Understanding COVID-19 vaccination willingness among youth: A survey study in the Netherlands

Intradermal delivery of the third dose of the mRNA-1273 SARS-CoV-2 vaccine: safety and immunogenicity of a fractional booster dose

OBJECTIVES

The aim of this study was to assess the safety and immunogenicity of a dose-sparing fractional intradermal (ID) booster strategy with the mRNA-1273 COVID-19 vaccine.

METHODS

COVID-19 naive adults aged 18-30 years were recruited from a previous study on primary vaccination regimens that compared 20 μg ID vaccinations with 100 μg intramuscular (IM) vaccinations with mRNA-1273 as the primary vaccination series. Participants previously immunized with ID regimens were randomly assigned (1:1) to receive a fractional ID booster dose (20 μg) or the standard-of-care intramuscular (IM) booster dose (50 μg) of the mRNA-1273 vaccine, 6 months after completing their primary series (ID-ID and ID-IM group, respectively). Participants that had received a full dose IM regimen as the primary series, received the IM standard-of-care booster dose (IM-IM group). In addition, COVID-19 naive individuals aged 18-40 years who had received an IM mRNA vaccine as the primary series were recruited from the general population to receive a fractional ID booster dose (IM-ID group). Immunogenicity was assessed using IgG anti-spike antibody responses and neutralizing capacity against SARS-CoV-2. Cellular immune responses were measured in a sub-group. Safety and tolerability were monitored.

RESULTS

In January 2022, 129 participants were included in the study. Fractional ID boosting was safe and well tolerated, with fewer systemic adverse events compared with IM boosting. At day 28 post-booster, anti-spike S1 IgG geometric mean concentrations were 9106 (95% CI, 7150-11 597) binding antibody units (BAU)/mL in the IM-IM group and 4357 (3003-6322) BAU/mL; 6629 (4913-8946) BAU/mL; and 5264 (4032-6873) BAU/mL in the ID-IM, ID-ID, and IM-ID groups, respectively.

DISCUSSION

Intradermal boosting provides robust immune responses and is a viable dose-sparing strategy for mRNA COVID-19 vaccines. The favourable side-effect profile supports its potential to reduce vaccine hesitancy. Fractional dosing strategies should be considered early in the clinical development of future mRNA vaccines to enhance vaccine availability and pandemic preparedness.

Immunogenicity and reactogenicity of intradermal mRNA-1273 SARS-CoV-2 vaccination: a non-inferiority, randomized-controlled trial

Fractional dosing can be a cost-effective vaccination strategy to accelerate individual and herd immunity in a pandemic. We assessed the immunogenicity and safety of primary intradermal (ID) vaccination, with a 1/5th dose compared with the standard intramuscular (IM) dose of mRNA-1273 in SARS-CoV-2 naïve persons. We conducted an open-label, non-inferiority, randomized controlled trial in the Netherlands between June and December 2021. One hundred and fifty healthy and SARS-CoV-2 naïve participants, aged 18-30 years, were randomized (1:1:1) to receive either two doses of 20 µg mRNA-1273 ID with a standard needle (SN) or the Bella-mu® needle (BM), or two doses of 100 µg IM, 28 days apart. The primary outcome was non-inferiority in seroconversion rates at day 43 (D43), defined as a neutralizing antibody concentration threshold of 465 IU/mL, the lowest response in the IM group. The non-inferiority margin was set at -15%. Neutralizing antibody concentrations at D43 were 1789 (95% CI: 1488-2150) in the IM and 1263 (951-1676) and 1295 (1020-1645) in the ID-SN and ID-BM groups, respectively. The absolute difference in seroconversion proportion between fractional and standard-dose groups was -13.95% (-24.31 to -3.60) for the ID-SN and -13.04% (-22.78 to -3.31) for the ID-BM group and exceeded the predefined non-inferiority margin. Although ID vaccination with 1/5th dose of mRNA-1273 did not meet the predefined non-inferior criteria, the neutralizing antibody concentrations in these groups are far above the proposed proxy for protection against severe disease (100 IU/mL), justifying this strategy in times of vaccine scarcity to accelerate mass protection against severe disease.

Motivations for Adolescent COVID-19 Vaccination: A Comparative Study of Adolescent and Caregiver Perspectives in Germany

Given the crucial role of vaccination in halting the COVID-19 pandemic, it is imperative to understand the factors that motivate adolescents to get vaccinated. We surveyed adolescents and their accompanying guardians scheduled to receive a COVID-19 vaccination (Comirnaty) in an urban region in Germany in mid-2021 regarding their motivation for getting vaccinated and collected data on their sociodemographic characteristics, medical history, vaccination status, and any history of COVID-19 infection in the family. We also queried information strategies related to the SARS-CoV-2 pandemic. Motivations for getting vaccinated were similar among adolescents and their parents. The primary reasons for vaccination were protection against SARS-CoV-2-related illness and gaining access to leisure facilities. This was not influenced by gender, health status, migration background, or the presence of chronic or acute diseases. The percentage of parents who had received SARS-CoV-2 immunization and the proportion of parents with a high level of education were higher among study participants than in the general population. Adolescents were especially willing to be vaccinated if they came from a better educational environment and had a high vaccination rate in the family. Emphasizing the importance of vaccination among all segments of the population and removing barriers to vaccines may lead to an ameliorated acceptance of COVID-19 vaccines.

The Impact Of Provincial Proof- Of-Vaccination Policies On Age-Specific First-Dose Uptake Of COVID-19 Vaccines In Canada

Requirements of proof of COVID-19 vaccination were mandated for nonessential businesses and venues by Canada's ten provinces throughout the fall of 2021. Leveraging variations in the timing of these measures across the provinces, we applied event study regression to estimate the impact the announcement of these measures had nationally on age-specific first-dose uptake in the subsequent seven-week period. Proof-of-vaccination mandate announcements were associated with a rapid, significant increase in first-dose uptake, particularly in people younger than age fifty. However, these behavioral changes were short-lived, with uptake returning to preannouncement levels-or lower-in all age groups within six weeks, despite mandates remaining in place for at least four months; this decline occurred earlier and was more apparent among adolescents ages 12-17. We estimated that nationally, 290,168 additional people received their first dose in the seven weeks after provinces announced proof-of-vaccination policies, for a 17.5 percent increase over the number of vaccinations estimated in the absence of these policies. This study provides novel age-specific evidence showing that proof-of-vaccination mandates led to an immediate, significant increase in national first-dose uptake and were particularly effective for increasing vaccination uptake in younger to middle-aged adults. Proof-of-vaccination mandates may be effective short-term policy measures for increasing population vaccination uptake, but their impact may differ across age groups.

Factors associated with COVID-19 vaccine uptake in adolescents: a national cross-sectional study, August 2021-January 2022, England

OBJECTIVES

To assess socioeconomic and geographical factors associated with COVID-19 vaccine uptake in pupils attending state-funded secondary schools in England.

DESIGN

Cross-sectional observational study.

SETTING

State-funded schools in England.

PARTICIPANTS

Pupils aged 12-17 years attending state-funded schools in England for the academic year 2021/2022.

OUTCOME MEASURES

Demographic, socioeconomic and geographical factors associated with vaccination uptake. We linked individual-level data from the English Schools Census to the National Immunisation Management System to obtain COVID-19 vaccination status of 3.2 million adolescents. We used multivariable logistic regression to assess demographic, socioeconomic and geographical factors associated with vaccination.

RESULTS

By 9 January 2022, 56.8% of adolescents aged 12-17 years old had received at least one dose, with uptake increasing from 48.7% in those aged 12 years old to 77.2% in those aged 17 years old. Among adolescents aged 12-15 years old, there were large variations in vaccine uptake by region and ethnic group. Pupils who spoke English as an additional language (38.2% vs 55.5%), with special educational needs (48.1% vs 53.5%), eligible for free school meals (35.9% vs 58.9%) and lived in more deprived areas (36.1% in most deprived vs 70.3% in least deprived) had lower vaccine uptake. Socioeconomic variables had greater impact on the odds of being vaccinated than geographical variables. School-level analysis found wide variation in vaccine uptake between schools even within the same region. Schools with higher proportions of pupils eligible for free school meals had lower vaccine uptake.

CONCLUSIONS

We found large differences in vaccine uptake by geographical region and ethnicity. Socioeconomic variables had a greater impact on the odds of being vaccinated than geographical variables. Further research is required to identify evidence-based interventions to improve vaccine uptake in adolescents.

Establishing immunogenicity and safety of needle-free intradermal delivery by nanoporous ceramic skin patch of mRNA SARS-CoV-2 vaccine as a revaccination strategy in healthy volunteers

INTRODUCTION

Nanoporous microneedle arrays (npMNA) are being developed as skin patches for vaccine delivery. As alternative for needle-based immunisation, they may potentially result in higher vaccine acceptance, which is important for future mass vaccination campaigns to control outbreaks, such as COVID-19, and for public vaccination in general. In this study we investigated the safety and immunogenicity of needle-free intradermal delivery of a fractional third or fourth dose of mRNA-1273 vaccine by npMNA.

METHODS

This study was an open-label, randomised-controlled, proof-of-concept study. Healthy adults were eligible if they had received a primary immunisation series against SARS-CoV-2 with two doses of mRNA-1273 (Moderna) or BNT162b2 (Pfizer-BioNTech) mRNA vaccine. A history of a COVID-19 infection or booster vaccination with mRNA-1273 or BNT162b2 was allowed if it occurred at least three months before inclusion. Participants were randomised in a 1:1 ratio to receive 20 µg mRNA-1273 vaccine, either through npMNA patch applied on the skin (ID-patch group), or through intramuscular (IM) injection (IM-control group). Primary outcomes were reactogenicity up to two weeks after vaccination, and fold-increase of SARS-CoV-2 spike S1-specific IgG antibodies 14 days post-vaccination.

RESULTS

In April 2022, 20 participants were enroled. The geometric mean concentration (GMC) did not increase in the ID-patch group after vaccination, in contrast to the IM-control group (GMC was 1,006 BAU/mL (95% CI 599-1,689), 3,855 (2,800-5,306), and 3,513 (2,554-4,833) at day 1, 15 and 29, respectively). In addition, SARS-CoV-2-specific T cell responses were lower after ID vaccination through npMNA.

CONCLUSION

Needle-free delivery of 20 µg mRNA-1273 vaccine by npMNA failed to induce antibody and T cell responses. As this is a potentially very useful vaccination method, it is important to determine which adjustments are needed to make this npMNA successful. CLINICAL TRIAL REGISTRY (ON CLINICALTRIAL.GOV): NCT05315362.

Intention to Vaccinate against COVID-19 in Adolescents: A Systematic Review

BACKGROUND

Multiple COVID-19 vaccines have been approved for use in adolescents; these vaccines play a critical role in limiting the transmission and impact of COVID-19. This systematic review aims to summarize the willingness of adolescents aged 10 to 19 years to receive the COVID-19 vaccination and the factors influencing their decision.

METHODS

A search of literature published between January 2018 and August 2022 was performed in Medline©, EMBASE©. and CINAHL© electronic databases. Studies published in English that assessed adolescents' intentions to receive the COVID-19 vaccine were included. Qualitative studies and those unrelated to the COVID-19 vaccine were excluded. The study was conducted based on the PRISMA guidelines.

RESULTS

Of the 1074 articles retrieved, 13 were included in the final review. Most studies were conducted in the US (n = 3) and China (n = 3). The pooled prevalence of COVID-19 vaccine acceptance among adolescents was 63% (95% CI: 52-73%). Factors influencing intent to vaccinate were divided into five categories: "Socio-demographic determinants"; "Communication about COVID-19 pandemic and vaccination"; "COVID-19 vaccine and related issues"; "COVID-19 infection and related issues" and "Other determinants". The enablers were sociodemographic factors including older age, higher education level, good health perception, and parental norms in terms of parental vaccination acceptance; perceived vaccine effectiveness and safety; a desire to protect themselves and others; recent vaccination; and anxiety. The barriers were concerns over vaccine effectiveness, safety, and long-term side effects; low perceived necessity and risk of infection; and needle phobia.

CONCLUSIONS

This review highlighted that adolescents' intent to vaccinate is driven by a desire to protect themselves and others. However, concerns over vaccine effectiveness, safety, and long-term side effects hinder COVID-19 vaccine uptake. To improve vaccination acceptance, policymakers should address adolescents' concerns via more targeted public health messaging, while schools should leverage peer norms to positively influence vaccination intent.

COVID-19 vaccination rates among adolescents (12-17 years) by immigrant background and sociodemographic factors: A nationwide registry study in Norway

PURPOSE

Lower COVID-19 vaccination rates have been observed among some adult immigrant populations in Norway, and there appears to be an association with sociodemographic factors. However, knowledge is lacking on the distribution of vaccination rates and role of sociodemographic factors among adolescents. This study aims to describe COVID-19 vaccination rates among adolescents according to immigrant background, household income, and parental education.

METHODS

In this nationwide registry study, we analyzed individual-level data on adolescents (12-17 years) from the Norwegian Emergency preparedness register for COVID-19 until September 15th, 2022. We estimated incidence rate ratios (IRR) for receiving at least one COVID-19 vaccine dose by country background, household income and parental education, using Poisson regression, adjusting for age, sex, and county.

RESULTS

The sample comprised 384,815 adolescents. Foreign-born and Norwegian-born with foreign-born parents, had lower vaccination rates (57 % and 58 %) compared to adolescents with at least one Norwegian-born parent (84 %). Vaccination rates by country background varied from 88 % (Vietnam) to 31 % (Russia). Variation and associations by country background, household income, and parental education were greater among 12-15-year-olds than 16-17-year-olds. Household income and parental education were positively associated with vaccination. Compared to the lowest income and education category, IRRs for household income ranged from 1.07 (95 % CI 1.06-1.09) to 1.31 (95 % CI 1.29-1.33) among 12-15-year-olds, and 1.06 (95 % CI 1.04-1.07) to 1.17 (95 % CI 1.15-1.18) among 16-17-year-olds. For parental education, from IRR 1.08 (95 % CI 1.06-1.09) to 1.18 (95 % CI 1.17-1.20) among 12-15-year-olds, and 1.05 (95 % CI 1.04-1.07) to 1.09 (95 % CI 1.07-1.10) among 16-17-year-olds.

CONCLUSION

COVID-19 vaccination rates varied by immigrant background and age group, with lower rates especially among adolescents with background from Eastern Europe and among younger adolescents. Household income and parental education were positively associated with vaccination rates. Our results may help target measures to increase vaccination rates among adolescents.

Knowledge, Attitude, and Behavior toward COVID-19 Vaccination in Young Italians

Purpose: The knowledge, attitudes, and behavior of young Italians towards the COVID-19 vaccination were analyzed in order to provide information useful to elaborate the strategies that can be implemented to obtain the best possible vaccination coverage in this population. Methods: A cross-sectional study was conducted on 5313 young people aged between 11 and 30 years. Data were collected through an online survey during the period from 1 to 10 March 2021. The answers to the questionnaire were analyzed using SPSS statistical software. Intention to vaccinate was studied by univariate analysis using Pearson’s chi-square test to assess differences between groups for categorical variables, and by multivariate analysis applying the binary logistic regression model, and the Hosmer−Lemeshow test was performed to assess goodness of fit. Results: Television (32.1%), internet/search engine (25.9%), and social networks (10.4%) were the main sources of information for young Italians. The survey analysis showed that 74.5% (3956) of the respondents were willing to be vaccinated against COVID-19 versus 25.5% (1357) who were against it. Demographic data, in particular, age, gender, experience with influenza vaccine, and level of knowledge about the disease, were significant determinants (p < 0.001) for the choice to vaccinate against COVID-19. Discussion: These results suggest that in order to implement the vaccination campaign, correct information is needed to improve awareness of the vaccine and COVID-19, while also taking into account the target group, which differs not only in age but also in the sources of information used compared to the adult population.

Determinants of COVID-19 vaccine behaviour intentions among the youth in Kenya: a cross-sectional study

Introduction

COVID-19 has become a public health concern globally with increased numbers of cases of the disease and deaths reported daily. The key strategy for the prevention of COVID-19 disease is to enhance mass COVID-19 vaccination. However, mass vaccination faces challenges of hesitation to acceptance of the vaccine in the community. The youth may not be among the vulnerable population to severe COVID-19 disease but are highly susceptible to contracting the virus and spreading it. The aim of the study was to assess COVID-19 vaccine youth behavior intentions and their determinants in Kenya.

Methods

The study used a mixed method design, employing a cross-sectional survey and focused group discussions across 47 counties in Urban, Peri-Urban and Rural settings of Kenya. The interviewees were youths aged 18–35, registered in online platforms/peer groups that included Shujaaz, Brck Moja, Aiffluence, Y Act and Heroes for Change. Quantitative data was collected using Google forms. A total of 665 interviews were conducted. Quantitative data was analysed using STATA version 16. In this paper we report quantitative study findings.

Results

The findings of the study indicated that only 42% of the youth were ready to be vaccinated, with 52% adopting a wait and see approach to what happens to those who had received the vaccine and 6% totally unwilling to be vaccinated. The determinants of these behavior intentions included: the perceived adverse effects of the vaccine on health, inadequate information about the COVID-19 vaccine, conflicting information about COVID-19 vaccine from the social media, religious implications of the vaccine, impact of education level on understanding of the vaccine, perceived risk of contracting the COVID-19 disease, efficacy of the COVID-19 vaccine, COVID-19 affecting women than men and trust in the ministry of health to lead COVID-19 interventions. Significantly it was found that hesitancy is higher among females, protestants and those with post-secondary education. Lack of information and concerns around vaccine safety and effectiveness were main cause of COVID-19 vaccine hesitancy. Social media was the major source of information contributing to hesitancy. Other contributors to hesitancy included low trust in the MoH and belief that mass vaccination is not helpful.

Conclusion

Vaccine hesitancy remains high among the youth but the causes of it are modifiable and health systems need to have evidence based engagements with the youth to reduce vaccine hesitancy.

Effectiveness of Social Video Platforms in Promoting COVID-19 Vaccination Among Youth: A Content-Specific Analysis of COVID-19 Vaccination Topic Videos on Bilibili

Background

With the widespread promotion of the COVID-19 vaccination in China, videos about the vaccination have become increasingly available on social video platforms. With the User Generated Content model, different creators’ interpretations of COVID-19 vaccines may influence the attitudes towards the vaccines and vaccination.

Objective

To explore the overview of COVID-19 vaccine-related videos on Bilibili, discussing the communication effects of COVID-19 topic videos and its influencing factors.

Methods

A content analysis was applied to the 202 video samples obtained through data mining regarding the creator’s information, video presentation, and COVID-19 vaccine-related content.

Results

Individuals and medical professionals preferred VLOG videos, media chose to upload informational videos, and enterprises preferred to post showcase videos. Individuals were more likely to discuss the adverse reactions in their videos, while medical professionals were more likely to discuss the vaccination process for the COVID-19 vaccine. Videos with core issues positively influenced the video’s dissemination breadth. The attitudes toward the COVID-19 vaccine in the videos positively influence the recognition of the videos. The richness of knowledge points related to the COVID-19 vaccine negatively affected the recognition and participation.

Conclusion

Social video platforms could play an active role in the vaccination promotion for the youth. Health promotion-related departments and individuals could strengthen agenda setting, grasp the characteristics of young groups, and express positive attitudes toward health issues to achieve better health (vaccine) promotion.

Myocarditis or Pericarditis Following the COVID-19 Vaccination in Adolescents: A Systematic Review

Background: By 16 May 2022, 12,186,798,032 people had been vaccinated with COVID-19 vaccines. Our study found that myocarditis/pericarditis may occur in adolescents after COVID-19 vaccination. Methods: In this regard, we conducted a meta-analysis of seven groups of adolescents aged 12–19 years to compare the incidence of myocarditis/pericarditis after vaccination and compare the relative risk incidence after the first and second doses of a COVID-19 vaccine, and between males and females for risk incidence. Results: We analyzed 22,020,997 subjects from seven studies, including 130 cases of confirmed myocarditis/pericarditis. The overall mean incidence rate was 1.69 cases per 100,000 person-years. Of these, 19 of the 12,122,244 people who received a first dose of a COVID-19 vaccine had myocarditis/pericarditis, an incidence rate of 0.0022% (95% CI 0.0001–0.0034), and 111 of the 1,008,753 people who received a second dose had myocarditis/pericarditis, an incidence rate of 0.0107% (95% CI 0.0059–0.0155). The prevalence relative ratio (RR) after the first and second doses was RR = 5.53 (95% CI: 3.01–10.16), with a higher prevalence after the second dose than after the first dose of a COVID-19 vaccine. After a second dose of a COVID-19 vaccine, the RR for males relative to females was RR = 13.91 (95% CI: 4.30–44.95), with a more pronounced risk of disease in males than in females. Conclusions: Our study showed that myocarditis/pericarditis occurred after vaccination with the BNT162b2 or Comirnaty vaccine, especially after the second vaccination in male adolescents, but the incidence of myocarditis/pericarditis after vaccination with the above vaccines was very rare (0.0022%). Therefore, it is recommended that adolescents should be vaccinated with the COVID-19 universal vaccine as soon as possible and closely monitored for subsequent adverse reactions, which can be treated promptly.

Career Aspiration Fulfillment and COVID-19 Vaccination Intention among Nigerian Youth: An Instrumental Variable Approach

COVID-19 is a pandemic of economic significance in the world. Vaccination has been identified as one of the veritable means to address the problem. Few studies have focused on youths’ vaccination intentions and the role of career aspiration fulfillment. This study therefore analyzed the effect engagement with dream jobs has on the willingness to get vaccinated for COVID-19. The data were from the 12th wave of the Nigeria COVID-19 National Longitudinal Phone Survey (NLPS) collected from 974 youths 15−25 years old. Instrumental Variable Probit regression was used for data analysis. The results showed that 86.57% and 80.34% of the rural and urban youths were willing to take the vaccines, respectively. Moreover, 31.18% and 25.94% of urban and rural youths, respectively, were engaged in their dream jobs. The Probit regression results showed that engagement with dream jobs was positively and significantly influenced (p < 0.01) by knowing someone who has a dream job, age and residence in the Southwest zone, while having a formal education reduced it. Instrumental Variable Probit regression results showed that willingness to take COVID-19 vaccine was positively influenced (p < 0.05) by having a dream job and intending to migrate to rural areas, while urban residence, age and residence in southern geopolitical zones decreased it. It was concluded that having a dream job promotes acceptance of COVID-19 vaccines among the youths, and there is a need for interventions to address hesitancy among urban youths and those in the southern geopolitical zones.

SARS-CoV-2 the ASIA virus (autoimmune/autoinflammatory syndrome induced by adjuvants), the risk of infertility and vaccine hesitancy

INTRODUCTION

COVID-19 has had a calamitous impact on the global community. The current death toll far exceeds 6 million and large numbers of patients are experiencing long-term medical and psychiatric morbidity from the infection. The immunopathology of severe COVID-19 is now better understood. In severely affected patients, there is a chaotic, destructive immune response triggered by SARS-CoV-2, where autoimmunity features prominently.

AREAS COVERED

COVID-19 vaccines ensure a coordinated, balanced immune response to future SARS-CoV-2 infection. The rapid global deployment of effective COVID-19 vaccines has been hindered by financial, logistical and political barriers. Of concern is increasing vaccine hesitancy caused by unfounded conspiracy theories of vaccine adverse effects, often fueled by misinformation and disinformation on social media.

EXPERT OPINION

This perspective discusses the potential impact of the so-called autoimmune/autoinflammatory syndrome caused by adjuvants (ASIA) on COVID-19 vaccine uptake. Proponents of the ASIA syndrome have inappropriately linked infertility to HPV vaccines and have recently suggested antigenic cross-reactivity between SARS-CoV-2 and ovarian follicles. COVID-19 vaccines have also been linked to ASIA and unfounded fear of infertility is a leading cause of vaccine hesitancy. Vaccine hesitancy caused by spurious disorders such as ASIA are likely to harm individuals and delay global vaccination efforts leading to emergence of vaccine and monoclonal antibody resistant mutants, thereby prolonging the COVID-19 pandemic.

Investigating sustainable development for the COVID-19 vaccine supply chain: a structural equation modelling approach

Purpose

Immunization is one of the most cost-effective ways to save lives while promoting good health and happiness. The coronavirus disease 2019 (COVID-19) pandemic has served as a stark reminder of vaccines' ability to prevent transmission, save lives, and have a healthier, safer and more prosperous future. This research investigates the sustainable development (SD) of the COVID-19 vaccine supply chain (VSC).

Design/methodology/approach

This study investigates the relationship between internal process, organizational growth, and its three pillars of SD environmental sustainability, economic sustainability and social sustainability. Survey-based research is carried out in the hospitals providing COVID-19 vaccines. Nine hypotheses are proposed for the study, and all the hypotheses got accepted. The survey was sent to 428 respondents and received 291 responses from health professionals with a response rate of 68%. For the study, the healthcare professionals working in both private and public hospitals across India were selected.

Findings

The structural equation modelling (SEM) approach is used to test the hypothesis. All nine hypotheses are supported. This study examines a link between internal processes and organizational learning and the three sustainability pillars (environmental sustainability, economic sustainability and social sustainability).

Practical implications

This study will help the management and the policymakers to think and adopt SD in the COVID-19 VSC. This paper also implies that robust immunization systems will be required in the future to ensure that people worldwide are protected from COVID-19 and other diseases.

Originality/value

This paper shows the relationship between organizational learning and internal process with environmental sustainability, economic sustainability and social sustainability for the COVID-19. Studies on VSC of COVID-19 are not evident in any previous literature.

An Online Experiment of NHS Information Framing on Mothers’ Vaccination Intention of Children against COVID-19

Children under the age of 5, will likely all be offered vaccination against SARS-CoV-2 soon. Parental concerns over vaccination of children are long standing and could impede the success of a vaccination campaign. In the UK, a trusted source to inform vaccination choices is the NHS website. Here we used a randomized controlled experiment of framing effects in NHS information content for COVID-19 and flu with 550 mothers under the age of 5. We compared both vaccination offers following two commonly used frames in vaccination informational campaigns: alerting to the risks of no vaccination for the child itself vs. those in their community. We find that vaccination intention was twice as high when risks to the child are emphasized, relative to risks to the community. Exploratory analyses suggest that these effects may differ between white and non-white mothers. Whilst communication directed at adult vaccination against COVID-19 generally focuses on risks of infecting others, communication about vaccination of children may benefit from emphasizing risks to the children themselves. This pattern is in line with flu vaccination research from pre-COVID-19 times.

The Effect of Message Framing on COVID-19 Vaccination Intentions among the Younger Age Population Groups: Results from an Experimental Study in the Italian Context

The coronavirus pandemic has been recognized as a major threat to public health. Widespread acceptance of COVID-19 vaccines is crucial for achieving adequate immunization coverage to end the global pandemic. However, to date, there are still hesitant people, especially among the younger population groups. For this reason, it is essential to identify the psychological variables that may affect vaccination intention among these “at risk groups” and to select possible successful communication frames in order to increase vaccination rates. An online cross-sectional survey was carried out on 208 Italian citizens younger than 50 years old, to explore message framing effects on their intention to receive the vaccination and to understand the psychological factors influencing it. Results showed that depending on the goal (stimulate vaccination intention, vaccination trust, or vaccine attitude), not all the communication stimuli are equally effective on this target population. Furthermore, the study showed that sociodemographic variables do not help to explain the vaccination intention of the younger population groups, while the psychological variables have been found to have a stronger impact on such attitude. Trust and attitudes towards vaccines, concern about the pandemic and concern about infecting others have been found to be the most effective predictive variables of people vaccination intention. The study results underline the importance of understanding the psychological roots behind vaccine hesitancy to shape sensitization actions and vaccination campaigns targeting this population group.