Trust in the public health system as a source of information on vaccination matters most when environments are supportive

Using the diffusion of innovations theory to understand factors associated with COVID-19 vaccination among tobacco users

The coronavirus disease (COVID-19) pandemic has spread in the US with more than 100 million human infections and a million deaths since March 2020. A population of concern are high-risk individuals such as adults who are tobacco users, since COVID-19 is a respiratory disease that affects the lungs. Although 79% of the US population ≥ 18 years of age have completed the primary COVID-19 vaccine series; it is imperative to understand the factors associated with receiving or declining the COVID-19 vaccine among high-risk populations to improve vaccination rates. Guided by the diffusion of innovations (DOI) theory, this study identified factors associated with COVID-19 vaccination and the impact on COVID-19 vaccine uptake in adults who use tobacco. We conducted a cross-sectional study using a sample of Pennsylvanian adult tobacco users by sending a unique survey link to 4,081 email addresses in April 2022. Participants were asked about tobacco use, COVID-19 vaccination status, and reasons for receiving/declining the COVID-19 vaccine. Participants (n = 157) were 75% female, 96% White, 74% current tobacco users, and had a mean age of 50.1 (SD = 10.8) years. Nearly 78% (n = 119) received at least one dose of the COVID-19 vaccine (primary series). We categorized all vaccinated tobacco users into adopter categories of the DOI theory; innovators (10%), early adopters (14%), early majority (33%), late majority (11%), and laggards (32%). The major reason that prompted participants to get the COVID-19 vaccine was to ensure they were well protected against COVID-19 infection (77%). Additionally, the only reason for receiving the vaccine that significantly predicted early vaccine uptake (being an innovator or early adopter) was "to loosen restrictions on mask mandates and social/physical distancing" (p = 0.0180). Among the 22% that did not receive a COVID-19 vaccine, the most common major reason they declined the vaccine was because they felt politics played a big role in the vaccine development process (94%). Our findings suggest that major f actors that influenced why adult tobacco users would receive or decline the COVID-19 vaccine included infection control mandates, protection from the COVID-19 infection, and politics. Investigating these factors can help public health professionals design or develop future vaccination programs for high-risk populations in order to scale up vaccination rates.

Does Trust Mediate the Relationship Between Experiences of Discrimination and Health Care Access and Utilization Among Minoritized Canadians During COVID-19 Pandemic?

OBJECTIVES

We sought to determine if trust in government institutions mediate the relationship between experiences of discrimination and health care utilization during the COVID-19 pandemic.

METHODS

We used data from Statistics Canada's Crowdsourcing Data: Impacts of COVID-19 on Canadians-Experiences of Discrimination. We used generalized linear latent and mixed models (Gllamm) with a binomial and logit link function as well as generalized structural equation modeling (GSEM) to determine if reported discrimination and trust were associated with difficulties in accessing health services, health care, and the likelihood of experiencing negative health impacts. We also examined if trust mediated the relationship between experiences of discrimination and these health outcomes. Our analytical sample consisted of 2568 individuals who self-identified as belonging to a visible minority group.

RESULTS

The multivariate results indicate that experiences of discrimination during COVID-19 were associated with higher odds of reporting difficulties in accessing general health services (OR = 1.99, p ≤ 0.01), receiving care (OR = 1.65, p ≤ 0.01), and higher likelihood of reporting negative health impacts (OR = 1.68, p ≤ 0.01). Our mediation analysis indicated that trust in public institutions explained a substantial portion of the association between reported discrimination and all the health outcomes, although the effects of experiencing discrimination remain significant and robust.

CONCLUSION

The findings show that building and maintaining trust is important and critical in a pandemic recovery world to build back better.

Do COVID-19 Vaccination Policies Backfire? The Effects of Mandates, Vaccination Passports, and Financial Incentives on COVID-19 Vaccination

Faced with the challenges of motivating people to vaccinate, many countries have introduced policy-level interventions to encourage vaccination against COVID-19. For example, mandates were widely imposed requiring individuals to vaccinate to work and attend school, and vaccination passports required individuals to show proof of vaccination to travel and access public spaces and events. Furthermore, some countries also began offering financial incentives for getting vaccinated. One major criticism of these policies was the possibility that they would produce reactance and thus undermine voluntary vaccination. This article therefore reviews relevant empirical evidence to examine whether this is indeed the case. Specifically, we devote separate sections to reviewing and discussing the impacts of three major policies that were implemented during the COVID-19 pandemic: vaccination mandates, vaccination passports, and the provision of financial incentives. A careful analysis of the evidence provides little support that these policies backfire but instead can effectively promote vaccination at the population level. The policies are not without limitations, however, such as their inability to mobilize those that are strongly hesitant to vaccines. Finally, we discuss how policy-level interventions should be designed and implemented to address future epidemics and pandemics.

A behaviour and disease transmission model: incorporating the Health Belief Model for human behaviour into a simple transmission model

The health and economic impacts of infectious diseases such as COVID-19 affect all levels of a community from the individual to the governing bodies. However, the spread of an infectious disease is intricately linked to the behaviour of the people within a community since crowd behaviour affects individual human behaviour, while human behaviour affects infection spread, and infection spread affects human behaviour. Capturing these feedback loops of behaviour and infection is a well-known challenge in infectious disease modelling. Here, we investigate the interface of behavioural science theory and infectious disease modelling to explore behaviour and disease (BaD) transmission models. Specifically, we incorporate a visible protective behaviour into the susceptible-infectious-recovered-susceptible (SIRS) transmission model using the socio-psychological Health Belief Model to motivate behavioural uptake and abandonment. We characterize the mathematical thresholds for BaD emergence in the BaD SIRS model and the feasible steady states. We also explore, under different infectious disease scenarios, the effects of a fully protective behaviour on long-term disease prevalence in a community, and describe how BaD modelling can investigate non-pharmaceutical interventions that target-specific components of the Health Belief Model. This transdisciplinary BaD modelling approach may reduce the health and economic impacts of future epidemics.

Organizations affect their employees' vaccine readiness: A self-perception theory perspective

Over the past 3 years, employees have constantly witnessed how their organizations have responded to the challenges posed by the COVID-19 pandemic. Here, we hypothesize that employees' perceptions of the COVID-19 safety climate of their organization positively affect their vaccine readiness. To examine the underlying mechanisms of this effect, we use a self-perception theory lens. Thus, we hypothesize that an organization's COVID-19 safety climate affects employees' COVID-19 vaccine readiness through employees' adherence to COVID-19 guidelines. We conducted a time-lagged study over the time span of 1 year (N = 351) to test our hypotheses. In general, results support our hypotheses. In particular, results showed that perceived COVID-19 safety climate assessed at an early stage of the pandemic (April 2020, when no vaccines were available) predicted employees' COVID-19 vaccine readiness more than a year later. In line with self-perception theory, this effect was mediated by employees' adherence to COVID-19 guidelines. The present study provides theoretical insight into the underlying mechanisms of organizational climate on employees' attitudes. From a practical perspective, our results suggest that organizations are a powerful lever for promoting vaccine readiness.