indirect effect (through trust in science and government) on vaccine hesitancy. Two studies (Study 1: N = 968 French and British; Study 2, pre-registered: N = 716 Americans) tested our hypotheses and compared vaccinated and non-vaccinated individuals using multigroup structural equation models. We found positive direct (in both studies) and indirect (in Study 1) effects of autonomy satisfaction on vaccine acceptance. In contrast, competence satisfaction was directly and indirectly, via science mistrust, related to vaccine hesitancy, particularly among non-vaccinated people. Competence satisfaction also indirectly reduced the intention to vaccinate in both studies. We found no impact of relatedness. Complementing previous work on self-determination theory, our research demonstrates the importance of considering the distinct roles of basic needs. Moreover, we highlight that increasing autonomy and science trust may be an efficient strategy to improve vaccine acceptance and vaccination, even among reluctant individuals.
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Affiliation(s)
- Gaëlle Marinthe
- Laboratoire Parisien de Psychologie Sociale, University of Paris 8 Vincennes, 2 rue de la Liberté, 93200 Saint-Denis, France.
| | - Genavee Brown
- Department of Psychology, Northumbria University, Ellison Pl, Newcastle upon Tyne NE1 8ST, United Kingdom.
| | - Mioara Cristea
- School of Social Sciences, Heriot Watt University, Edinburgh EH14 4AS, United Kingdom.
| | - Maja Kutlaca
- Department of Psychology, Durham University, Upper Mountjoy, South Rd, Durham DH1 3LE, United Kingdom.
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Guo X, Han Q, Wang Y, Zhang R, Huang Y, Guo B. Influenza Vaccine Hesitancy among Cancer Survivors in China: A Multicenter Survey. Vaccines (Basel) 2024; 12:639. [PMID: 38932368 PMCID: PMC11209103 DOI: 10.3390/vaccines12060639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 06/03/2024] [Accepted: 06/06/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND Cancer survivors are at higher risk of developing severe complications from influenza due to their compromised immune systems. Despite their increased vulnerability to influenza and the availability of vaccines, vaccine hesitancy among cancer survivors remains a significant public health concern in China. METHODS A multicenter, cross-sectional study was conducted among cancer survivors in China from January to December 2023. A total of 500 participants were recruited from the oncology departments of five tertiary hospitals. A structured, self-administered questionnaire was used to collect data on socio-demographic characteristics, cancer-related information, medical history, lifestyle factors, and influenza vaccine hesitancy. Univariate and multivariate logistic regression analyses were performed to identify factors associated with influenza vaccine hesitancy. RESULTS The response rate was 97.0% (485/500). Among all participants, 204 (42.06%) reported vaccine hesitancy. The results of multiple logistic regression showed that the longer the end of anti-cancer treatment, without a history of adverse vaccine reactions, and the level of family support played a protective role in vaccine hesitancy. Current rehabilitation status, frequent colds, not being informed by doctors about vaccination, exercising, lack of community vaccination education programs, and concerns about vaccine safety were risk factors that increase vaccine hesitancy. CONCLUSIONS A high proportion of cancer survivors in our study reported influenza vaccine hesitancy. Addressing concerns about vaccine safety, improving access to vaccination services, and enhancing doctor-patient communication are crucial for increasing influenza vaccine uptake in this vulnerable population.
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Affiliation(s)
- Xin Guo
- Department of General Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, China (R.Z.)
| | - Qi Han
- Department of General Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, China (R.Z.)
| | - Yuqin Wang
- Department of General Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, China (R.Z.)
| | - Rui Zhang
- Department of General Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, China (R.Z.)
| | - Yuenan Huang
- Department of General Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China
| | - Botang Guo
- Department of Medical Psychology, Harbin Medical University, Baojian Road 158, Harbin 150078, China
- Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University Medical School, Shenzhen 518001, China
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McClymont H, Hu W. The effect of public health interventions on COVID-19 incidence in Queensland, Australia: a spatial cluster analysis. Infect Dis (Lond) 2024; 56:460-475. [PMID: 38446488 DOI: 10.1080/23744235.2024.2324355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 02/23/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Using SaTScan™ Geographical Information Systems (GIS), spatial cluster analysis was used to examine spatial trends and identify high-risk clusters of Coronavirus 2019 (COVID-19) incidence in response to changing levels of public health intervention phases including international and state border closures, statewide vaccination coverage, and masking requirements. METHODS Changes in COVID-19 incidence were mapped at the statistical area 2 (SA2) level using a GIS and spatial cluster analysis was performed using SaTScan™ to identify most-likely clusters (MLCs) during intervention phases. RESULTS Over the study period, significant high-risk clusters were identified in Brisbane city (relative risk = 30.83), the southeast region (RR = 1.71) and moving to Far North Queensland (FNQ) (RR = 2.64). For masking levels, cluster locations were similar, with MLC in phase 1 in the southeast region (RR = 2.56) spreading to FNQ in phase 2 (RR = 2.22) and phase 3 (RR = 2.64). All p values <.0001. CONCLUSIONS Movement restrictions in the form of state and international border closures were highly effective in delaying the introduction of COVID-19 into Queensland, with very low levels of transmission prior to border reopening while mandatory masking may have played a role in decreasing transmission through behavioural changes. Early clusters were in highly populated regions, as restrictions eased clusters were identified in regions more likely to be rural or remote, with higher numbers of Indigenous people, lower vaccination coverage or lower socioeconomic status.
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Affiliation(s)
- Hannah McClymont
- School of Public Health and Social Work, Ecosystem Change, Population Health and Early Warning (ECAPH) Research Group, Queensland University of Technology (QUT), Brisbane, Australia
| | - Wenbiao Hu
- School of Public Health and Social Work, Ecosystem Change, Population Health and Early Warning (ECAPH) Research Group, Queensland University of Technology (QUT), Brisbane, Australia
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Sharif-Nia H, She L, Allen KA, Marôco J, Kaur H, Arslan G, Gorgulu O, Osborne JW, Rahmatpour P, Khoshnavay Fomani F. Parental hesitancy toward children vaccination: a multi-country psychometric and predictive study. BMC Public Health 2024; 24:1348. [PMID: 38762744 PMCID: PMC11102617 DOI: 10.1186/s12889-024-18806-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 05/09/2024] [Indexed: 05/20/2024] Open
Abstract
AIM Understanding vaccine hesitancy, as a critical concern for public health, cannot occur without the use of validated measures applicable and relevant to the samples they are assessing. The current study aimed to validate the Vaccine Hesitancy Scale (VHS) and to investigate the predictors of children's vaccine hesitancy among parents from Australia, China, Iran, and Turkey. To ensure the high quality of the present observational study the STROBE checklist was utilized. DESIGN A cross-sectional study. METHOD In total, 6,073 parent participants completed the web-based survey between 8 August 2021 and 1 October 2021. The content and construct validity of the Vaccine Hesitancy Scale was assessed. Cronbach's alpha and McDonald's omega were used to assess the scale's internal consistency, composite reliability (C.R.) and maximal reliability (MaxR) were used to assess the construct reliability. Multiple linear regression was used to predict parental vaccine hesitancy from gender, social media activity, and perceived financial well-being. RESULTS The results found that the VHS had a two-factor structure (i.e., lack of confidence and risk) and a total of 9 items. The measure showed metric invariance across four very different countries/cultures, showed evidence of good reliability, and showed evidence of validity. As expected, analyses indicated that parental vaccine hesitancy was higher in people who identify as female, more affluent, and more active on social media. CONCLUSIONS The present research marks one of the first studies to evaluate vaccine hesitancy in multiple countries that demonstrated VHS validity and reliability. Findings from this study have implications for future research examining vaccine hesitancy and vaccine-preventable diseases and community health nurses.
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Affiliation(s)
- Hamid Sharif-Nia
- Psychosomatic Research Center, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Nursing, Amol School of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
| | - Long She
- Sunway Business School, Sunway University, Sunway City, Malaysia
| | - Kelly-Ann Allen
- School of Educational Psychology and Counselling, Faculty of Education, Monash University, Clayton, Australia
- Centre for Wellbeing Science, Faculty of Education, University of Melbourne, Parkville, Australia
| | - João Marôco
- William James Centre for Research ISPA - Instituto Universitário, Lisboa, Portugal
| | - Harpaljit Kaur
- Business School, Taylor's University Lakeside Campus, Subang Jaya, Malaysia
| | - Gökmen Arslan
- Department of Psychological Counseling, Burdur Mehmet Akif Ersoy University, Burdur, Turkey
| | - Ozkan Gorgulu
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Kırşehir Ahi Evran University, Kırşehir, Turkey
| | | | - Pardis Rahmatpour
- School of Nursing, Alborz University of Medical Sciences, Karaj, Iran
| | - Fatemeh Khoshnavay Fomani
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
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Nyalundja AD, Bugeme PM, Ntaboba AB, Hatu’m VU, Ashuza GS, Tamuzi JL, Ndwandwe D, Iwu-Jaja C, Wiysonge CS, Katoto PDMC. COVID-19 Vaccine Hesitancy and Associated Oral Cholera Vaccine Hesitancy in a Cholera-Endemic Country: A Community-Based Cross-Sectional Study in the Democratic Republic of Congo. Vaccines (Basel) 2024; 12:444. [PMID: 38675826 PMCID: PMC11053998 DOI: 10.3390/vaccines12040444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 04/09/2024] [Accepted: 04/14/2024] [Indexed: 04/28/2024] Open
Abstract
COVID-19 vaccine hesitancy and its enablers shape community uptake of non-covid vaccines such as the oral cholera vaccine (OCV) in the post-COVID-19 era. This study assessed the impact of COVID-19 vaccine hesitancy and its drivers on OCV hesitancy in a cholera-endemic region of the Democratic Republic of Congo. We conducted a community-based survey in Bukavu. The survey included demographics, intention to take OCV and COVID-19 vaccines, reasons for COVID-19 hesitancy, and thoughts and feelings about COVID-19 vaccines. Poisson regression analyses were performed. Of the 1708 respondents, 84.66% and 77.57% were hesitant to OCV alone and to both OCV and COVID-19, respectively. Hesitancy to COVID-19 vaccines rose OCV hesitancy by 12% (crude prevalence ratio, [cPR] = 1.12, 95%CI [1.03-1.21]). Independent predictors of OCV hesitancy were living in a semi-urban area (adjusted prevalence ratio [aPR] = 1.10, 95%CI [1.03-1.12]), religious refusal of vaccines (aPR = 1.06, 95%CI [1.02-1.12]), concerns about vaccine safety (aPR = 1.05, 95%CI [1.01-1.11]) and adverse effects (aPR = 1.06, 95%CI [1.01-1.12]), as well as poor vaccine literacy (aPR = 1.07, 95%CI [1.01-1.14]). Interestingly, the belief in COVID-19 vaccine effectiveness reduced OCV hesitancy by 24% (aPR = 0.76, 95%CI [0.62-0.93]). COVID-19 vaccine hesitancy and its drivers exhibited a significant domino effect on OCV uptake. Addressing vaccine hesitancy through community-based health literacy and trust-building interventions would likely improve the introduction of novel non-COVID-19 vaccines in the post-COVID-19 era.
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Affiliation(s)
- Arsene Daniel Nyalundja
- Center for Tropical Diseases and Global Health (CTDGH), Catholic University of Bukavu (UCB), Bukavu 285, Democratic Republic of the Congo; (A.D.N.); (P.M.B.)
- Faculty of Medicine, Catholic University of Bukavu (UCB), Bukavu 285, Democratic Republic of the Congo; (A.B.N.); (V.U.H.); (G.S.A.)
| | - Patrick Musole Bugeme
- Center for Tropical Diseases and Global Health (CTDGH), Catholic University of Bukavu (UCB), Bukavu 285, Democratic Republic of the Congo; (A.D.N.); (P.M.B.)
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Alain Balola Ntaboba
- Faculty of Medicine, Catholic University of Bukavu (UCB), Bukavu 285, Democratic Republic of the Congo; (A.B.N.); (V.U.H.); (G.S.A.)
| | - Victoire Urbain Hatu’m
- Faculty of Medicine, Catholic University of Bukavu (UCB), Bukavu 285, Democratic Republic of the Congo; (A.B.N.); (V.U.H.); (G.S.A.)
| | - Guillaume Shamamba Ashuza
- Faculty of Medicine, Catholic University of Bukavu (UCB), Bukavu 285, Democratic Republic of the Congo; (A.B.N.); (V.U.H.); (G.S.A.)
| | - Jacques Lukenze Tamuzi
- Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town 7505, South Africa;
| | - Duduzile Ndwandwe
- Cochrane South Africa, South African Medical Research Council, Cape Town 7501, South Africa; (D.N.); (C.I.-J.); (C.S.W.)
| | - Chinwe Iwu-Jaja
- Cochrane South Africa, South African Medical Research Council, Cape Town 7501, South Africa; (D.N.); (C.I.-J.); (C.S.W.)
| | - Charles Shey Wiysonge
- Cochrane South Africa, South African Medical Research Council, Cape Town 7501, South Africa; (D.N.); (C.I.-J.); (C.S.W.)
- Vaccine-Preventable Diseases Programme, World Health Organization Regional Office for Africa, Brazzaville P.O. Box 06, Congo
| | - Patrick D. M. C. Katoto
- Center for Tropical Diseases and Global Health (CTDGH), Catholic University of Bukavu (UCB), Bukavu 285, Democratic Republic of the Congo; (A.D.N.); (P.M.B.)
- Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town 7505, South Africa;
- Cochrane South Africa, South African Medical Research Council, Cape Town 7501, South Africa; (D.N.); (C.I.-J.); (C.S.W.)
- Centre for General Medicine and Global Health, Department of Medicine, University of Cape Town, Cape Town 7505, South Africa
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Tan H, Liu J, Zhang Y. Effects of COVID-19 vaccine safety framing on parental reactions. PLoS One 2024; 19:e0302233. [PMID: 38626128 PMCID: PMC11020397 DOI: 10.1371/journal.pone.0302233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 03/29/2024] [Indexed: 04/18/2024] Open
Abstract
As a major concern shared by parents globally, COVID-19 vaccine safety is typically being messaged to the public in a negative frame in many countries. However, whether the COVID-19 vaccine safety framing have an effect on parents when vaccinating their children is unclear. Here we implement an online survey with a convenience sample of 3,861 parents living in mainland China, all over 18 years old and with at least one child under 18. The parents were randomly assigned to receive information about COVID-19 vaccine safety in either a negative frame (incidence of side effects) or a positive frame (the inverse incidence of side effects), to compare parental reactions to a range of questions about communication, risk perception, trust, involvement and behavioral intention. We found that parents were more likely to regard vaccine safety as relevant to policy support and as a higher priority for government when receiving positively framed information (p = 0.002). For some specific subgroups, parents in positive framing group showed lower risk perception and higher trust (p<0.05). This suggests that positive framing of COVID-19 vaccine safety messages show more effective performance than negative framing in terms of involvement, as well as trust and risk perception in specific subgroups, which may lead to a reflection on whether to adjust the current widespread use of negative framing. Our findings inform how governments and health care workers strategically choose the framing design of COVID-19 vaccine safety information, and have important implications for promoting COVID-19 vaccination in children in the future.
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Affiliation(s)
- Hao Tan
- Lushan Lab, Hunan University, Changsha, China
- School of Design, Hunan University, Changsha, China
| | - Jiayan Liu
- Lushan Lab, Hunan University, Changsha, China
- School of Design, Hunan University, Changsha, China
| | - Yingli Zhang
- Lushan Lab, Hunan University, Changsha, China
- School of Design, Hunan University, Changsha, China
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Cameron DB, Grage L, Van Wyck R, Edwards A, Chavez Mapaye J, Cheng A, Garcia G. Identifying trusted local sources and predicting behavior change pathways according to COVID-19 vaccination status: Results of a 2022 statewide survey of Alaskan adults. Vaccine 2024; 42:2592-2607. [PMID: 38490821 PMCID: PMC11005074 DOI: 10.1016/j.vaccine.2024.03.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 03/08/2024] [Accepted: 03/09/2024] [Indexed: 03/17/2024]
Abstract
BACKGROUND Low rates of COVID-19 vaccination remain a substantial public health challenge. Despite early successes, vaccinations of Alaskans trail the US average, drawing attention to the need for better-designed and targeted vaccine confidence interventions. Our objective was to assess levels of community trust and theory-driven predictors of vaccination status to inform the design of future programs. METHODS We conducted a cross-sectional, telephone-based survey of 940 Alaskan adults between May and June 2022. Data were collected on vaccination status (including initial vaccination and receipt of booster shots), trust in local community members, demographic characteristics, and thematic questions designed using the Capability, Opportunity, Motivation - Behavior (COM-B) model to examine possible predictors (barriers/facilitators) of vaccination status. FINDINGS Among those who are not fully vaccinated and boosted, we observe significantly lower trust placed in many immediate community members, especially health workers (e.g., doctors, nurses, specialty care physicians, health administrators). Firefighters and emergency medical technicians enjoy the most community trust, followed by medical professionals. Among those who received only a primary vaccine series, we find that perceptions of whether close friends are vaccinated, a sense of professional responsibility, and age were the strongest predictors vaccination status. Among the unvaccinated, we find significant predictive power from the same variables, as well as perceptions of whether family members are vaccinated, perceived risks from non-vaccination and whether vaccination is a healthy choice. CONCLUSIONS These findings will help inform the design and targeting of future vaccine promotion interventions to adult populations in Alaska. Interventions that leverage reflective motivation and social opportunity domains of the COM-B framework may be most effective. Local community members including firefighters and emergency medical technicians, as well as medical professionals may be perceived as the most trustworthy and influential messengers among those who are not fully vaccinated and boosted.
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Affiliation(s)
- Drew B Cameron
- Department of Health Policy and Management, Yale School of Public Health, Yale University, 60 College Street, New Haven, CT 06502, United States.
| | - Laura Grage
- Information Insights, PO Box 83070, Fairbanks, AK 99708, United States.
| | - Rebecca Van Wyck
- DPHS Institute for Circumpolar Health Sciences, University of Alaska, Anchorage, 3211 Providence Dr., Anchorage, AK 99508, United States; Institute for Social and Economic Research, University of Alaska, Anchorage, 3211 Providence Dr., Anchorage, AK 99508, United States.
| | - Alexandra Edwards
- Institute for Social and Economic Research, University of Alaska, Anchorage, 3211 Providence Dr., Anchorage, AK 99508, United States; Center for Behavioral Health Research & Services, University of Alaska, Anchorage, 3211 Providence Dr., Anchorage, AK 99508, United States.
| | - Joy Chavez Mapaye
- Department of Journalism and Public Communications, Fine Arts Building, 3211 Providence Drive, Anchorage, AK 99508, United States.
| | - Ann Cheng
- Department of Social and Behavioral Sciences, Yale School of Public Health, Yale University, 60 College Street, New Haven, CT 06502, United States; L&M Policy Research, 1743 Connecticut Ave NW, Suite 200, Washington, DC 20009, United States.
| | - Gabriel Garcia
- Division of Population Health Sciences, University of Alaska, 3211 Providence Dr., PSB 206J, Anchorage, AK 99508, United States.
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Drabo EF, Kelley MA, Gong CL. Appealing to Americans' altruism is not enough to nudge them to accept novel vaccines. J Public Health (Oxf) 2024:fdae048. [PMID: 38570896 DOI: 10.1093/pubmed/fdae048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 02/06/2024] [Accepted: 03/19/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND The role of altruism in the acceptance of novel preventive healthcare technologies like vaccines has not been thoroughly elucidated. METHODS We 1:1 randomized n = 2004 Amazon Mechanical Turk (MTurk) participants residing in the USA into a control or treatment arm with vaccination decisions framed altruistically, to elicit their preferences for COVID-19 vaccination using web-based discrete choice experiments. We used conditional and mixed logit models to estimate the impact of framing decisions in terms of altruism on vaccination acceptance. RESULTS Valid responses were provided by 1674 participants (control, n = 848; treatment, n = 826). Framing vaccination decisions altruistically had no significant effect on vaccination acceptance. Further, respondents' degree of altruism had no association with vaccination acceptance. LIMITATIONS The MTurk sample may not be representative of the American population. We were unable to ascertain concordance between stated and revealed preferences. CONCLUSIONS AND IMPLICATIONS Framing vaccination decisions in terms of altruism does not appear to significantly influence vaccination acceptance and may not be an effective nudging mechanism to increase the uptake of novel vaccines. Instead, a favorable vaccination profile appears to be the primary driver of uptake.
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Affiliation(s)
- Emmanuel F Drabo
- Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Marcella A Kelley
- Leonard D. Schaeffer Center for Health Policy & Economics, University of Southern California, Los Angeles, CA 90007, USA
| | - Cynthia L Gong
- Division of Neonatology, Department of Pediatrics, Children's Hospital Los Angeles, Keck School of Medicine, Fetal and Neonatal Institute, University of Southern California, Los Angeles, CA 90027, USA
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Lamot M, Kirbiš A. Multilevel analysis of COVID-19 vaccination intention: the moderating role of economic and cultural country characteristics. Eur J Public Health 2024; 34:380-386. [PMID: 38569192 PMCID: PMC10990524 DOI: 10.1093/eurpub/ckae022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND Predictors of COVID-19 (coronavirus) vaccination have been extensively researched; however, the contextual factors contributing to understanding vaccination intention remain largely unexplored. The present study aimed to investigate the moderating role of economic development (Gross domestic product - GDP per capita), economic inequality (Gini index), the perceived corruption index and Hofstede's measurements of cultural values-index of individualism/collectivism and power distance index-in the relationship between determinants of satisfaction with the healthcare system, trust in political institutions, conspiracy beliefs and COVID-19 vaccination intention. METHODS A multilevel modelling approach was employed on a sample of approximately 51 000 individuals nested within 26 countries. Data were drawn from the European Social Survey Round 10. The model examined the effect of individual- and country-level predictors and their interaction on vaccination intention. RESULTS Satisfaction with the healthcare system had a stronger positive effect on intention to get vaccinated in countries with lower perceived corruption and more individualistic countries. Trust in political institutions had a stronger positive effect on vaccination intention in countries with higher economic development and lower perceived corruption, while a negative effect of conspiracy beliefs on vaccination intention was stronger in countries with lower economic development, higher perceived corruption and a more collectivistic cultural orientation. CONCLUSION Our findings highlight the importance of considering individual and contextual factors when addressing vaccination intention.
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Affiliation(s)
- Monika Lamot
- Department of Sociology, Faculty of Arts, University of Maribor, Maribor, Slovenia
| | - Andrej Kirbiš
- Department of Sociology, Faculty of Arts, University of Maribor, Maribor, Slovenia
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11
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Barlow M, Jones P, Weerasuria M, O'Bryan J, Spelman D, Woolley I. Impact of COVID-19 on people with non-functioning spleens in Australia. J Infect Public Health 2024; 17:657-662. [PMID: 38430719 DOI: 10.1016/j.jiph.2024.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 02/05/2024] [Accepted: 02/11/2024] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND COVID-19 has had enormous impact on health and social systems, with stringent public health measures enacted across Australia. The virus itself disproportionately affects immunocompromised individuals including people without functioning spleens. We thus sought to characterise the psychological and physical impact of COVID-19 and such measures upon this oft-neglected patient group. METHODS Adults ≥ 18 years old identified from the Spleen Australia (SA) database were invited to participate in an online survey in November to December 2021 to assess the impact of the COVID-19 pandemic. Stata (v17, StataCorps, Texas, USA) was used to conduct descriptive and frequency analyses. RESULTS 2864 respondents were surveyed. The majority were female (1473/2838, 51.9%), Australian-born (2257/2835, 79.6%), and living in Victoria (1755/2822, 62.2%). The largest age group was 61-70 years-old (841/2858, 29.4%). Trauma was the commonest reason for asplenia (826/2724, 30.3%). Respondents reported the pandemic reduced their ability to visit a GP (753/2864, 26.3%), access food (153/2864, 5.3%), medications (179/2864, 6.3%) or spleen-specific vaccines (120/2864, 4.2%), maintain relationships (503/2864, 17.6%), or care for children (127/2864, 4.4%). 84.8% of participants reported at least one impact of COVID, including negative physical health (1463/2864, 51.1%), mental health (733/2864, 25.6%) and financial repercussions (509/2864, 17.8%). 96.9% (2743/2831) had received at least one dose of COVID-19 vaccines. CONCLUSIONS Overall, we found detailed evidence of the negative psychological and physical impacts of the pandemic upon this cohort. We recommend that providers consider people without functioning spleens as requiring extra social and psychological support in circumstances such as the COVID-19 pandemic.
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Affiliation(s)
- Maeve Barlow
- Spleen Australia, Department of Infectious Diseases, Alfred Hospital, Commercial Rd, Prahran, Vic 3004, Australia
| | - Penelope Jones
- Spleen Australia, Department of Infectious Diseases, Alfred Hospital, Commercial Rd, Prahran, Vic 3004, Australia; Department of Infectious Diseases, Alfred Hospital, Commercial Rd, Prahran, Vic 3004, Australia
| | - Mihiri Weerasuria
- Department of Infectious Diseases, Alfred Hospital, Commercial Rd, Prahran, Vic 3004, Australia; Monash Infectious Diseases, Monash Health, Clayton Rd, Clayton, Vic 3168, Australia; Faculty of Medicine, Monash University, Clayton, Vic 3168, Australia
| | - Jessica O'Bryan
- Monash Infectious Diseases, Monash Health, Clayton Rd, Clayton, Vic 3168, Australia; Faculty of Medicine, Monash University, Clayton, Vic 3168, Australia
| | - Denis Spelman
- Spleen Australia, Department of Infectious Diseases, Alfred Hospital, Commercial Rd, Prahran, Vic 3004, Australia; Department of Infectious Diseases, Alfred Hospital, Commercial Rd, Prahran, Vic 3004, Australia; Faculty of Medicine, Monash University, Clayton, Vic 3168, Australia
| | - Ian Woolley
- Spleen Australia, Department of Infectious Diseases, Alfred Hospital, Commercial Rd, Prahran, Vic 3004, Australia; Department of Infectious Diseases, Alfred Hospital, Commercial Rd, Prahran, Vic 3004, Australia; Monash Infectious Diseases, Monash Health, Clayton Rd, Clayton, Vic 3168, Australia; Faculty of Medicine, Monash University, Clayton, Vic 3168, Australia.
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12
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Choi SI, Kim S, Jin Y, Valentini C, Badham M, Colleoni E, Romenti S. Effects of Individuals' Cultural Orientations and Trust in Government Health Communication Sources on Behavioral Intentions During a Pandemic: A Cross-Country Study. HEALTH COMMUNICATION 2024; 39:107-121. [PMID: 36576168 DOI: 10.1080/10410236.2022.2159975] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Public health messages disseminated by trusted government authorities are likely to have more influence over individuals' intentions and behaviors. However, individuals worldwide have different levels of trust in government authorities, which leads to varying levels of compliance intentions. Additionally, these trust levels may vary during major public crises, such as pandemics. Based on a COVID-19 pandemic communication survey (N = 3,065) disseminated throughout six countries (Australia, Finland, Italy, South Korea, Sweden, and the United States), this study examined the association among trust in distinct government sources, cultural orientations, and health behavioral intentions. Findings indicated that trust in official health communication sources at four governmental levels (i.e. national government, the head of the national government, the national health authority, and the chief representative of the national health authority) was related to vaccination intentions and other behavioral compliance intentions (i.e. willingness to prevent COVID-19 infection in other ways). Meanwhile, these direct associations were mediated by the cultural orientations of power distance and uncertainty avoidance. Findings also revealed that the direct association of trust in government sources and the indirect relationship through the above cultural orientations varied by country. This study offers insight into the important role of credible sources and individuals' cultural orientations in the domain of health communication aimed at influencing behavioral intentions.
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Affiliation(s)
- Sung In Choi
- Grady College of Journalism and Mass Communication, University of Georgia
| | - Sungsu Kim
- School of Communication, Kookmin University
| | - Yan Jin
- Grady College of Journalism and Mass Communication, University of Georgia
| | | | - Mark Badham
- Leeds Business School, Leeds Beckett University
| | - Elanor Colleoni
- Department of Business, Law, Economics and Consumer Behavior, IULM University
| | - Stefania Romenti
- Department of Business, Law, Economics and Consumer Behavior, IULM University
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13
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Kuo CT, Yu RR. Association of National Identity and Trust in Government with COVID-19 Vaccination and Brand Choice in Taiwan. J Community Health 2024:10.1007/s10900-024-01347-4. [PMID: 38522040 DOI: 10.1007/s10900-024-01347-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2024] [Indexed: 03/25/2024]
Abstract
In Taiwan, hesitancy regarding COVID-19 vaccination centered more on the choice of vaccine brand than on the decision to vaccinate. However, there is limited research exploring the factors influencing COVID-19 vaccine brand preferences from a sociopolitical perspective. Thus, we aimed to examine how Taiwanese national identity and trust in government influence vaccination status and vaccine brand choice, using longitudinal data from 2020, 2021, and 2023. This study utilized data from the Taiwan Panel Study of Family Dynamics 2020 survey, and combined it with data from two self-administered surveys conducted in 2021 and 2023. We focused on four vaccines commonly administered in Taiwan: AstraZeneca, Moderna, Pfizer-BioNTech, and the domestically-developed Medigen. Using Poisson regression models with robust standard errors, we assessed the effects of national identity and trust in government on the choice of COVID-19 vaccine brand. By analyzing data from 2361 participants, we found that national identity and trust in government were associated with the likelihood of COVID-19 vaccination, the number of vaccine doses received, and the brand of vaccine taken. Those who identified themselves as Taiwanese were more inclined to receive the Medigen and AstraZeneca vaccines, but less willing to receive Pfizer-BioNTech vaccine. Those who trusted the government were more likely to prefer and receive the Medigen vaccine. Conversely, those who didn't trust the government were less likely to prefer Medigen and AstraZeneca vaccines, but were willing to receive Pfizer-BioNTech vaccine. Vaccine brand preferences and uptake in Taiwan were affected by individuals' national identity and their trust in government. This highlights the critical role of sociopolitical factors in shaping public health strategies.
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Affiliation(s)
- Chun-Tung Kuo
- Center for Survey Research, Research Center for Humanities and Social Sciences, Academia Sinica, Taipei, Taiwan.
- Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan.
| | - Ruoh-Rong Yu
- Center for Survey Research, Research Center for Humanities and Social Sciences, Academia Sinica, Taipei, Taiwan
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14
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Marinda E, Mathentamo Q, Coulson N, Parker S, Dmc Katoto P, Houston G, Magampa M, Pillay N, Ngungu M, Wiysonge CS, van Rooyen H. Impact evaluation of a youth led intervention to increase COVID-19 vaccine uptake in Kwazulu-Natal, South Africa. Vaccine 2024; 42:2089-2098. [PMID: 38423816 DOI: 10.1016/j.vaccine.2024.02.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 02/14/2024] [Accepted: 02/17/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND COVID-19 vaccination rates in South Africa remain low at 51% of the adult population being fully vaccinated, defined as having two shorts of the COVID-19 vaccine with or without a booster. To improve vaccine uptake, a community-based intervention was tested in a high vaccine hesitancy community in South Africa. Trained community youths used social media, face to face interactions, door to door and neighbourhood outreach activities to deliver the intervention. METHODS To assess if the intervention had an impact, data was collected before the intervention and after the intervention in two districts, Wentworth an intervention site and Newlands East a control site. Both districts are in KwaZulu Natal Province, South Africa. The following outcomes, changes on perceptions and knowledge about COVID-19, intention to get vaccinated for those who were not fully vaccinated and vaccination uptake were assessed using difference-in-difference methods applied through Augmented Inverse-Probability Weighting and contrasts of Potential Outcome Means (POM). RESULTS One thousand, one hundred and fifty (1 150) participants agreed to take part in the study at baseline, and 916 (80%) were followed up after the 9-week intervention period. Intention to get vaccinated for COVID-19 was higher (difference-in-difference, DID 20%, 95% CI 6% - 35% higher), more people were fully vaccinated (DID 10%, 95% CI 0% - 20%) or partially vaccinated (DID 16%, 95% CI 6% - 26%) in Wentworth the intervention site compared to Newlands East, the control site. There were noticeable increases on the percentage of study participants indicating trust on the Government's COVID 19 programme, from 24% at baseline to 48% after the intervention in the intervention group than in the control group, 26% baseline and 29% at follow-up. There was a 10% (absolute) increase on the percentage of participants' saying they believed health care workers provided reliable information, 58% at baseline and 68% at follow-up in the intervention group, but there was little change in the control group 56% and 57% for baseline and follow-up respectively. CONCLUSION The youth-led intervention implemented in Wentworth, a community with a high rate of vaccine hesitancy, was effective in increasing vaccination uptake. Given the low COVID-19 vaccine coverage in South Africa and across the African region, as well as the new emerging variant of concern (XBB 1.5), there is an urgent need to scale up such intervention at the community level to address persistent misinformation and promote vaccine equality.
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Affiliation(s)
- Edmore Marinda
- Human Sciences Research Council, Pretoria, South Africa; School of Public Health, University of the Witwatersrand, Johannesburg 2050, South Africa.
| | | | - Nancy Coulson
- The Sarraounia Public Health Trust, Johannesburg 2193, South Africa; Wits Mining Institute, University of the Witwatersrand, Johannesburg 2050, South Africa
| | | | - Patrick Dmc Katoto
- Cochrane South Africa, South African Medical Research Council, Cape Town 7501, South Africa; Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town 7505, South Africa; Centre for General Medicine and Global Health, Department of Medicine, University of Cape Town, Cape Town 7505, South Africa
| | | | | | - Nirvana Pillay
- School of Public Health, University of the Witwatersrand, Johannesburg 2050, South Africa; The Sarraounia Public Health Trust, Johannesburg 2193, South Africa
| | - Mercy Ngungu
- Human Sciences Research Council, Pretoria, South Africa
| | - Charles S Wiysonge
- Cochrane South Africa, South African Medical Research Council, Cape Town 7501, South Africa; HIV and Other Infectious Diseases Research Unit, South African Medical Research Council, Durban, 4001, South Africa
| | - Heidi van Rooyen
- Human Sciences Research Council, Pretoria, South Africa; SAMRC-Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2050, South Africa
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15
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Yu H, Bauermeister JA, Oyiborhoro U, Aryal S, Lipman TH, Tan ASL, Glanz K, Villarruel AM, Bonett S. Trust in federal COVID-19 vaccine oversight and parents' willingness to vaccinate their children against COVID-19: a cross-sectional study. BMC Public Health 2024; 24:830. [PMID: 38493101 PMCID: PMC10943829 DOI: 10.1186/s12889-024-18342-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 03/12/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND Over half of the youth population in the United States, aged 6 months to 17 years, have not received the Coronavirus Disease 2019 (COVID-19) vaccine. Given parents' central role in vaccinating their children, we examined associations between parents' trust of the federal oversight of COVID-19 vaccine safety and their willingness to vaccinate their children against COVID-19. METHODS This cross-sectional study included 975 parents of minor children residing in Philadelphia who completed the online survey between September 2021 and February 2022. Trust was measured using a four-point Likert scale ranging from 'do not trust' to 'fully trust' for two variables: (1) trust in federal oversight of COVID-19 vaccine safety for children and (2) trust in federal oversight of COVID-19 vaccine safety for the general public. A multiple logistic regression evaluated associations between trust and parents' willingness to vaccinate their children, which was measured on a five-point Likert scale ranging from 'strongly disagree' to 'strongly agree.' The analysis was adjusted for race/ethnicity, age, sexual orientation, gender, education, insurance, and parents' vaccination status. RESULTS Analyses included 975 parents whose children had not previously been vaccinated against COVID-19 (mean age 36.79, standard deviation 6.4; 42.1% racial/ethnic minorities; 93.2% heterosexual; and 73.7% with a college degree). Greater trust regarding federal oversight of COVID-19 vaccine safety for children [adjusted odds ratio (aOR) = 1.52, 95% confidence interval (CI): 1.13-2.04] and for the public (aOR = 1.58, 95% CI: 1.17-2.14) were each associated with increased willingness to have their child vaccinated against COVID-19. Unvaccinated parents had decreased willingness compared to parents who had received at least one dose of the vaccine (aOR = 0.14, 95% CI: 0.04-0.41). College-graduate parents exhibited increased willingness compared to those without a college degree (aOR = 2.07, 95% CI: 1.52-2.81). Non-heterosexual parents showed increased willingness compared to heterosexual parents (aOR = 2.30, 95% CI: 1.20-4.76). CONCLUSIONS Trust in federal COVID-19 vaccine oversight was associated with parental willingness to vaccinate their children against COVID-19 among parents whose children have not yet been vaccinated. Identifying and addressing causes of mistrust are crucial next steps to promote child vaccination. Intervention efforts to address trust gaps should remain a public health priority.
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Affiliation(s)
- Hyunmin Yu
- School of Nursing, University of Pennsylvania, 418 Curie Blvd, Philadelphia, Pennsylvania, 19104, USA.
| | - José A Bauermeister
- School of Nursing, University of Pennsylvania, 418 Curie Blvd, Philadelphia, Pennsylvania, 19104, USA
| | - Ufuoma Oyiborhoro
- School of Nursing, University of Pennsylvania, 418 Curie Blvd, Philadelphia, Pennsylvania, 19104, USA
| | - Subhash Aryal
- School of Nursing, University of Pennsylvania, 418 Curie Blvd, Philadelphia, Pennsylvania, 19104, USA
| | - Terri H Lipman
- School of Nursing, University of Pennsylvania, 418 Curie Blvd, Philadelphia, Pennsylvania, 19104, USA
| | - Andy S L Tan
- Annenberg School for Communication, University of Pennsylvania, 3620 Walnut Street, Philadelphia, Pennsylvania, 19104, USA
| | - Karen Glanz
- School of Nursing, University of Pennsylvania, 418 Curie Blvd, Philadelphia, Pennsylvania, 19104, USA
- Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, Pennsylvania, 19104, USA
| | - Antonia M Villarruel
- School of Nursing, University of Pennsylvania, 418 Curie Blvd, Philadelphia, Pennsylvania, 19104, USA
| | - Stephen Bonett
- School of Nursing, University of Pennsylvania, 418 Curie Blvd, Philadelphia, Pennsylvania, 19104, USA
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16
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Capasso M, Conner M, Caso D. Testing an extended theory of planned behaviour in predicting Covid-19 vaccination intention over the course of the pandemic: A three-wave repeated cross-sectional study. Heliyon 2024; 10:e24826. [PMID: 38314287 PMCID: PMC10837554 DOI: 10.1016/j.heliyon.2024.e24826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 01/06/2024] [Accepted: 01/15/2024] [Indexed: 02/06/2024] Open
Abstract
Background Mass vaccination against Covid-19 has been recognised as the most effective strategy for overcoming the pandemic emergency and remains crucial in the ongoing efforts to mitigate the impact of the virus. The present study aimed to test the efficacy of an extended Theory of Planned Behaviour (TPB) model in predicting vaccination intention in three different phases of the pandemic. Understanding how psychological drivers of vaccine acceptance may have changed throughout the pandemic is essential for informing public health strategies and addressing vaccine hesitancy, even in the current post-pandemic context. Methods Using a repeated cross-sectional survey, we tested the hypothesised extended TPB model (intention, attitude, subjective norms, perceived behavioural control, anticipated affective reactions, risk perception, trust in science, trust in institutions and religiosity) across three independent samples: before (T1: November-December 2020; N = 657), during (T2: March-May 2021; N = 818), and after (T3: February-March 2022; N = 605) the start of the vaccination campaign in Italy. Results Results indicated significant differences between the time points in all investigated variables, pointing to a general trend of improvement in vaccine acceptability levels at T2 compared to T1, and a worsening at T3 compared to the other two time points. Interestingly, net of these differences, a multi-group Structural Equation Modeling analysis supported the invariance, across time, of the structural relationships examined within the extended TPB. Conclusion Findings demonstrated the efficacy of the TPB in predicting Covid-19 vaccination intention at different stages of the pandemic, suggesting that the model, in its extended version, represents a valuable framework for designing interventions aimed at promoting vaccine acceptance.
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Affiliation(s)
- Miriam Capasso
- Department of Humanities, University of Naples Federico II, Italy
| | - Mark Conner
- School of Psychology, University of Leeds, UK
| | - Daniela Caso
- Department of Humanities, University of Naples Federico II, Italy
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17
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Pedrana A, Bowring A, Heath K, Thomas AJ, Wilkinson A, Fletcher-Lartey S, Saich F, Munari S, Oliver J, Merner B, Altermatt A, Nguyen T, Nguyen L, Young K, Kerr P, Osborne D, Kwong EJL, Corona MV, Ke T, Zhang Y, Eisa L, Al-Qassas A, Malith D, Davis A, Gibbs L, Block K, Horyniak D, Wallace J, Power R, Vadasz D, Ryan R, Shearer F, Homer C, Collie A, Meagher N, Danchin M, Kaufman J, Wang P, Hassani A, Sadewo GRP, Robins G, Gallagher C, Matous P, Roden B, Karkavandi MA, Coutinho J, Broccatelli C, Koskinen J, Curtis S, Doyle JS, Geard N, Hill S, Coelho A, Scott N, Lusher D, Stoové MA, Gibney KB, Hellard M. Priority populations' experiences of isolation, quarantine and distancing for COVID-19: protocol for a longitudinal cohort study (Optimise Study). BMJ Open 2024; 14:e076907. [PMID: 38216183 PMCID: PMC10806709 DOI: 10.1136/bmjopen-2023-076907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 12/04/2023] [Indexed: 01/14/2024] Open
Abstract
INTRODUCTION Longitudinal studies can provide timely and accurate information to evaluate and inform COVID-19 control and mitigation strategies and future pandemic preparedness. The Optimise Study is a multidisciplinary research platform established in the Australian state of Victoria in September 2020 to collect epidemiological, social, psychological and behavioural data from priority populations. It aims to understand changing public attitudes, behaviours and experiences of COVID-19 and inform epidemic modelling and support responsive government policy. METHODS AND ANALYSIS This protocol paper describes the data collection procedures for the Optimise Study, an ongoing longitudinal cohort of ~1000 Victorian adults and their social networks. Participants are recruited using snowball sampling with a set of seeds and two waves of snowball recruitment. Seeds are purposively selected from priority groups, including recent COVID-19 cases and close contacts and people at heightened risk of infection and/or adverse outcomes of COVID-19 infection and/or public health measures. Participants complete a schedule of monthly quantitative surveys and daily diaries for up to 24 months, plus additional surveys annually for up to 48 months. Cohort participants are recruited for qualitative interviews at key time points to enable in-depth exploration of people's lived experiences. Separately, community representatives are invited to participate in community engagement groups, which review and interpret research findings to inform policy and practice recommendations. ETHICS AND DISSEMINATION The Optimise longitudinal cohort and qualitative interviews are approved by the Alfred Hospital Human Research Ethics Committee (# 333/20). The Optimise Study CEG is approved by the La Trobe University Human Ethics Committee (# HEC20532). All participants provide informed verbal consent to enter the cohort, with additional consent provided prior to any of the sub studies. Study findings will be disseminated through public website (https://optimisecovid.com.au/study-findings/) and through peer-reviewed publications. TRIAL REGISTRATION NUMBER NCT05323799.
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Affiliation(s)
- Alisa Pedrana
- Burnet Institute, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Anna Bowring
- Burnet Institute, Melbourne, Victoria, Australia
| | | | | | - Anna Wilkinson
- Burnet Institute, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | | | - Freya Saich
- Burnet Institute, Melbourne, Victoria, Australia
| | | | - Jane Oliver
- Department of Infectious Diseases, The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - Bronwen Merner
- Centre for Health Communication and Participation, La Trobe University, Melbourne, Victoria, Australia
| | | | - Thi Nguyen
- Burnet Institute, Melbourne, Victoria, Australia
| | - Long Nguyen
- Burnet Institute, Melbourne, Victoria, Australia
| | | | - Phoebe Kerr
- Burnet Institute, Melbourne, Victoria, Australia
| | | | | | - Martha Vazquez Corona
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Tianhui Ke
- Burnet Institute, Melbourne, Victoria, Australia
| | - Yanqin Zhang
- Burnet Institute, Melbourne, Victoria, Australia
| | - Limya Eisa
- Burnet Institute, Melbourne, Victoria, Australia
| | | | - Deng Malith
- Burnet Institute, Melbourne, Victoria, Australia
| | - Angela Davis
- Burnet Institute, Melbourne, Victoria, Australia
| | - Lisa Gibbs
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Centre for Disaster Management and Public Safety, The University of Melbourne, Melbourne, Victoria, Australia
| | - Karen Block
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Danielle Horyniak
- Burnet Institute, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Jack Wallace
- Burnet Institute, Melbourne, Victoria, Australia
| | - Robert Power
- Burnet Institute, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Danny Vadasz
- Health Issues Centre, Melbourne, Victoria, Australia
| | - Rebecca Ryan
- Centre for Health Communication and Participation, La Trobe University, Melbourne, Victoria, Australia
| | - Freya Shearer
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | | | - Alex Collie
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Niamh Meagher
- Department of Infectious Diseases, The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - Margaret Danchin
- Murdoch Childrens Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jessica Kaufman
- Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Peng Wang
- School of Business, Law and Entrepreneurship, Swinburne University of Technology, Hawthorn, Victoria, Australia
- SNA Toolbox, Melbourne, Victoria, Australia
| | | | | | - Garry Robins
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Colin Gallagher
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Petr Matous
- The University of Sydney Faculty of Engineering and Information Technologies, Sydney, New South Wales, Australia
| | - Bopha Roden
- School of Business, Law and Entrepreneurship, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | | | - James Coutinho
- School of Business, Law and Entrepreneurship, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Chiara Broccatelli
- Institute for Social Science Research, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Johan Koskinen
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Statistics, Stockholm University, Stockholm, Sweden
| | - Stephanie Curtis
- Burnet Institute, Melbourne, Victoria, Australia
- Department of Infectious Diseases, Monash University, Clayton, Victoria, Australia
| | - Joseph S Doyle
- Burnet Institute, Melbourne, Victoria, Australia
- Department of Infectious Diseases, Monash University, Clayton, Victoria, Australia
| | - Nicholas Geard
- School of Computing & Information Systems, The University of Melbourne, Melbourne, Victoria, Australia
| | - Sophie Hill
- Centre for Health Communication and Participation, La Trobe University, Melbourne, Victoria, Australia
| | | | - Nick Scott
- Burnet Institute, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Dean Lusher
- School of Business, Law and Entrepreneurship, Swinburne University of Technology, Hawthorn, Victoria, Australia
- SNA Toolbox, Melbourne, Victoria, Australia
| | - Mark A Stoové
- Burnet Institute, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Katherine B Gibney
- Department of Infectious Diseases, The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - Margaret Hellard
- Burnet Institute, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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18
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Yuan Y, Yeo SY, Lee KS. Different roles of interpersonal trust and institutional trust in motivating older adults to receive COVID-19 vaccines in Singapore. Soc Sci Med 2024; 340:116475. [PMID: 38064820 DOI: 10.1016/j.socscimed.2023.116475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 10/23/2023] [Accepted: 11/25/2023] [Indexed: 01/23/2024]
Abstract
Since the approvals of several vaccines against COVID-19 by the World Health Organization, a large body of research has studied the determinants of individuals' intention to be vaccinated against COVID-19 in a variety of societies. Vaccine intention is a complex construct rooted in the social context that informs the decision-making process. The underlying reasons for older adults' intention to receive the vaccination is even more important to health authorities in societies with large proportions of older adults. In this paper, we interview 27 women over age 55 in Singapore about their COVID-19 vaccine decision-making. Using a social-ecological framework of trust, we identify factors at both individual and institutional levels that build or undermine trust and underlie older women's decisions to receive COVID-19 vaccinations in an authoritarian regime. Findings show that both interpersonal trust and institutional trust contribute to vaccine uptake, however, trust can also contribute to delays in vaccination. Moreover, a sizable minority of respondents report that they were vaccinated not because of institutional trust, but because they felt compelled to do so. The results shed light on directions for future vaccination campaigns.
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Affiliation(s)
- Yaqi Yuan
- School of History and Sociology, Georgia Institute of Technology, USA.
| | - Shun Yuan Yeo
- Department of Humanities, Arts and Social Sciences, Singapore University of Technology and Design, Singapore
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19
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Koban D, Abroms LC, Napolitano M, Simmens S, Broniatowski DA. Trust in public health institutions moderates the effectiveness of COVID-19 vaccine discussion groups on Facebook. JOURNAL OF COMMUNICATION IN HEALTHCARE 2023; 16:375-384. [PMID: 38095610 DOI: 10.1080/17538068.2023.2283308] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
BACKGROUND Distrust and partisan identity are theorized to undermine health communications. We examined the role of these factors on the efficacy of discussion groups intended to promote vaccine uptake. METHOD We analyzed survey data from unvaccinated Facebook users (N = 371) living in the US between January and April 2022. Participants were randomly assigned to Facebook discussion groups (intervention) or referred to Facebook's COVID-19 Information Center (control). We used Analysis of Covariance to test if the intervention was more effective at changing vaccination intentions and beliefs compared to the control in subgroups based on participants' partisan identity, political views, and information trust views. RESULTS We found a significant interaction between the intervention and trust in public health institutions (PHIs) for improving intentions to vaccinate (P = .04), intentions to encourage others to vaccinate (P = .03), and vaccine confidence beliefs (P = .01). Among participants who trusted PHIs, those in the intervention had higher posttest intentions to vaccinate (P = .008) and intentions to encourage others to vaccinate (P = .002) compared to the control. Among non-conservatives, participants in the intervention had higher posttest intentions to vaccinate (P = .048). The intervention was more effective at improving intentions to encourage others to vaccinate within the subgroups of Republicans (P = .03), conservatives (P = .02), and participants who distrusted government (P = .02). CONCLUSIONS Facebook discussion groups were more effective for people who trusted PHIs and non-conservatives. Health communicators may need to segment health messaging and develop strategies around trust views.
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Affiliation(s)
- Donald Koban
- School of Engineering & Applied Science, George Washington University, Washington, DC, USA
| | - Lorien C Abroms
- Milken Institute School of Public Health, George Washington University, Washington, DC, USA
- Institute for Data Democracy and Politics, George Washington University, Washington, DC, USA
| | - Melissa Napolitano
- Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Samuel Simmens
- Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - David A Broniatowski
- School of Engineering & Applied Science, George Washington University, Washington, DC, USA
- Institute for Data Democracy and Politics, George Washington University, Washington, DC, USA
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20
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Wiltse D, Viskupič F. Age and partisan self-identification predict uptake of additional COVID-19 booster doses: Evidence from a longitudinal study. Prev Med Rep 2023; 36:102407. [PMID: 37766728 PMCID: PMC10520422 DOI: 10.1016/j.pmedr.2023.102407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 09/07/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023] Open
Abstract
COVID-19 continues to threaten public health and authorities recommend that people receive additional doses of booster vaccines. We conducted a longitudinal study to investigate the correlates of uptake of additional COVID-19 booster doses among that population that already received a booster dose. In February 2023, we completed a panel study of 208 adults in the U.S. state of South Dakota who indicated receiving a booster dose in a similar survey conducted in May 2022. We measured COVID-19 vaccination status, trust in government, interpersonal trust, age, gender, education, income, and partisan self-identification. We examined the effect of change in these values of the two trust variables over time. We found statistically significant associations between age, partisan self-identification, and the uptake of additional booster doses. Neither of the time-variant trust variables were statistically significant. Our results showed the presence of differences in vaccination behavior even among the people who are fully vaccinated and boosted.
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Affiliation(s)
- David Wiltse
- School of American and Global Studies, South Dakota State University, Box 2212, Brookings, SD 57007, United States
| | - Filip Viskupič
- School of American and Global Studies, South Dakota State University, Box 2212, Brookings, SD 57007, United States
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21
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Jiao L, Wachinger J, Dasch S, Bärnighausen T, McMahon SA, Chen S. Calculation, knowledge, and identity: Dimensions of trust when making COVID-19 vaccination choices in China. SSM. QUALITATIVE RESEARCH IN HEALTH 2023; 4:100288. [PMID: 37334196 PMCID: PMC10232919 DOI: 10.1016/j.ssmqr.2023.100288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 05/21/2023] [Accepted: 05/22/2023] [Indexed: 06/20/2023]
Abstract
Vaccine hesitancy threatens the response to the COVID-19 pandemic and to other infectious disease outbreaks globally. Fostering trust has been highlighted as a critical factor in addressing vaccine hesitancy and expanding vaccine coverage, but qualitative exploration of trust in the context of vaccination remains limited. We contribute to filling this gap by providing a comprehensive qualitative analysis of trust in the context of COVID-19 vaccination in China. We conducted 40 in-depth interviews with Chinese adults in December 2020. During data collection, trust emerged as a highly salient topic. Interviews were audio-recorded, transcribed verbatim, translated into English, and analyzed with a combination of inductive and deductive coding. Following established trust literature, we differentiate between three types of trust - calculation-based trust, knowledge-based trust, and identity-based trust - which we grouped across components of the health system, as informed by the WHO's building blocks. Our results highlight how participants attributed their level of trust in COVID-19 vaccines to their trust in the medical technology itself (based on assessing risks and benefits or previous vaccination experiences), the service delivery and health workforce (informed by past experiences with health providers and their role throughout the pandemic), and leadership and governance (drawing on notions of government performance and patriotism). Reducing negative impact from past vaccine controversies, increasing the credibility of pharmaceutical companies, and fostering clear communication are identified as important channels for facilitating trust. Our findings emphasize a strong need for comprehensive information on COVID-19 vaccines and increased promotion of vaccination by credible figures.
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Affiliation(s)
- Lirui Jiao
- Columbia University Mailman School of Public Health, New York, USA
| | - Jonas Wachinger
- Heidelberg Institute of Global Health, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Germany
| | - Selina Dasch
- Heidelberg Institute of Global Health, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Germany
| | - Till Bärnighausen
- Heidelberg Institute of Global Health, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Germany
- Department of Global Health and Population, Harvard School of Public Health, Massachusetts, USA
- Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Shannon A McMahon
- Heidelberg Institute of Global Health, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Germany
- International Health Department, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Simiao Chen
- Heidelberg Institute of Global Health, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Germany
- Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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22
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Sacco A, Robbins ML, Paiva AL, Monahan K, Lindsey H, Reyes C, Rusnock A. Measuring Motivation for COVID-19 Vaccination: An Application of the Transtheoretical Model. Am J Health Promot 2023; 37:1109-1120. [PMID: 37612233 DOI: 10.1177/08901171231197899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Abstract
PURPOSE In the United States (US), individuals vary widely in their readiness to get vaccinated for COVID-19. The present study developed measures based on the transtheoretical model (TTM) to better understand readiness, decisional balance (DCBL; pros and cons), self-efficacy (SE), as well as other motivators for change such as myths and barriers for COVID-19 vaccination. DESIGN Cross-sectional measurement development. SETTING Online survey. SAMPLE 528 US adults ages 18-75. MEASURES Demographics, stage of change (SOC), DCBL, SE, myths, and barriers. ANALYSIS The sample was randomly split into halves for exploratory factor analysis using principal components analysis (EFA/PCA), followed by confirmatory factor analyses (CFA) to test measurement models. Correlation matrices were assessed and multivariate analyses examined relationships between constructs and sub-constructs. RESULTS For DCBL, EFA/PCA revealed three correlated factors (one pros, two cons) (n1 = 8, α = .97; n2 = 5, α = .93; n3 = 4, α = .84). For SE, two correlated factors were revealed (n1 = 12, α = .96; n2 = 3, α = .89). Single-factor solutions for Myths (n = 13, α = .94) and Barriers (n = 6, α = .82) were revealed. CFA confirmed models from EFAs/PCAs. Follow-up analyses of variance aligned with past theoretical predictions of the relationships between SOC, pros, cons, and SE, and the predicted relationships with myths and barriers. CONCLUSION This study produced reliable and valid measures of TTM constructs, myths, and barriers to understand motivation to receive COVID-19 vaccination that can be used in future research.
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Affiliation(s)
- Allegra Sacco
- Department of Psychology, College of Health Sciences, University of Rhode Island, Kingston, RI, USA
| | - Mark L Robbins
- Department of Psychology, College of Health Sciences, University of Rhode Island, Kingston, RI, USA
| | - Andrea L Paiva
- Department of Psychology, College of Health Sciences, University of Rhode Island, Kingston, RI, USA
| | - Kathleen Monahan
- Department of Psychology, College of Health Sciences, University of Rhode Island, Kingston, RI, USA
| | - Hayley Lindsey
- Department of Psychology, College of Health Sciences, University of Rhode Island, Kingston, RI, USA
| | - Cheyenne Reyes
- Department of Psychology, College of Health Sciences, University of Rhode Island, Kingston, RI, USA
| | - Andrea Rusnock
- Department of History, College of Arts and Sciences, University of Rhode Island, Kingston, RI, USA
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23
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Reddon H, Barker B, Bartlett S, Márquez AC, Sekirov I, Jassem A, Morshed M, Clemens A, Beck McGreevy P, Hayashi K, DeBeck K, Krajden M, Milloy MJ, Socías ME. Uptake of SARS-CoV-2 vaccination among structurally-marginalized people who use drugs in Vancouver, Canada. Sci Rep 2023; 13:17930. [PMID: 37863999 PMCID: PMC10589278 DOI: 10.1038/s41598-023-44069-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 10/03/2023] [Indexed: 10/22/2023] Open
Abstract
We sought to evaluate the rates and predictors of SARS-CoV-2 vaccination among members of a structurally-marginalized population of people who use drugs (PWUD) during a targeted, community-wide, vaccination campaign in Vancouver, Canada. Interviewer-administered data were collected from study participants between June 2021 and March 2022. Generalized estimating equation analysis was used to identify factors associated with SARS-CoV-2 vaccine uptake, ascertained through a province-wide vaccine registry. Among 223 PWUD, 107 (48.0%) reported receipt of at least two SARS-CoV-2 vaccine doses at baseline and this increased to 151 (67.7%) by the end of the study period. Using social media as a source of vaccine information was negatively associated with SARS-CoV-2 vaccine uptake (Adjusted odds ratio [AOR] 0.27, 95% confidence interval [CI] 0.09-0.81) and HIV seropositivity (AOR 2.68, 95% CI 1.12-6.39) and older age (AOR 1.27, 95% CI 1.07-1.51) were positively associated with SARS-CoV-2 vaccine uptake. These findings suggest that the targeted vaccination campaign in Vancouver may be an effective model to promote SARS-CoV-2 vaccination in other jurisdictions. However, using social media as a source of vaccine information likely reduced SARS-CoV-2 vaccine uptake in PWUD arguing for further efforts to promote accessible and evidence-based vaccine information among marginalized populations.
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Affiliation(s)
- Hudson Reddon
- BC Centre on Substance Use, 400-1045 Howe St., Vancouver, BC, V6Z 2A9, Canada.
- Division of Social Medicine, Department of Medicine, University of British Columbia, 2775 Laurel St., Vancouver, BC, V5Z 1M9, Canada.
| | - Brittany Barker
- BC Centre on Substance Use, 400-1045 Howe St., Vancouver, BC, V6Z 2A9, Canada
- Division of Social Medicine, Department of Medicine, University of British Columbia, 2775 Laurel St., Vancouver, BC, V5Z 1M9, Canada
| | - Sofia Bartlett
- Public Health Laboratory, BC Centre for Disease Control, Vancouver, BC, V5Z 4R4, Canada
| | - Ana Citlali Márquez
- Public Health Laboratory, BC Centre for Disease Control, Vancouver, BC, V5Z 4R4, Canada
| | - Inna Sekirov
- Public Health Laboratory, BC Centre for Disease Control, Vancouver, BC, V5Z 4R4, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, V6T 1Z7, Canada
| | - Agatha Jassem
- Public Health Laboratory, BC Centre for Disease Control, Vancouver, BC, V5Z 4R4, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, V6T 1Z7, Canada
| | - Muhammad Morshed
- Public Health Laboratory, BC Centre for Disease Control, Vancouver, BC, V5Z 4R4, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, V6T 1Z7, Canada
| | - Ari Clemens
- BC Centre on Substance Use, 400-1045 Howe St., Vancouver, BC, V6Z 2A9, Canada
| | | | - Kanna Hayashi
- BC Centre on Substance Use, 400-1045 Howe St., Vancouver, BC, V6Z 2A9, Canada
- Faculty of Health Sciences, Simon Fraser University, 8888 University Dr, Burnaby, BC, V5A 1S6, Canada
| | - Kora DeBeck
- BC Centre on Substance Use, 400-1045 Howe St., Vancouver, BC, V6Z 2A9, Canada
- School of Public Policy, Simon Fraser University, 8888 University Dr, Burnaby, BC, V5A 1S6, Canada
| | - Mel Krajden
- Public Health Laboratory, BC Centre for Disease Control, Vancouver, BC, V5Z 4R4, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, V6T 1Z7, Canada
| | - M-J Milloy
- BC Centre on Substance Use, 400-1045 Howe St., Vancouver, BC, V6Z 2A9, Canada
- Division of Social Medicine, Department of Medicine, University of British Columbia, 2775 Laurel St., Vancouver, BC, V5Z 1M9, Canada
| | - Maria Eugenia Socías
- BC Centre on Substance Use, 400-1045 Howe St., Vancouver, BC, V6Z 2A9, Canada
- Division of Social Medicine, Department of Medicine, University of British Columbia, 2775 Laurel St., Vancouver, BC, V5Z 1M9, Canada
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24
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Metta E, Shayo EH, Ngalesoni F, Kalolo A, Nyamuryekung'e K, Mboya IB, Ndumwa HP, Njiro BJ, Amour MA. The role of trust in the implementation and uptake of COVID-19 response measures: a qualitative study of health professionals' experiences in Tanzania. BMC Health Serv Res 2023; 23:1077. [PMID: 37817175 PMCID: PMC10566036 DOI: 10.1186/s12913-023-10043-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 09/17/2023] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND Even though trust is placed at the central point in ensuring proper functioning of the health systems, studies remain scant on how it affects both the implementation and uptake of COVID-19 response measures in low- and middle-income countries such as Tanzania. This study, therefore, explored the role of trust in the implementation and uptake of recommended COVID-19 response measures including vaccines from the perspective of health professionals in Tanzania. METHODS This cross-sectional qualitative study was implemented in four of Tanzania's thirty-one regions. Qualitative data was collected through 26 in-depth interviews held with regional and district disease outbreak response teams, district cold chain co-ordinators and health facility in-charges. In addition, five focus group discussions and seven group interviews were conducted with healthcare workers from the lower-level health facilities. Thematic analysis was conducted and applied the trust constructs. RESULTS Interpersonal trust and health system trust emerged as two major themes in the study. Interpersonal trust was reported to stem from lack of transparency that instigated fear, worries, and confusion regarding the implementation and uptake of the recommended response measures. The distrust was mainly between health professionals in health facilities and those assigned to isolation centres as well as between patients and community members. On the other hand, the health system trust was shaped by mixed feelings regarding COVID-19 vaccine national decisions, and conflicting messages from national officials, politicians and religious leaders on COVID-19 responses, safety, and effectiveness of the vaccines. Questions surrounding the short duration of clinical trials, indeterminate post-vaccination protection duration, impotence-linked beliefs, freemasonry notion and unclear vaccinated cards information are other reported contributory factors to mistrust in the health system. However, after a comprehensive health education and experience in COVID-19 vaccination administration most professionals affirmed the effectiveness of the vaccines in limiting infections and its severe consequences. CONCLUSION Participants indicated limited trust at both interpersonal and health system levels aggravated by lack of transparency, unclear and conflicting messages on COVID-19 infections and response measures. Enforced transparency on pandemics alongside standardised messages from the reliable sources is crucial in enhancing trust in implementation and uptake of the recommended response measures.
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Affiliation(s)
- Emmy Metta
- Department of Behavioral Sciences, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania.
| | - Elizabeth H Shayo
- National Institute for Medical Research, P.O. Box 9653, Dar es Salaam, Tanzania
| | - Frida Ngalesoni
- AMREF Health Africa in Tanzania, P.O. Box 2773, Dar es Salaam, Tanzania
| | - Albino Kalolo
- Department of Public Health, St. Francis University College of Health, and Allied Sciences, P.O. Box 175, Morogoro, Tanzania
| | - Kasusu Nyamuryekung'e
- Department of Community Dentistry, School of Dentistry, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania
| | - Innocent B Mboya
- Department of Epidemiology and Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College, P.O. Box 2240, Moshi, Tanzania
- Department of Translational Medicine, Lund University, 202 13 Malmö, P.O. Box 50332, Malmö, Sweden
| | - Harrieth P Ndumwa
- Department of Community Health, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania
| | - Belinda J Njiro
- Department of Community Health, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania
| | - Maryam A Amour
- Department of Community Health, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania
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25
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Eichelberger L, Hansen A, Cochran P, Fried R, Hahn M. "In the beginning, I said I wouldn't get it.": Hesitant adoption of the COVID-19 vaccine in remote Alaska between November 2020 and 2021. Soc Sci Med 2023; 334:116197. [PMID: 37666096 DOI: 10.1016/j.socscimed.2023.116197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 08/07/2023] [Accepted: 08/29/2023] [Indexed: 09/06/2023]
Abstract
Achieving sufficient COVID-19 vaccination coverage has been hindered in many areas by vaccine hesitancy. Many studies based on large survey samples have characterized vaccine refusal, but there are fewer in-depth qualitative studies that explore hesitant adoption: the middle-ground between vaccine acceptance and refusal, and how individuals may move across this continuum depending on their lived experience. For this paper, we use the narratives of 25 adults living in off-road, predominately Alaska Native communities to describe the complex decision-making processes undertaken by 'hesitant adopters', defined in our study as those who completed their initial COVID-19 series despite reporting hesitancy. Interviewees' stories help illustrate how hesitant adopters' decision-making processes involved making sense of information through interactions with trusted individuals, lived experiences, observations, emotions, and personal motivations. For the majority of these hesitant adopters' (n = 20, 80%) interpersonal interactions were key in helping to make the decision to get vaccinated. Over half of the interviewees (n = 14, 56%) described how conversations with individuals they trusted, including healthcare providers, family, friends, and interactions through their professional network made them feel safe. One third of the hesitant adopters (n = 7, 28%) attributed their decision to get vaccinated based on the influence of Alaska Native Elders including their knowledge, personal experiences, as well as being motivated by the desire to protect them. Independent research was also important to about a quarter of hesitant adopters (n = 6, 24%), and for these interviewees it was the process of gathering information on their own and learning from others, especially healthcare providers who could answer their questions and alleviate their concerns. This paper illustrates the temporality of vaccine decision-making: vaccine acceptance for those who are hesitant may be an ongoing process that is influenced by personal experience, relationships, and context.
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Affiliation(s)
- Laura Eichelberger
- Alaska Native Tribal Health Consortium, Tribal Water Center. 4000 Ambassador Drive Anchorage, Alaska, 99508, USA.
| | - Amanda Hansen
- Alaska Native Tribal Health Consortium, Tribal Water Center. 4000 Ambassador Drive Anchorage, Alaska, 99508, USA.
| | - Patricia Cochran
- Alaska Native Science Commission. 429 L Street, Anchorage, AK 99501, USA.
| | - Ruby Fried
- University of Alaska Anchorage (UAA), Institute for Circumpolar Health Studies (ICHS), 1901 Bragaw, Suite 220, Anchorage, Alaska, 99508, USA.
| | - Micah Hahn
- University of Alaska Anchorage (UAA), Institute for Circumpolar Health Studies (ICHS), 1901 Bragaw, Suite 220, Anchorage, Alaska, 99508, USA.
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26
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Anderson A. Regional and neighbourhood-based variation in three types of vaccine attitude in Britain. Health Place 2023; 83:103098. [PMID: 37572542 DOI: 10.1016/j.healthplace.2023.103098] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 08/04/2023] [Accepted: 08/07/2023] [Indexed: 08/14/2023]
Abstract
This study investigates the geographic patterning of attitudes towards vaccination in Britain (England, Wales, and Scotland). Using survey data from the 2018 Wellcome Monitor linked to lower super output areas and NUTS2 regions, this study provides evidence that negative attitudes regarding the risk of side-effects from vaccination and regarding the efficacy of vaccination are correlated with higher levels of local deprivation. While previous research has highlighted associations between vaccine uptake and deprivation for a variety of reasons, this study specifically contends that particular individualised types of caution about vaccines also tend to cluster in deprived areas.
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Affiliation(s)
- Alistair Anderson
- School of Sociology and Social Policy, Law and Social Sciences Building, University Park, Nottingham, NG7 2RD, UK.
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27
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Dickson K, Aboltins C, Pelly J, Jessup RL. Effective communication of COVID-19 vaccine information to recently-arrived culturally and linguistically diverse communities from the perspective of community engagement and partnership organisations: a qualitative study. BMC Health Serv Res 2023; 23:877. [PMID: 37605184 PMCID: PMC10440864 DOI: 10.1186/s12913-023-09836-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 07/20/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND In many high-income countries, COVID-19 has disproportionately impacted Culturally and Linguistically Diverse (CALD) communities. Barriers to engaging with essential health messaging has contributed to difficulties in following public health advice and exacerbated existing inequity in Australia. Research suggests that recently-arrived CALD populations are particularly vulnerable to misinformation and are more likely to experience vaccine hesitancy. The aim of this study was to explore the barriers and enablers to COVID-19 vaccination among recently-arrived CALD communities in Melbourne's outer north and identify strategies to reduce hesitancy in this population. METHODS Semi-structured interviews were conducted with representatives from community organisations working with recently-arrived CALD communities in Melbourne's north. This included a mix of peer (from the community) and health care workers. RESULTS Fifteen participants from community organisations participated in interviews. Thematic analysis identified four themes; (1) trusted sources, (2) accurate and culturally sensitive information, (3) supported pathways and (4) enablers to vaccination. CONCLUSIONS Participants reported a perceived lack of accurate, culturally sensitive health information and service provision as key barriers to vaccination in recently-arrived CALD communities. Participants identified a range of perceived enablers to increasing vaccination uptake in the communities they work with, including utilising established channels of communication and harnessing the communities' strong sense of collective responsibility. Specific strategies to reduce vaccine hesitancy included identifying and utilising trusted sources (e.g. faith leaders) to disseminate information, tailoring health messages to address cultural differences, providing opportunities to contextualise information, and modifying service delivery to enhance cultural sensitivity. There is an urgent need for increased efforts from health and government agencies to build sustainable, collaborative relationships with CALD communities.
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Affiliation(s)
- Kara Dickson
- School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Craig Aboltins
- Department of Infectious Diseases, Northern Health, Epping, VIC, 3076, Australia
- Adjunct Associate Professor, Department of Medical Education, The University of Melbourne, Melbourne, Australia
| | - Janet Pelly
- Northern Health, Epping, VIC, 3076, Australia
| | - Rebecca Leigh Jessup
- Director of Research and Evaluation, Staying Well. Northern Health, Epping, VIC, 3076, Australia.
- Adjunct Research Fellow, School of Allied Health, Human Services and Sport, La Tobe University, Bundoora, Australia.
- Adjunct Research Fellow, School of Rural Health, Monash University, Warragul, Australia.
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28
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Hu S, Xiong C, Zhao Y, Yuan X, Wang X. Vaccination, human mobility, and COVID-19 health outcomes: Empirical comparison before and during the outbreak of SARS-Cov-2 B.1.1.529 (Omicron) variant. Vaccine 2023; 41:5097-5112. [PMID: 37270367 PMCID: PMC10234469 DOI: 10.1016/j.vaccine.2023.05.056] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 04/27/2023] [Accepted: 05/22/2023] [Indexed: 06/05/2023]
Abstract
The B.1.1.529 (Omicron) variant surge has raised concerns about the effectiveness of vaccines and the impact of imprudent reopening. Leveraging over two years of county-level COVID-19 data in the US, this study aims to investigate relationships among vaccination, human mobility, and COVID-19 health outcomes (assessed via case rate and case-fatality rate), controlling for socioeconomic, demographic, racial/ethnic, and partisan factors. A set of cross-sectional models was first fitted to empirically compare disparities in COVID-19 health outcomes before and during the Omicron surge. Then, time-varying mediation analyses were employed to delineate how the effects of vaccine and mobility on COVID-19 health outcomes vary over time. Results showed that vaccine effectiveness against case rate lost significance during the Omicron surge, while its effectiveness against case-fatality rate remained significant throughout the pandemic. We also documented salient structural inequalities in COVID-19-related outcomes, with disadvantaged populations consistently bearing a larger brunt of case and death tolls, regardless of high vaccination rates. Last, findings revealed that mobility presented a significantly positive relationship with case rates during each wave of variant outbreak. Mobility substantially mediated the direct effect from vaccination to case rate, leading to a 10.276 % (95 % CI: 6.257, 14.294) decrease in vaccine effectiveness on average. Altogether, our study implies that sole reliance on vaccination to halt COVID-19 needs to be re-examined. Well-resourced and coordinated efforts to enhance vaccine effectiveness, mitigate health disparity and selectively loosen non-pharmaceutical interventions are essential to bringing the pandemic to an end.
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Affiliation(s)
- Songhua Hu
- Department of Civil and Environmental Engineering, University of Maryland, College Park, MD 20742, United States.
| | - Chenfeng Xiong
- Department of Civil and Environmental Engineering, Villanova University, PA 19085, United States.
| | - Yingrui Zhao
- Department of Geographical Sciences, University of Maryland, College Park, MD 20742, United States
| | - Xin Yuan
- Department of Civil and Environmental Engineering, Villanova University, PA 19085, United States
| | - Xuqiu Wang
- Department of Civil and Environmental Engineering, Villanova University, PA 19085, United States
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29
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Viskupič F, Wiltse DL. Attitudes toward annual COVID-19 boosters are highly structured by partisan self-identification and trust in government: Evidence from a longitudinal survey. Vaccine X 2023; 14:100337. [PMID: 37388416 PMCID: PMC10290170 DOI: 10.1016/j.jvacx.2023.100337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 06/08/2023] [Accepted: 06/20/2023] [Indexed: 07/01/2023] Open
Abstract
Objectives On January 26, 2023, an advisory panel of the United States Food and Drug Administration (FDA) approved a plan for annual vaccination for COVID-19. Given slowing booster uptake in the US, full participation of the public is in doubt. Using data from a longitudinal survey, we investigated the predictors of attitudes toward receiving a COVID-19 booster dose annually. Study design In February 2023, we completed a panel study of 243 adults from South Dakota who indicated being at least fully vaccinated in a survey conducted in May 2022. Methods In addition to attitudes on an annual booster, we measured partisan self-identification, trust in government, interpersonal trust, COVID-19 vaccination status, age, gender, education, and income. We examined the effect of changes in COVID-19 vaccination status, and the two trust variables on the willingness to receive a COVID-19 booster dose annually. Results Logistic regression analysis results showed statistically significant relationships between partisan self-identification, changes in trust in government and COVID-19 vaccination status, age, and the willingness to receive a COVID-19 booster dose annually. Conclusions The findings underscore the continued relevance of partisan self-identification and trust in government on attitudes toward COVID-19 mitigation measures.
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Affiliation(s)
- Filip Viskupič
- School of American and Global Studies, South Dakota State University, Brookings, SD, United States
| | - David L Wiltse
- School of American and Global Studies, South Dakota State University, Brookings, SD, United States
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Tzeng R, Huang FY, Lee J. Compliance, procrastination and refusal: American COVID-19 vaccination trust and value orientation. Vaccine 2023; 41:4950-4957. [PMID: 37394373 PMCID: PMC10277854 DOI: 10.1016/j.vaccine.2023.06.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 05/31/2023] [Accepted: 06/15/2023] [Indexed: 07/04/2023]
Abstract
INTRODUCTION COVID-19 vaccine hesitancy studies, most of which were completed prior to the release of the vaccine, speculated on factors that might influence inoculation intention when a vaccine was introduced. This paper examines actual vaccination decisions among US residents after COVID-19 vaccines were approved, with a focus on trust in vaccine effectiveness, increased trust in government pandemic response, and individual-versus-collective value orientation. METHOD The data set was from the Kaiser Family Foundation COVID-19 Vaccine Monitor, a nationally representative sample reflecting the opinions of 1519 American adults aged 18 and above. Data were collected in September 2021-approximately nine months after the first COVID-19 vaccines were approved for distribution. Indicators of trust in vaccine effectiveness included individual opinions regarding breakthrough infections and vaccine boosters. Increased trust in government indicated approval of official COVID-19 responses, and value orientation denoted respondent emphasis on personal choice versus protecting the health of others. We established three categories of a vaccine hesitancy dependent variable: none, some, and full rejection. A multinomial regression analysis was employed to compare vaccine hesitancy in three pairs of contrasting groups. RESULTS While we noted distinct patterns in decision-making factors for each of the contrasting pairs, we also observed strong effects for trust in vaccine effectiveness and value orientation on vaccine decisions across all three. Both effects were more substantial than those associated with three control variables-social-demographic characteristics, political party affiliation, and health risk. CONCLUSION Our findings suggest that in order to increase vaccination rates, policymakers and influencers should focus on reducing individual scepticism over breakthrough infections and vaccine boosters, and on influencing a value orientation shift from personal choice to social responsibility.
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Affiliation(s)
- Rueyling Tzeng
- Institute of European and American Studies, Academia Sinica, 128, Academia Road, Section 2, Nankang, Taipei 115, Taiwan.
| | - Fang-Yi Huang
- Department of Sociology, Soochow University, No. 70, Linxi Rd., Shilin Dist., Taipei 111002, Taiwan.
| | - Jaein Lee
- Department of Sociology and Criminology, Arkansas State University, Jonesboro, AR, United States.
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McGuinness SL, Eades O, Seale H, Cheng AC, Leder K. Pre-travel vaccine information needs, attitudes, drivers of uptake and the role for decision aids in travel medicine. J Travel Med 2023; 30:taad056. [PMID: 37074157 PMCID: PMC10289516 DOI: 10.1093/jtm/taad056] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 04/13/2023] [Accepted: 04/14/2023] [Indexed: 04/20/2023]
Abstract
BACKGROUND Many travellers do not receive vaccines pre-travel. Tools such as vaccine decision aids could support informed vaccine decision-making. We aimed to characterise Australians' pre-travel vaccine attitudes, behaviours and information needs and examine the role for decision aids in travel medicine. METHODS Online cross-sectional survey of Australian adults in December 2022. We included questions on demographics, pre-travel health-seeking behaviour, and information needs. We measured vaccine confidence (Vaccine Confidence Index Index) and used hypothetical disease scenarios to evaluate behavioural and social drivers of vaccination. We used multivariable logistic regression models to identify predictors of vaccine uptake and thematically analysed free-text responses. RESULTS We received complete survey responses from 1223/1326 Australians (92% response rate). Amongst those reporting previous overseas travel, 67% (778/1161) reported past pre-travel health encounter(s) and 64% (743/1161) reported past pre-travel vaccination. Half (50%) strongly agreed that vaccines were important for their health; fewer strongly agreed that vaccines were safe (37%) and effective (38%). In multivariable analyses, past pre-travel vaccine uptake was associated with increasing age (OR = 1.17 [95% CI 1.08-1.27] p < 0.001 per ten-year increase) and travel to higher-risk destinations (OR = 2.92 [2.17-3.93] p < 0.001); travellers visiting friends and relatives (VFRs) were less likely to have received pre-travel vaccines (OR = 0.74 [0.56-0.97] p = 0.028). Predictors for wanting vaccination against hypothetical diseases included past pre-travel vaccination (Disease X: OR 2.60 [1.91-3.56] p < 0.001) and confidence in vaccine safety (Disease X: OR 7.18 [5.07-10.18], p < 0.001); past VFR travel was predictive of not wanting vaccination (Disease X: OR 0.72 [0.52-1.00], p = 0.049). Most (63%) were interested in using a vaccine decision aid, generally together with a trusted health professional. CONCLUSIONS Health professionals play an important role in supporting pre-travel vaccine decision-making. However, our findings indicate that reliable, accurate and engaging digital resources, such as decision aids, could support travellers to make informed pre-travel vaccine decisions.
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Affiliation(s)
- Sarah L McGuinness
- School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
- Department of Infectious Diseases, The Alfred Hospital and Central Clinical School, Monash University, Melbourne 3004, Australia
| | - Owen Eades
- School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
- Department of Infectious Diseases, The Alfred Hospital and Central Clinical School, Monash University, Melbourne 3004, Australia
| | - Holly Seale
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney 2052, Australia
| | - Allen C Cheng
- School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
- Monash Infectious Diseases Service, Monash Health and School of Clinical Sciences, Monash University, Melbourne 3168, Australia
| | - Karin Leder
- School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
- Victorian Infectious Diseases Service, Royal Melbourne Hospital at the Peter Doherty Institute for Infection and Immunity, Melbourne 3000, Australia
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Bolsewicz KT, Steffens MS, King C, Abdi I, Bullivant B, Beard F. A qualitative study on COVID-19 pandemic impacts on parental attitudes and intentions for routine adolescent vaccinations: The role of trust. Vaccine 2023:S0264-410X(23)00586-8. [PMID: 37246066 DOI: 10.1016/j.vaccine.2023.05.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 05/12/2023] [Accepted: 05/16/2023] [Indexed: 05/30/2023]
Abstract
INTRODUCTION The COVID-19 pandemic has contributed to declines in routine childhood and adolescent vaccination coverage globally. While the declines in Australia have been less, they are a concern, given steady increases in coverage prior to the pandemic. Given limited evidence on how the experiences of parents during the pandemic affected their attitudes about and intentions towards adolescent vaccinations, with this study we aimed to explore these. METHODS This was a qualitative study. We invited parents of adolescents eligible for school-based vaccinations in 2021 from metropolitan, regional and rural areas of New South Wales and Victoria (the most affected States) and South Australia (less affected) to half hour-long online semi-structured interviews. We analysed data thematically and applied a conceptual model of trust in vaccination. RESULTS In July 2022 we interviewed 15 accepting, 4 hesitant and two parents who refused adolescent vaccinations. We identified three themes: 1. Pandemic impacting on professional and personal lives and routine immunisations; 2. Pandemic strengthening preexisting vaccine hesitancy, with perceived lack of clarity in governmental information about vaccination and stigma around non-vaccinating as contributing factors; 3. Pandemic raising awareness of the benefits of COVID-19 and routine vaccinations, with communication campaigns and one's trusted doctor's vaccination recommendations as contributing factors. CONCLUSIONS For some parents, experiences of poor system readiness and growing distrust towards health and vaccination systems strengthened their pre-existing vaccine hesitancy. We offer recommendations on how trust in the health system and immunisation can be optimised post-pandemic to increase uptake of routine vaccines. These include improving access to vaccination services and clear, timely information about vaccines; supporting immunisation providers in their immunisation consultations; working alongside communities, and building capacity of vaccine champions.
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Affiliation(s)
- Katarzyna T Bolsewicz
- National Centre for Immunisation Research and Surveillance, Westmead, NSW 2145, Australia; School of Public Health, The University of Sydney, NSW 2006, Australia.
| | - Maryke S Steffens
- National Centre for Immunisation Research and Surveillance, Westmead, NSW 2145, Australia; School of Public Health, The University of Sydney, NSW 2006, Australia
| | - Catherine King
- National Centre for Immunisation Research and Surveillance, Westmead, NSW 2145, Australia; The Children's Hospital at Westmead Clinical School, The Faculty of Medicine and Health, The University of Sydney, Australia
| | - Ikram Abdi
- National Centre for Immunisation Research and Surveillance, Westmead, NSW 2145, Australia; School of Public Health, The University of Sydney, NSW 2006, Australia
| | - Bianca Bullivant
- National Centre for Immunisation Research and Surveillance, Westmead, NSW 2145, Australia; School of Public Health, The University of Sydney, NSW 2006, Australia
| | - Frank Beard
- National Centre for Immunisation Research and Surveillance, Westmead, NSW 2145, Australia; School of Public Health, The University of Sydney, NSW 2006, Australia
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Nogueira de Brito R, Passarella Teixeira AI, Carvalho Gontijo C, Da Silva Faria R, Massa Ramalho W, Sierra Romero GA, Castro M, Pessoa V, Araújo Torres L, Pereira Leite L, Ferreira Noronha E, Haddad R, Navegantes de Araújo W. Seroprevalence of SARS-CoV-2 and Vaccination Coverage among Residents of a Lower-Middle-Class Population in the Federal District, Brazil. Vaccines (Basel) 2023; 11:vaccines11050916. [PMID: 37243020 DOI: 10.3390/vaccines11050916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 04/01/2023] [Accepted: 04/13/2023] [Indexed: 05/28/2023] Open
Abstract
Estimating seroprevalence and vaccination coverage against COVID-19 is crucial to the development of well-targeted public health policies at the local level. Here, we estimated seroprevalence and vaccination coverage in a lower-middle-class population in Brazil. We conducted an observational, cross-sectional, population-based survey from 24 September to 19 December 2021. CMIA tests were used to detect anti-SARS-CoV-2 IgG against the N-protein. The overall seroprevalence was 24.15% (177/733), and vaccination coverage was 91.40% (670/733); 72.09% (483/670) were fully vaccinated. Among vaccinated participants, seroprevalence was 24.77% (95% CI 21.50-28.04; 166/670), with a prevalence ratio (PR) of 1.03 (95% CI 0.98-1.08; p-value 0.131). Among participants who received an mRNA vaccine with S-based epitope (485), seroprevalence was 16.29% (95% CI 13.04-19.85; 79/485). Among unvaccinated participants, seroprevalence was 17.46% (95% CI 10.04-28.62; 11/63). Finally, in spite of the political climate and other possible causes for vaccine hesitancy, the positive Brazilian culture towards vaccination might have curbed hesitancy.
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Affiliation(s)
| | | | | | - Rafael Da Silva Faria
- Department of Tropical Medicine, University of Brasilia, Brasilia 70910-900, DF, Brazil
| | - Walter Massa Ramalho
- Department of Tropical Medicine, University of Brasilia, Brasilia 70910-900, DF, Brazil
| | | | - Manoel Castro
- Department of Tropical Medicine, University of Brasilia, Brasilia 70910-900, DF, Brazil
| | - Vitoria Pessoa
- Department of Tropical Medicine, University of Brasilia, Brasilia 70910-900, DF, Brazil
| | - Larissa Araújo Torres
- Department of Tropical Medicine, University of Brasilia, Brasilia 70910-900, DF, Brazil
| | - Larissa Pereira Leite
- Department of Tropical Medicine, University of Brasilia, Brasilia 70910-900, DF, Brazil
| | - Elza Ferreira Noronha
- Department of Tropical Medicine, University of Brasilia, Brasilia 70910-900, DF, Brazil
| | - Rodrigo Haddad
- Laboratório de Diagnóstico Molecular, Hospital Universitário de Brasília, Brasilia 70910-900, DF, Brazil
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Anas AL, Salifu M, Zakaria HL. COVID-19 Pandemic and Vaccination Skepticism. HUMAN ARENAS 2023. [PMCID: PMC10130805 DOI: 10.1007/s42087-023-00334-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 12/13/2022] [Accepted: 01/21/2023] [Indexed: 10/25/2023]
Abstract
The purpose of this study is to examine some of the reasons why people are skeptical about the COVID-19 vaccination despite assurances from the authorities. In terms of methodological consideration, the study is situated within the qualitative research paradigm. The study adopted interviews and documentary analysis as the main source of data. The themes were generated from the data using the Voyant software, and the empirical discussion based on thematic analysis approach. The study reveals that trust in the COVID-19 vaccines, institutions, and cultural and religious beliefs determines people’s vaccination decisions in a significant manner. The study further highlighted that the quick production and administration of the various COVID-19 vaccines and history of previous epidemics/pandemic’s vaccination programs (such as the side effects of the vaccines) could have made people hesitant towards the COVID-19 vaccination. Furthermore, trust in governments, pharmaceutical companies, and healthcare institutions informs people whether to participate in the COVID-19 pandemic vaccination project. Last but not the least, religious and cultural beliefs have sown seeds of skepticism in people and, ultimately, their COVID-19 vaccination decisions.
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Affiliation(s)
- Abdul Latif Anas
- Aalborg University, Fredrik Bajers Vej 7K, 9220 Aalborg East, Denmark
| | - Mashudu Salifu
- Aalborg University, Fredrik Bajers Vej 7K, 9220 Aalborg East, Denmark
| | - Hanan Lassen Zakaria
- Danish Centre for African Business (DaNCAB), Aalborg University, Aalborg, Denmark
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Bürzle O, Menges D, Maier JD, Schams D, Puhan MA, Fehr J, Ballouz T, Frei A. Adverse effects, perceptions and attitudes related to BNT162b2, mRNA-1273 or JNJ-78436735 SARS-CoV-2 vaccines: Population-based cohort. NPJ Vaccines 2023; 8:61. [PMID: 37095137 PMCID: PMC10123463 DOI: 10.1038/s41541-023-00657-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 03/29/2023] [Indexed: 04/26/2023] Open
Abstract
Long-term control of SARS-CoV-2 requires effective vaccination strategies. This has been challenged by public mistrust and the spread of misinformation regarding vaccine safety. Better understanding and communication of the longer-term and comparative experiences of individuals in the general population following vaccination are required. In this population-based longitudinal study, we included 575 adults, randomly selected from all individuals presenting to a Swiss reference vaccination center, for receipt of BNT162b2, mRNA1273, or JNJ-78436735. We assessed the prevalence, onset, duration, and severity of self-reported adverse effects over 12 weeks following vaccination. We additionally evaluated participants' perceptions of vaccines, trust in public health authorities and pharmaceutical companies, and compliance with public health measures. Most participants reported at least one adverse effect within 12 weeks following vaccination. Adverse effects were mostly mild or moderate, resolved within three days, and rarely resulted in anaphylaxis or hospitalizations. Female sex, younger age, higher education, and receipt of mRNA-1273 were associated with reporting adverse effects. Compared to JNJ-78436735 recipients, a higher proportion of mRNA vaccine recipients agreed that vaccination is important, and trusted public health authorities. Our findings provide real-world estimates of the prevalence of adverse effects following SARS-CoV-2 vaccination and highlight the importance of transparent communication to ensure the success of current or future vaccination campaigns.
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Affiliation(s)
- Oliver Bürzle
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich (UZH), Zurich, Switzerland
| | - Dominik Menges
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich (UZH), Zurich, Switzerland
| | - Julian D Maier
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich (UZH), Zurich, Switzerland
| | - Daniel Schams
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich (UZH), Zurich, Switzerland
| | - Milo A Puhan
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich (UZH), Zurich, Switzerland
| | - Jan Fehr
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich (UZH), Zurich, Switzerland.
| | - Tala Ballouz
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich (UZH), Zurich, Switzerland
| | - Anja Frei
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich (UZH), Zurich, Switzerland.
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Rivera JD. Trust in government actors and COVID-19 vaccination uptake among Hispanics and Latinos in the U.S. INTERNATIONAL JOURNAL OF DISASTER RISK REDUCTION : IJDRR 2023; 89:103627. [PMID: 36909818 PMCID: PMC9987608 DOI: 10.1016/j.ijdrr.2023.103627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 02/27/2023] [Accepted: 03/03/2023] [Indexed: 06/18/2023]
Abstract
Although the federal government has made official recommendations to the public advocating vaccinations against COVID-19 various communities have decided against doing so. In this regard, various studies have indicated that trust in government to provide accurate information about vaccines during a pandemic are related to whether people get vaccinated. Various studies have investigated factors contributing to vaccine decision-making, but none specifically focus on Hispanic and Latinos in the United States. This study identifies factors associated with COVID-19 vaccination among Hispanics and Latinos using a nation-wide, phone-based survey. Using data generated by the Kaiser Family Foundation's COVID-19 Vaccine Monitor, collected in June 2021, a logistic regression on the decision to get vaccinated, trust in various governmental actors, in addition to demographic variables such as age, race, employment status, parental status, employment status, and income are observed to be significant in Hispanics' and Latinos' decision to be vaccinated against COVID-19. As a byproduct of these findings, recommendations for future research are provided that relate to expanding our understanding of these factors among different ethnicities of Latinos.
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Affiliation(s)
- Jason D Rivera
- John Jay College of Criminal Justice, Department of Public Management, USA
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37
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El-Mohandes A, Wyka K, White TM, El-Sadr WM, Rauh L, Vasan A, Greene D, Rabin K, Ratzan SC, Chaudhri S, Kimball S, Lazarus JV. Comparison of Current Attitudes Toward COVID-19 Vaccination in New York City and the US Nationally. JOURNAL OF HEALTH COMMUNICATION 2023; 28:34-44. [PMID: 37390011 DOI: 10.1080/10810730.2023.2208071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/02/2023]
Abstract
COVID-19 vaccination has resulted in decreased hospitalization and mortality, particularly among those who have received a booster. As new effective pharmaceutical treatments are now available and requirements for non-pharmaceutical interventions (e.g. masking) are relaxed, perceptions of the risk and health consequences of SARS-CoV-2 infection have decreased, risking potential resurgence. This June 2022 cross-sectional comparative study of representative samples in New York City (NYC, n = 2500) and the United States (US, n = 1000) aimed to assess differences in reported vaccine acceptance as well as attitudes toward vaccination mandates and new COVID-19 information and treatments. NYC respondents reported higher COVID-19 vaccine acceptance and support for vaccine mandate than U.S. respondents, yet lower acceptance for the booster dose. Nearly one-third of both NYC and U.S. respondents reported paying less attention to COVID-19 vaccine information than a year earlier, suggesting health communicators may need innovation and creativity to reach those with waning attention to COVID-19-related information.
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Affiliation(s)
- Ayman El-Mohandes
- Graduate School of Public Health & Health Policy, City University of New York (CUNY), New York, New York, USA
| | - Katarzyna Wyka
- Graduate School of Public Health & Health Policy, City University of New York (CUNY), New York, New York, USA
| | - Trenton M White
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | | | - Lauren Rauh
- Graduate School of Public Health & Health Policy, City University of New York (CUNY), New York, New York, USA
| | - Ashwin Vasan
- Office of the Commissioner of Health, New York City Department of Health and Mental Hygiene, New York, New York, USA
| | - Danielle Greene
- Graduate School of Public Health & Health Policy, City University of New York (CUNY), New York, New York, USA
| | - Kenneth Rabin
- Graduate School of Public Health & Health Policy, City University of New York (CUNY), New York, New York, USA
| | - Scott C Ratzan
- Graduate School of Public Health & Health Policy, City University of New York (CUNY), New York, New York, USA
| | - Simran Chaudhri
- Office of the Commissioner of Health, New York City Department of Health and Mental Hygiene, New York, New York, USA
| | - Spencer Kimball
- Emerson Polling, Emerson College, Boston, Massachusetts, USA
| | - Jeffrey V Lazarus
- Graduate School of Public Health & Health Policy, City University of New York (CUNY), New York, New York, USA
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
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Ige O, Sakas Z, Kang M, Green C, Brown D. Vaccine Confidence in NYC: Thematic Analysis of Community Stories. JOURNAL OF HEALTH COMMUNICATION 2023; 28:45-53. [PMID: 37390013 DOI: 10.1080/10810730.2023.2191226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/02/2023]
Abstract
The vaccine community has produced extensive evidence on vaccine hesitancy, but research to understand the factors that affect public trust in vaccines and vaccine confidence among Black, Indigenous and People of Color (BIPOC) remains limited. To enrich extant literature, we present themes from 332 stories collected from predominantly BIPOC communities in New York City that explored motivators for vaccination during the COVID-19 pandemic. Stories were collected by trained community health workers from December 2021 to June 2022. The most frequently reported motivators to getting vaccinated against COVID-19 were related to preventing sickness and death from COVID-19 infection, for oneself and for others. Information from medical professionals, the news and social media, and community-based organizations contributed to decision-making about vaccines. Findings point to a strong sense of social solidarity, with the desire to protect and positively influence others, including friends, family, and the community at large, as salient motivators to vaccination. Accessible information through trusted messengers played a key role in decisions to get vaccinated. To better represent communities of color in literature, we call for more research on vaccine confidence and motivators for vaccination in BIPOC and other communities.
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Affiliation(s)
- Olusimbo Ige
- New York City Department of Health and Mental Hygiene, Bureau of Health Equity and Capacity Building, Center for Health Equity and Community Wellness (CHECW), New York, New York, USA
| | - Zoe Sakas
- New York City Department of Health and Mental Hygiene, Bureau of Health Equity and Capacity Building, Center for Health Equity and Community Wellness (CHECW), New York, New York, USA
| | - Monica Kang
- New York City Department of Health and Mental Hygiene, Bureau of Health Equity and Capacity Building, Center for Health Equity and Community Wellness (CHECW), New York, New York, USA
| | - Corrinne Green
- New York City Department of Health and Mental Hygiene, Bureau of Health Equity and Capacity Building, Center for Health Equity and Community Wellness (CHECW), New York, New York, USA
| | - Daphne Brown
- New York City Department of Health and Mental Hygiene, Bureau of Health Equity and Capacity Building, Center for Health Equity and Community Wellness (CHECW), New York, New York, USA
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Payne JR, Bose S, Kubiak RW, Nolen LD. Evaluation of mortality risk after COVID-19 vaccination, Utah 2021. Vaccine 2023; 41:2996-3002. [PMID: 37037710 PMCID: PMC10073592 DOI: 10.1016/j.vaccine.2023.03.072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 03/23/2023] [Accepted: 03/29/2023] [Indexed: 04/08/2023]
Abstract
Introduction In order to evaluate trends in death after COVID-19 vaccination we analyzed the timing of death relative to vaccination date and the causes of death in vaccinated Utahns in 2021. Methods We matched people in the Utah immunization registry with documented COVID-19 vaccinations between December 18, 2020 and December 31, 2021 to Utah’s 2021 vital statistics death records. Vaccinated people were categorized as having one, two, or ≥three COVID-19 vaccine doses in a time-updated metric. We examined crude mortality rates by dosing groups in two-week intervals for all deaths, and by COVID-19 versus non-COVID-19 causes, within the 44 weeks following receipt of the most recent vaccine. Results We identified 2,072,908 individuals who received at least one dose of COVID-19 vaccine of whom 10,997 died in 2021. Only 17.5% of the total vaccinated population was age 65+, while 80.9% of those who died were over 65. In the four weeks following the first or second vaccination, all-cause mortality was low and then stabilized for the remainder of the evaluation period at a bi-weekly average of 33.0 and 39.0 deaths/100,000 people for one and two doses, respectively. Typical seasonal variation in death was observed among those with two doses. Small sample size precluded analysis of those with ≥three doses, but trends were similar. Conclusions Mortality rates in the 44 weeks following the COVID-19 vaccination did not show trends suggesting an increase in mortality related to COVID-19 vaccination, reinforcing the safety of COVID-19 vaccines. This represents an accessible approach for local evaluation.
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Affiliation(s)
- Jessica R Payne
- Utah Department of Health and Human Services, Salt Lake City, UT, USA.
| | - Srimoyee Bose
- Utah Department of Health and Human Services, Salt Lake City, UT, USA
| | - Rachel W Kubiak
- Utah Department of Health and Human Services, Salt Lake City, UT, USA; CDC Foundation, Atlanta, GA, USA
| | - Leisha D Nolen
- Utah Department of Health and Human Services, Salt Lake City, UT, USA
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Toshkov D. What accounts for the variation in COVID-19 vaccine hesitancy in Eastern, Southern and Western Europe? Vaccine 2023; 41:3178-3188. [PMID: 37059674 PMCID: PMC10070781 DOI: 10.1016/j.vaccine.2023.03.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 03/03/2023] [Accepted: 03/15/2023] [Indexed: 04/16/2023]
Abstract
In the wake of mass COVID-19 vaccination campaigns in 2021, significant differences in vaccine skepticism emerged across Europe, with Eastern European countries in particular facing very high levels of vaccine hesitancy and refusal. This study investigates the determinants of COVID-19 vaccine hesitancy and refusal, with a focus on these differences across Eastern, Southern and Western Europe. The statistical analyses are based on individual-level survey data comprising quota-based representative samples from 27 European countries from May 2021. The study finds that demographic variables have complex associations with vaccine hesitancy and refusal. The relationships with age and education are non-linear. Trust in different sources of health-related information has significant associations as well, with people who trust the Internet, social networks and 'people around' in particular being much more likely to express vaccine skepticism. Beliefs in the safety and effectiveness of vaccines have large predictive power. Importantly, this study shows that the associations of demographic, belief-related and other individual-level factors with vaccine hesitancy and refusal are context-specific. Yet, explanations of the differences in vaccine hesitancy across Eastern, Southern and Eastern Europe need to focus on why levels of trust and vaccine-relevant beliefs differ across regions, because the effects of these variables appear to be similar. It is the much higher prevalence of factors such as distrust of national governments and medical processionals as sources of relevant medical information in Eastern Europe that are relevant for explaining the higher levels of vaccine skepticism observed in that region.
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Affiliation(s)
- Dimiter Toshkov
- Institute of Public Administration, Leiden University, the Netherlands
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Storph RP, Essuman MA, Duku‐Takyi R, Akotua A, Asante S, Armah R, Donkoh IE, Addo PA. Willingness to receive COVID-19 booster dose and its associated factors in Ghana: A cross-sectional study. Health Sci Rep 2023; 6:e1203. [PMID: 37064312 PMCID: PMC10090037 DOI: 10.1002/hsr2.1203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 03/11/2023] [Accepted: 03/30/2023] [Indexed: 04/18/2023] Open
Abstract
Background and Aim The COVID-19 booster dose has been cited as an important supplement for the control of the COVID-19 pandemic due to reports of waning immunity among fully vaccinated persons. Determining factors that would affect its acceptability is necessary for initiating successful vaccination programs. In this study, we aimed to evaluate the factors associated with the acceptability of the COVID-19 booster dose in Ghana. Methods We conducted an online cross-sectional survey among the public. A self-administered questionnaire was used to collect information on demographic characteristics, willingness to vaccinate, perceptions toward COVID-19 vaccines, and trust in the government. Participants provided reasons and sources of advice that may affect their willingness to accept a booster dose. Using IBM SPSS and R Statistic; descriptive, univariate, and multivariate analyses were performed. Results Out of 812 respondents, 375 (46.2%) intended to accept the booster dose. Individuals who were males (adjusted odds ratio [aOR] 1.63, 95% confidence interval [CI] 1.07-2.48), had previously received other forms of vaccination twice (aOR 1.96, 95% CI 1.07-3.57) or in most years (aOR 2.51, 95% CI 1.38-4.57), tested positive for COVID-19 (aOR 3.46, 95% CI 1.23-10.52), have high trust in government (aOR=1.77, 95% CI: 1.15-2.74) and had positive perceptions regarding COVID-19 vaccines (OR = 14.24, 95% CI: 9.28-22.44) were more likely to accept a booster dose. Experiencing side effects from the primer dose (aOR 0.12, 95% CI 0.08-0.18) was associated with reduced acceptance. Concerns about vaccine safety and efficacy were the common reasons impeding willingness, while advice from health professionals would be the most considered. Conclusion Low intention to accept the booster dose which is associated with a range of factors including the perception of vaccines and trust in the government, is a cause for concern. Thus, more effort would have to be taken through education and policy interventions to increase booster vaccine acceptability.
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Affiliation(s)
| | - Mainprice Akuoko Essuman
- Department of Medical Laboratory Science, School of Allied Health Sciences, College of Health and Allied SciencesUniversity of Cape CoastCape CoastGhana
| | - Ruth Duku‐Takyi
- Department of Medical Laboratory TechnologyAccra Technical UniversityAccraGhana
| | - Albert Akotua
- ICT DepartmentUniversity Practice Senior High SchoolCape CoastGhana
| | - Samuel Asante
- Laboratory DepartmentCape Coast Teaching HospitalCape CoastGhana
| | - Richard Armah
- Department of Medical Laboratory Science, School of Allied Health Sciences, College of Health and Allied SciencesUniversity of Cape CoastCape CoastGhana
| | - Irene Esi Donkoh
- Department of Medical Laboratory Science, School of Allied Health Sciences, College of Health and Allied SciencesUniversity of Cape CoastCape CoastGhana
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Intent to vaccinate against SARS-CoV-2 and its determinants across six ethnic groups living in Amsterdam, the Netherlands: A cross-sectional analysis of the HELIUS study. Vaccine 2023; 41:2035-2045. [PMID: 36803902 PMCID: PMC9922586 DOI: 10.1016/j.vaccine.2023.02.030] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 12/19/2022] [Accepted: 02/09/2023] [Indexed: 02/15/2023]
Abstract
BACKGROUND Ethnic minority groups experience a disproportionately high burden of infections, hospitalizations and mortality due to COVID-19, and therefore should be especially encouraged to receive SARS-CoV-2 vaccination. This study aimed to investigate the intent to vaccinate against SARS-CoV-2, along with its determinants, in six ethnic groups residing in Amsterdam, the Netherlands. METHODS We analyzed data of participants enrolled in the population-based multi-ethnic HELIUS cohort, aged 24 to 79 years, who were tested for SARS-CoV-2 antibodies and answered questions on vaccination intent from November 23, 2020 to March 31, 2021. During the study period, SARS-CoV-2 vaccination in the Netherlands became available to individuals working in healthcare or > 75 years old. Vaccination intent was measured by two statements on a 7-point Likert scale and categorized into low, medium, and high. Using ordinal logistic regression, we examined the association between ethnicity and lower vaccination intent. We also assessed determinants of lower vaccination intent per ethnic group. RESULTS A total of 2,068 participants were included (median age 56 years, interquartile range 46-63). High intent to vaccinate was most common in the Dutch ethnic origin group (369/466, 79.2%), followed by the Ghanaian (111/213, 52.1%), South-Asian Surinamese (186/391, 47.6%), Turkish (153/325, 47.1%), African Surinamese (156/362, 43.1%), and Moroccan ethnic groups (92/311, 29.6%). Lower intent to vaccinate was more common in all groups other than the Dutch group (P < 0.001). Being female, believing that COVID-19 is exaggerated in the media, and being < 45 years of age were common determinants of lower SARS-CoV-2 vaccination intent across most ethnic groups. Other identified determinants were specific to certain ethnic groups. CONCLUSIONS Lower intent to vaccinate against SARS-CoV-2 in the largest ethnic minority groups of Amsterdam is a major public health concern. The ethnic-specific and general determinants of lower vaccination intent observed in this study could help shape vaccination interventions and campaigns.
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Hegde SJ, Mahmassani H, Smilowitz K. A two-regime analysis of the COVID-19 vaccine distribution process. JOURNAL OF HUMANITARIAN LOGISTICS AND SUPPLY CHAIN MANAGEMENT 2023. [DOI: 10.1108/jhlscm-10-2021-0106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
Purpose
The purpose of this paper is to develop a framework to evaluate and assess the performance of the COVID-19 vaccine distribution process that is sensitive to the unique supply-side and demand-side constraints exhibited in the US vaccine rollout.
Design/methodology/approach
A queuing framework that operates under two distinct regimes is formulated to analyze service rates that represent system capacity to vaccinate (under the first regime) and hesitancy-induced throughput (under the second regime). These supply- and hesitancy-constrained regimes form the focus of the present paper, as the former reflects the inherent ability of the nation in its various jurisdictions to mobilize, whereas the latter reflects a critical area for public policy to protect the population’s overall health and safety.
Findings
The two-regime framework analysis provides insights into the capacity to vaccinate and hesitancy-constrained demand, which is found to vary across the country primarily by politics and region. The framework also allows analysis of the end-to-end supply chain, where it is found that the ability to vaccinate was likely constrained by last-mile administration issues, rather than the capacity of the manufacturing and transportation steps of the supply chain.
Originality/value
This study presents a new framework to consider end-to-end supply chains as dynamic systems that exhibit different regimes because of unique supply- and demand-side characteristics and estimate rollout capacity and underlying determinants at the national, state and county levels.
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Hong SA. COVID-19 vaccine communication and advocacy strategy: a social marketing campaign for increasing COVID-19 vaccine uptake in South Korea. HUMANITIES & SOCIAL SCIENCES COMMUNICATIONS 2023; 10:109. [PMID: 36942012 PMCID: PMC10018596 DOI: 10.1057/s41599-023-01593-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 02/23/2023] [Indexed: 06/18/2023]
Abstract
Research evidence suggests that communication is a powerful tool for influencing public opinion and attitudes toward various health-related issues, such as vaccine reluctance, provided it is well-designed and thoughtfully conducted. In particular, social marketing techniques that alter the target audience's behaviors for the public good can substantially improve vaccine uptake if adopted as a communication strategy in immunization programs to counter public hesitancy. This study presents evidence from the Korean government's current coronavirus disease 2019 (COVID-19) vaccination campaign, which successfully applied a social marketing approach. By the end of August 2022, South Korea had achieved high vaccine coverage, with 94.8% of the population (12+) receiving a second dose, 71.3% a third dose, and a fourth dose drive currently underway. There are five crucial factors to consider when preparing official communication for an immunization program: (i) a high degree of proactiveness, (ii) credibility, (iii) fighting misinformation, (iv) emphasizing social norms and prosocial behavior, and (v) coherence. Although using social marketing strategies may not be successful in all circumstances, the lessons learned and current implementation in Korea suggest their efficacy in fostering vaccine acceptance. This study offers valuable insights for government agencies and global public health practitioners to develop effective targeted campaign strategies that enhance the target population's vaccination intention.
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Affiliation(s)
- Shin-Ae Hong
- Crisis, Disaster and Risk Management, Sungkyunkwan University, Suwon, South Korea
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45
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Frietze GA, Mancera BM, Kenney MJ. COVID-19 Testing, Vaccine Perceptions, and Trust among Hispanics Residing in an Underserved Community. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5076. [PMID: 36981984 PMCID: PMC10049437 DOI: 10.3390/ijerph20065076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 03/07/2023] [Accepted: 03/10/2023] [Indexed: 06/18/2023]
Abstract
The Borderplex region has been profoundly impacted by the COVID-19 pandemic. Borderplex residents live in low socioeconomic (SES) neighborhoods and lack access to COVID-19 testing. The purpose of this study was two-fold: first, to implement a COVID-19 testing program in the Borderplex region to increase the number of residents tested for COVID-19, and second, to administer a community survey to identify trusted sources of COVID-19 information and factors associated with COVID-19 vaccine uptake. A total of 4071 community members were tested for COVID-19, and 502 participants completed the survey. COVID-19 testing resulted in 66.8% (n = 2718) positive cases. The community survey revealed that the most trusted sources of COVID-19 information were doctors or health care providers (67.7%), government websites (e.g., CDC, FDA, etc.) (41.8%), and the World Health Organization (37.8%). Logistic regression models revealed several statistically significant predictors of COVID-19 vaccine uptake such as having a trusted doctor or health care provider, perceiving the COVID-19 vaccine to be effective, and perceiving that the COVID-19 vaccine does not cause side-effects. Findings from the current study highlight the need for utilizing an integrated, multifactorial approach to increase COVID-19 testing and to identify factors associated with COVID-19 vaccine uptake in underserved communities.
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46
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Baeker Bispo JA, Douyon A, Ashad-Bishop K, Balise R, Kobetz EK. How Trust in Cancer Information Has Changed in the Era of COVID-19: Patterns by Race and Ethnicity. JOURNAL OF HEALTH COMMUNICATION 2023; 28:131-143. [PMID: 36927415 PMCID: PMC10132996 DOI: 10.1080/10810730.2022.2117439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
COVID-19 emerged during an era of heightened attention to systemic racism and the spread of misinformation. This context may have impacted public trust in health information about chronic diseases like cancer. Here, we examine data from the 2018 and 2020 Health Information National Trends Survey (N = 7,369) to describe how trust in cancer information from government health agencies, doctors, family and friends, charitable organizations, and religious organizations changed after COVID-19 became a pandemic, and whether that change varied by race/ethnicity. Statistical methods included chi-square tests and multiple logistic regression modeling. Overall, the proportion of respondents who reported a high degree of trust in cancer information from doctors increased (73.65% vs. 77.34%, p = .04). Trends for trust in information from government health agencies and family and friends varied significantly by race/ethnicity, with substantial declines observed among non-Hispanic Blacks (NHB) only. The odds of reporting a high degree of trust in cancer information from government health agencies and friends and family decreased by 53% (OR = 0.47, 95% CI = 0.24-0.93) and 73% (OR = 0.27, 95% CI = 0.09-0.82), respectively, among NHB, but were stable for other groups. Future studies should monitor whether recent declines in trust among NHB persist and unfavorably impact participation in preventive care.
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Affiliation(s)
- JA Baeker Bispo
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - A Douyon
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - K Ashad-Bishop
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - R Balise
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - EK Kobetz
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
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47
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Cooper CA. Vaccine hesitancy and respect for public health measures: Citizens’ trust in politicians and public servants across national, subnational and municipal levels of government. SSM Popul Health 2023; 22:101386. [PMID: 37090687 PMCID: PMC10119790 DOI: 10.1016/j.ssmph.2023.101386] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 03/18/2023] [Accepted: 03/20/2023] [Indexed: 04/03/2023] Open
Abstract
Research shows that citizens' trust in government is associated with lower vaccine hesitancy and an increased willingness to follow public health measures. Thus far, however, the population health literature has largely conceptualized "government" as a unitary actor. This article furthers our understanding of this relationship by examining two important features of modern governance that have largely gone unexamined: (1) that governing involves popularly elected politicians and appointed bureaucrats; and (2), that governing often comprises many levels of government within the same country. Analyzing survey data from Canada with various multivariate regression models, this article finds that the relationship political trust has with vaccine hesitancy and intention to follow for public health measures is more complex than presently recognized. Specifically, a larger change in citizens' public health behaviors is associated with trust in public health officials than with trust in government, and of particular importance is trust in national public health authorities, despite the fact that public health measures in Canada are largely the jurisdiction of subnational governments. The implications of these findings for population health research and policymakers are discussed.
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Viskupič F, Wiltse DL. Political Partisanship and Trust in Government Predict Popular Support for COVID-19 Vaccine Mandates for Various Professions and Demographic Groups: A Research Note. AMERICAN POLITICS RESEARCH 2023; 51:139-146. [PMID: 38603210 PMCID: PMC9364069 DOI: 10.1177/1532673x221118888] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
Due to the slow rate of COVID-19 vaccine uptake and the spread of the highly contagious Omicron variant, governments are considering mandating COVID-19 vaccination for specific professions and demographic groups. This study evaluates popular attitudes toward such policies. We fielded a survey of 535 registered voters in South Dakota to examine popular attitudes towards vaccine mandates for five groups-children 12 and older, K-12 teachers, medical staff, nursing homes staff, and police personnel. We estimated a series of logistic regression models and presented predicted probabilities to find the primary determinants of these attitudes. Results revealed that political partisanship and trust in government are strong predictors of support for vaccine mandates across all models. Should government and public health officials wish to increase the proportion of people vaccinated for COVID-19, they must recognize the limitations of current public health campaigns, and reshape their efforts in congruence with scientific findings.
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Price O, Maher L, Dietze PM, Bruno R, Crawford S, Sutherland R, Salom C, Dore GJ, Peacock A. COVID-19 vaccine attitudes and facilitators among people in Australia who inject drugs. Drug Alcohol Rev 2023. [PMID: 36802338 DOI: 10.1111/dar.13621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 01/17/2023] [Accepted: 01/18/2023] [Indexed: 02/23/2023]
Abstract
INTRODUCTION We aimed to describe COVID-19 vaccination attitudes and identify potential facilitators for vaccine uptake among people who inject drugs. METHODS People who inject drugs were recruited from all eight Australian capital cities (N = 884; 65% male, mean age 44 years) and interviewed face-to-face or via telephone in June-July 2021. COVID-19 and broader vaccination attitudes were used to model latent classes. Correlates of class membership were assessed through multinomial logistic regression. Probability of endorsing potential vaccination facilitators were reported by class. RESULTS Three classes of participants were identified: 'vaccine acceptant' (39%), 'vaccine hesitant' (34%) and 'vaccine resistant' (27%). Those in the hesitant and resistant groups were younger, more likely to be unstably housed and less likely to have received the current season influenza vaccine than the acceptant group. In addition, hesitant participants were less likely to report a chronic medical condition than acceptant participants. Compared to vaccine acceptant and hesitant participants, vaccine-resistant participants were more likely to predominantly inject methamphetamine and to inject drugs more frequently in the past month. Both vaccine-hesitant and resistant participants endorsed financial incentives for vaccination and hesitant participants also endorsed facilitators related to vaccine trust. DISCUSSION AND CONCLUSION People who inject drugs who are unstably housed or predominantly inject methamphetamine are subgroups that require targeted interventions to increase COVID-19 vaccination uptake. Vaccine-hesitant people may benefit from interventions that build trust in vaccine safety and utility. Financial incentives may improve vaccine uptake among both hesitant and resistant people.
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Affiliation(s)
- Olivia Price
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Lisa Maher
- Kirby Institute, UNSW Sydney, Sydney, Australia
| | - Paul M Dietze
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia.,Behaviours and Health Risks Program, Burnet Institute, Melbourne, Australia.,National Drug Research Institute, Melbourne, Australia.,Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Raimondo Bruno
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia.,School of Psychological Science, University of Tasmania, Hobart, Australia
| | | | - Rachel Sutherland
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Caroline Salom
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia.,Institute for Social Science Research, University of Queensland, Brisbane, Australia
| | | | - Amy Peacock
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia.,School of Psychological Science, University of Tasmania, Hobart, Australia
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Makadzange AT, Gundidza P, Lau C, Dietrich J, Myburgh N, Elose N, James W, Stanberry L, Ndhlovu C. Investigating Attitudes, Motivations and Key Influencers for COVID-19 Vaccination Uptake among Late Adopters in Urban Zimbabwe. Vaccines (Basel) 2023; 11:411. [PMID: 36851288 PMCID: PMC9958877 DOI: 10.3390/vaccines11020411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 01/24/2023] [Accepted: 01/31/2023] [Indexed: 02/15/2023] Open
Abstract
The rapid development of vaccines in response to the COVID-19 pandemic has provided an effective tool for the management of COVID-19. However, in many African countries there has been a poor uptake of COVID-19 vaccines with only 32.5% first vaccine dose coverage compared to the WHO global target of 70%. As vaccine access improves, one of the important drivers of low uptake has been vaccine hesitancy, driven by levels of confidence, convenience, and complacency. Between 4 January-11 February 2022, we conducted a survey of vaccine late adopters to assess factors that influenced adults in Harare, Zimbabwe to present for their first COVID-19 vaccine dose almost 12 months after the vaccination program began. Of the 1016 adults enrolled, 50% were female and 12.4% had HIV co-infection. Binary logistic regression models were developed to understand factors associated with vaccine confidence. Women were more likely to have negative views about the COVID-19 vaccine compared to men (OR 1.51 (95%CI 1.16, 1.97, p = 0.002). Older adults (≥40 years) compared with youth (18-25 years) were more likely to have 'major concerns' about vaccines. When asked about their concerns, 602 (59.3%) considered immediate side effects as a major concern and 520 (52.1%) were concerned about long-term health effects. People living with HIV (PLWH) were more likely to perceive vaccines as safe (OR 1.71 (95%CI: 1.07, 2.74, p = 0.025) and effective (1.68 (95%CI: 1.07, 2.64, p = 0.026). Internet users were less likely to perceive vaccines as safe (OR 0.72 (95% CI: 0.55, 0.95, p = 0.021) compared to non-Internet users; and social media was a more likely source of information for youth and those with higher education. Family members were the primary key influencers for 560 (55.2%) participants. The most important reason for receiving the COVID-19 vaccine for 715 (70.4%) participants was the protection of individual health. Improving vaccine coverage will need targeted communication strategies that address negative perceptions of vaccines and associated safety and effectiveness concerns. Leveraging normative behavior as a social motivator for vaccination will be important, as close social networks are key influences of vaccination.
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Affiliation(s)
| | - Patricia Gundidza
- Charles River Medical Group, 155 King George Avenue, Avondale, Harare, Zimbabwe
| | | | - Janan Dietrich
- Perinatal HIV Research Unit (PHRU), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2000, South Africa
- African Social Sciences Unit of Research and Evaluation (ASSURE), Division of the Wits Health Consortium, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2000, South Africa
- Health Systems Research Unit, South African Medical Research Council, Bellville 7530, South Africa
| | - Nellie Myburgh
- Wits Vaccines & Infectious Diseases Analytics (VIDA) Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2000, South Africa
| | - Nyasha Elose
- Charles River Medical Group, 155 King George Avenue, Avondale, Harare, Zimbabwe
| | - Wilmot James
- Institute for Social and Economic Research and Policy, Columbia University, IAB 118th Street, New York, NY 10025, USA
| | - Lawrence Stanberry
- Vaccine Information Network, Columbia University, 533 W 218th St., New York, NY 10032, USA
- Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
| | - Chiratidzo Ndhlovu
- Charles River Medical Group, 155 King George Avenue, Avondale, Harare, Zimbabwe
- Internal Medicine Unit, Faculty of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
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