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Lee P, Rothman E. Real-World Implementation of a COVID-19 Monoclonal Antibody Treatment Program in a Los Angeles County Safety Net Ambulatory Healthcare System - Barriers to Treatment and Lessons Learned. J Racial Ethn Health Disparities 2024; 11:2174-2181. [PMID: 37405563 DOI: 10.1007/s40615-023-01686-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 06/13/2023] [Accepted: 06/18/2023] [Indexed: 07/06/2023]
Abstract
Throughout the COVID-19 pandemic, low-income, minority, and otherwise vulnerable populations have repeatedly been shown to receive unequal access to novel therapies. Addressing this inequity requires specific awareness of the barriers experienced by vulnerable patients, and systemic efforts to address these barriers to provide equitable health care. We designed and implemented an ambulatory COVID-19 treatment program expressly aimed at increasing COVID-19 treatment uptake in a safety-net healthcare system. We describe systemic and human obstacles encountered as well as strategies used to increase use of COVID-19 treatments. Thanks to these strategies, we observed an increase in monoclonal antibody acceptance rate from 29 to 69% over the course of 10 months. We found that interventions such as engaging primary care providers, creating clear-language scripts for outreach calls, assisting with logistic barriers such as transportation, and addressing medical mistrust and hesitancy among both staff and patients were critical to increasing treatment uptake among our safety-net patient population.
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Affiliation(s)
- Pamela Lee
- Los Angeles County Department of Health Services, Los Angeles, CA, USA.
| | - Ellen Rothman
- Los Angeles County Department of Health Services, Los Angeles, CA, USA
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Barwise A, Tekin A, Domecq Garces JP, Gajic O, Pickering BW, Malinchoc M. Impact of SARS-CoV-2 Vaccine Rollout on Hispanic and Non-Hispanic Admission and Mortality Trends: An Interrupted Time Series Analysis. Chest 2024; 165:1341-1351. [PMID: 38145716 DOI: 10.1016/j.chest.2023.12.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 11/29/2023] [Accepted: 12/01/2023] [Indexed: 12/27/2023] Open
Abstract
BACKGROUND Challenges with SARS-CoV-2 vaccine prioritization, access, and hesitancy have influenced vaccination uptake. RESEARCH QUESTION Was the impact of SARS-CoV-2 vaccine rollout on COVID-19 monthly admission and mortality trends different between Hispanic and non-Hispanic populations? STUDY DESIGN AND METHODS We used interrupted time series analysis to conduct an ancillary study of the Viral Infection and Respiratory Illness Universal Study registry supplemented by electronic health record data from five participating Mayo Clinic sites in Florida, Arizona, Minnesota, and Wisconsin. We included hospitalized patients with COVID-19 admitted between April 2020 and December 2021. Our primary outcome was the impact of vaccine rollout on admission trends. Our secondary outcome was the impact of vaccine rollout on mortality trends. RESULTS This interrupted time series analysis includes 6,442 patients. Vaccine rollout was associated with improved monthly hospital admission trends among both Hispanic and non-Hispanic patients. Among Hispanic patients, pre-vaccine rollout, monthly admissions increased by 12.9% (95% CI, 8.1%-17.9%). Immediately after vaccine rollout, patient admissions declined by -66.3% (95% CI, -75.6% to -53.9%). Post-vaccine rollout, monthly admissions increased by 3.7% (95% CI, 0.2%-7.3%). Among non-Hispanic patients, pre-vaccine rollout, monthly admissions increased by 35.8% (95% CI, 33.4%-38.1%). Immediately after vaccine rollout, patient admissions declined by -75.2% (95% CI, -77.6% to -72.7%). Post-vaccine rollout, monthly admissions increased by 5.6% (95% CI, 4.5%-6.7%). These pre-vaccine rollout admission trends were significantly different (P < .001). Post-vaccine rollout, the change in admission trend was significantly different (P < .001). The associated beneficial impact from vaccine rollout on monthly hospital admission trends among Hispanic patients was significantly lower. The trend in monthly mortality rate was fourfold greater (worse) among Hispanic patients (8.3%; 95% CI, 3.6%-13.4%) vs non-Hispanic patients (2.2%; 95% CI, 0.6%-3.8%), but this was not shown to be related to vaccine rollout. INTERPRETATION SARS-CoV-2 vaccine rollout was associated with improved COVID-19 admission trends among non-Hispanic vs Hispanic patients. Vaccine rollout was not shown to influence mortality trends in either group, which were four times higher among Hispanic patients. Improved vaccine rollout may have reduced disparities in admission trends for Hispanic patients, but other factors influenced their mortality trends.
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Affiliation(s)
- Amelia Barwise
- Division of Pulmonary and Critical Care Medicine, Rochester, MN; Bioethics Research Program, Rochester, MN.
| | - Aysun Tekin
- Department of Anesthesiology and Perioperative Medicine, Rochester, MN
| | | | | | - Brian W Pickering
- Department of Anesthesiology and Perioperative Medicine, Rochester, MN
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Haidar S, Roederer T, Allaire C, Mollo B, Vincent C, Bonmarin I, Mosnier M, Richard E, Vandentorren S. A conceptual framework to model social determinants of COVID-19 vaccination uptake among underserved homeless populations. Vaccine X 2024; 18:100472. [PMID: 38523621 PMCID: PMC10958472 DOI: 10.1016/j.jvacx.2024.100472] [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: 08/24/2023] [Revised: 01/31/2024] [Accepted: 03/12/2024] [Indexed: 03/26/2024] Open
Abstract
Background Homeless people have a higher risk of COVID-19 infection, linked to several social, economic and environmental determinants, frequent comorbidities, obstacles to exercising their constitutional social and health rights, poor medical cover, and insufficient use of the healthcare system. Data on COVID-19 vaccine uptake and its main determinants are lacking for this underserved population. Objectives To construct and test a conceptual framework to model structural social determinants of COVID-19 vaccine uptake among underserved homeless populations, and to test this model to identify the determinants of COVID-19 vaccine uptake on the homeless population living in two metropolitan areas in France. Methods We implemented a multicenter cross-sectional survey from 15/11/2021 to 22/12/2021 in homeless adults in the city of Marseille and in the greater Paris area. Persons sheltered in migrant worker hostels or in emergency social shelters, members of the COVID HOMELESS cohort study in Marseille, and Travelers living in traditional housing were all eligible. A standardized face-to-face questionnaire was administered to the participants where they lived in various languages by trained interviewers. We used structural equation modeling to analyze the structural social determinants of COVID-19 vaccine uptake, the latter defined as receiving at least one dose. Results The participation rate was 64 %, accounting for 3811 participants. There were three main factors associated with greater vaccine uptake: i) opportunity, which included having a personal general practitioner (β = 0.05, p < 0.05), healthcare cover (β = 0.05, p < 0.05), and somebody to accompany the participant for medical appointments (β = -0.04, p < 0.05); ii) motivation, which included attitudes towards vaccination (β = 0.55, p < 0.05), press- and poster-based information (β = 0.03, p < 0.05), and vaccination history (β = 0.03, p < 0.05); iii) type of housing (β = 0.13, p < 0.05) and housing stability (β = 0.04, p < 0.05). Conclusion Our results highlight that housing exclusion is a structural social determinant of COVID-19 vaccine uptake in homeless people in France. They also underline the role which opportunity and motivation play in improving uptake in this underserved homeless population.
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Affiliation(s)
| | | | | | - Bastien Mollo
- Epicentre, Paris, France
- Médecins Sans Frontières, Paris, France
- Infectious Diseases department, Bichat Claude-Bernard Hospital, Paris, France
| | | | | | - Marine Mosnier
- Médecins du Monde, France
- Prospective Coopération, Marseille, France
| | - Elodie Richard
- Bordeaux Population Health, Université de Bordeaux. Centre Inserm U1219, Bordeaux, France
- Fédération nationale des associations solidaires d’action avec les tsiganes et les Gens du voyage (FNASAT – Gens du voyage), Paris, France
| | - Stéphanie Vandentorren
- Santé publique France, Saint-Maurice, France
- Bordeaux Population Health, Université de Bordeaux. Centre Inserm U1219, Bordeaux, France
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Wang X, Pan J, Yan B, Zhang R, Yang T, Zhou X. Inequities in human papillomavirus vaccination among children aged 9-14 years old under constrained vaccine supply in China. Int J Equity Health 2024; 23:112. [PMID: 38822383 PMCID: PMC11141026 DOI: 10.1186/s12939-024-02199-z] [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: 04/05/2024] [Accepted: 05/20/2024] [Indexed: 06/03/2024] Open
Abstract
BACKGROUND Inequities in access to human papillomavirus (HPV) vaccine are becoming a growing critical issue globally. Few studies investigate the factors determining HPV vaccine uptake disparities when vaccine supply is constrained, especially in low- and middle-income countries. The aim of this study was to investigate inequities of HPV vaccination and related factors under the constrained vaccine supply in China. METHODS A cross-sectional survey was conducted in a developed eastern coastal province and a developing western one in China between November and December 2022. Employing multistage stratified cluster random sampling, the study collected data from parents of children aged 9-14. Mixed-effects logistic regression models with school units as random effects were used for analysis. RESULTS From 4,127 eligible parents (as vaccine decision makers for girls), 1,346 (32.6%) intended to vaccinate their daughters against HPV, of which 836 (62.1%) attempted to schedule a vaccination appointment. Only 16.4% succeeded in booking an appointment. More than half of the intended parents expected the imported 9-valent HPV vaccine. There were significant disparities in HPV vaccine awareness, intention, and vaccination behavior across educational, income, geographic, ethnic, gender, and health literacy levels. Vaccine awareness and intentions were higher among parents with higher socioeconomic status; however, girls from lower socioeconomic families were more likely to receive the HPV vaccine and had a higher domestically produced vaccination rate. Significant disparities exist in vaccination intentions and actual vaccination behaviors, primarily due to large supply constraints of the HPV vaccine. CONCLUSIONS Sustained health education campaigns are needed to raise awareness of the HPV vaccine, improve health literacy, and decrease over-preference for the 9-valent HPV vaccine. A mother's HPV vaccination behavior was positively associated with increased intention and actual vaccination behavior for her daughter. This study advocates for complementary cervical cancer prevention programs targeting both mothers and daughters.
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Affiliation(s)
- Xiaomin Wang
- School of Public Health, Hangzhou Normal University, No. 2318 Yuhangtang Road, Yuhang District, Hangzhou, 311121, China
| | - Jiayi Pan
- Institute of Social Medicine, School of Medicine, Zhejiang University, 866 Yuhangtang Road, Xihu District, Hangzhou, 310058, China
| | - Bo Yan
- Institute of Social Medicine, School of Medicine, Zhejiang University, 866 Yuhangtang Road, Xihu District, Hangzhou, 310058, China
| | - Ran Zhang
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
| | - Tianchi Yang
- Institute of Immunization and Prevention, Ningbo Municipal Center for Disease Control and Prevention, No.1166, Fan Jiangan Road, Haishu District, Ningbo City, 315000, Zhejiang Province, China.
| | - Xudong Zhou
- Institute of Social Medicine, School of Medicine, Zhejiang University, 866 Yuhangtang Road, Xihu District, Hangzhou, 310058, China.
- The Second Affiliated Hospital, School of Medicine, Zhejiang University, 88 Jiefang Road, Hangzhou, 310009, China.
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Haq ZU, Yunus S, Jafri N. Building confidence in the COVID-19 vaccine in a polio-endemic country: strategic communication lessons from Pakistan. BMJ Glob Health 2024; 9:e015200. [PMID: 38599665 PMCID: PMC11015175 DOI: 10.1136/bmjgh-2024-015200] [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: 01/29/2024] [Accepted: 03/31/2024] [Indexed: 04/12/2024] Open
Abstract
In a health emergency, governments rely on public trust in their policy, and anticipate its compliance to protect health and save lives. Vaccine hesitancy compromises this process when an emergency involves infections. The prevailing discourse on vaccine hesitancy often describes it as a static phenomenon, ignoring its expanse and complexity, and neglecting the exploration of tools to address it. This article diverges from the conventional perspective by explaining the case of Pakistan and its communication strategy for the COVID-19 vaccine. Decades of polio vaccine hesitancy, rooted in the country's fight against terrorism, constitute its history. On the other hand, the first-ever launch of typhoid conjugate vaccine involving 35 million kids during 2019-2021 was a success. Against this backdrop, the country considered vaccine hesitancy as a dynamic phenomenon, interwoven with the social ecology and the responsiveness of the healthcare system. Its communication strategy facilitated those willing to receive the vaccine, while being responsive to the information needs of those still in the decision-making process. In the face of both hesitancy and a scarcity of vaccine doses, the country successfully inoculated nearly 70% (160 million) of its population in just over 1 year. People's perceptions about the COVID-19 vaccine also improved over time. This achievement offers valuable insights and tools for policymakers and strategists focused on the demand side of vaccine programmes. The lessons can significantly contribute to the global discourse on improving vaccine confidence and bolstering global health security.
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Affiliation(s)
| | | | - Naveed Jafri
- Expanded Programme on Immunisation, Pakistan Ministry of National Health Services Regulations and Coordination, Islamabad, Pakistan
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Pavey L, Rotella A, Vallée-Tourangeau G. Moral obligation, autonomous motivation and vaccine hesitancy: Highlighting moral obligation increases reactance in hesitant individuals. Appl Psychol Health Well Being 2024. [PMID: 38561930 DOI: 10.1111/aphw.12540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 03/12/2024] [Indexed: 04/04/2024]
Abstract
Vaccine hesitancy is widespread, and developing effective communication strategies that encourage hesitant individuals to choose vaccination is essential. This pre-registered research aimed to examine associations among moral obligation, autonomous motivation, vaccination intentions and reactance, and to test messages highlighting moral obligation and autonomy support. In Study 1, participants who had not received a Covid-19 vaccine (N = 1036) completed measures of autonomous motivation, moral obligation, reactance, intentions to vaccinate and vaccine hesitancy. Autonomous motivation and moral obligation emerged as strong independent predictors of lower reactance, lower hesitancy and greater vaccination intentions. In Study 2 (N = 429), the participants received a vaccination-promoting message that highlighted moral obligation versus personal protection and used autonomy supportive versus controlling language. Messages with autonomy-supportive language and highlighting personal protection elicited lower reactance and greater perceived legitimacy compared to messages with controlling language and highlighting moral obligation. All messages elicited greater reactance and lower perceived legitimacy compared to an information-only message, and there were no effects of message type on vaccination intentions or vaccine hesitancy. The research has implications for the design of communications encouraging vaccination in hesitant individuals and suggests caution should be taken when developing messages to encourage vaccination in hesitant individuals.
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Affiliation(s)
- Louisa Pavey
- Department of Psychology, Kingston University, Kingston-upon-Thames, UK
| | - Amanda Rotella
- Department of Psychology, Northumbria University, Newcastle upon Tyne, UK
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Owen-Smith A, Porter J, Thomas CM, Clarke S, Ogrodnick MM, Hand LJ, Dawson-Hahn E, O'Connor MH, Feinberg I, Adde S, Desta R, Yubo Z, Chin A, Safi M. 'Getting control of Corona takes many angles': COVID-19 vaccine knowledge, attitudes and beliefs among refugee/immigrant/migrant communities in four US cities. HEALTH EDUCATION RESEARCH 2024; 39:182-196. [PMID: 38300230 DOI: 10.1093/her/cyae003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 12/21/2023] [Accepted: 01/10/2024] [Indexed: 02/02/2024]
Abstract
The objectives of the study were to (i) document refugee, immigrant and migrant (RIM) communities' knowledge, attitudes and beliefs (KABs) related to the Coronavirus disease (COVID-19) vaccine and (ii) identify best practices for developing and disseminating culturally and linguistically responsive health messaging addressing those KABs. Thirteen online focus groups (OFGs) in 10 languages were conducted. Each OFG was conducted in the participants' native language. OFGs were recorded, transcribed, translated and uploaded to qualitative software for coding. A thematic analysis was conducted. Results suggest that while there was some variation between different language groups (e.g. whether religious leaders were seen as trusted sources of information about COVID), there were also important commonalities. Most language groups (i) alluded to hearing about or having gaps in knowledge about COVID-19/the COVID-19 vaccine, (ii) reported hearing negative or conflicting stories about the vaccine and (iii) shared concerns about the negative side effects of the vaccine. There continues to be a need for health messaging in RIM communities that is culturally and linguistically concordant and follows health literacy guidelines. Message content about the COVID-19 vaccine should focus on vaccine importance, effectiveness and safety, should be multimodal and should be primarily delivered by healthcare professionals and community members who have already been vaccinated.
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Affiliation(s)
- A Owen-Smith
- Department of Health Policy and Behavioral Sciences, Georgia State University, School of Public Health, 140 Decatur Street, Atlanta, GA 30303, USA
| | - J Porter
- International Rescue Committee UK, 100 Wood Street, London EC2V 7AN, United Kingdom
| | - C M Thomas
- Department of Medicine, University of Minnesota, Division of Infectious Diseases and International Medicine, 401 East River Parkway, Minneapolis, MN 55455, USA
| | - S Clarke
- Society of Refugee Healthcare Providers, 172 Colby St, Spencerport, New York 14559
| | - M M Ogrodnick
- Department of Health Policy and Behavioral Sciences, Georgia State University, School of Public Health, 140 Decatur Street, Atlanta, GA 30303, USA
| | - L J Hand
- Department of Communication, Georgia State University, 800 Twenty Five Park Place NE, Atlanta, GA 30303, USA
- School of Communication and Media, Kennesaw State University, 1000 Chastain Road, Kennesaw, GA 30144, USA
| | - E Dawson-Hahn
- Department of Pediatrics, University of Washington, 4245 Roosevelt Way NE, Seattle, WA 98105, USA
| | - M H O'Connor
- Department of Health Policy and Behavioral Sciences, Georgia State University, School of Public Health, 140 Decatur Street, Atlanta, GA 30303, USA
| | - I Feinberg
- College of Education and Human Development, Georgia State University, 30 Pryor St. SW, Atlanta, GA 30303, USA
| | - S Adde
- Department of Health Policy and Behavioral Sciences, Georgia State University, School of Public Health, 140 Decatur Street, Atlanta, GA 30303, USA
| | - R Desta
- Department of Health Policy and Behavioral Sciences, Georgia State University, School of Public Health, 140 Decatur Street, Atlanta, GA 30303, USA
| | - Z Yubo
- Department of Health Policy and Behavioral Sciences, Georgia State University, School of Public Health, 140 Decatur Street, Atlanta, GA 30303, USA
| | - A Chin
- Department of Health Policy and Behavioral Sciences, Georgia State University, School of Public Health, 140 Decatur Street, Atlanta, GA 30303, USA
| | - M Safi
- International Rescue Committee UK, 100 Wood Street, London EC2V 7AN, United Kingdom
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Schüz B, Jones C. [Mis- and disinformation in social media: mitigating risks in digital health communication]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2024; 67:300-307. [PMID: 38332143 DOI: 10.1007/s00103-024-03836-2] [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: 09/29/2023] [Accepted: 01/15/2024] [Indexed: 02/10/2024]
Abstract
Misinformation and disinformation in social media have become a challenge for effective public health measures. Here, we examine factors that influence believing and sharing false information, both misinformation and disinformation, at individual, social, and contextual levels and discuss intervention possibilities.At the individual level, knowledge deficits, lack of skills, and emotional motivation have been associated with believing in false information. Lower health literacy, a conspiracy mindset and certain beliefs increase susceptibility to false information. At the social level, the credibility of information sources and social norms influence the sharing of false information. At the contextual level, emotions and the repetition of messages affect belief in and sharing of false information.Interventions at the individual level involve measures to improve knowledge and skills. At the social level, addressing social processes and social norms can reduce the sharing of false information. At the contextual level, regulatory approaches involving social networks is considered an important point of intervention.Social inequalities play an important role in the exposure to and processing of misinformation. It remains unclear to which degree the susceptibility to belief in and share misinformation is an individual characteristic and/or context dependent. Complex interventions are required that should take into account multiple influencing factors.
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Affiliation(s)
- Benjamin Schüz
- Institut für Public Health und Pflegeforschung, Universität Bremen, Grazer Straße 4, 28359, Bremen, Deutschland.
- Leibniz-WissenschaftsCampus Digital Public Health, Bremen, Deutschland.
| | - Christopher Jones
- Institut für Public Health und Pflegeforschung, Universität Bremen, Grazer Straße 4, 28359, Bremen, Deutschland
- Leibniz-WissenschaftsCampus Digital Public Health, Bremen, Deutschland
- Zentrum für Präventivmedizin und Digitale Gesundheit (CPD), Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Deutschland
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Goodwill JR, Fike KJ. Black in the pandemic: Comparing experiences of mistrust, anxiety, and the COVID-19 vaccine among Black adults in the U.S. Soc Sci Med 2023; 338:116302. [PMID: 37871396 DOI: 10.1016/j.socscimed.2023.116302] [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: 06/22/2023] [Revised: 08/21/2023] [Accepted: 10/04/2023] [Indexed: 10/25/2023]
Abstract
COVID-19 vaccine decisions are shaped by many factors including historical and contemporary patterns of medical mistreatment of marginalized communities. In attending to these concerns, we measured whether fear of COVID-19, general feelings of mistrust, and race-specific mistrust of the government and healthcare providers are indirectly associated with COVID-19 vaccination status via anxiety among Black Americans. We analyzed responses from 996 Black adults who participated in the AmeriSpeak panel - a nationally representative probability-based sample recruited from the National Opinion Research Center from April-June 2022. We used multiple-group structural equation modeling to compare outcomes among those who lost a loved one to COVID-19 to those who did not. Results indicate that fear of COVID-19 was associated with a greater probability of being fully vaccinated for those who lost a family member/friend. Race-specific mistrust was positively associated with anxiety, but was negatively associated with being fully vaccinated for bereaved Black Americans. Targeted efforts are needed to specifically reach those who lost a loved one to COVID-19. More within-group evaluations are needed to identify barriers to COVID-19 vaccination that are specific to Black Americans living with loss and grief.
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Affiliation(s)
- Janelle R Goodwill
- University of Chicago, Crown Family School of Social Work, Policy, and Practice, United States.
| | - Kayla J Fike
- Vanderbilt University, Peabody College of Education and Human Development, United States
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Friedrich B, Forbes G, Jhass A, Lorencatto F, Shallcross L, Antonopoulou V. Factors influencing staff attitudes to COVID-19 vaccination in care homes in England: a qualitative study. BMC Health Serv Res 2023; 23:1066. [PMID: 37798753 PMCID: PMC10557274 DOI: 10.1186/s12913-023-10031-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 09/14/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic disproportionately affected people living and working in UK care homes causing high mortality rates. Vaccinating staff members and residents is considered the most effective intervention to reduce infection and its transmission rates. However, uptake of the first dose of the COVID-19 vaccine in care homes was variable. We sought to investigate factors influencing uptake of COVID-19 vaccination in care home staff to inform strategies to increase vaccination uptake and inform future preparedness. METHODS Twenty care home staff including managerial and administrative staff, nurses, healthcare practitioners and support staff from nine care homes across England participated in semi-structured telephone interviews (March-June 2021) exploring attitudes towards the COVID-19 vaccine and factors influencing uptake. We used thematic analysis to generate themes which were subsequently deductively mapped to the Capability, Opportunity, Motivation-Behaviour (COM-B) model. The Behavioural Change Wheel (BCW) was used to identify potential intervention strategies to address identified influences. RESULTS Enablers to vaccine uptake included the willingness to protect care home residents, staff and family/friends from infection and the belief that vaccination provided a way back to normality (reflective motivation); convenience of vaccination and access to accurate information (physical opportunity); and a supporting social environment around them favouring vaccination (social opportunity). Barriers included fears about side-effects (automatic motivation); a lack of trust due to the quick release of the vaccine (reflective motivation); and feeling pressurised to accept vaccination if mandatory (automatic motivation). CONCLUSIONS We identified influences on COVID-19 vaccine uptake by care home staff that can inform the implementation of future vaccination programmes. Strategies likely to support uptake include information campaigns and facilitating communication between staff and managers to openly discuss concerns regarding possible vaccination side effects. Freedom of choice played an important role in the decision to be vaccinated suggesting that the decision to mandate vaccination may have unintended behavioural consequences.
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Affiliation(s)
- Bettina Friedrich
- Institute of Health Informatics, Faculty of Population Sciences, University College London, 222 Euston Road, London, NW1 2DA, UK
| | - Gillian Forbes
- Centre for Behaviour Change, Department of Clinical, Education and Health Psychology, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Arnoupe Jhass
- Institute of Health Informatics, Faculty of Population Sciences, University College London, 222 Euston Road, London, NW1 2DA, UK
| | - Fabiana Lorencatto
- Centre for Behaviour Change, Department of Clinical, Education and Health Psychology, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
- NIHR Policy Research Unit in Behavioural Science, Population Health Sciences Institute, Newcastle University, Newcastle, NE2 4AX, UK
| | - Laura Shallcross
- Institute of Health Informatics, Faculty of Population Sciences, University College London, 222 Euston Road, London, NW1 2DA, UK
| | - Vivi Antonopoulou
- Centre for Behaviour Change, Department of Clinical, Education and Health Psychology, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
- NIHR Policy Research Unit in Behavioural Science, Population Health Sciences Institute, Newcastle University, Newcastle, NE2 4AX, UK.
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Aitken Z, Emerson E, Kavanagh AM. COVID-19 vaccination coverage and vaccine hesitancy among Australians with disability and long-term health conditions. Health Promot J Austr 2023; 34:895-902. [PMID: 36565293 PMCID: PMC9880664 DOI: 10.1002/hpja.691] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 09/29/2022] [Accepted: 12/21/2022] [Indexed: 12/25/2022] Open
Abstract
ISSUE ADDRESSED COVID-19 vaccination is the cornerstone of managing Australia's COVID-19 pandemic and the success of the vaccination program depends on high vaccination coverage. This paper examined differences in COVID-19 vaccination coverage and vaccine hesitancy for people with disability, long-term health conditions, and carers - subgroups that were prioritised in Australia's vaccination program. METHODS Using data from 2400 Australians who participated in two waves of the Taking the Pulse of the Nation survey in April and May 2021, we described vaccination coverage and hesitancy among people with disability, severe mental health conditions, severe long-term health conditions, frequent need for assistance with everyday activities, and carers. RESULTS Vaccination coverage was estimated to be 8.2% in the population overall and was similar for people with disability, those with frequent need for assistance, and carers. It was higher for people with severe long-term health conditions (13.4%) and lower for people with severe mental health conditions (4.3%). Vaccine hesitancy was high overall (35.6%) and was similarly high across the priority groups, with only small differences for people with disability, severe long-term health conditions and frequent need for assistance. CONCLUSIONS This study highlights a lack of difference in vaccination coverage for people with disability, long-term health conditions, and carers compared to the general population. So what? Sub-optimal vaccination coverage for people in the priority groups leaves many people at significant risk of serious disease or death if exposed to COVID-19, particularly in light of easing of disease-control restrictions across Australia and the emergence of new variants.
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Affiliation(s)
- Zoe Aitken
- Disability and Health Unit, Centre for Health Equity, Melbourne School of Population and Global HealthThe University of MelbourneMelbourneAustralia
| | - Eric Emerson
- Faculty of Health and MedicineLancaster UniversityLancasterUK
| | - Anne Marie Kavanagh
- Disability and Health Unit, Centre for Health Equity, Melbourne School of Population and Global HealthThe University of MelbourneMelbourneAustralia
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Carmona N, Trujillo M. Developing Vaccine Literacy for Urban Health Science Students, the Future Health Workforce. JOURNAL OF MICROBIOLOGY & BIOLOGY EDUCATION 2023; 24:e00038-23. [PMID: 37614881 PMCID: PMC10443395 DOI: 10.1128/jmbe.00038-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 04/20/2023] [Indexed: 08/25/2023]
Abstract
The 2019 coronavirus disease pandemic underlined a shift in attitudes against vaccines and a rise in hesitancy among some members of the population, despite the overwhelming evidence that vaccinations are one of the most successful and safe health interventions. Research has shown that vaccine hesitancy is complex and can result from an intersectionality of multiple factors. Research has also shown that to tackle vaccine hesitancy in the community, health care workers play a pivotal role, as they are trusted sources who can provide reliable information and can address vaccination concerns for the public. Unfortunately, health care workers are also susceptible to vaccine hesitancy. Thus, to curb these negative attitudes and doubts against vaccinations, we propose to improve vaccine competency among health science students, who are the future health workforce. Here, we propose a comprehensive pedagogical approach that aims to improve the vaccine literacy in this student population in two urban community colleges. The approach includes the use of high-impact pedagogical interventions to achieve three main objectives: (i) to teach students the nature and process of science to have them become "competent outsiders"; (ii) to enhance students' knowledge of the complex science behind emerging infectious diseases and vaccine action, adopting a learner-centered and concept-focused instructional design, and (iii) to address the social, cultural, and historical aspects of vaccine development and the historical and present inequities that characterize this health intervention.
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Affiliation(s)
- Naydu Carmona
- Biological Sciences and Geology Department, Queensborough Community College, City University of New York, Queens, New York, USA
| | - Monica Trujillo
- Biological Sciences and Geology Department, Queensborough Community College, City University of New York, Queens, New York, USA
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13
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Chipman SA, Meagher K, Barwise AK. A Public Health Ethics Framework for Populations with Limited English Proficiency. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2023:1-16. [PMID: 37379053 DOI: 10.1080/15265161.2023.2224263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/29/2023]
Abstract
25.6 Million people in the United States have Limited English Proficiency (LEP), defined as insufficient ability to read, write, or understand English. We will (1) Delineate the merits of approaching language as a social determinant of health, (2) highlight pertinent public health values and guidelines which are most relevant to the plight of populations with LEP and (3) Use the COVID-19 pandemic as an example of how a breakdown in public health ethics values created harm for populations and patients with LEP. We define a framework to tease out public health responsibilities given some populations' limited proficiency in a society's predominant language. The American Public Health Association (APHA) public health ethics core values serve as a framework to interrogate current practices. We use the COVID-19 case to illustrate gaps between health policy and healthcare disparities experienced by populations with LEP.
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14
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Meyer C, Goffe L, Antonopoulou V, Graham F, Tang MY, Lecouturier J, Grimani A, Chadwick P, Sniehotta FF. Using the precaution adoption process model to understand decision-making about the COVID-19 booster vaccine in England. Vaccine 2023; 41:2466-2475. [PMID: 36933983 PMCID: PMC9935297 DOI: 10.1016/j.vaccine.2023.02.047] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 12/21/2022] [Accepted: 02/13/2023] [Indexed: 02/19/2023]
Abstract
BACKGROUND COVID-19 continues to pose a threat to public health. Booster vaccine programmes are critical to maintain population-level immunity. Stage theory models of health behaviour can help our understanding of vaccine decision-making in the context of perceived threats of COVID-19. PURPOSE To use the Precaution Adoption Process Model (PAPM) to understand decision-making about the COVID-19 booster vaccine (CBV) in England. METHODS An online, cross-sectional survey informed by the PAPM, the extended Theory of Planned Behaviour and Health Belief Model administered to people over the age of 50 residing in England, UK in October 2021. A multivariate, multinomial logistic regression model was used to examine associations with the different stages of CBV decision-making. RESULTS Of the total 2,004 participants: 135 (6.7%) were unengaged with the CBV programme; 262 (13.1%) were undecided as to whether to have a CBV; 31 (1.5%) had decided not to have a CBV; 1,415 (70.6%) had decided to have a CBV; and 161 (8.0%) had already had their CBV. Being unengaged was positively associated with beliefs in their immune system to protect against COVID-19, being employed, and low household income; and negatively associated with CBV knowledge, a positive COVID-19 vaccine experience, subjective norms, anticipated regret of not having a CBV, and higher academic qualifications. Being undecided was positively associated with beliefs in their immune system and having previously received the Oxford/AstraZeneca (as opposed to Pfizer/BioNTech) vaccine; and negatively associated with CBV knowledge, positive attitudes regarding CBV, a positive COVID-19 vaccine experience, anticipated regret of not having a CBV, white British ethnicity, and living in East Midlands (vs London). CONCLUSIONS Public health interventions promoting CBV may improve uptake through tailored messaging directed towards the specific decision stage relating to having a COVID-19 booster.
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Affiliation(s)
- Carly Meyer
- NIHR Policy Research Unit in Behavioural Science - Health Psychology Research Group, Department of Clinical, Education and Health Psychology, University College London, UK.
| | - Louis Goffe
- NIHR Policy Research Unit in Behavioural Science - Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, UK
| | - Vivi Antonopoulou
- NIHR Policy Research Unit in Behavioural Science - Health Psychology Research Group, Department of Clinical, Education and Health Psychology, University College London, UK
| | - Fiona Graham
- NIHR Policy Research Unit in Behavioural Science - Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, UK
| | - Mei Yee Tang
- NIHR Policy Research Unit in Behavioural Science - Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, UK
| | - Jan Lecouturier
- NIHR Policy Research Unit in Behavioural Science - Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, UK
| | - Aikaterini Grimani
- NIHR Policy Research Unit in Behavioural Science - Behavioural Science Group, Warwick Business School, University of Warwick, UK
| | - Paul Chadwick
- NIHR Policy Research Unit in Behavioural Science - Health Psychology Research Group, Department of Clinical, Education and Health Psychology, University College London, UK
| | - Falko F Sniehotta
- NIHR Policy Research Unit in Behavioural Science - Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, UK; Department of Public Health, Preventive and Social Medicine, Center for Preventive Medicine and Digital Health Baden-Wuerttemberg, Heidelberg University, Germany
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15
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Ignacio M, Oesterle S, Mercado M, Carver A, Lopez G, Wolfersteig W, Ayers S, Ki S, Hamm K, Parthasarathy S, Berryhill A, Evans L, Sabo S, Doubeni C. Narratives from African American/Black, American Indian/Alaska Native, and Hispanic/Latinx community members in Arizona to enhance COVID-19 vaccine and vaccination uptake. J Behav Med 2023; 46:140-152. [PMID: 35322313 PMCID: PMC8942760 DOI: 10.1007/s10865-022-00300-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 02/15/2022] [Indexed: 12/25/2022]
Abstract
The state of Arizona has experienced one of the highest novel coronavirus disease 2019 (COVID-19) positivity test rates in the United States with disproportionally higher case rates and deaths among African-American/Black (AA/B), American Indian/Alaska Native (Native), and Hispanic/Latinx (HLX) individuals. To reduce disparities and promote health equity, researchers from Arizona State University, Mayo Clinic in Arizona, Northern Arizona University, and the University of Arizona formed a partnership with community organizations to conduct state-wide community-engaged research and outreach. This report describes results from 34 virtually-held focus groups and supplemental survey responses conducted with 153 AA/B, HLX, and Native community members across Arizona to understand factors associated with COVID-19 vaccine hesitancy and confidence. Focus groups revealed common themes of vaccine hesitancy stemming from past experiences of research abuses (e.g., Tuskegee syphilis experiment) as well as group-specific factors. Across all focus groups, participants strongly recommended the use of brief, narrative vaccination testimonials from local officials, community members, and faith leaders to increase trust in science, vaccine confidence and to promote uptake.
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Affiliation(s)
- Matt Ignacio
- Southwest Interdiciplinary Research Center, School of Social Work, Arizona State University, University Center, 411 N Central Ave #800, Phoenix, AZ, 85006, USA.
| | - Sabrina Oesterle
- Southwest Interdiciplinary Research Center, School of Social Work, Arizona State University, University Center, 411 N Central Ave #800, Phoenix, AZ, 85006, USA
| | - Micaela Mercado
- Southwest Interdiciplinary Research Center, School of Social Work, Arizona State University, University Center, 411 N Central Ave #800, Phoenix, AZ, 85006, USA
| | - Ann Carver
- Southwest Interdiciplinary Research Center, School of Social Work, Arizona State University, University Center, 411 N Central Ave #800, Phoenix, AZ, 85006, USA
| | - Gilberto Lopez
- School of Transborder Studies, Arizona State University, Phoenix, AZ, USA
| | - Wendy Wolfersteig
- Southwest Interdiciplinary Research Center, School of Social Work, Arizona State University, University Center, 411 N Central Ave #800, Phoenix, AZ, 85006, USA
| | - Stephanie Ayers
- Southwest Interdiciplinary Research Center, School of Social Work, Arizona State University, University Center, 411 N Central Ave #800, Phoenix, AZ, 85006, USA
| | - Seol Ki
- Southwest Interdiciplinary Research Center, School of Social Work, Arizona State University, University Center, 411 N Central Ave #800, Phoenix, AZ, 85006, USA
| | - Kathryn Hamm
- Southwest Interdiciplinary Research Center, School of Social Work, Arizona State University, University Center, 411 N Central Ave #800, Phoenix, AZ, 85006, USA
| | - Sairam Parthasarathy
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona, Tucson, AZ, USA
| | - Adam Berryhill
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona, Tucson, AZ, USA
| | - Linnea Evans
- Center for Health Equity Research, Department of Health Sciences, Northern Arizona University, Flagstaff, AZ, USA
| | - Samantha Sabo
- Center for Health Equity Research, Department of Health Sciences, Northern Arizona University, Flagstaff, AZ, USA
| | - Chyke Doubeni
- Department of Family Medicine, Center for Health Equity and Community Engagement Research, Mayo Clinic, Rochester, MN, USA
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16
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Martinez Leal I, Njoh J, Chen TA, Foreman-Hays F, Reed BC, Haley SA, Chavez K, Reitzel LR, Obasi EM. Exploring COVID-19 Vaccine Attitudes among Racially and Ethnically Minoritized Communities: Community Partners' and Residents' Perspectives. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3372. [PMID: 36834067 PMCID: PMC9964615 DOI: 10.3390/ijerph20043372] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 02/11/2023] [Accepted: 02/12/2023] [Indexed: 06/18/2023]
Abstract
COVID-19 has disproportionately affected Black, Indigenous, and People of Color (BIPOC) communities, yet rates of COVID-19 vaccination remain low among these groups. A qualitative study was undertaken to better understand the factors contributing to low vaccine acceptance among these communities. Seventeen focus groups were conducted in English and Spanish from 8/21 to 9/22, with representatives from five critical community sectors: (1) public health departments (n = 1); (2) Federally Qualified Health Centers (n = 2); (3) community-based organizations (n = 1); (4) faith-based organizations (n = 2); and (5) BIPOC residents in six high-risk, underserved communities in metropolitan Houston (n = 11), for a total of 79 participants, comprising 22 community partners and 57 community residents. A social-ecological model and anti-racism framework were adopted to guide data analysis using thematic analysis and constant comparison, which yielded five key themes: (1) legacy of structural racism: distrust and threat; (2) media misinformation: mass and social; (3) listening and adapting to community needs; (4) evolving attitudes towards vaccination; and (5) understanding alternative health belief systems. Although structural racism was a key driver of vaccine uptake, a notable finding indicated community residents' vaccine attitudes can be changed once they are confident of the protective benefits of vaccination. Study recommendations include adopting an explicitly anti-racist lens to: (1) listen to community members' needs and concerns, acknowledge their justified institutional distrust concerning vaccines, and learn community members' healthcare priorities to inform initiatives built on local data; (2) address misinformation via culturally informed, consistent messaging tailored to communal concerns and delivered by trusted local leaders through multimodal community forums; (3) take vaccines to where people live through pop-up clinics, churches, and community centers for distribution via trusted community members, with educational campaigns tailored to the needs of distinct communities; (4) establish vaccine equity task forces to continue developing sustainable policies, structures, programs and practices to address the structural issues driving vaccine and health inequities within BIPOC communities; and (5) continue investing in an effective infrastructure for healthcare education and delivery, essential for competently responding to the ongoing healthcare and other emergency crises that impact BIPOC communities to achieve racial justice and health equity in the US. Findings underscore the crucial need to provide culturally tailored health education and vaccination initiatives, focused on cultural humility, bidirectionality, and mutual respect to support vaccine re-evaluation.
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Affiliation(s)
- Isabel Martinez Leal
- Department of Health Disparities Research, MD Anderson Cancer Center, Houston, TX 77230, USA
- Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd., Stephen Power Farish Hall, Houston, TX 77204, USA
| | - Journa Njoh
- Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd., Stephen Power Farish Hall, Houston, TX 77204, USA
- HEALTH Research Institute, The University of Houston, 4349 Martin Luther King Blvd., Houston, TX 77204, USA
| | - Tzuan A. Chen
- Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd., Stephen Power Farish Hall, Houston, TX 77204, USA
- HEALTH Research Institute, The University of Houston, 4349 Martin Luther King Blvd., Houston, TX 77204, USA
| | - Faith Foreman-Hays
- Houston Health Department, 8000 North Stadium Dr., Houston, TX 77054, USA
| | - Brian C. Reed
- Department of Clinical Sciences, Tillman J. Fertitta Family College of Medicine, The University of Houston, 5055 Medical Circle, Houston, TX 77204, USA
| | - Sean A. Haley
- Center for Civic & Public Policy Improvement, 5445 Almeda Rd., Suite 504, Houston, TX 77004, USA
| | - Kerry Chavez
- Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd., Stephen Power Farish Hall, Houston, TX 77204, USA
- HEALTH Research Institute, The University of Houston, 4349 Martin Luther King Blvd., Houston, TX 77204, USA
| | - Lorraine R. Reitzel
- Department of Health Disparities Research, MD Anderson Cancer Center, Houston, TX 77230, USA
- Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd., Stephen Power Farish Hall, Houston, TX 77204, USA
| | - Ezemenari M. Obasi
- Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd., Stephen Power Farish Hall, Houston, TX 77204, USA
- HEALTH Research Institute, The University of Houston, 4349 Martin Luther King Blvd., Houston, TX 77204, USA
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17
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Valero-Martínez C, Martínez-Rivera C, Zhen-Duan J, Fukuda M, Alegría M. Attitudes toward COVID-19 Vaccine Uptake: A Qualitative Study of Mostly Immigrant Racial/Ethnic Minority Older Adults. Geriatrics (Basel) 2023; 8:17. [PMID: 36826359 PMCID: PMC9956127 DOI: 10.3390/geriatrics8010017] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/16/2023] [Accepted: 01/18/2023] [Indexed: 01/22/2023] Open
Abstract
(1) Background: Few qualitative studies address diverse older adults' perceptions of COVID-19 vaccination in the United States, including non-English speakers and immigrant populations. This study aims to understand the attitudes of diverse, primarily immigrant older adults in the U.S. toward the COVID-19 vaccine and its influences on their vaccination decision-making. (2) Methods: The research team conducted semi-structured interviews (N = 100) in 2021 focused on understanding ethnically/racially diverse older adults' perceptions of the COVID-19 vaccine. Interviews were recorded, coded, and analyzed using a thematic analysis approach. (3) Results: Thematic analyses identified three themes. (1) Older adults showed mixed attitudes toward the COVID-19 vaccine associated with information consumed and trust in healthcare systems; (2) health concerns and underlying medical conditions were the most influential factors of vaccine uptake; and (3) systemic barriers and trusted figures impacted vaccination decision-making of older adults. (4) Conclusions: Accessible information in diverse languages tailored to the community's fears is needed to combat vaccine mistrust. Vaccine rollout programs need to tackle the fear of vaccine side effects. Attitudes of religious leaders, family members, and physicians considerably influenced vaccine uptake, suggesting their role as trusted members for vaccine messaging for older, primarily immigrant adults. Systemic barriers, namely lack of transportation and inaccessible vaccination sites, contributed to vaccine deterrence.
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Affiliation(s)
- Carla Valero-Martínez
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Psychology, Faculty of Social Sciences, Río Piedras Campus, University of Puerto Rico, San Juan, PR 00925, USA
| | - Christopher Martínez-Rivera
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
- School of Medicine, Ponce Health Sciences University, Ponce, PR 00716, USA
| | - Jenny Zhen-Duan
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA 02215, USA
| | - Marie Fukuda
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Margarita Alegría
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA 02215, USA
- Department of Medicine, Harvard Medical School, Boston, MA 02115, USA
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18
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Van Bortel T, Lombardo C, Guo L, Solomon S, Martin S, Hughes K, Weeks L, Crepaz-Keay D, McDaid S, Chantler O, Thorpe L, Morton A, Davidson G, John A, Kousoulis AA. The mental health experiences of ethnic minorities in the UK during the Coronavirus pandemic: A qualitative exploration. Front Public Health 2022; 10:875198. [PMID: 36276403 PMCID: PMC9582845 DOI: 10.3389/fpubh.2022.875198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 08/15/2022] [Indexed: 12/04/2022] Open
Abstract
Background Worldwide, the Coronavirus pandemic has had a major impact on people's health, lives, and livelihoods. However, this impact has not been felt equally across various population groups. People from ethnic minority backgrounds in the UK have been more adversely affected by the pandemic, especially in terms of their physical health. Their mental health, on the other hand, has received less attention. This study aimed to explore the mental health experiences of UK adults from ethnic minorities during the Coronavirus pandemic. This work forms part of our wider long-term UK population study "Mental Health in the Pandemic." Methods We conducted an exploratory qualitative study with people from ethnic minority communities across the UK. A series of in-depth interviews were conducted with 15 women, 14 men and 1 non-binary person from ethnic minority backgrounds, aged between 18 and 65 years old (mean age = 40). We utilized purposefully selected maximum variation sampling in order to capture as wide a variety of views, perceptions and experiences as possible. Inclusion criteria: adults (18+) from ethnic minorities across the UK; able to provide full consent to participate; able to participate in a video- or phone-call interview. All interviews took place via MS Teams or Zoom. The gathered data were transcribed verbatim and underwent thematic analysis following Braun and Clarke carried out using NVivo 12 software. Results The qualitative data analysis yielded seven overarching themes: (1) pandemic-specific mental health and wellbeing experiences; (2) issues relating to the media; (3) coping mechanisms; (4) worries around and attitudes toward vaccination; (5) suggestions for support in moving forward; (6) best and worst experiences during pandemic and lockdowns; (7) biggest areas of change in personal life. Generally, participants' mental health experiences varied with some not being affected by the pandemic in a way related to their ethnicity, some sharing positive experiences and coping strategies (exercising more, spending more time with family, community cohesion), and some expressing negative experiences (eating or drinking more, feeling more isolated, or even racism and abuse, especially toward Asian communities). Concerns were raised around trust issues in relation to the media, the inadequate representation of ethnic minorities, and the spread of fake news especially on social media. Attitudes toward vaccinations varied too, with some people more willing to have the vaccine than others. Conclusion This study's findings highlight the diversity in the pandemic mental health experiences of ethnic minorities in the UK and has implications for policy, practice and further research. To enable moving forward beyond the pandemic, our study surfaced the need for culturally appropriate mental health support, financial support (as a key mental health determinant), accurate media representation, and clear communication messaging from the Governments of the UK.
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Affiliation(s)
- Tine Van Bortel
- Faculty of Health and Life Sciences, Leicester School of Allied Health Sciences, Gateway House, De Montfort University, Leicester, United Kingdom
- Cambridge Public Health, Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Chiara Lombardo
- Cambridge Public Health, Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
- Mental Health Foundation, London, United Kingdom
| | - Lijia Guo
- Cambridge Public Health, Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
- Department of Sociology, School of Humanities and Social Sciences, University of Cambridge, Cambridge, United Kingdom
| | | | - Steven Martin
- Faculty of Health and Life Sciences, Leicester School of Allied Health Sciences, Gateway House, De Montfort University, Leicester, United Kingdom
| | - Kate Hughes
- Mental Health Foundation, London, United Kingdom
| | - Lauren Weeks
- Mental Health Foundation, London, United Kingdom
| | | | - Shari McDaid
- Mental Health Foundation, London, United Kingdom
| | | | - Lucy Thorpe
- Mental Health Foundation, London, United Kingdom
| | - Alec Morton
- Department of Management Science, Strathclyde Business School, University of Strathclyde, Glasgow, United Kingdom
| | - Gavin Davidson
- School of Social Sciences, Education and Social Work, Queen's University Belfast, Belfast, United Kingdom
| | - Ann John
- Health Data Research UK, Swansea University Medical School, Swansea, United Kingdom
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19
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Zhang Z, Liu G, Chen B, Huang K. Social asset or social liability? How partisanship moderates the relationship between social capital and Covid-19 vaccination rates across United States counties. Soc Sci Med 2022; 311:115325. [PMID: 36115131 PMCID: PMC9434956 DOI: 10.1016/j.socscimed.2022.115325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 05/21/2022] [Accepted: 08/26/2022] [Indexed: 11/21/2022]
Abstract
This study investigates the interactive effect of social capital and partisanship on COVID-19 vaccination rates. Using county-level data from the United States (U.S.), we empirically find that social capital is a double-edged sword. Its effect on the vaccination rate depends on the dominant partisanship of the jurisdiction. In more liberal counties, stronger social capital is a social asset that encourages people to seek vaccination and results in a higher vaccination rate. In contrast, in more conservative counties where the Trump-voting rate reaches 73% and beyond, stronger social capital becomes a social liability for public health by reinforcing residents' hesitancy toward or rejection of vaccinations, leading to a lower vaccination rate. This study implies the need for reducing the partisanship salience and investing in bridging and linking social capital in polarized communities.
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Affiliation(s)
- Zhiwei Zhang
- Department of Political Science, Kansas State University, USA.
| | - Gao Liu
- School of Public Administration, Florida Atlantic University, USA.
| | - Bin Chen
- Marxe School of Public and International Affairs, Baruch College & The Graduate Center, The City University of New York, USA.
| | - Kun Huang
- School of Public Administration and College of Population Health, The University of New Mexico, USA.
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20
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Caperon L, Saville F, Ahern S. Developing a socio-ecological model for community engagement in a health programme in an underserved urban area. PLoS One 2022; 17:e0275092. [PMID: 36155664 PMCID: PMC9512167 DOI: 10.1371/journal.pone.0275092] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 09/11/2022] [Indexed: 11/18/2022] Open
Abstract
Despite a recent increase in community engagement in health initiatives during the COVID-19 pandemic, health inequalities and health inequities remain a serious problem for society, often affecting those in underserved communities the most. Often individualised incentives such as payment for vaccinations have been used to increase involvement in health initiatives but evidence suggests that these do not always work and can be ineffective. This paper addresses the real world problem of a lack of involvement of communities in health programmes and subsequent health inequalities. Using data from nine workshops with community members evaluating a large community health programme, we develop a socio-ecological model [SEM] of influences on community engagement in health programmes to identify holistic and systemic barriers and enablers to such engagement. To date SEM has not been used to develop solutions to improve community engagement in health programmes. Such an approach holds the potential to look beyond individualised conceptualisations of behaviour and instead consider a multitude of social and cultural influences. This knowledge can then be used to develop multi-faceted and multi-layered solutions to tackle the barriers to community engagement in health programmes. Our SEM highlights the overarching importance of the socio-cultural environment in influencing community engagement. Within the socio-cultural environment were factors such as trust, social support and community mindedness. We also found that other factors affecting community engagement fall within individual, economic, technological, political and physical environments. Such factors include engagement in community organisation governance and processes, access to and ability to use technology and access to safe outdoor spaces. We propose further testing our socioecological model in other communities.
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Affiliation(s)
- Lizzie Caperon
- Bradford Institute for Health Research, Bradford, United Kingdom
- * E-mail:
| | - Fiona Saville
- Better Start Bradford, Mayfield Centre, Bradford, United Kingdom
| | - Sara Ahern
- Bradford Institute for Health Research, Bradford, United Kingdom
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21
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Nellums LB, Latif A, Nkhoma K, Timmons S, Pareek M, Almidani S, Hussain B. COVID-19 boosters and building trust among UK minority ethnic communities. Lancet 2022; 400:643-644. [PMID: 35643093 PMCID: PMC9132542 DOI: 10.1016/s0140-6736(22)00945-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 05/18/2022] [Indexed: 12/23/2022]
Affiliation(s)
- Laura B Nellums
- Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham NG5 1PB, UK.
| | - Asam Latif
- School of Health Sciences, University of Nottingham, Nottingham NG5 1PB, UK
| | - Kennedy Nkhoma
- Cicely Saunders Institute, King's College London, London, UK
| | - Stephen Timmons
- Nottingham University Business School, University of Nottingham, Nottingham NG5 1PB, UK
| | - Manish Pareek
- Department of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK; Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Salma Almidani
- Yale School of Public Health, Yale University, New Haven, CT, USA
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22
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Pickersgill M, Manda-Taylor L, Niño-Machado N. Pandemic preparedness means policy makers need to work with social scientists. Lancet 2022; 400:547-549. [PMID: 35654080 PMCID: PMC9150864 DOI: 10.1016/s0140-6736(22)00983-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 05/20/2022] [Indexed: 02/02/2023]
Affiliation(s)
- Martyn Pickersgill
- Usher Institute, Old Medical School, University of Edinburgh, Edinburgh EH8 9AG, UK.
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Lin S. COVID-19 Pandemic and Im/migrants' Elevated Health Concerns in Canada: Vaccine Hesitancy, Anticipated Stigma, and Risk Perception of Accessing Care. J Immigr Minor Health 2022; 24:896-908. [PMID: 35212825 PMCID: PMC8874751 DOI: 10.1007/s10903-022-01337-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2022] [Indexed: 01/10/2023]
Abstract
Vaccine hesitancy has taken a toll on COVID-19 immunization globally. This study aims to characterize three COVID-19-related health concerns (i.e., vaccine hesitancy, anticipated stigma, and risk perception) in Canada and how they differ based on im/migration status and other social determinants. Data were obtained from a nationwide probability sample of the Canadian Perspective Survey Series 3 (June 15 to 21, 2020). Multivariable binary logistic regression analysis was performed to investigate the association between each COVID-19 concern and nativity status, while controlling for socio-demographics. Of 3522 participants aged ≥ 25 years, the estimated overall prevalence of vaccine hesitancy was 16.9%, with im/migrants being greater than non-immigrants (21.5% vs. 15.5%, p < 0.001). After controlling for all covariates, im/migrants had around two-fold greater odds of all three health concerns, including risk perception of accessing care (aOR 2.44, 95% CI 1.89-3.15), anticipated stigma of being targeted (aOR 2.24, 95% CI 1.81, 2.78) and COVID-19 vaccine hesitancy (aOR 1.99, 95% CI 1.57-2.52), compared to their Canadian-born peers. Among vaccine-hesitant individuals (n = 596), im/migrants reported higher concerns, than non-immigrants, on vaccine safety (71.3% vs. 49.5%), side effects (66.4% vs 47.3%) and mistrust in vaccinations (12.5% vs 6.6%) as possible reasons of vaccine refusal. For migrant justice, health authorities should ensure equitable access to COVID-19 vaccines and other health-enhancing resources for im/migrants to mitigate their heightened fear, stigma, and mistrust of new vaccines amidst turbulent times.
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Affiliation(s)
- Shen Lin
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street W, Toronto, ON, M5S 1V4, Canada.
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24
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Avelino-Silva VI, de Barros MTL. Assessment of novel technologies in healthcare - off-label use of drugs and the ethics of implementation and distribution of COVID-19 vaccines. EINSTEIN-SAO PAULO 2022; 19:eED6840. [PMID: 35019043 PMCID: PMC8693880 DOI: 10.31744/einstein_journal/2021ed6840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Vivian Iida Avelino-Silva
- Faculdade Israelita de Ciências da Saúde Albert EinsteinHospital Israelita Albert EinsteinSão PauloSPBrazilFaculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | - Mario Thadeu Leme de Barros
- Faculdade Israelita de Ciências da Saúde Albert EinsteinHospital Israelita Albert EinsteinSão PauloSPBrazilFaculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | - Class 8 FICSAE Working Group
- Faculdade Israelita de Ciências da Saúde Albert EinsteinHospital Israelita Albert EinsteinSão PauloSPBrazilFaculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
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González-Block MÁ, Portillo SPD, Laguna JA, Comes Y, Crocco P, Fachel-Leal A, Noboa L, Knauth DR, Rodríguez-Zea B, Ruoti M, Sarti E, Puentes E. Barriers and facilitators to influenza vaccination observed by officers of national immunization programs in South America countries with contrasting coverage rates. CAD SAUDE PUBLICA 2022; 38:e00045721. [DOI: 10.1590/0102-311x00045721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 09/24/2021] [Indexed: 11/22/2022] Open
Abstract
Influenza is a severe, vaccine-preventable disease. Vaccination programs across Latin American countries show contrasting coverage rates, from 29% in Paraguay to 89% in Brazil. This study explores how national influenza vaccination programs in the chosen South American countries address vaccine confidence and convenience, as well as complacency toward the disease. Barriers and facilitators to influenza vaccination programs in their relation to vaccine hesitancy were observed by documentary analysis and interviews with 38 national immunization program officers in high- (Brazil and Chile) and low-performing (Paraguay, Peru, and Uruguay) countries. Influenza vaccination policies, financing, purchasing, coordination, and accessibility are considered good or acceptable. National communication strategies focus on vaccine availability during campaigns. In Chile, Paraguay, and Uruguay, anti-vaccine propaganda was mentioned as a problem. Programming and implementation face human resource shortages across most countries. Statistical information, health information systems, and nominal risk-group records are available, with limitations in Peru and Paraguay. Health promotion, supervision, monitoring, and evaluation are perceived as opportunities to address confidence and complacency. Influenza vaccination programs identify and act on most barriers and facilitators affecting influenza vaccine hesitancy via supply-side strategies which mostly address vaccine convenience. Confidence and complacency are insufficiently addressed, except for Uruguay. Programs have the opportunity to develop integral supply and demand-side approaches.
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26
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Cheong Q, Au-Yeung M, Quon S, Concepcion K, Kong JD. Predictive Modeling of Vaccination Uptake in US Counties: A Machine Learning-Based Approach. J Med Internet Res 2021; 23:e33231. [PMID: 34751650 PMCID: PMC8623305 DOI: 10.2196/33231] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 10/17/2021] [Accepted: 11/01/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Although the COVID-19 pandemic has left an unprecedented impact worldwide, countries such as the United States have reported the most substantial incidence of COVID-19 cases worldwide. Within the United States, various sociodemographic factors have played a role in the creation of regional disparities. Regional disparities have resulted in the unequal spread of disease between US counties, underscoring the need for efficient and accurate predictive modeling strategies to inform public health officials and reduce the burden on health care systems. Furthermore, despite the widespread accessibility of COVID-19 vaccines across the United States, vaccination rates have become stagnant, necessitating predictive modeling to identify important factors impacting vaccination uptake. OBJECTIVE This study aims to determine the association between sociodemographic factors and vaccine uptake across counties in the United States. METHODS Sociodemographic data on fully vaccinated and unvaccinated individuals were sourced from several online databases such as the US Centers for Disease Control and Prevention and the US Census Bureau COVID-19 Site. Machine learning analysis was performed using XGBoost and sociodemographic data. RESULTS Our model predicted COVID-19 vaccination uptake across US counties with 62% accuracy. In addition, it identified location, education, ethnicity, income, and household access to the internet as the most critical sociodemographic features in predicting vaccination uptake in US counties. Lastly, the model produced a choropleth demonstrating areas of low and high vaccination rates, which can be used by health care authorities in future pandemics to visualize and prioritize areas of low vaccination and design targeted vaccination campaigns. CONCLUSIONS Our study reveals that sociodemographic characteristics are predictors of vaccine uptake rates across counties in the United States and, if leveraged appropriately, can assist policy makers and public health officials to understand vaccine uptake rates and craft policies to improve them.
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Affiliation(s)
- Queena Cheong
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada
| | - Martin Au-Yeung
- Faculty of Science, University of British Columbia, Vancouver, BC, Canada
| | - Stephanie Quon
- Faculty of Applied Science, University of British Columbia, Vancouver, BC, Canada
| | - Katsy Concepcion
- Faculty of Science, University of British Columbia, Vancouver, BC, Canada
| | - Jude Dzevela Kong
- Africa-Canada Artificial Intelligence and Data Innovation Consortium, Department of Mathematics and Statistics, York University, Toronto, ON, Canada
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27
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Zhao YM, Liu L, Sun J, Yan W, Yuan K, Zheng YB, Lu ZA, Liu L, Ni SY, Su SZ, Zhu XM, Zeng N, Gong YM, Wu P, Ran MS, Leng Y, Shi J, Shi L, Lu L, Bao YP. Public Willingness and Determinants of COVID-19 Vaccination at the Initial Stage of Mass Vaccination in China. Vaccines (Basel) 2021; 9:vaccines9101172. [PMID: 34696281 PMCID: PMC8538840 DOI: 10.3390/vaccines9101172] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 09/30/2021] [Accepted: 10/09/2021] [Indexed: 01/06/2023] Open
Abstract
The present study assessed the willingness of the general population to receive COVID-19 vaccines and identified factors that influence vaccine hesitancy and resistance. A national online survey was conducted from 29 January 2021 to 26 April 2021 in China. Multinomial logistic regression analyses were conducted to identify factors that influence vaccine hesitancy and resistance. Of the 34,041 participants surveyed, 18,810 (55.3%) were willing to get vaccinated, 13,736 (40.3%) were hesitant, and 1495 (4.4%) were resistant. Rates of vaccine acceptance increased over time, with geographical discrepancies in vaccine hesitancy and resistance between provinces in China. Vaccine safety was the greatest concern expressed by most participants (24,461 [71.9%]), and the major reason for participants’ refusing vaccination (974 [65.2%]). Government agencies (23,131 [68.0%]) and social media (20,967 [61.6%]) were the main sources of COVID-19 vaccine information. Compared with vaccination acceptance, female, young and middle-aged, high income, and perceived low-risk of infection were associated with vaccine hesitancy. Histories of allergic reactions to other vaccines and depression symptoms were related to vaccine resistance. Common factors that influenced vaccine hesitancy and resistance were residing in cities and perceiving less protection with vaccines than with other protective measures. The results indicate that the rate of vaccine resistance is relatively low, but vaccine hesitancy is common. Individuals who are female, young and middle-aged, with a high income, and residing in cities are more likely to be hesitant for vaccination and should be the target populations for vaccination campaigns. Specific vaccine messaging from the government and social media could alleviate public concerns about vaccine safety and efficacy.
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Affiliation(s)
- Yi-Miao Zhao
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China; (Y.-M.Z.); (L.L.); (S.-Y.N.); (N.Z.); (P.W.); (J.S.)
- School of Public Health, Peking University, Beijing 100191, China
| | - Lin Liu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing 100191, China; (L.L.); (W.Y.); (K.Y.); (Y.-B.Z.); (Z.-A.L.); (S.-Z.S.); (X.-M.Z.); (Y.-M.G.)
| | - Jie Sun
- Pain Medicine Center, Peking University Third Hospital, Beijing 100191, China;
| | - Wei Yan
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing 100191, China; (L.L.); (W.Y.); (K.Y.); (Y.-B.Z.); (Z.-A.L.); (S.-Z.S.); (X.-M.Z.); (Y.-M.G.)
| | - Kai Yuan
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing 100191, China; (L.L.); (W.Y.); (K.Y.); (Y.-B.Z.); (Z.-A.L.); (S.-Z.S.); (X.-M.Z.); (Y.-M.G.)
| | - Yong-Bo Zheng
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing 100191, China; (L.L.); (W.Y.); (K.Y.); (Y.-B.Z.); (Z.-A.L.); (S.-Z.S.); (X.-M.Z.); (Y.-M.G.)
- Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing 100871, China
| | - Zheng-An Lu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing 100191, China; (L.L.); (W.Y.); (K.Y.); (Y.-B.Z.); (Z.-A.L.); (S.-Z.S.); (X.-M.Z.); (Y.-M.G.)
| | - Lin Liu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China; (Y.-M.Z.); (L.L.); (S.-Y.N.); (N.Z.); (P.W.); (J.S.)
- School of Public Health, Peking University, Beijing 100191, China
| | - Shu-Yu Ni
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China; (Y.-M.Z.); (L.L.); (S.-Y.N.); (N.Z.); (P.W.); (J.S.)
- School of Public Health, Peking University, Beijing 100191, China
| | - Si-Zhen Su
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing 100191, China; (L.L.); (W.Y.); (K.Y.); (Y.-B.Z.); (Z.-A.L.); (S.-Z.S.); (X.-M.Z.); (Y.-M.G.)
| | - Xi-Mei Zhu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing 100191, China; (L.L.); (W.Y.); (K.Y.); (Y.-B.Z.); (Z.-A.L.); (S.-Z.S.); (X.-M.Z.); (Y.-M.G.)
| | - Na Zeng
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China; (Y.-M.Z.); (L.L.); (S.-Y.N.); (N.Z.); (P.W.); (J.S.)
- School of Public Health, Peking University, Beijing 100191, China
- Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Yi-Miao Gong
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing 100191, China; (L.L.); (W.Y.); (K.Y.); (Y.-B.Z.); (Z.-A.L.); (S.-Z.S.); (X.-M.Z.); (Y.-M.G.)
| | - Ping Wu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China; (Y.-M.Z.); (L.L.); (S.-Y.N.); (N.Z.); (P.W.); (J.S.)
| | - Mao-Sheng Ran
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China;
| | - Yue Leng
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA 94121, USA;
| | - Jie Shi
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China; (Y.-M.Z.); (L.L.); (S.-Y.N.); (N.Z.); (P.W.); (J.S.)
| | - Le Shi
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing 100191, China; (L.L.); (W.Y.); (K.Y.); (Y.-B.Z.); (Z.-A.L.); (S.-Z.S.); (X.-M.Z.); (Y.-M.G.)
- Correspondence: (L.S.); (L.L.); (Y.-P.B.); Tel.: +86-10-8280-2470 (L.S. & Y.-P.B.); +86-10-8280-5308 (L.L.); Fax: +86-10-6203-2624 (L.S., L.L. & Y.-P.B.)
| | - Lin Lu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China; (Y.-M.Z.); (L.L.); (S.-Y.N.); (N.Z.); (P.W.); (J.S.)
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing 100191, China; (L.L.); (W.Y.); (K.Y.); (Y.-B.Z.); (Z.-A.L.); (S.-Z.S.); (X.-M.Z.); (Y.-M.G.)
- Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing 100871, China
- Correspondence: (L.S.); (L.L.); (Y.-P.B.); Tel.: +86-10-8280-2470 (L.S. & Y.-P.B.); +86-10-8280-5308 (L.L.); Fax: +86-10-6203-2624 (L.S., L.L. & Y.-P.B.)
| | - Yan-Ping Bao
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China; (Y.-M.Z.); (L.L.); (S.-Y.N.); (N.Z.); (P.W.); (J.S.)
- School of Public Health, Peking University, Beijing 100191, China
- Correspondence: (L.S.); (L.L.); (Y.-P.B.); Tel.: +86-10-8280-2470 (L.S. & Y.-P.B.); +86-10-8280-5308 (L.L.); Fax: +86-10-6203-2624 (L.S., L.L. & Y.-P.B.)
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28
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Mozid NE, Amin MA, Jhumur SS, Monju IH, Ahmed SB, Sharmin S, Sarker W, Hawlader MDH. COVID-19 risk of infection and vaccination during Ramadan fasting: knowledge and attitudes of Bangladeshi general population. Heliyon 2021; 7:e08174. [PMID: 34664033 PMCID: PMC8514325 DOI: 10.1016/j.heliyon.2021.e08174] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 07/13/2021] [Accepted: 10/11/2021] [Indexed: 12/19/2022] Open
Abstract
There is some debate whether COVID-19 infection and vaccination will hamper Ramadan among the Muslim population worldwide. Therefore, this study aimed to assess the total proportion of the Bangladeshi population who has adequate knowledge and attitude towards COVID-19 risk of infections and vaccination during Ramadan fasting. A cross-sectional study had conducted among 502 adult participants of Bangladesh. We have used a structured questionnaire which had implemented through a face-to-face interview by trained data collectors. Data were analyzed using statistical package software SPSS version 25.0. Of the 502 participants, 50.2% were male, and most (49.6%) lived in urban areas. About 72.5% and 76.30% reported having adequate knowledge and a positive attitude, respectively, regarding COVID-19 risk of infection and vaccination during Ramadan fasting. Among all variables, no formal education and up to class 8 education had significantly associated with inadequate knowledge (OR = 5.14, 95% CI = 1.63-16.19, and OR = 6.42, 95% CI = 2.55-16.19). Educational status was also associated with attitude (OR = 3.68, 95%CI = 1.17-11.55). Current smokers reported a negative attitude in comparison to non-smokers (OR = 2.48, 95% CI = 1.36-4.50). In conclusion, our study found overall moderate knowledge and attitude among the Bangladeshi population towards COVID-19 infection and vaccination. Government should continue its efforts to increase the knowledge and attitude level to a higher level, and anti-smoking campaigns should strengthen to make people stop smoking to reduce the COVID-19 severity.
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Affiliation(s)
- Nusrat-E Mozid
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
| | | | | | - Imran Hossain Monju
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
| | - Sanjana Binte Ahmed
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
| | - Shakila Sharmin
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
| | - Wharesha Sarker
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
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Tu L, Bajaj SS, Stanford FC. What the COVID-19 pandemic can teach us about inclusive blood donation. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2021; 19:357-359. [PMID: 34369868 PMCID: PMC8486603 DOI: 10.2450/2021.0191-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 07/26/2021] [Indexed: 06/13/2023]
Affiliation(s)
- Lucy Tu
- Department of Sociology, Harvard College, Cambridge, MA, United States of America
| | - Simar S. Bajaj
- Department of the History of Science, Harvard College, Cambridge, MA, United States of America
| | - Fatima Cody Stanford
- Massachusetts General Hospital, MGH Weight Center, Department of Medicine-Division of Endocrinology-Neuroendocrine, Department of Pediatrics-Division of Endocrinology, Nutrition Obesity Research Center at Harvard (NORCH), Boston, MA, United States of America
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Abstract
When the novel coronavirus was described in late 2019, it could not have been imagined that within a year, more than 100 vaccine candidates would be in preclinical development and several would be in clinical trials and even approved for use. The scale of the COVID-19 outbreak pushed the scientific community, working in collaboration with pharmaceutical companies, public health bodies, policymakers, funders and governments, to develop vaccines against SARS-CoV-2 at record-breaking speed. As well as driving major amendments to the usual timeframe for bringing a vaccine to fruition, the pandemic has accelerated the development of next-generation technologies for vaccinology, giving rise to two frontrunner RNA vaccines. Although none of the critical safety and efficacy steps have been skipped within the compressed schedules, and the technologies underpinning the novel vaccines have been refined by scientists over many years, a significant proportion of the global population is sceptical of the benefits of COVID-19 vaccines and wary of potential risks. In this interview-based article, we give an overview of how the vaccines were developed and how they work to generate a robust immune response against COVID-19, as well as addressing common questions relating to safety and efficacy.
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Affiliation(s)
| | - Daniel Altmann
- Department of Immunology and InflammationFaculty of MedicineImperial College LondonHammersmith HospitalLondonUK
| | - Victoria Male
- Department of Metabolism, Digestion and ReproductionImperial College LondonChelsea and Westminster HospitalLondonUK
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Warren CM, Snow TT, Lee AS, Shah MM, Heider A, Blomkalns A, Betts B, Buzzanco AS, Gonzalez J, Chinthrajah RS, Do E, Chang I, Dunham D, Lee G, O’Hara R, Park H, Shamji MH, Schilling L, Sindher SB, Sisodiya D, Smith E, Tsai M, Galli SJ, Akdis C, Nadeau KC. Assessment of Allergic and Anaphylactic Reactions to mRNA COVID-19 Vaccines With Confirmatory Testing in a US Regional Health System. JAMA Netw Open 2021; 4:e2125524. [PMID: 34533570 PMCID: PMC8449279 DOI: 10.1001/jamanetworkopen.2021.25524] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
IMPORTANCE As of May 2021, more than 32 million cases of COVID-19 have been confirmed in the United States, resulting in more than 615 000 deaths. Anaphylactic reactions associated with the Food and Drug Administration (FDA)-authorized mRNA COVID-19 vaccines have been reported. OBJECTIVE To characterize the immunologic mechanisms underlying allergic reactions to these vaccines. DESIGN, SETTING, AND PARTICIPANTS This case series included 22 patients with suspected allergic reactions to mRNA COVID-19 vaccines between December 18, 2020, and January 27, 2021, at a large regional health care network. Participants were individuals who received at least 1 of the following International Statistical Classification of Diseases and Related Health Problems, Tenth Revision anaphylaxis codes: T78.2XXA, T80.52XA, T78.2XXD, or E949.9, with documentation of COVID-19 vaccination. Suspected allergy cases were identified and invited for follow-up allergy testing. EXPOSURES FDA-authorized mRNA COVID-19 vaccines. MAIN OUTCOMES AND MEASURES Allergic reactions were graded using standard definitions, including Brighton criteria. Skin prick testing was conducted to polyethylene glycol (PEG) and polysorbate 80 (P80). Histamine (1 mg/mL) and filtered saline (negative control) were used for internal validation. Basophil activation testing after stimulation for 30 minutes at 37 °C was also conducted. Concentrations of immunoglobulin (Ig) G and IgE antibodies to PEG were obtained to determine possible mechanisms. RESULTS Of 22 patients (20 [91%] women; mean [SD] age, 40.9 [10.3] years; 15 [68%] with clinical allergy history), 17 (77%) met Brighton anaphylaxis criteria. All reactions fully resolved. Of patients who underwent skin prick tests, 0 of 11 tested positive to PEG, 0 of 11 tested positive to P80, and 1 of 10 (10%) tested positive to the same brand of mRNA vaccine used to vaccinate that individual. Among these same participants, 10 of 11 (91%) had positive basophil activation test results to PEG and 11 of 11 (100%) had positive basophil activation test results to their administered mRNA vaccine. No PEG IgE was detected; instead, PEG IgG was found in tested individuals who had an allergy to the vaccine. CONCLUSIONS AND RELEVANCE Based on this case series, women and those with a history of allergic reactions appear at have an elevated risk of mRNA vaccine allergy. Immunological testing suggests non-IgE-mediated immune responses to PEG may be responsible in most individuals.
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Affiliation(s)
- Christopher Michael Warren
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Stanford, California
- Center for Food Allergy and Asthma Research, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Theo Thomas Snow
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Stanford, California
| | - Alexandra S. Lee
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Stanford, California
| | - Mihir Mukesh Shah
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Stanford, California
| | - Anja Heider
- Swiss Institute of Allergy and Asthma Research, University of Zurich, Davos, Switzerland
| | - Andra Blomkalns
- Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, California
| | | | | | - Joseph Gonzalez
- Stanford University School of Medicine, Stanford, California
| | - R. Sharon Chinthrajah
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Stanford, California
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Stanford, California
| | - Evan Do
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Stanford, California
| | - Iris Chang
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Stanford, California
| | - Diane Dunham
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Stanford, California
| | - Grace Lee
- Stanford Children’s Health and Stanford University School of Medicine, Department of Pediatrics, Palo Alto, California
| | - Ruth O’Hara
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California
| | - Helen Park
- VA Palo Alto Health Care System, Palo Alto, California
| | - Mohamed H. Shamji
- Immunomodulation and Tolerance Group, Allergy and Clinical Immunology, Department of National Heart and Lung Institute, Imperial College London, London, United Kingdom
- Centre in Allergic Mechanisms of Asthma, London, United Kingdom
| | | | - Sayantani B. Sindher
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Stanford, California
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Stanford, California
| | | | - Eric Smith
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Stanford, California
| | - Mindy Tsai
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Stanford, California
- Department of Pathology, Stanford University School of Medicine, Stanford, California
| | - Stephen J. Galli
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Stanford, California
- Department of Pathology, Stanford University School of Medicine, Stanford, California
- Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, California
| | - Cezmi Akdis
- Swiss Institute of Allergy and Asthma Research, University of Zurich, Davos, Switzerland
| | - Kari C. Nadeau
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Stanford, California
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Stanford, California
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Jiang DH, Roy DJ, Gu BJ, Hassett LC, McCoy RG. Postacute Sequelae of Severe Acute Respiratory Syndrome Coronavirus 2 Infection: A State-of-the-Art Review. JACC Basic Transl Sci 2021; 6:796-811. [PMID: 34541421 PMCID: PMC8442719 DOI: 10.1016/j.jacbts.2021.07.002] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 06/22/2021] [Accepted: 07/07/2021] [Indexed: 01/08/2023]
Abstract
The vast majority of patients (>99%) with severe acute respiratory syndrome coronavirus 2 survive immediate infection but remain at risk for persistent and/or delayed multisystem. This review of published reports through May 31, 2021, found that manifestations of postacute sequelae of severe acute respiratory syndrome coronavirus 2 infection (PASC) affect between 33% and 98% of coronavirus disease 2019 survivors and comprise a wide range of symptoms and complications in the pulmonary, cardiovascular, neurologic, psychiatric, gastrointestinal, renal, endocrine, and musculoskeletal systems in both adult and pediatric populations. Additional complications are likely to emerge and be identified over time. Although data on PASC risk factors and vulnerable populations are scarce, evidence points to a disproportionate impact on racial/ethnic minorities, older patients, patients with preexisting conditions, and rural residents. Concerted efforts by researchers, health systems, public health agencies, payers, and governments are urgently needed to better understand and mitigate the long-term effects of PASC on individual and population health.
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Affiliation(s)
- David H. Jiang
- Division of Health Care Delivery and Research, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, USA
| | - Darius J. Roy
- Division of Cardiovascular Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | - Brett J. Gu
- School of Medicine, Yale University; New Haven, Connecticut, USA
| | | | - Rozalina G. McCoy
- Division of Health Care Delivery and Research, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, USA
- Division of Community Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA
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Mondal P, Sinharoy A, Sankoorikal BJ, Siddaiah R, Mazur L, Graff G. The Influence of Sociodemographic Heterogeneity on the Perceptions of COVID-19: A Countrywide Survey Study in the USA. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8922. [PMID: 34501512 PMCID: PMC8431068 DOI: 10.3390/ijerph18178922] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 08/04/2021] [Accepted: 08/18/2021] [Indexed: 12/18/2022]
Abstract
Background: Sociodemographic factors such as age, race, education, family income, and sex have been reported to influence COVID-related perceptions, reflected by knowledge, stress, and preventive behavior. We conducted a US-based survey to estimate the difference in COVID-related perceptions among diverse sociodemographic groups and the influence of sociodemographic heterogeneity on COVID-related perceptions. Methods: The survey enquired about sociodemographic parameters and relevant information to measure knowledge, stress, and preventive behavior. COVID-perception scores among sociodemographic subgroups were compared with ANOVA (Bonferroni). The general linear model (GLM) was used to estimate the association among sociodemographic factors and COVID-related perceptions. Results: Females (75%) and White participants (78%) were the predominant (N = 3734). Females, White participants, wealthy, and educated participants demonstrated better knowledge, while participants of minority races, younger ages, low incomes, and females experienced high stress. Females, African-Americans, and educated participants better adopted preventive behaviors. Race, family income, and sex were the highest contributors to the predictive model. Sociodemographic determinants had statistically significant associations with knowledge (F-score = 7.72, p < 0.001; foremost predictor: race), stress (F-score = 16.46, p < 0.001; foremost predictor: income), and preventive behavior (GLM: F-score = 7.72, p < 0.001, foremost predictor: sex). Conclusion: Sociodemographic heterogeneity significantly influenced COVID-related perceptions, while race, family income, and sex were the strongest determinants of COVID-related perceptions.
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Affiliation(s)
- Pritish Mondal
- Division of Pediatric Pulmonology, Department of Pediatrics, Penn State College of Medicine, Hershey, PA 17033, USA; (B.-J.S.); (R.S.); (G.G.)
| | | | - Binu-John Sankoorikal
- Division of Pediatric Pulmonology, Department of Pediatrics, Penn State College of Medicine, Hershey, PA 17033, USA; (B.-J.S.); (R.S.); (G.G.)
| | - Roopa Siddaiah
- Division of Pediatric Pulmonology, Department of Pediatrics, Penn State College of Medicine, Hershey, PA 17033, USA; (B.-J.S.); (R.S.); (G.G.)
| | - Lauren Mazur
- Penn State College of Medicine, Hershey, PA 17033, USA;
| | - Gavin Graff
- Division of Pediatric Pulmonology, Department of Pediatrics, Penn State College of Medicine, Hershey, PA 17033, USA; (B.-J.S.); (R.S.); (G.G.)
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Abstract
It has long been apparent that gross disparities exist in health care in the United States, and, indeed, other nations with fully developed economies. All kinds of markers point to these inequities, with measures such as overall life expectancy, hospitalization rates, premature mortality, adverse outcomes associated with medical and surgical treatment, infant mortality, and the impact of many significant disease types higher and more impactful among minority groups and those of the most modest economic means. This is not new. Are there pointers to what might underpin the disparities in outcomes among the different minority groups?
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Tankwanchi AS, Bowman B, Garrison M, Larson H, Wiysonge CS. Vaccine hesitancy in migrant communities: a rapid review of latest evidence. Curr Opin Immunol 2021; 71:62-68. [PMID: 34118728 DOI: 10.1016/j.coi.2021.05.009] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 05/19/2021] [Accepted: 05/21/2021] [Indexed: 12/30/2022]
Abstract
By refusing or delaying vaccination, vaccine hesitant individuals and communities undermine the prevention, and ultimately, elimination of communicable diseases against which safe and effective vaccines are available. We reviewed recent evidence of vaccine hesitancy within migrant communities in the context of increased human mobility and widespread anti-immigrant sentiment and manifest xenophobia. Among many immigrant parents and families, vaccine hesitancy is largely associated with fears and misinformation about vaccine harms, limited knowledge of both preventable diseases and vaccines, distrust of host countries' health systems and their attendant intentions, language barriers, and perceived incompatibility between vaccine uptake and migrants' religion. Hesitancy toward measles, influenza, and human papillomavirus vaccines are most discernible, and main migrant populations involved include Somalis and Poles.
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Affiliation(s)
| | - Brett Bowman
- Department of Psychology, School of Human and Community Development, University of the Witwatersrand, Johannesburg, South Africa
| | - Michelle Garrison
- Department of Health Services, University of Washington School of Public Health, Seattle, WA, USA; Department of Psychiatry and Behavioral Sciences, Seattle Children's Hospital and University of Washington, Seattle, WA, USA
| | - Heidi Larson
- Department of Health Metrics Sciences, University of Washington School of Medicine, Seattle, WA USA; Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Charles Shey Wiysonge
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa; Department of Global Health, Stellenbosch University, Cape Town, South Africa; School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
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