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Helary A, Botelho-Nevers E, Bonneton M, Khennouf L, Sambourg J, Launay O, Gagneux-Brunon A. Factors, motivations and barriers associated with eagerness to volunteer in COVID-19 vaccine clinical trials in France: A mixed-method study. Vaccine 2024; 42:126035. [PMID: 38910094 DOI: 10.1016/j.vaccine.2024.06.003] [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: 11/10/2023] [Revised: 05/03/2024] [Accepted: 06/01/2024] [Indexed: 06/25/2024]
Abstract
INTRODUCTION During the COVID-19 pandemic, there was an unprecedented effort to engage people in clinical vaccine research. Most of the French volunteers registered in the first weeks after the launch in October 2020 of COVIREIVAC, an electronic platform dedicated to COVID-19 vaccine clinical trials (VCT). In the context of pandemic preparedness, identifying factors associated with eagerness or hesitancy to participate in VCT may help to increase recruitment of volunteers from diverse backgrounds. METHODS We used a mixed-method survey offered to the volunteers registered on the COVIREIVAC platform, and semi-directed interviews in participants to COVID-19 VCTs. Volunteers were divided into three categories: early volunteers (EV), registered before the launch of the COVID-19 vaccination campaign, middle volunteers (MV) registered between the first of January 2021 and the generalization of the COVID-19 vaccination to the entire population in May 2021, and late volunteers (LV) registered afterward. RESULTS Among the 56,101 COVIREIVAC registered volunteers, 2,741 (4.9 %) completed the survey, 1,915 (69.6%) were EV, 301 (11.0%) were MV and 525 (19.2 %) were LV. Sixteen were face-to-face interviewed. Age, educational level, attitudes toward vaccination evaluated with the 5C-model did not differ between EV and MV. Women gender and the possibility to choose the vaccine platform was associated with being a MV. LV were significantly younger, had a lower educational level and had less positive attitudes toward vaccines than EV and MV. The main motivations for participation in VCTs were altruistic notably in EV and MV. For LV, they registered in the hope to choice the vaccine technology. Among the respondents, 2,041 (74.5 %) would consider to participate in a non-COVID-19 VCT. CONCLUSION LV on the COVIREIVAC platform had a distinct profile from EV and MV, and were less confident in vaccines. Restoring confidence in vaccines and clinical may help to engage more diverse populations in VCTs.
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Affiliation(s)
- Aloïs Helary
- Inserm, F-CRIN, I-REIVAC/COVIREIVAC, 75679 Paris, France
| | - Elisabeth Botelho-Nevers
- Centre International de Recherche en Infectiologie, Team GIMAP, Univ Lyon, Université Jean Monnet, Université Claude Bernard Lyon 1, Inserm, U1111, CNRS, UMR530, France; CIC INSERM 1408 Vaccinologie, CHU de Saint-Etienne, France; Chaire PREVACCI, Université Jean Monnet, Saint-Etienne, France
| | - Marion Bonneton
- PCCEI, UMR 1058, Université de Montpellier, INSERM, EFS, France
| | - Léa Khennouf
- Centre International de Recherche en Infectiologie, Team GIMAP, Univ Lyon, Université Jean Monnet, Université Claude Bernard Lyon 1, Inserm, U1111, CNRS, UMR530, France; CIC INSERM 1408 Vaccinologie, CHU de Saint-Etienne, France; Chaire PREVACCI, Université Jean Monnet, Saint-Etienne, France
| | | | - Odile Launay
- Inserm, F-CRIN, I-REIVAC/COVIREIVAC, 75679 Paris, France; Université de Paris, Inserm CIC 1417, Assistance publique - Hôpitaux de Paris, hôpital Cochin, 75679 Paris, France
| | - Amandine Gagneux-Brunon
- Centre International de Recherche en Infectiologie, Team GIMAP, Univ Lyon, Université Jean Monnet, Université Claude Bernard Lyon 1, Inserm, U1111, CNRS, UMR530, France; CIC INSERM 1408 Vaccinologie, CHU de Saint-Etienne, France; Chaire PREVACCI, Université Jean Monnet, Saint-Etienne, France.
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Gonzalez-Jaramillo N, Abbühl D, Roa-Díaz ZM, Kobler-Betancourt C, Frahsa A. COVID-19 vaccine acceptance in the general population and under-resourced communities from high-income countries: realist review. BMJ Open 2024; 14:e084560. [PMID: 38631831 PMCID: PMC11029206 DOI: 10.1136/bmjopen-2024-084560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 03/28/2024] [Indexed: 04/19/2024] Open
Abstract
OBJECTIVE To compare vaccination willingness before rollout and 1 year post-rollout uptake among the general population and under-resourced communities in high-income countries. DESIGN A realist review. DATA SOURCES Embase, PubMed, Dimensions ai and Google Scholar. SETTING High-income countries. DEFINITIONS We defined vaccination willingness as the proportion of participants willing or intending to receive vaccines prior to availability. We defined vaccine uptake as the real proportion of the population with complete vaccination as reported by each country until November 2021. RESULTS We included data from 62 studies and 18 high-income countries. For studies conducted among general populations, the proportion of vaccination willingness was 67% (95% CI 62% to 72%). In real-world settings, the overall proportion of vaccine uptake among those countries was 73% (95% CI 69% to 76%). 17 studies reported pre-rollout willingness for under-resourced communities. The summary proportion of vaccination willingness from studies reporting results among people from under-resourced communities was 52% (95% CI 0.46% to 0.57%). Real-world evidence about vaccine uptake after rollout among under-resourced communities was limited. CONCLUSION Our review emphasises the importance of realist reviews for assessing vaccine acceptance. Limited real-world evidence about vaccine uptake among under-resourced communities in high-income countries is a call to context-specific actions and reporting.
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Affiliation(s)
| | - Dominik Abbühl
- ISPM, University of Bern, Bern, Switzerland
- Faculty of Medicine, University of Bern, Bern, Switzerland
| | - Zayne Milena Roa-Díaz
- ISPM, University of Bern, Bern, Switzerland
- Faculty of Medicine, University of Bern, Bern, Switzerland
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Tang S, Ji L, Bishwajit G, Guo S. Uptake of COVID-19 and influenza vaccines in relation to preexisting chronic conditions in the European countries. BMC Geriatr 2024; 24:56. [PMID: 38216899 PMCID: PMC10785450 DOI: 10.1186/s12877-023-04623-5] [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: 02/24/2023] [Accepted: 12/18/2023] [Indexed: 01/14/2024] Open
Abstract
BACKGROUND The suboptimal uptake of COVID-19 and influenza vaccines among those with non-communicable chronic diseases is a public health concern, because it poses a higher risk of severe illness for individuals with underlying health conditions, emphasizing the need to address barriers to vaccination and ensure adequate protection for this vulnerable population. In the present study, we aimed to identify whether people with chronic illnesses are more likely to get vaccinated against COVID-19 and influenza in the European Union. METHODS Cross-sectional data on 49,253 men (n = 20,569) and women (n = 28,684) were obtained from the ninth round of the Survey of Health, Ageing and Retirement in Europe (June - August, 2021). The outcome variables were self-reported COVID-19 and influenza vaccine uptake status. The association between the uptake of the vaccines and six preexisting conditions including high blood pressure, high blood cholesterol, chronic lung disease, diabetes, chronic bronchitis, and asthma was estimated using binary logistic regression methods. RESULTS The vaccination coverage for COVID-19 ranged from close to 100% in Denmark (98.2%) and Malta (98.2%) to less than 50% in Bulgaria (19.1%) and Romania (32.7%). The countries with the highest percentage of participants with the influenza vaccine included Malta (66.7%), Spain (63.7%) and the Netherlands (62.5%), and those with the lowest percentage included Bulgaria (3.7%), Slovakia (5.8%) and Poland (9.2%). Participants with high blood pressure were 3% less likely [Risk difference (RD) = -0.03, 95% CI = -0.04, -0.03] to report taking COVID-19 and influenza [RD = -0.03, 95% CI= -0.04, -0.01] vaccine. Those with chronic lung disease were 4% less likely [RD = -0.04, 95% CI= -0.06, -0.03] to report taking COVID-19 and 2% less likely [RD= -0.02, 95% CI = -0.04, -0.01] to report taking influenza vaccine. Men and women with high blood pressure were 3% less likely to have reported taking both of the vaccines. CONCLUSIONS Current findings indicate a suboptimal uptake of COVID-19 and influenza vaccines among adult men and women in the EU countries. Those with preexisting conditions, including high blood pressure and chronic lung disease are less likely to take the vaccines.
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Affiliation(s)
- Shangfeng Tang
- School of Medicine and Health Management, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Lu Ji
- School of Medicine and Health Management, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Ghose Bishwajit
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Shuyan Guo
- National Institute of Hospital Administration, National Health Commission, Beijing, China.
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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: 8] [Impact Index Per Article: 8.0] [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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Zimmermann BM, Paul KT, Araújo ER, Buyx A, Ferstl S, Fiske A, Kraus D, Marelli L, McLennan S, Porta V, Prainsack B, Radhuber IM, Saxinger G. The social and socio-political embeddedness of COVID-19 vaccination decision-making: A five-country qualitative interview study from Europe. Vaccine 2023; 41:2084-2092. [PMID: 36813665 PMCID: PMC9933319 DOI: 10.1016/j.vaccine.2023.02.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 02/02/2023] [Accepted: 02/03/2023] [Indexed: 02/18/2023]
Abstract
The uptake ofCOVID-19 vaccines has varied considerably across European countries. This study investigates people's decision-making process regarding vaccination by analyzing qualitative interviews (n = 214) with residents from five European countries: Austria, Germany, Italy, Portugal, and Switzerland. We identify three factors that shape vaccination decision-making: individual experiences and pre-existing attitudes towards vaccination, social environment, and socio-political context. Based on this analysis, we present a typology of decision-making regarding COVID-19 vaccines, where some types present stable stances towards vaccines and others change over time. Trust in government and relevant stakeholders, broader social factors, and people's direct social environment were particularly relevant to these dynamics. We conclude that vaccination campaigns should be considered long-term projects (also outside of pandemics) in need of regular adjustment, communication and fine-tuning to ensure public trust. This is particularly pertinent for booster vaccinations, such as COVID-19 or influenza.
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Affiliation(s)
- Bettina M Zimmermann
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland; Institute of History and Ethics in Medicine, School of Social Sciences, TUM School of Medicine, Technical University of Munich, Munich, Germany.
| | - Katharina T Paul
- Department of Political Science & Research Platform Governance of Digital Practices (DigiGov), University of Vienna, Universitätsstraße 7, 1010 Wien, Austria.
| | - Emília R Araújo
- Institute of Social Sciences, Research Center on Communication Studies, University of Minho, Gualtar, 4710-057 Braga, Portugal.
| | - Alena Buyx
- Institute of History and Ethics in Medicine, School of Social Sciences, TUM School of Medicine, Technical University of Munich, Munich, Germany.
| | - Sebastian Ferstl
- Department of Political Science & Research Platform Governance of Digital Practices (DigiGov), University of Vienna, Universitätsstraße 7, 1010 Wien, Austria.
| | - Amelia Fiske
- Institute of History and Ethics in Medicine, School of Social Sciences, TUM School of Medicine, Technical University of Munich, Munich, Germany.
| | - David Kraus
- Department of Political Science & Research Platform Governance of Digital Practices (DigiGov), University of Vienna, Universitätsstraße 7, 1010 Wien, Austria.
| | - Luca Marelli
- Department of Medical Biotechnology and Translational Medicine, University of Milan, Via Vanvitelli 32, 20129 Milan, Italy; Life Sciences & Society Lab, Centre for Sociological Research, KU Leuven, Parkstraat 45, 3000 Leuven, Belgium.
| | - Stuart McLennan
- Institute of History and Ethics in Medicine, School of Social Sciences, TUM School of Medicine, Technical University of Munich, Munich, Germany.
| | - Vittoria Porta
- Department of Experimental Oncology, IEO, Istituto Europeo di Oncologia IRCCS, Via Adamello 16, 20139 Milan, Italy.
| | - Barbara Prainsack
- Department of Political Science & Research Platform Governance of Digital Practices (DigiGov), University of Vienna, Universitätsstraße 7, 1010 Wien, Austria.
| | - Isabella M Radhuber
- Department of Political Science, University of Vienna, Universitätsstraße 7, 1010 Wien, Austria.
| | - Gertrude Saxinger
- Department of Political Science, University of Vienna, Universitätsstraße 7, 1010 Wien, Austria Institute of Social Anthropology, University of Bern, Lerchenweg 36, 3012 Bern, Switzerland.
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Lockyer B, Moss RH, Endacott C, Islam S, Sheard L. Compliant citizens, defiant rebels or neither? Exploring change and complexity in COVID-19 vaccine attitudes and decisions in Bradford, UK: Findings from a follow-up qualitative study. Health Expect 2023; 26:376-387. [PMID: 36457270 PMCID: PMC9854290 DOI: 10.1111/hex.13667] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 10/24/2022] [Accepted: 11/06/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND COVID-19 vaccines have been the central pillar of the public health response to the pandemic, intended to enable us to 'live with Covid'. It is important to understand change and complexity of COVID-19 vaccines attitudes and decisions to maximize uptake through an empathetic lens. OBJECTIVE To explore the factors that influenced people's COVID-19 vaccines decisions and how their complex attitudes towards the vaccines had changed in an eventful year. DESIGN AND PARTICIPANTS This is a follow-up study that took place in Bradford, UK between October 2021 and January 2022, 1 year after the original study. In-depth phone interviews were conducted with 12 (of the 20 originally interviewed) people from different ethnic groups and areas of Bradford. Reflexive thematic analysis was conducted. RESULTS Eleven of the 12 participants interviewed had received both doses of the COVID-19 vaccine and most intended to have a booster dose. Participants described a variety of reasons why they had decided to have the vaccines, including the following: feeling at increased risk at work; protecting family and others in their communities; unrestricted travel and being influenced by the vaccine decisions of family, friends and colleagues. All participants discussed ongoing interaction with COVID-19 misinformation and for some, this meant they were uneasy about their decision to have the vaccine. They described feeling overloaded by and disengaged from COVID-19 information, which they often found contradictory and some felt mistrustful of the UK Government's motives and decisions during the pandemic. CONCLUSIONS The majority of participants had managed to navigate an overwhelming amount of circulating COVID-19 misinformation and chosen to have two or more COVID-19 vaccines, even if they had been previously said they were unsure. However, these decisions were complicated, demonstrating the continuum of vaccine hesitancy and acceptance. This follow-up study underlines that vaccine attitudes are changeable and contextual. PATIENT OR PUBLIC CONTRIBUTION The original study was developed through a rapid community and stakeholder engagement process in 2020. Discussion with the Bradford Council Public Health team and the public through the Bradford COVID-19 Community Insights Group was undertaken in 2021 to identify important priorities for this follow-up study.
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Affiliation(s)
- Bridget Lockyer
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation TrustBradfordUK
| | - Rachael H. Moss
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation TrustBradfordUK
| | - Charlotte Endacott
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation TrustBradfordUK
| | - Shahid Islam
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation TrustBradfordUK
| | - Laura Sheard
- Department of Health SciencesUniversity of YorkYorkUK
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Heyerdahl LW, Dielen S, Dodion H, Van Riet C, Nguyen T, Simas C, Boey L, Kattumana T, Vandaele N, Larson HJ, Grietens KP, Giles-Vernick T, Gryseels C. Strategic silences, eroded trust: The impact of divergent COVID-19 vaccine sentiments on healthcare workers' relations with peers and patients. Vaccine 2023; 41:883-891. [PMID: 36319488 PMCID: PMC9606030 DOI: 10.1016/j.vaccine.2022.10.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 10/14/2022] [Accepted: 10/15/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Polarized debates about Covid-19 vaccination and vaccine mandates for healthcare workers (HCWs) challenge Belgian HCWs ability to discuss Covid-19 vaccine sentiments with peers and patients.Although studies have identified drivers of HCWs vaccine hesitancy, they do not include effects of workplace interactions and have not addressed consequences beyond vaccine coverage. METHODS Interviews and focus group discussions with 74 HCWs practicing in Belgium addressed Covid-19 vaccine sentiments and experiences of discussing vaccination with peers and patients. RESULTS Most participating HCWs reported difficulties discussing Covid-19 vaccination with peers and patients. Unvaccinated HCWs often feared that expressing their vaccine sentiments might upset patients or peers and that they would be suspended. Consequently, they used social cues to evaluate others' openness to vaccine-skeptical discourses and avoided discussing vaccines. Surprisingly, some vaccine-confident HCWs hid their vaccine sentiments to avoid peer and patient conflicts. Both vaccinated and unvaccinated HCWs observed that unvaccinated patients occasionally received suboptimal care. Suboptimal care was central in unvaccinated HCW unwillingness to express their vaccine sentiments to peers. Both vaccinated and unvaccinated HCWs described loss of trust and ruptured social relations with peers and patients holding divergent vaccine sentiments. DISCUSSION Belgian HCW perceived Covid-19 vaccines as a risky discussion topic and engaged in "strategic silences" around vaccination to maintain functional work relationships and employment in health institutions. Loss of trust between HCW and peers or patients, along with suboptimal patient care based on vaccination status, threaten to weaken Belgium's, and by implication, other health systems, and to catalyze preventable disease outbreaks.
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Affiliation(s)
- Leonardo W Heyerdahl
- Department of Global Health, Anthropology and Ecology of Disease Emergence Unit, Institut Pasteur, Paris, France.
| | - Stef Dielen
- Socio-Ecological Health Research Unit, Institute of Tropical Medicine, Antwerp, Belgium
| | - Hélène Dodion
- Socio-Ecological Health Research Unit, Institute of Tropical Medicine, Antwerp, Belgium
| | | | - ToTran Nguyen
- Socio-Ecological Health Research Unit, Institute of Tropical Medicine, Antwerp, Belgium
| | - Clarissa Simas
- Vaccine Confidence Project and London School of Hygiene and Tropical Medicine, United Kingdom
| | - Lise Boey
- Access-To-Medicines Research Centre, KU Leuven, Belgium
| | - Tarun Kattumana
- Access-To-Medicines Research Centre, KU Leuven, Belgium; Husserl Archives, Research Center for Phenomenology and Continental Philosophy, Institute of Philosophy, KU Leuven, Belgium
| | - Nico Vandaele
- Access-To-Medicines Research Centre, KU Leuven, Belgium
| | - Heidi J Larson
- Vaccine Confidence Project and London School of Hygiene and Tropical Medicine, United Kingdom
| | - Koen Peeters Grietens
- Socio-Ecological Health Research Unit, Institute of Tropical Medicine, Antwerp, Belgium; School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Tamara Giles-Vernick
- Department of Global Health, Anthropology and Ecology of Disease Emergence Unit, Institut Pasteur, Paris, France
| | - Charlotte Gryseels
- Socio-Ecological Health Research Unit, Institute of Tropical Medicine, Antwerp, Belgium
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Markovic-Denic L, Nikolic V, Pavlovic N, Maric G, Jovanovic A, Nikolic A, Marusic V, Sipetic Grujicic S, Pekmezovic T. Changes in Attitudes toward COVID-19 Vaccination and Vaccine Uptake during Pandemic. Vaccines (Basel) 2023; 11:147. [PMID: 36679992 PMCID: PMC9864985 DOI: 10.3390/vaccines11010147] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 01/05/2023] [Accepted: 01/06/2023] [Indexed: 01/11/2023] Open
Abstract
The epidemic control approach was based on non-pharmacological measures in the first year of the COVID-19 pandemic, followed by vaccine uptake in the second year. Vaccine uptake depends on the individual attitude toward vaccination. The aim was to assess the changes in attitudes regarding COVID-19 vaccine protection during the pandemic and to determine the vaccination uptake concerning these attitudes. A panel study on COVID-19 vaccine attitudes and vaccination against COVID-19 was conducted in Belgrade, Serbia. The first survey was carried out in May−June 2020, and the second survey was organized in August−September 2021. During the baseline testing performed in 2020, 64.4% of respondents believed that the future vaccine against COVID-19 could protect against the COVID-19 disease, while 9.7% thought that it could not, and 25.9% were unsure. One year later, in the second survey, the percentage of participants with positive attitudes was slightly lower (64.7% vs. 62.5%). However, negative attitudes turned positive in 34% of cases, and 28.9% became unsure about vaccine protection (p < 0.001). Out of the 390 participants included in the study, 79.7% were vaccinated against COVID-19 until follow-up. There is a statistically significant difference in vaccination uptake compared to the baseline attitude about the protection of the COVID-19 vaccine. The main finding of our study is that the majority of participants who were vaccine hesitant during the baseline testing changed their opinion during the follow-up period. Additionally, the baseline attitude about the protection of the COVID-19 vaccine has been shown to be a potential determinant of vaccination uptake.
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Affiliation(s)
- Ljiljana Markovic-Denic
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Vladimir Nikolic
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Nevenka Pavlovic
- Center for Disease Control and Prevention, Institute of Public Health of Belgrade, 11000 Belgrade, Serbia
| | - Gorica Maric
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Aleksa Jovanovic
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Aleksandra Nikolic
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Vuk Marusic
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Sandra Sipetic Grujicic
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Tatjana Pekmezovic
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
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Exploring the Association between Negative Emotions and COVID-19 Vaccine Acceptance: A Cross-Sectional Analysis of Unvaccinated Adults in Sweden. Vaccines (Basel) 2022; 10:vaccines10101695. [PMID: 36298560 PMCID: PMC9608178 DOI: 10.3390/vaccines10101695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 10/06/2022] [Accepted: 10/07/2022] [Indexed: 11/17/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has had a significant impact on individuals’ mental health. This study aimed to investigate how negative emotions toward the COVID-19 pandemic, including feeling anxious, depressed, upset, and stressed, were associated with COVID-19 vaccine acceptance in Sweden. The study is a cross-sectional online survey conducted between 21–28 May 2021, using three nested hierarchical logistic regression models to assess the association. The study included 965 unvaccinated individuals, 51.2% (n = 494) of whom reported their intention to get vaccinated. We observed graded positive associations between reported negative emotions and vaccine acceptance. Individuals who experienced economic stress had lower odds of vaccine acceptance while having a positive opinion of the government’s response to COVID-19 was associated with higher odds of being vaccine-acceptant. In conclusion, unvaccinated individuals experiencing negative emotions about the pandemic were more willing to get the vaccine. On the contrary, those with a negative opinion about the government’s response, and those that had experienced economic stress were less likely to accept the immunization.
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Ludvigsson JF, Loboda A. Systematic review of health and disease in Ukrainian children highlights poor child health and challenges for those treating refugees. Acta Paediatr 2022; 111:1341-1353. [PMID: 35466444 PMCID: PMC9324783 DOI: 10.1111/apa.16370] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 04/19/2022] [Accepted: 04/21/2022] [Indexed: 12/24/2022]
Abstract
Aim Millions of Ukrainian children have been internally displaced or fled to other countries because of the Russian war. This systematic review focused on their health needs and future challenges for clinicians. Methods A systematic literature search of the Medline, Embase and MedRxiv databases from 1 January 2010 to 31 March 2022 identified 1628 papers on the health of Ukrainian children and 112 were relevant to this review. Results In 2019, under‐5 mortality was 8 per 1000 live births in Ukraine. Underweight and adverse childhood experiences, including child abuse, were frequent compared to other European countries, while childhood obesity seemed less common. Alcohol consumption was common in women of reproductive age, including during pregnancy, risking foetal alcohol syndrome. Neonatal screening programmes provided low coverage. Vaccine hesitancy was common and vaccination rates were low. Other concerns were measles, HIV, antibiotic resistance and multi‐resistant tuberculosis. Many children are expected to suffer from psychological and physical trauma due to the war. Other healthcare challenges include low COVID‐19 vaccination rates and a preference for secondary and tertiary care, rather than primary care. Many people cannot afford medication. Conclusion Ukrainian children often have poor health and host countries need to be aware of their needs.
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Affiliation(s)
- Jonas F. Ludvigsson
- Department of Medical Epidemiology and Biostatistics Karolinska Institutet Stockholm Sweden
- Department of Paediatrics Orebro University Hospital Orebro Sweden
- Department of Medicine Columbia University College of Physicians and Surgeons New York New York USA
| | - Andrii Loboda
- Department of Paediatrics, Academic and Research Medical Institute Sumy State University Sumy Ukraine
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Siewchaisakul P, Sarakarn P, Nanthanangkul S, Longkul J, Boonchieng W, Wungrath J. Role of literacy, fear and hesitancy on acceptance of COVID-19 vaccine among village health volunteers in Thailand. PLoS One 2022; 17:e0270023. [PMID: 35749368 PMCID: PMC9231694 DOI: 10.1371/journal.pone.0270023] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 06/02/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The roles of literacy, fear and hesitancy were investigated for acceptance of COVID-19 vaccine (AV) types among village health volunteers (VHVs) in Thailand. MATERIALS AND METHODS A cross-sectional study was conducted using an unidentified online questionnaire to assess literacy, fear and hesitancy of COVID-19 vaccine acceptance among Thai VHVs between 1 and 15 October 2021. The questionnaire was developed based on the HLVa-IT (Health Literacy Vaccinale degli adulti in Italiano) for vaccine literacy (VL), using an adult Vaccine Hesitancy Scale (aVHS) for COVID-19 vaccine hesitancy (VH) and Fear of COVID-19 scale (FCoV-19S) for the distress of COVID-19 vaccine. The effects of VL, VH and vaccine fear (VF) on AV were estimated using multivariable logistic regression. RESULTS A total of 5,312 VHVs completed the questionnaire. After adjustment with variables in the multivariable analysis, the VL score was insignificantly associated with increased vaccination (aOR = 1.002; (95%CI: 0.994-1.01)), while VF and VH significantly decreased the chance of vaccination, aOR = 0.966 (95%CI: 0.953-0.978) and aOR = 0.969; (95%CI: 0.960-0.979), respectively and VF and VH were negatively associated with AV for all types of vaccine preference, with VL showing a reverse relationship only for mRNA-based vaccines. CONCLUSION VL may not increase AV among VHVs. To increase attitudes toward receiving COVID-19 vaccination in Thailand, the government and health-related organizations should instigate policies to significantly reduce VF and VH among Thai VHVs.
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Affiliation(s)
- Pallop Siewchaisakul
- Faculty of Public Health, Chiang Mai University, Chiang Mai, Thailand
- The Center of Excellence in Community Health Informatics, Chiang Mai University, Chiang Mai, Thailand
| | - Pongdech Sarakarn
- Epidemiology and Biostatistics Department, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand
- ASEAN Cancer Epidemiology and Prevention Research Group, Khon Kaen, Thailand
| | - Sirinya Nanthanangkul
- Research Publishing and Academic support Department, Udonthani Cancer Hospital, Department of Medical Services, Ministry of Public Health, Nong Phai, Thailand
| | - Jirapat Longkul
- Faculty of Public health, Thammasat University, Bangkok, Thailand
| | - Waraporn Boonchieng
- Faculty of Public Health, Chiang Mai University, Chiang Mai, Thailand
- The Center of Excellence in Community Health Informatics, Chiang Mai University, Chiang Mai, Thailand
| | - Jukkrit Wungrath
- Faculty of Public Health, Chiang Mai University, Chiang Mai, Thailand
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Overheu O, Lendowski S, Quast DR, Marheinecke CS, Kourti E, Lugnier C, Andreica I, Kiltz U, Pfaender S, Reinacher-Schick A. Attitude towards and perception of individual safety after SARS-CoV-2 vaccination among German cancer patients. J Cancer Res Clin Oncol 2022; 149:1985-1992. [PMID: 35731276 PMCID: PMC9215322 DOI: 10.1007/s00432-022-04099-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 05/29/2022] [Indexed: 11/25/2022]
Abstract
Purpose Refusal to receive SARS-CoV-2 vaccination poses a threat to fighting the COVID-19 pandemic. Little is known about German cancer patients’ attitude towards and experience with SARS-CoV-2 vaccination. Methods Patients were enrolled between 04–11/2021. They completed a baseline questionnaire (BLQ) containing multiple choice questions and Likert items ranging from 1 (“totally disagree”) to 11 (“totally agree”) regarding their attitude towards vaccination and COVID-19. A follow-up questionnaire (FUQ) was completed after vaccination. Results 218 patients (43% female) completed BLQ (110 FUQ; 48% female). Most patients agreed to “definitely get vaccinated” (82%) and disagreed with “SARS-CoV-2 vaccination is dispensable due to COVID-19 being no serious threat” (82%; more dissent among men, p = 0.05). Self-assessment as a member of a risk group (p = 0.03) and fear of COVID-19 (p = 0.002) were more common among women. Fear of side effects was more common among women (p = 0.002) and patients with solid or GI tumors (p = 0.03; p < 0.0001). At FUQ, almost all (91%) reported their vaccination to be well tolerated, especially men (p = 0.001). High tolerability correlated with confidence in the vaccine being safe (r = 0.305, p = 0.003). Most patients would agree to get it yearly (78%). After vaccination, patients felt safe meeting friends/family (91%) or shopping (62%). Vacation (32%) or work (22%) were among others considered less safe (less frequent among men, p < 0.05). Conclusion Acceptance of SARS-CoV-2 vaccination is high and it is well tolerated in this sensitive cohort. However, concerns about vaccine safety remain. Those and gender differences need to be addressed. Our results help identify patients that benefit from pre-vaccination consultation.
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Affiliation(s)
- Oliver Overheu
- Department of Hematology and Oncology with Palliative Care, St. Josef Hospital, Ruhr University Bochum, Gudrunstr 56, 44791, Bochum, Germany.
| | - Simon Lendowski
- Department of Hematology and Oncology with Palliative Care, St. Josef Hospital, Ruhr University Bochum, Gudrunstr 56, 44791, Bochum, Germany
| | - Daniel R Quast
- Department of Internal Medicine, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany
| | - Corinna S Marheinecke
- Department of Molecular and Medical Virology, Ruhr University Bochum, Bochum, Germany
| | - Eleni Kourti
- Department of Hematology and Oncology with Palliative Care, St. Josef Hospital, Ruhr University Bochum, Gudrunstr 56, 44791, Bochum, Germany
| | - Celine Lugnier
- Department of Hematology and Oncology with Palliative Care, St. Josef Hospital, Ruhr University Bochum, Gudrunstr 56, 44791, Bochum, Germany
| | - Ioana Andreica
- Rheumazentrum Ruhrgebiet, Ruhr University Bochum, Herne, Germany
| | - Uta Kiltz
- Rheumazentrum Ruhrgebiet, Ruhr University Bochum, Herne, Germany
| | - Stephanie Pfaender
- Department of Molecular and Medical Virology, Ruhr University Bochum, Bochum, Germany
| | - Anke Reinacher-Schick
- Department of Hematology and Oncology with Palliative Care, St. Josef Hospital, Ruhr University Bochum, Gudrunstr 56, 44791, Bochum, Germany
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