Social media use and vaccine hesitancy in the European Union

Oxford Vaccine Hesitancy Scale (OVHS): a UK-based and US-based online mixed-methods psychometric development and validation study of an instrument to assess vaccine hesitancy

OBJECTIVES

To describe the development, validation and reliability of the Oxford Vaccine Hesitancy Scale (OVHS), a new instrument to assess vaccine hesitancy in the general population.

DESIGN

Cross-sectional validation study.

SETTING

Internet-based study with participants in the UK and USA.

PARTICIPANTS

Demographically representative (stratified by age, sex and race) samples from the UK and USA recruited through the Prolific Academic platform.

MAIN OUTCOME MEASURES

To demonstrate OVHS development, exploratory factor analysis with categorical variables and a polychoric correlation matrix followed by promax oblique rotation on the UK sample was performed. Confirmatory factor analysis with a Satorra-Bentler scaled test statistic evaluating goodness of fit statistics including the root mean squared error of approximation (RMSEA), standardised root mean squared residual (SRMR) and comparative fit index (CFI) was performed on the US sample. Reliability as internal consistency was assessed using McDonald's omega. Evidence in support of the predictive, convergent and discriminant validity of the scale was assessed using logistic regression ORs of association (OR) or Pearson correlation coefficients.

RESULTS

Data for factor analysis were obtained from 1004 respondents, 504 in the UK and 500 in the USA. A scree plot, minimum average partial correlation analysis and parallel analysis suggested a three-factor 13-item scale with domains of vaccine beliefs (seven items), pain (three items) and personal deliberation (three items). Responses were recorded on a Likert scale ranging from disagree completely to agree completely, with higher score reflecting greater hesitancy. Potential total scores ranged from 13 to 65. Goodness of fit was excellent, with RMSEA=0.044, SRMR=0.041 and CFI=0.977. Predictive validity for COVID-19 vaccination status was excellent, with logistic regression ORs of association (95% CI) of 0.07 (0.04, 0.13), p<0.0001 for the UK sample for each SD increase in OVHS score, suggesting a 93% decrease in the odds of being vaccinated against COVID-19 for each SD increase in OVHS score. Convergent validity between the OVHS score and the 5C short version scale demonstrated a correlation coefficient of 0.32 (p<0.0001). Discriminant validity with an unrelated desire to perform outdoor activities demonstrated an OR (95% CI) of 1.06 (0.88, 1.29), p=0.523 for the UK sample for each SD increase in OVHS score. McDonald's omega was 0.86 and 0.87 in the UK and US samples, respectively.

CONCLUSIONS

The OVHS is a feasible, valid and reliable scale for assessing vaccine hesitancy; further testing is warranted.

Do social media epistemological beliefs and health perception impact parents' vaccine hesitancy? A mediation analysis

In recent years, there has been a notable increase in vaccine hesitancy among individuals. It is crucial to identify the factors contributing to vaccine hesitancy to effectively address this issue. This study aims to investigate the impact of social media-specific epistemological beliefs on vaccine hesitancy and the mediating role of health perception in this impact. This study is a cross-sectional study conducted with 444 parents. Data were collected using the Personal Information Form, the Social Media-Specific Epistemological Beliefs Scale, the Perception of Health Scale, and the Vaccine Hesitancy Scale. When there is no mediator variable, the total effect of social media-specific epistemological beliefs on vaccine hesitancy is statistically significant (β = -0.219, p < 0.001). However, it was found that health perception did not mediate the relationship between social media-specific epistemological beliefs and vaccine hesitancy (β = 0.0038, 95% confidence interval (-0.0090, 0.0205)). Furthermore, it was determined that social media-specific epistemological beliefs positively predicted health perception (β = 0.136, p < 0.01). Health perception was found to have no significant effect on vaccine hesitancy (β = 0.028, p > 0.05). It can be concluded that social media-specific epistemological beliefs negatively predict vaccine hesitancy, and this effect is independent of health perception. Primary healthcare professionals should consider incorporating interventions aimed at enhancing individuals' social media-specific epistemological beliefs into their health education programs related to vaccines.

Determinants of Parental Vaccine Hesitancy During the COVID-19 Era in Saudi Arabia: A Cross-Sectional Survey

Background Despite the success of childhood vaccination in reducing vaccine-preventable diseases (VPDs), vaccine hesitancy remains a significant challenge in several countries, such as Saudi Arabia, both during and beyond the COVID-19 era. Furthermore, the pandemic may have impacted vaccine hesitancy trends, potentially affecting parents' intentions to adhere to scheduled childhood vaccination programs. Aim This article aims to assess the extent of parents' hesitancy toward childhood vaccination, determine if it increased or decreased due to the COVID-19 pandemic, highlight the factors and determinants that influenced this hesitancy, whether positively or negatively, during the COVID-19 era, and estimate the acceptance of COVID-19 vaccination in relation to the acceptance of scheduled childhood vaccination. Methods A cross-sectional study was conducted in Saudi Arabia through a snowball sampling technique. Data were collected between September 2022 and October 2022 using an online survey using Google Forms. The inclusion criteria were parents or guardians in Saudi Arabia with a child up to 18 years of age. Responses were analyzed using SPSS V25 (IBM Corp., Armonk, NY, US), with chi-square tests and logistic regression performed to compare hesitancy and vaccination status. Results Among the 1,209 parents and care providers who participated, the prevalence of parents' vaccine hesitancy was 374 (30.9%). The educational level of the parents was not significantly associated with hesitancy status (p 0.490). The most refused vaccine was Mpox (345; 28.5%), whereas the one that caused the most hesitancy was the COVID-19 vaccine (352; 29.1%). Regarding the parents' concerns, the main reason for their hesitancy was the influence of their negative perceptions from social media content, including false or misleading information and negative allegations about vaccines, reported by 449 (18.98%) of the participants. Logistic regression analysis indicated that negative social media perceptions significantly increased the likelihood of vaccine hesitancy (OR = 2.15, 95% CI = 1.78-2.60, p < 0.001). Conclusion Our study highlights the prevalence of parental vaccine hesitancy during the COVID-19 era; the most significant hesitancy was observed toward the COVID-19 vaccine, and the mpox vaccine was the most rejected. Negative social media was the main reason for parental hesitancy; public health efforts should focus on providing accurate and easily accessible information through educational campaigns on social media and other platforms.

Impact of COVID-19 vaccination on seminal and systemic inflammation in men

Expedited development of SARS-CoV-2 vaccines led to public concerns regarding impacts of the novel vaccine on gametes in patients seeking assisted reproduction. In cases of an acute intermittent illness or fever in men, it is often advised to postpone ART treatments so that efforts can be made to enhance wellbeing and improve sperm parameters. However, it is unknown whether sperm parameters are altered in the acute (24-72 hour) phase following COVID-19 vaccination. We performed a longitudinal cohort study of 17 normospermic male patients attending a fertility clinic for semen analysis. Semen and matched peripheral blood samples were collected prior to vaccination, within 46 + 18.9 hours of vaccine course completion (acute) and at 88.4 + 12 days (3 months) post-vaccination. No overall change from baseline was seen in symptoms, mean volume, pH, sperm concentration, motility, morphology or DNA damage in the acute or long phase. Seminal plasma was found to be negative for anti-SARS-CoV2 Spike antibody detection, and MCP-1 levels showed an acute but transient elevation post-vaccine, while IL-8 was marginally increased 3 months after completion of vaccination. A modest, positive correlation was noted between serum levels of the anti-inflammatory cytokine IL-10 and self-reported symptoms post-vaccine. Our findings are reassuring in that no significant adverse effect of vaccination was noted and provide evidence to support the current recommendations of reproductive medicine organisations regarding timing of vaccination during fertility treatment.

Impact of prior SARS-CoV-2 infection on college students' hesitancy to receive additional COVID-19 vaccine booster doses: A study from Taizhou, China

Purpose

This study aimed to examine the impact of a history of SARS-CoV-2 infection on the hesitancy of college students to receive additional COVID-19 vaccine booster doses.

Methods

A population-based self-administered online survey was conducted in July 2024 in Taizhou, China. A total of 792 respondents were included in this study. Logistic regression was conducted to identify factors associated with college students' hesitation to receive booster doses of the COVID-19 vaccine.

Results

Of 792 respondents, 32.2 % hesitated to receive additional doses of the COVID-19 vaccine booster. Furthermore, 23.5 % of the respondents reported an increase in hesitancy to receiving additional COVID-19 vaccine booster doses compared to before they were infected with SARS-CoV-2. In the regression analyses, college students who had a secondary infection were more hesitant to receive additional COVID-19 vaccine booster doses (OR = 0.481, 95 % CI: (0.299-0.774), P = 0.003). Moreover, students with secondary infections who were male (OR = 0.417, 95 % CI: 0.221-0.784, P = 0.007), with lower than a bachelor's degree (OR = 0.471, 95 % CI: 0.272-0.815, P = 0.007), in non-medical majors (OR = 0.460, 95 % CI: 0.248-0.856, P = 0.014), and sophomores or below (OR = 0.483, 95 % CI: 0.286-0.817, P = 0.007) were more hesitant to receive additional COVID-19 vaccine booster doses.

Conclusion

A history of SARS-CoV-2 infection affects college students' hesitation to receive additional COVID-19 vaccine booster doses, which was higher in those who experienced secondary infections.

Traditional and Social Media Usage Associated With COVID-19 Vaccine Uptake in Sapporo, Japan

This study aimed to determine the relationship between specific information source usage and uptake of the coronavirus disease 2019 (COVID-19) vaccine. We analyzed 3348 participants aged 20 to 65 years who were not diagnosed with COVID-19 in a case-control study in Sapporo, Japan. The most prevalent information source on COVID-19 was television (TV; 87.8%), followed by online news sites (74.3%), newspapers (38.7%), websites of public institutions (30.9%), and families (29.7%). Multivariate logistic regression showed that the adjusted odds ratios of incompletion of second vaccinations for users of TV and newspaper to gather COVID-19 information were 0.31 and 0.32, respectively, whereas those for users of books, commercial video sites, Facebook, and "personal blog or bulletin board system" were 3.34, 2.22, 2.36, and 4.81, respectively. Social media use among older or male participants was associated with lower vaccine uptake.

Pandemic antecedents - Exploring predictivity and relationships between COVID-19 vaccine uptake and influenza, shingles, and HPV vaccination

BACKGROUND

A wealth of extant research focuses on identifying barriers to, and predictors of, COVID-19 vaccination. In addition to treating COVID-19 vaccination and related experiences as antecedents, this study analyzes the relationships between COVID-19 vaccination experiences and intent to receive the flu, shingles, and HPV vaccines.

METHOD

Analyses were performed on the responses from U.S. survey panel of 1,024 participants (n = 1,024), 530 (51.8 %) who received at least a dose of the COVID-19 vaccine and 494 (48.2 %) who had not. Descriptive and inferential statistics identify participant demographic characteristics, prior vaccination behavior, vaccination intentions, risk behavior assessment, vaccination attitudes and beliefs, and the predictivity of COVID-19 vaccination, when treated as an antecedent.

RESULTS

Receiving a first dose of the COVID-19 vaccine interacted with receiving a past influenza vaccine, predicting the future intention to receive a COVID-19 vaccine or booster. Vaccine hesitancy in parents is significantly related to vaccination behaviors for themselves and their children. Analyses also showed differences between the vaccinated group (VG) and the unvaccinated group (UVG) on hesitancy, beliefs, and attitudes toward the COVID-19 vaccine.

CONCLUSION

Experience with COVID-19 vaccination and the relationship of those experiences with other vaccinations provide useful insight on leveraging vaccine uptake. Healthcare professionals should improve the COVID-19 vaccination experience and use vaccination appointments to promote other vaccinations. Research should continue to compare vaccination experiences and how they may persuade or dissuade vaccination intent for other vaccinations.

Agency in urgency and uncertainty. Vaccines and vaccination in European media discourses

Although Covid-19 was not the first pandemic, it was unique in the scale and intensity with which societies responded. Countries reacted differently to the threat posed by the new virus. The public health crisis affected European societies in many ways. It also influenced the way the media portrayed vaccines and discussed factors related to vaccine hesitancy. Europeans differed in their risk perceptions, attitudes towards vaccines and vaccine uptake. In European countries, Covid-19-related discourses were at the centre of media attention for many months. This paper reports on a media analysis which revealed significant differences as well as some similarities in the media debates in different countries. The study focused on seven European countries and considered two dimensions of comparison: between the pre-Covid period and the beginning of the Covid pandemic period, and between countries. The rich methodological approach, including linguistics, semantic field analysis and discourse analysis of mainstream news media, allowed the authors to explore the set of meanings related to vaccination that might influence actors' agency. This approach led the authors to redefine vaccine hesitancy in terms of characteristics of the "society in the situation" rather than the psychological profile of individuals. We argue that vaccine hesitancy can be understood in terms of agency and temporality. This dilemma of choice that transforms the present into an irreversible past and must be taken in relation to an uncertain future, is particularly acute under the pressure of urgency and when someone's health is at stake. As such, it is linked to how vaccine meaning is co-produced within public discourses.

Promoter or barrier? Assessing how social media predicts Covid-19 vaccine acceptance and hesitancy: A systematic review of primary series and booster vaccine investigations

RATIONALE

Prior research indicates that social media is primarily a negative contributor to Covid-19 vaccine outcomes.

OBJECTIVE

The current systematic review of Covid-19 primary series and booster vaccine investigations provides a more nuanced and comprehensive assessment of this association by exploring a) how distinct social media judgments and actions predict different vaccine-related outcomes - perceptions and intentions/uptake, b) both primary series and booster findings, c) types of social media, and d) comparisons across different populations.

METHOD

We conducted a systematic review of published research examining the link between social media and COVID-19 vaccine outcomes - judgments, intentions, and uptake. Overall, we identified 113 published articles.

RESULTS

The findings reveal complex associations between distinct social media predictors and these outcomes. The most consistent negative relationships emerge within studies looking at 'social media as an information source,' 'trust', and 'general social media use/passive exposure' as predictors of less favorable vaccine judgments and intentions/uptake. Conversely, studies focused on 'information seeking' indicate more mixed results. Among the few booster investigations, there are more positive than negative associations between social media predictors and Covid-19 vaccine intentions. Across different social media platforms and sample populations, social media was a less robust/consistent negative predictor of COVID-19 judgments and intentions.

CONCLUSIONS

While social media can contribute to more negative COVID-19 vaccine judgments and motivations, the consistency of this relationship may vary across populations, the platforms users access, and the nature of exposure. Overall, social media campaigns promoting COVID-19 vaccines should employ distinct strategies to target those individuals that value social media as an information resource.

Vaccine Hesitancy Among Parents and Its Determinants During the Era of COVID-19 in Taif City, Saudi Arabia

Background Vaccine hesitancy is a growing concern worldwide, particularly during the COVID-19 pandemic. The aim was to investigate vaccine hesitancy and its determinants among parents in Taif, Saudi Arabia. Methods A cross-sectional study was conducted among parents using a validated and reliable questionnaire, the parent attitudes about childhood vaccines (PACV). Parents of children aged (two months to seven years) attending primary health care centers (PHCC) outpatient clinics were selected using a stratified sampling technique and interviewed to fill out the pre-structured questionnaire. Result The study included 301 parents, with 41.2% between the ages of 30-39 years and 25.2%% between 40-49 years. Mothers constituted 69.1% of the respondents. The most common sources of information regarding vaccinations were the doctor (34.9%), the internet (27.9%), and social media (16.6%). COVID-19 influenced the beliefs of more than half (52.5%) of parents regarding the importance of vaccinations. The median PACV score for vaccination hesitancy was 23.3/100, interquartile range (IQR) (13.3-33.3). The highest hesitation was among the age group of 30-39 years old (21.6%) and those whose beliefs were not influenced by the COVID-19 pandemic (16.1% vs. 5.7%) (p-value=0.003). The study found a significant difference in vaccine hesitancy rates between the different sources of information (p-value <0.001); parents who got their information about vaccinations from social media were more likely to be hesitant about vaccinations (40%). Concerns about side effects (93.8%), thinking that vaccines are not safe (84.4%), and thinking that fewer vaccines are needed (78.1%) were the top three factors influencing vaccine hesitancy. Conclusion This study urges promoting vaccine uptake through healthcare providers and combating vaccine misinformation on social media. Additionally, addressing safety concerns and misconceptions about vaccine necessity, and focusing on first-time parents, younger parents, and those with lower socioeconomic status are recommended strategies to improve vaccine uptake rates.

Hotel employees' knowledge of monkeypox's source, symptoms, transmission, prevention, and treatment in Egypt

BACKGROUND

The re-emerging human monkeypox virus (MPXV) poses a global threat. The rising number of confirmed MPXV cases worldwide is a significant reason for concern. This study aims to investigate (1) hotel employees' knowledge in Egypt of MPXV source, signs/symptoms, transmission, prevention, and treatment, (2) the primary sources of their information about MPXV, (3) whether or not they received information about MPXV from their hotels, and (4) the differences of employees' knowledge in terms of gender, age, marital status, level of education, type of contract, professional category, hotel department, type of hotel, seniority in the hotel, and the number of hotel rooms.

METHODS

Using a quantitative approach, we collected data from 453 employees in Egyptian hotels via a web-based questionnaire. The survey included questions regarding the MPXV source, signs/symptoms, transmission, prevention, and treatment, as well as its primary information sources. The questionnaire also included questions regarding participants' demographics and hotel characteristics.

RESULTS

The findings indicated that more than half of hotel employees have inadequate knowledge of MPXV. Additionally, the majority of employees selected social media as their primary source of MPXV-related information. Surprisingly, most participants reported that their hotels neglected to provide them with the MPXV's information. Age, marital status, education, professional category, and tenure in the hotel all have a significant impact on their MPXV knowledge level.

CONCLUSION

The current paper presents significant implications for both theory and practice. This study provides government agencies and hotels with guidelines for preventing the outbreak of MPXV. According to our knowledge, this is the first study conducted with hotel employees in the MPXV Egyptian context.

COVID-19 Vaccine Hesitancy in China: An Analysis of Reasons through Mixed Methods

This study aims to investigate the causes of COVID-19 vaccine hesitancy among the Chinese population. The LDA model and content analysis were used to analyze the content of COVID-19 vaccine hesitancy expressed by the Chinese on Weibo from 2020 to 2022, the leading causes of vaccine hesitancy, and the changes in the reasons for vaccine hesitancy over time. The study found that when the Chinese expressed vaccine hesitancy, it usually involved themes such as information access (18.59%), vaccination services (13.91%), and physical illness (13.24%), and topics such as vaccination process (6.83%), allergic diseases (6.59%), and international news (6.43%). Constraints (35.48%), confidence (17.94%), and calculation (15.99%) are the leading causes of vaccine hesitancy on Weibo. These findings provide a comprehensive picture of how the Chinese express vaccine hesitancy in social media and the reasons and changes for vaccine hesitancy, which can help inspire public health experts, health organizations, or governments in various countries to improve the phenomenon of vaccine hesitancy.

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

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.

Exploring key informants' perceptions of Covid-19 vaccine hesitancy in a disadvantaged urban community in Ireland: Emergence of a '4Cs' model

AIM

The aim of this study was to explore key informants' views on and experiences with Covid-19 vaccine hesitancy in a Dublin community with a high concentration of economic and social disadvantage and to identify feasible, community-centred solutions for improving vaccination acceptance and uptake.

METHODS

Qualitative, semi-structured interviews were carried out at a local community-centre and a central hair salon. Twelve key informants from the target community were selected based on their professional experience with vulnerable population groups: the unemployed, adults in recovery from addiction, the elderly, and Irish Travellers. Inductive thematic framework analysis was conducted to identify emergent themes and sub-themes.

RESULTS

Drivers of vaccine hesitancy identified by key informants largely fell under the WHO '3Cs' model of hesitancy: lack of confidence in the vaccine and its providers, complacency towards the health risks of Covid-19, and inconvenient access conditions. Covid-19 Communications emerged as a fourth 'C' whereby unclear and negative messages, confusing public health measures, and unmet expectations of the vaccine's effectiveness exacerbated anti-authority sentiments and vaccine scepticism during the pandemic. Community-specific solutions involve the provision of accurate and accessible information, collaborating with community-based organizations to build trust in the vaccine through relationship building and ongoing dialogue, and ensuring acceptable access conditions.

CONCLUSIONS

The proposed Confidence, Complacency, Convenience, Covid-19 Communications ('4Cs') model provides a tool for considering vaccine hesitancy in disadvantaged urban communities reacting to the rapid development and distribution of a novel vaccine. The model and in-depth key informants' perspectives can be used to compliment equitable vaccination efforts currently underway by public health agencies and non-governmental organizations.

COVID-19 vaccination-related exacerbation of seizures in persons with epilepsy

Although vaccines are generally safe in persons with epilepsy (PWE), seizures can be associated with vaccination, including COVID-19. This study assessed the occurrence of COVID-19 vaccination-related seizure exacerbations in PWE. Adult PWE who had received a COVID-19 vaccine were consecutively recruited at a tertiary epilepsy clinic between June 2021 and April 2022. Patient demographics, including epilepsy history, vaccination details, and reported adverse effects were recorded. Seizure exacerbation, defined as occurring within one week of vaccination, was assessed. Five hundred and thirty PWE received the COVID-19 vaccine. 75 % received the Comirnaty (Pfizer) vaccine as their initial dose. Most patients (72 %) were taking ≥ 2 antiseizure medications (ASM) and had focal epilepsy (73 %). One-third were 12 months seizure free at their first vaccination. 13 patients (2.5 %) reported a seizure exacerbation following their first vaccination, three of whom required admission. None were seizure-free at baseline. Six of these patients (46 %) had a further exacerbation of seizures with their second vaccine. An additional four patients reported increased seizures only with the second vaccine dose. Seizure exacerbations are infrequently associated with COVID-19 vaccination, mainly in patients with ongoing seizures. The likelihood of COVID-19 infection complications in PWE outweighs the risk of vaccination-related seizure exacerbations.

Vaccines, media and politics: A corpus-assisted discourse study of press representations of the safety and efficacy of COVID-19 vaccines

This study gives a corpus-assisted discourse study of the representations of the safety and efficacy of COVID-19 vaccines in three representative newspapers from the US, Hong Kong, and the Chinese mainland: New York Times (NYT), South China Morning Post (SCMP), and China Daily (CD). The primary purpose is to explicate the dynamics between vaccines, media, and politics. Combining the theories and methods of critical discourse analysis and corpus linguistics, this study has revealed their preferential ways of constructing the safety and efficacy of COVID-19 vaccines at different levels of discourse. The safety and efficacy of COVID-19 vaccines thus serve as an important ideological battlefield for newspapers from different origins to advance their respective national or regional interests and shape understanding of different COVID-19 vaccines in the international arena.

Perception of Availability, Accessibility, and Affordability of COVID-19 Vaccines and Hesitancy: A Cross-Sectional Study in India

Background: The current study aimed to identify the perceptions and issues regarding the affordability, availability, and accessibility of COVID-19 vaccination and determine the extent of vaccine hesitancy among non-vaccinated individuals. Methods: A Prospective cross-sectional study was conducted among 575 individuals for a period of six months. All the relevant information was collected using the peer-validated survey questionnaire. An independent t-test was applied to check the association between variables. Results: Among 575 participants, 80.8% were vaccinated, and 19.2% were non-vaccinated. Among the vaccinated, 35.1% were vaccinated in private centres and 64.9% in public health centres (PHC). In total, 32% had accessibility issues and 24.5% had availability issues. However, responders vaccinated at PHC were having more issues in comparison to other groups which was statistically significant (p < 0.05). Among the 163 privately vaccinated participants, 69.9% found it completely affordable. Another 26.9% and 3.1% found vaccines partly affordable and a little unaffordable. Among the 110 non-vaccinated, 38.1% were found to be vaccine-hesitant. Conclusions: Individuals vaccinated at PHC experienced issues such as long waiting times, unavailability of doses, and registration. Further, a significant level of hesitancy towards COVID-19 vaccines was observed. The safety and efficacy of COVID-19 vaccines contributed to negative attitudes.

Parents' Attitudes toward Childhood Vaccines and COVID-19 Vaccines in a Turkish Pediatric Outpatient Population

Vaccination hesitancy (VH) is an important public health issue. The determinants of parental decisions on whether to vaccinate their children are multidimensional and need to be carefully considered in the COVID-19 era. Our study aims to investigate the prevalence of VH among parents, parents’ use of social media, and their attitudes toward the COVID-19 vaccine upon vaccine refusal. Materials and methods: Our participants were the parents of children admitted to hospitals in three different cities in Turkey between September 2021 and December 2021. The parents were asked to complete sociodemographic data and their attitudes toward COVID-19 diseases, the Parental Attitudes Toward Childhood Vaccines (PACV) scale, and the Attitudes Toward COVID-19 Vaccine (ATV-COVID-19) scale. Participants were categorized as “non-hesitant”, with a score of <50, and “hesitant”, with a score of ≥50. Results: A total of 1087 parents with a mean age of 33.66 (SD 9.1) years old participated in the study. VH was noted in 102 (9.38%) parents. Age, gender, education, and income levels did not significantly differ from one another, according to the PACV; however, parents who delayed vaccinating their children and indicated that social media had an impact on vaccination decisions were more hesitant. Parents who were male and had a family member diagnosed with COVID-19 showed more positive attitudes in the ATV-COVID-19. Parents who were hesitant about childhood vaccinations had lower positive attitudes toward the COVID-19 vaccine (2.84 ± 0.97) than parents who were not hesitant (3.77 ± 0.9). A total of 761 (70.14%) parents need more information about childhood immunizations. Conclusion: Parents who are hesitant about childhood immunization programs in Turkey have a less positive attitude toward COVID-19 vaccines and are affected by social media. Parents need information about vaccines, and because the controversy surrounding COVID-19 vaccines can diminish parents’ confidence in routine childhood immunizations, understanding the complex causes behind vaccination hesitancy can help public health policy break through barriers and increase immunization rates.

Vaccine Hesitancy: Obstacles and Challenges

Purpose of Review

In 2019, vaccine hesitancy (VH) was named as one of the top 10 threats to global health by the World Health Organization (WHO). We highlight the factors affecting VH, the role of VH in limiting vaccine uptake and inability to achieve collective immunity, and possible solutions.

Recent Findings

There are still uncertainties and concerns about the safety and efficacy of vaccines, which promote VH and undermine public confidence in immunization. WHO has designed the behavioral and social drivers (BeSD) tools and survey instruments that can be used by countries to assess reasons for poor vaccine uptake in childhood for COVID-19 and plan national vaccination programs to counter these misconceptions.

Summary

Vaccines are one of the best preventative measures that public health care has to offer. Evidence from across the world both in high-income countries (HICs) and low/middle-income countries (LMICs) show that VH is a significant phenomenon which is translating into geographical clustering of epidemics. A reasonably high acceptance and coverage rates are necessary for an immunization program to be successful. A context-specific and multifactorial intervention with more high-quality research is needed globally.

Global Predictors of COVID-19 Vaccine Hesitancy: A Systematic Review

Background: vaccine hesitancy is defined as a delay in the acceptance or refusal of vaccination, even though immunisation is a determinant in reducing the mortality and morbidity associated with Coronavirus Disease 2019 (COVID-19). Aim: to identify and analyse the predictors of COVID-19 vaccine acceptance and/or hesitancy. Methods: a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. Keywords: vaccine and (COVID or SARS) and (acceptance or acceptability or willingness or hesitancy or refusal) and (multivariate or regression) and (questionnaire or survey) and national. Databases/resources: PubMed, DOAJ, SciELO and b-on. Timeframe: March 2020–2022. Inclusion criteria: general population, questionnaire-based, calculation of a multivariate regression model and national studies. Quality assessment: application of the National Heart, Lung, and Blood institute (NHLBI) tool. Results: a total of 37 studies were selected, whose overall rate was fair. The most predominant predictors of vaccine hesitancy were a lower perceived risk of getting infected, a lower level of institutional trust, not being vaccinated against influenza, lower levels of perceived severity of COVID-19, or stronger beliefs that the vaccination would cause side effects or be unsafe. Discussion and conclusion: the identified predictors can be used to design tailored health policies and/or public health interventions, or to evaluate subjects’ vaccine hesitancy.

Social media and attitudes towards a COVID-19 vaccination: A systematic review of the literature

Background

Vaccine hesitancy continues to limit global efforts in combatting the COVID-19 pandemic. Emerging research demonstrates the role of social media in disseminating information and potentially influencing people's attitudes towards public health campaigns. This systematic review sought to synthesize the current evidence regarding the potential role of social media in shaping COVID-19 vaccination attitudes, and to explore its potential for shaping public health interventions to address the issue of vaccine hesitancy.

Methods

We performed a systematic review of the studies published from inception to 13 of March2022 by searching PubMed, Web of Science, Embase, PsychNET, Scopus, CINAHL, and MEDLINE. Studies that reported outcomes related to coronavirus disease 2019 (COVID-19) vaccine (attitudes, opinion, etc.) gathered from the social media platforms, and those analyzing the relationship between social media use and COVID-19 hesitancy/acceptance were included. Studies that reported no outcome of interest or analyzed data from sources other than social media (websites, newspapers, etc.) will be excluded. The Newcastle Ottawa Scale (NOS) was used to assess the quality of all cross-sectional studies included in this review. This study is registered with PROSPERO (CRD42021283219).

Findings

Of the 2539 records identified, a total of 156 articles fully met the inclusion criteria. Overall, the quality of the cross-sectional studies was moderate - 2 studies received 10 stars, 5 studies received 9 stars, 9 studies were evaluated with 8, 12 studies with 7,16 studies with 6, 11 studies with 5, and 6 studies with 4 stars. The included studies were categorized into four categories. Cross-sectional studies reporting the association between reliance on social media and vaccine intentions mainly observed a negative relationship. Studies that performed thematic analyses of extracted social media data, mainly observed a domination of vaccine hesitant topics. Studies that explored the degree of polarization of specific social media contents related to COVID-19 vaccines observed a similar degree of content for both positive and negative tone posted on different social media platforms. Finally, studies that explored the fluctuations of vaccination attitudes/opinions gathered from social media identified specific events as significant cofactors that affect and shape vaccination intentions of individuals.

Interpretation

This thorough examination of the various roles social media can play in disseminating information to the public, as well as how individuals behave on social media in the context of public health events, articulates the potential of social media as a platform of public health intervention to address vaccine hesitancy.

Funding

None.

How Were Healthcare Workers after Anti-SARS-CoV-2 Vaccination? A Study of the Emotional Side Effects of Vaccination

Anti-SARS-CoV-2 vaccines appear to be the only escape from the COVID-19 pandemic. As healthcare workers were among the first in society to be vaccinated, understanding their emotional status post-vaccination is fundamental to the promotion of COVID-19 vaccines among the rest of society. The aims of this study were to investigate the predictors of positive and negative emotions experienced by healthcare workers after being vaccinated and to understand whether those emotions were related to the modalities of vaccine promotion within the community. A cohort of 5790 Italian healthcare workers completed an original online survey regarding their experience with anti-SARS-CoV-2 vaccines and reported on a series of personal and environmental factors. The data obtained show that increased risk perception of COVID-19, vaccine confidence and receipt of greater quantities of information regarding vaccines are predictors of a more positive emotional state post-vaccination. Predictors of a more negative emotional state are older age, lower education, lower confidence and receipt of smaller quantities of information, in addition to neurotic personality traits and high risk perception of COVID-19. Importantly, vaccination promotion may be favoured by a happy emotional status after vaccination. This study can serve as a source of guidelines for the promotion of COVID-19 vaccination among healthcare workers and laypeople.

COVID-19 vaccine hesitancy and confidence in the Philippines and Malaysia: A cross-sectional study of sociodemographic factors and digital health literacy

With the emergence of the highly transmissible Omicron variant, large-scale vaccination coverage is crucial to the national and global pandemic response, especially in populous Southeast Asian countries such as the Philippines and Malaysia where new information is often received digitally. The main aims of this research were to determine levels of hesitancy and confidence in COVID-19 vaccines among general adults in the Philippines and Malaysia, and to identify individual, behavioural, or environmental predictors significantly associated with these outcomes. Data from an internet-based cross-sectional survey of 2558 participants from the Philippines (N = 1002) and Malaysia (N = 1556) were analysed. Results showed that Filipino (56.6%) participants exhibited higher COVID-19 hesitancy than Malaysians (22.9%; p < 0.001). However, there were no significant differences in ratings of confidence between Filipino (45.9%) and Malaysian (49.2%) participants (p = 0.105). Predictors associated with vaccine hesitancy among Filipino participants included women (OR, 1.50, 95% CI, 1.03-1.83; p = 0.030) and rural dwellers (OR, 1.44, 95% CI, 1.07-1.94; p = 0.016). Among Malaysian participants, vaccine hesitancy was associated with women (OR, 1.50, 95% CI, 1.14-1.99; p = 0.004), social media use (OR, 11.76, 95% CI, 5.71-24.19; p < 0.001), and online information-seeking behaviours (OR, 2.48, 95% CI, 1.72-3.58; p < 0.001). Predictors associated with vaccine confidence among Filipino participants included subjective social status (OR, 1.13, 95% CI, 1.54-1.22; p < 0.001), whereas vaccine confidence among Malaysian participants was associated with higher education (OR, 1.30, 95% CI, 1.03-1.66; p < 0.028) and negatively associated with rural dwellers (OR, 0.64, 95% CI, 0.47-0.87; p = 0.005) and online information-seeking behaviours (OR, 0.42, 95% CI, 0.31-0.57; p < 0.001). Efforts should focus on creating effective interventions to decrease vaccination hesitancy, increase confidence, and bolster the uptake of COVID-19 vaccination, particularly in light of the Dengvaxia crisis in the Philippines.