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Li DJ, Huang JJ, Hsu ST, Hsieh KY, Lin GG, Wu PJ, Liu CL, Wu HC, Chou FHC. Characteristics of Sleep Disturbance and Comparison Across Three Waves of the COVID-19 Pandemic Among Healthcare Workers. Psychiatry Investig 2024; 21:838-849. [PMID: 39111749 PMCID: PMC11321876 DOI: 10.30773/pi.2024.0006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 04/09/2024] [Accepted: 05/26/2024] [Indexed: 08/15/2024] Open
Abstract
OBJECTIVE Healthcare workers (HCWs) suffered from a heavy mental health burden during the coronavirus disease-2019 (COVID-19) pandemic. We aimed to explore the differences in sleep disturbance in three waves of the COVID-19 pandemic in Taiwan among HCWs. Moreover, factors associated with sleep disturbances in the third wave were investigated. METHODS This study, with three waves of cross-sectional surveys, recruited first-line and second-line HCWs. The level of sleep disturbance and related demographic variables were collected through self-report questionnaires. Differences in sleep disturbance across the three waves were compared with analysis of variance. Factors associated with the level of sleep disturbance were identified using univariate linear regression and further used for multivariate stepwise and bootstrap linear regression to identify the independent predictors. RESULTS In total, 711, 560, and 747 HCWs were included in the first, second, and third waves, respectively. For first-line HCWs, sleep disturbance was significantly higher in the third wave than in the first wave. The level of sleep disturbance gradually increased across the three waves for all HCWs. In addition, sleep disturbance was associated with depression, posttraumatic stress disorder (PTSD) symptoms, anxiety about COVID-19, vaccine mistrust, and poorer physical and mental health among first-line HCWs. Among second-line HCWs, sleep disturbance was associated with younger age, depression, PTSD symptoms, lower preference for natural immunity, and poorer physical health. CONCLUSION The current study identified an increase in sleep disturbance and several predictors among HCWs. Further investigation is warranted to extend the application and generalizability of the current study.
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Affiliation(s)
- Dian-Jeng Li
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
- Department of Nursing, Meiho University, Pingtung, Taiwan
| | - Joh-Jong Huang
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Su-Ting Hsu
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Kuan-Ying Hsieh
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Guei-Ging Lin
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Pei-Jhen Wu
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Chin-Lien Liu
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Hui-Ching Wu
- Department of Social Work, Taiwan Social Resilience Center, National Taiwan University, Taipei, Taiwan
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Bosnjak MC, Kuljancic D, Vejnovic AM, Hinic D, Knezevic V, Ratkovic D, Bosic V, Vasic V, Sakic B, Segan D, Savic P, Abazovic M, Comic M, Siladji D, Simic-Panic D, Ivetic Poledica O. Rates of Vaccination against COVID-19 in Psychiatric Outpatients. J Pers Med 2024; 14:748. [PMID: 39064002 PMCID: PMC11278123 DOI: 10.3390/jpm14070748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Revised: 07/02/2024] [Accepted: 07/12/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND The aim of this study was to compare the rates of vaccination against COVID-19 infection in psychiatric outpatients and the general population, as well as rates of infected patients. In addition, the level and type of anxiety due to the pandemic were observed in patients with psychotic, anxiety, and depressive disorders. MATERIALS AND METHODS In the present study, 171 patients with pre-existing mental disorders completed the questionnaire about the doses and types of vaccination against COVID-19. During 2021-2023, patients with different mental disorders, aged from 18 to 80, were included. All patients filled in a self-reported questionnaire including general information (age, sex, marriage, education, working status, comorbid conditions) as well as questions about mental health, receiving vaccination, and the course of COVID-19 infection if it was present. All patients gave informed consent for the interview. RESULTS Patients with pre-existing mental disorders were more likely to be vaccinated against COVID-19 compared with the general population. The Sinopharm vaccine was most frequently applied. In the observed patients, 46.8% were infected, but just 7% had a medium or serious form of infection and were not vaccinated. CONCLUSIONS In our study, the percentage of vaccinated psychiatric patients was greater than that in the general population, except in psychotic patients, who were mostly limited by fear. Such results can be explained by the high percentage of somatic comorbidities in this population and perhaps insufficient information about the positive effects of vaccination.
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Affiliation(s)
- Mina Cvjetkovic Bosnjak
- Medical Faculty, University of Novi Sad, Hajduk Vejkova 3, 21000 Novi Sad, Serbia; (A.-M.V.); (V.K.); (D.R.); (V.B.); (V.V.); (B.S.); (D.S.); (P.S.); (M.A.); (M.C.); (D.S.); (D.S.-P.); (O.I.P.)
- Clinics of Psichiatry, University Clinical Centre of Vojvodina, Hajduk Veljkova 4, 21000 Novi Sad, Serbia
| | - Dusan Kuljancic
- Medical Faculty, University of Novi Sad, Hajduk Vejkova 3, 21000 Novi Sad, Serbia; (A.-M.V.); (V.K.); (D.R.); (V.B.); (V.V.); (B.S.); (D.S.); (P.S.); (M.A.); (M.C.); (D.S.); (D.S.-P.); (O.I.P.)
- Clinics of Psichiatry, University Clinical Centre of Vojvodina, Hajduk Veljkova 4, 21000 Novi Sad, Serbia
| | - Ana-Marija Vejnovic
- Medical Faculty, University of Novi Sad, Hajduk Vejkova 3, 21000 Novi Sad, Serbia; (A.-M.V.); (V.K.); (D.R.); (V.B.); (V.V.); (B.S.); (D.S.); (P.S.); (M.A.); (M.C.); (D.S.); (D.S.-P.); (O.I.P.)
- Clinics of Psichiatry, University Clinical Centre of Vojvodina, Hajduk Veljkova 4, 21000 Novi Sad, Serbia
| | - Darko Hinic
- PMF Kragujevac, University of Kragujevac, Radoja Domanovića 14, 34111 Kragujevac, Serbia;
| | - Vladimir Knezevic
- Medical Faculty, University of Novi Sad, Hajduk Vejkova 3, 21000 Novi Sad, Serbia; (A.-M.V.); (V.K.); (D.R.); (V.B.); (V.V.); (B.S.); (D.S.); (P.S.); (M.A.); (M.C.); (D.S.); (D.S.-P.); (O.I.P.)
- Clinics of Psichiatry, University Clinical Centre of Vojvodina, Hajduk Veljkova 4, 21000 Novi Sad, Serbia
| | - Dragana Ratkovic
- Medical Faculty, University of Novi Sad, Hajduk Vejkova 3, 21000 Novi Sad, Serbia; (A.-M.V.); (V.K.); (D.R.); (V.B.); (V.V.); (B.S.); (D.S.); (P.S.); (M.A.); (M.C.); (D.S.); (D.S.-P.); (O.I.P.)
- Clinics of Psichiatry, University Clinical Centre of Vojvodina, Hajduk Veljkova 4, 21000 Novi Sad, Serbia
| | - Vanja Bosic
- Medical Faculty, University of Novi Sad, Hajduk Vejkova 3, 21000 Novi Sad, Serbia; (A.-M.V.); (V.K.); (D.R.); (V.B.); (V.V.); (B.S.); (D.S.); (P.S.); (M.A.); (M.C.); (D.S.); (D.S.-P.); (O.I.P.)
- Clinics of Psichiatry, University Clinical Centre of Vojvodina, Hajduk Veljkova 4, 21000 Novi Sad, Serbia
| | - Vesna Vasic
- Medical Faculty, University of Novi Sad, Hajduk Vejkova 3, 21000 Novi Sad, Serbia; (A.-M.V.); (V.K.); (D.R.); (V.B.); (V.V.); (B.S.); (D.S.); (P.S.); (M.A.); (M.C.); (D.S.); (D.S.-P.); (O.I.P.)
- Clinics of Psichiatry, University Clinical Centre of Vojvodina, Hajduk Veljkova 4, 21000 Novi Sad, Serbia
| | - Branislav Sakic
- Medical Faculty, University of Novi Sad, Hajduk Vejkova 3, 21000 Novi Sad, Serbia; (A.-M.V.); (V.K.); (D.R.); (V.B.); (V.V.); (B.S.); (D.S.); (P.S.); (M.A.); (M.C.); (D.S.); (D.S.-P.); (O.I.P.)
- Clinics of Psichiatry, University Clinical Centre of Vojvodina, Hajduk Veljkova 4, 21000 Novi Sad, Serbia
| | - Darja Segan
- Medical Faculty, University of Novi Sad, Hajduk Vejkova 3, 21000 Novi Sad, Serbia; (A.-M.V.); (V.K.); (D.R.); (V.B.); (V.V.); (B.S.); (D.S.); (P.S.); (M.A.); (M.C.); (D.S.); (D.S.-P.); (O.I.P.)
- Clinics of Psichiatry, University Clinical Centre of Vojvodina, Hajduk Veljkova 4, 21000 Novi Sad, Serbia
| | - Predrag Savic
- Medical Faculty, University of Novi Sad, Hajduk Vejkova 3, 21000 Novi Sad, Serbia; (A.-M.V.); (V.K.); (D.R.); (V.B.); (V.V.); (B.S.); (D.S.); (P.S.); (M.A.); (M.C.); (D.S.); (D.S.-P.); (O.I.P.)
- Clinics of Psichiatry, University Clinical Centre of Vojvodina, Hajduk Veljkova 4, 21000 Novi Sad, Serbia
| | - Minja Abazovic
- Medical Faculty, University of Novi Sad, Hajduk Vejkova 3, 21000 Novi Sad, Serbia; (A.-M.V.); (V.K.); (D.R.); (V.B.); (V.V.); (B.S.); (D.S.); (P.S.); (M.A.); (M.C.); (D.S.); (D.S.-P.); (O.I.P.)
- Clinics of Psichiatry, University Clinical Centre of Vojvodina, Hajduk Veljkova 4, 21000 Novi Sad, Serbia
| | - Masa Comic
- Medical Faculty, University of Novi Sad, Hajduk Vejkova 3, 21000 Novi Sad, Serbia; (A.-M.V.); (V.K.); (D.R.); (V.B.); (V.V.); (B.S.); (D.S.); (P.S.); (M.A.); (M.C.); (D.S.); (D.S.-P.); (O.I.P.)
- Clinics of Psichiatry, University Clinical Centre of Vojvodina, Hajduk Veljkova 4, 21000 Novi Sad, Serbia
| | - Djendji Siladji
- Medical Faculty, University of Novi Sad, Hajduk Vejkova 3, 21000 Novi Sad, Serbia; (A.-M.V.); (V.K.); (D.R.); (V.B.); (V.V.); (B.S.); (D.S.); (P.S.); (M.A.); (M.C.); (D.S.); (D.S.-P.); (O.I.P.)
- Clinics of Psichiatry, University Clinical Centre of Vojvodina, Hajduk Veljkova 4, 21000 Novi Sad, Serbia
| | - Dusica Simic-Panic
- Medical Faculty, University of Novi Sad, Hajduk Vejkova 3, 21000 Novi Sad, Serbia; (A.-M.V.); (V.K.); (D.R.); (V.B.); (V.V.); (B.S.); (D.S.); (P.S.); (M.A.); (M.C.); (D.S.); (D.S.-P.); (O.I.P.)
- Clinics of Medical Rehabilitation, University Clinical Centre of Vojvodina, Hajduk Veljkova 4, 21000 Novi Sad, Serbia
| | - Olga Ivetic Poledica
- Medical Faculty, University of Novi Sad, Hajduk Vejkova 3, 21000 Novi Sad, Serbia; (A.-M.V.); (V.K.); (D.R.); (V.B.); (V.V.); (B.S.); (D.S.); (P.S.); (M.A.); (M.C.); (D.S.); (D.S.-P.); (O.I.P.)
- Clinics of Psichiatry, University Clinical Centre of Vojvodina, Hajduk Veljkova 4, 21000 Novi Sad, Serbia
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Gonzalez-Jaramillo N, Abbühl D, Roa-Díaz ZM, Kobler-Betancourt C, Frahsa A. COVID-19 vaccine acceptance in the general population and under-resourced communities from high-income countries: realist review. BMJ Open 2024; 14:e084560. [PMID: 38631831 PMCID: PMC11029206 DOI: 10.1136/bmjopen-2024-084560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 03/28/2024] [Indexed: 04/19/2024] Open
Abstract
OBJECTIVE To compare vaccination willingness before rollout and 1 year post-rollout uptake among the general population and under-resourced communities in high-income countries. DESIGN A realist review. DATA SOURCES Embase, PubMed, Dimensions ai and Google Scholar. SETTING High-income countries. DEFINITIONS We defined vaccination willingness as the proportion of participants willing or intending to receive vaccines prior to availability. We defined vaccine uptake as the real proportion of the population with complete vaccination as reported by each country until November 2021. RESULTS We included data from 62 studies and 18 high-income countries. For studies conducted among general populations, the proportion of vaccination willingness was 67% (95% CI 62% to 72%). In real-world settings, the overall proportion of vaccine uptake among those countries was 73% (95% CI 69% to 76%). 17 studies reported pre-rollout willingness for under-resourced communities. The summary proportion of vaccination willingness from studies reporting results among people from under-resourced communities was 52% (95% CI 0.46% to 0.57%). Real-world evidence about vaccine uptake after rollout among under-resourced communities was limited. CONCLUSION Our review emphasises the importance of realist reviews for assessing vaccine acceptance. Limited real-world evidence about vaccine uptake among under-resourced communities in high-income countries is a call to context-specific actions and reporting.
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Affiliation(s)
| | - Dominik Abbühl
- ISPM, University of Bern, Bern, Switzerland
- Faculty of Medicine, University of Bern, Bern, Switzerland
| | - Zayne Milena Roa-Díaz
- ISPM, University of Bern, Bern, Switzerland
- Faculty of Medicine, University of Bern, Bern, Switzerland
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da Graca B, Bennett MM, Gottlieb RL, Douglas ME, Powers MB, Warren AM. Associations of Mental Health and Experience of the COVID-19 Pandemic with United States Adults' Intentions to Be Vaccinated. Popul Health Manag 2023; 26:317-324. [PMID: 37643305 DOI: 10.1089/pop.2023.0136] [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] [Indexed: 08/31/2023] Open
Abstract
COVID-19 vaccine uptake in the United States has proved challenging. A deeper characterization extending beyond demographics and political ideologies of those hesitating or resisting is needed to guide ongoing conversations. This study examined associations between US adults' vaccination intentions and mental health history, experience of the COVID-19 pandemic, and mental health outcomes. An online population-based cross-sectional survey was administered nationwide during January 4-7, 2021. Participants were questioned about past and current mental health, and completed the Patient Health Questionnaire 8 (PHQ-8), Generalized Anxiety Disorder 7-item (GAD-7), and Posttraumatic Diagnostic Scale (PDS)-5 (to capture symptoms of depression, anxiety, and traumatic stress, respectively). Experience of the pandemic included cumulative county-level COVID case and death rates, self-reported COVID-19 testing/exposure/diagnosis, and self-reported impact on routines, resources, and relationships. Of 936 respondents, 66% intended to be vaccinated, 14.7% responded "maybe," and 19.6% "no." Past diagnosis of obsessive compulsive disorder, less impact on routines or social supports, not having been screened or tested for COVID-19, not knowing someone who tested positive, and not self-isolating were associated with less intention to vaccinate. After controlling for demographic and pandemic experience factors, symptoms of traumatic stress, but not other mental health outcomes, were associated with less intention to vaccinate. The apparent contradiction between less negative impact of the pandemic and symptoms of traumatic stress being associated with less intention to be vaccinated indicates the complex nature of barriers to vaccine uptake. Results from this study contribute to the evidence base needed to improve ongoing and future communications about, and strategies to increase uptake of, vaccination.
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Affiliation(s)
| | | | | | | | - Mark B Powers
- Baylor Scott & White Research Institute, Dallas, Texas, USA
- Baylor University Medical Center, Dallas, Texas, USA
| | - Ann Marie Warren
- Baylor Scott & White Research Institute, Dallas, Texas, USA
- Baylor University Medical Center, Dallas, Texas, USA
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Anderson A. Regional and neighbourhood-based variation in three types of vaccine attitude in Britain. Health Place 2023; 83:103098. [PMID: 37572542 DOI: 10.1016/j.healthplace.2023.103098] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 08/04/2023] [Accepted: 08/07/2023] [Indexed: 08/14/2023]
Abstract
This study investigates the geographic patterning of attitudes towards vaccination in Britain (England, Wales, and Scotland). Using survey data from the 2018 Wellcome Monitor linked to lower super output areas and NUTS2 regions, this study provides evidence that negative attitudes regarding the risk of side-effects from vaccination and regarding the efficacy of vaccination are correlated with higher levels of local deprivation. While previous research has highlighted associations between vaccine uptake and deprivation for a variety of reasons, this study specifically contends that particular individualised types of caution about vaccines also tend to cluster in deprived areas.
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Affiliation(s)
- Alistair Anderson
- School of Sociology and Social Policy, Law and Social Sciences Building, University Park, Nottingham, NG7 2RD, UK.
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Kim HJ, Kim E, Han DH. Effect of psychological factors on COVID-19 vaccine hesitancy. J Public Health (Oxf) 2023; 45:e522-e531. [PMID: 37147915 DOI: 10.1093/pubmed/fdad050] [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: 07/18/2022] [Revised: 03/15/2023] [Indexed: 05/07/2023] Open
Abstract
BACKGROUND Vaccine hesitancy can prevent full immunization against coronavirus infectious disease-19 (COVID-19). We hypothesized that multiple factors, including an individual's personality and psychological factors, are associated with vaccine hesitancy. METHODS A total of 275 non-vaccinated individuals were recruited for this study. Participants completed a self-report questionnaire including sociodemographic factors, health status, COVID-19 literacy and psychological factors (depressive symptoms, generalized anxiety, somatization, illness anxiety, temperament and character). In a hierarchical logistic regression analysis, a discrete set of hierarchical variables with vaccine acceptance or hesitancy as the dependent variable was added to the demographic factors for Model 1; Model 1 + health status for Model 2; Model 2 + COVID-19 literacy for Model 3 and Model 3 + psychological factors for Model 4. RESULTS Models 3 and 4 could predict vaccine hesitancy. High scores on the Generalized Anxiety Disorder-7 and the Illness Attitude Scale, low confidence, low collective responsibility and low reward dependence were risk factors for vaccine hesitancy. CONCLUSIONS The present study demonstrates that psychological factors play critical roles in vaccine hesitancy. In addition to conventional policies that emphasize COVID-19 vaccines' safety and efficacy and the collective benefits of vaccination, a more individualized approach that considers an individual's emotions and personality is necessary.
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Affiliation(s)
- Hee Jin Kim
- Department of Psychiatry, Chung-Ang University Hospital, Seoul 06973, Republic of Korea
| | - Eun Kim
- Department of Psychiatry, Chung-Ang University Hospital, Seoul 06973, Republic of Korea
| | - Doug Hyun Han
- Department of Psychiatry, Chung-Ang University Hospital, Seoul 06973, Republic of Korea
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Wang Y, Beltran RM, Cumberland WG, Young SD. Factors Associated with COVID-19 Testing, Vaccination, and Use of Digital Contact Tracing Apps among Black and Latinx MSM (BLMSM) in Los Angeles. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01750-y. [PMID: 37566181 PMCID: PMC10953315 DOI: 10.1007/s40615-023-01750-y] [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: 02/21/2023] [Revised: 08/02/2023] [Accepted: 08/03/2023] [Indexed: 08/12/2023]
Abstract
This study examines the factors associated with COVID-19 testing, vaccination intent (both individually and jointly), and willingness to use contact tracing digital apps among a cohort of Black and Latinx men who have sex with men (BLMSM) living in Los Angeles during the initial peak (July 2020) of the COVID-19 pandemic. A questionnaire detailing participants COVID-19 experiences was sent to 300 primarily BLMSM after the first state-wide COVID-19 lockdown. Logistic regression models with random cluster effects were used for analyses. Forty-two percent (42%) tested for COVID-19, 27% were willing to get vaccinated, and about 45% reported willingness to use contact tracing digital apps. Controlling for intervention participation, age, education, marital status, employment, health, tobacco, binge drinking, and self-reported anxiety, those who were depressed had 33% (95% CI: 0.13 to 0.82) odds of using a prevention strategy (either test for COVID-19 or vaccination intent) as the group who were not depressed. Those who had high school diploma or less had 23% (95% CI: 0.11 to 0.48) odds to use digital contact tracing apps as the group with education level of at least Associate's or Bachelor's degree. Without considering the format of the test kits, vaccine side effects, and ease of use for digital contact tracing apps, participants appeared to still be hesitant in using COVID-19 prevention strategies at the initial height of the pandemic. Our findings suggest the need for further investigation into this hesitancy to better inform and prepare for future epidemics.
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Affiliation(s)
- Yan Wang
- Section of Public and Population Health, Division of Oral and Systemic Health Sciences, School of Dentistry, University of California, Los Angeles (UCLA), 10833 La Conte, Los Angeles, CA, 90095, USA.
| | - Raiza M Beltran
- Luskin School of Public Affairs, UCLA, 10833 La Conte, Los Angeles, CA, 90095, USA
| | - William G Cumberland
- Department of Biostatistics, Fielding School of Public Health, UCLA, 10833 La Conte, Los Angeles, CA, 90095, USA
| | - Sean D Young
- Department of Emergency Medicine, School of Medicine and Informatics, Information and Computer Sciences, University of California, Irvine, City Tower, Ste 640, Rt 128-01, Irvine, CA, 92697, USA
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Chen XK, Ong J, Neo LS, Tan LF. Using the increasing vaccination model and the moderating roles of chronic medical conditions and education to understand COVID-19 vaccination uptake in Singapore. Transl Behav Med 2023; 13:453-464. [PMID: 37084298 DOI: 10.1093/tbm/ibac095] [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] [Indexed: 04/23/2023] Open
Abstract
COVID-19 vaccination programmes have helped reduce deaths and morbidity from the pandemic and allowed for the resumption of normal life. However, vaccine hesitancy remains an issue even with recurrent surges in COVID-19 cases due to new SARS-CoV-2 variants. Purpose: To elucidate psychosocial factors that contribute to our understanding of vaccine hesitancy. 676 Participants in Singapore took part in an online survey on vaccine hesitancy and uptake between May and June 2021. Data on demographics, perception of the COVID-19 pandemic, and vaccine willingness and hesitancy factors were collected. The responses were analyzed using structural equation modeling (SEM). The study found that confidence in the COVID-19 vaccines and risk perception of the COVID-19 situation are significantly associated with vaccination intention, while vaccination intention is also significantly associated with reported vaccination status. Additionally, certain chronic medical conditions moderate the relationship between vaccine confidence/risk perception and vaccine intention. This study contributes to our understanding of factors behind vaccination uptake which can help anticipate challenges to future vaccination campaigns for the next pandemic.
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Affiliation(s)
- Xingyu Ken Chen
- Nanyang Technological University, Wee Kim Wee School of Communication and Information, Singapore
| | | | - Loo Seng Neo
- Singapore University of Social Sciences, Singapore
| | - Li Feng Tan
- Division of Healthy Ageing, Alexandra Hospital, 378 Alexandra Road, 159964, Singapore
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Tobi M, Bluth MH, Rossi NF, Demian E, Talwar H, Tobi YY, Sochacki P, Levi E, Lawson M, McVicker B. In the SARS-CoV-2 Pandora Pandemic: Can the Stance of Premorbid Intestinal Innate Immune System as Measured by Fecal Adnab-9 Binding of p87:Blood Ferritin, Yielding the FERAD Ratio, Predict COVID-19 Susceptibility and Survival in a Prospective Population Database? Int J Mol Sci 2023; 24:7536. [PMID: 37108697 PMCID: PMC10145175 DOI: 10.3390/ijms24087536] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 04/03/2023] [Accepted: 04/06/2023] [Indexed: 04/29/2023] Open
Abstract
SARS-CoV-2 severity predictions are feasible, though individual susceptibility is not. The latter prediction allows for planning vaccination strategies and the quarantine of vulnerable targets. Ironically, the innate immune response (InImS) is both an antiviral defense and the potential cause of adverse immune outcomes. The competition for iron has been recognized between both the immune system and invading pathogens and expressed in a ratio of ferritin divided by p87 (as defined by the Adnab-9 ELISA stool-binding optical density, minus the background), known as the FERAD ratio. Associations with the FERAD ratio may allow predictive modeling for the susceptibility and severity of disease. We evaluated other potential COVID-19 biomarkers prospectively. Patients with PCR+ COVID-19 tests (Group 1; n = 28) were compared to three other groups. In Group 2 (n = 36), and 13 patients displayed COVID-19-like symptoms but had negative PCR or negative antibody tests. Group 3 (n = 90) had no symptoms and were negative when routinely PCR-tested before medical procedures. Group 4 (n = 2129) comprised a pool of patients who had stool tests and symptoms, but their COVID-19 diagnoses were unknown; therefore, they were chosen to represent the general population. Twenty percent of the Group 4 patients (n = 432) had sufficient data to calculate their FERAD ratios, which were inversely correlated with the risk of COVID-19 in the future. In a case report of a neonate, we studied three biomarkers implicated in COVID-19, including p87, Src (cellular-p60-sarcoma antigen), and Abl (ABL-proto-oncogene 2). The InImS of the first two were positively correlated. An inverse correlation was found between ferritin and lysozyme in serum (p < 0.05), suggesting that iron could have impaired an important innate immune system anti-viral effector and could partially explain future COVID-19 susceptibility.
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Affiliation(s)
- Martin Tobi
- Research and Development Service, Detroit VAMC, 4747 John R Street, Detroit, MI 48602, USA
| | - Martin H. Bluth
- Blood Transfusion and Donor Services, Department of Pathology, Maimonides Medical Center, 4802 10th Avenue, Brooklyn, NY 11219, USA
- School of Medicine, Wayne State University, 540 E Canfield St, Detroit, MI 48201, USA
| | - Noreen F. Rossi
- Research and Development Service, Detroit VAMC, 4747 John R Street, Detroit, MI 48602, USA
- Division of Nephrology, Department of Physiology, School of Medicine, Wayne State University, 540 E. Canfield Ave., Detroit, MI 48201, USA
| | - Ereny Demian
- Department of Internal Medicine, Pennsylvania State University College of Medicine, 700 HMC Cres Rd., Hershey, PA 17033, USA
| | - Harvinder Talwar
- Research and Development Service, Detroit VAMC, 4747 John R Street, Detroit, MI 48602, USA
- School of Medicine, Wayne State University, 540 E Canfield St, Detroit, MI 48201, USA
| | - Yosef Y. Tobi
- Department of Thoracic Oncology, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY 10065, USA
| | - Paula Sochacki
- Department of Pathology, Detroit VAMC, 4747 John R Street, Detroit, MI 48602, USA
| | - Edi Levi
- Research and Development Service, Detroit VAMC, 4747 John R Street, Detroit, MI 48602, USA
| | - Michael Lawson
- Division of Gastroenterology and Hepatology, University of California at Sacramento, Sacramento, CA 95819, USA
| | - Benita McVicker
- Research Service, VA Nebraska-Western Iowa Health Care System, Omaha, NE 68105, USA
- Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE 68198, USA
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10
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Rosenkilde S, Ekholm O, Møller SP, Nielsen MBD, Thygesen LC. Factors related to COVID-19 vaccine hesitancy in Denmark: A national study in the autumn of 2021. Scand J Public Health 2023:14034948221144661. [PMID: 36609202 PMCID: PMC9829505 DOI: 10.1177/14034948221144661] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
AIMS The novelty of the COVID-19 pandemic and fast-developed vaccines may increase concerns about the safety and effectiveness of the COVID-19 vaccine and thereby influence vaccine hesitancy. The aims of this study were to examine (a) the main reasons for COVID-19 vaccine hesitancy and (b) factors associated with COVID-19 vaccine hesitancy. METHODS A nationwide survey was conducted in the autumn of 2021 when most Danes had received at least one dose of a COVID-19 vaccine. The sample (N=13,570) was based on a random selection of individuals (⩾15 years), and data were collected via self-administered mailed questionnaires (digital and physical). The participants were asked whether they had been vaccinated against COVID-19, and if they had not, they were asked about their reasons for vaccine hesitancy. Logistic regression models were used to determine factors associated with vaccine hesitancy. RESULTS In all, 5,384 (39.7%) individuals completed the questionnaire. The main reasons for vaccine hesitancy were worries about adverse effects (57.6%) and the belief that natural immunity is better than vaccination (43.8%). Factors associated with vaccine hesitancy included female sex, younger age, being divorced, a country of origin other than Denmark, lower educational level, being unemployed, previously infected with COVID-19 and being worried to a greater extent about oneself and others getting infected. Mental health indicators were not associated with vaccine hesitancy. CONCLUSIONS
COVID-19 vaccine hesitancy is likely to pose a challenge for population immunity. To reduce vaccine hesitancy and increase vaccination uptake, future vaccination programmes should focus on specific socio-demographic subgroups identified in this study.
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Affiliation(s)
- Siri Rosenkilde
- Siri Rosenkilde, National Institute of Public Health, University of Southern Denmark, Studiestræde 6, DK-1455 Copenhagen K, Denmark. E-mail:
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11
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Clair A, Baker E. Cold homes and mental health harm: Evidence from the UK Household Longitudinal Study. Soc Sci Med 2022; 314:115461. [PMID: 36327633 DOI: 10.1016/j.socscimed.2022.115461] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 09/25/2022] [Accepted: 10/13/2022] [Indexed: 11/05/2022]
Abstract
Cold homes are associated with a range of serious health conditions as well as excess winter mortality. Despite a comparatively mild climate cold homes are a significant problem in the UK, with a recent estimate finding that over one-quarter of low-income households had been unable to adequately heat their home in winter 2022. The magnitude of cold housing in a country that benefits from a mild climate indicates indifference towards, or acceptance of, a significant minority of people living in inadequate conditions on the part of policy makers. Cold homes are therefore a source of social harm. Recent changes to the household energy price cap, the rising cost of living, the ongoing effects of the benefit cap, and below inflation uprating to social security benefits is likely to greatly exacerbate this issue. In this research we use data from the UK Household Longitudinal Study to explore whether living in a cold home causes mental health harm. We control for mental distress and housing temperature on entry to the survey in order to account for the potentially bi-directional relationship. Multilevel discrete-time event history models show that the transition into living in a home that is not suitably warm is associated with nearly double the odds of experiencing severe mental distress for those who had no mental distress at the beginning of the survey; and over three times the odds of severe mental distress for those previously on the borderline of severe mental distress. These results show the significant costs of failing to ensure that people are able to live in homes in which they are able to live comfortably by even the most basic standards. These costs will be felt not just individually, but also more broadly in terms of increased health spending and reduced working.
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Affiliation(s)
- Amy Clair
- Australian Centre for Housing Research, University of Adelaide, Australia.
| | - Emma Baker
- Australian Centre for Housing Research, University of Adelaide, Australia.
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12
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Roberts LW, Kim JP, Rostami M, Kasun M, Kim B. Self-reported influences on willingness to receive COVID-19 vaccines among physically ill, mentally ill, and healthy individuals. J Psychiatr Res 2022; 155:501-510. [PMID: 36191518 PMCID: PMC9491855 DOI: 10.1016/j.jpsychires.2022.09.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 08/29/2022] [Accepted: 09/16/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Individuals with mental and physical disorders have been disproportionately affected by adverse health outcomes due to the COVID-19 pandemic, and yet vaccine hesitancy persists despite clear evidence of health benefits. Therefore, our study explored factors influencing willingness to receive a COVID-19 vaccine. METHODS Individuals with mental illness (n = 332), physical illness (n = 331), and no health issues (n = 328) were recruited via Amazon Mechanical Turk. Participants rated willingness to obtain a fully approved COVID-19 vaccine or a vaccine approved only for experimental/emergency use and influences in six domains upon their views. We examined differences by health status. RESULTS Participants across groups were moderately willing to receive a COVID-19 vaccine. Perceived risk was negatively associated with willingness. Participants differentiated between vaccine risk by approval stage and were less willing to receive an experimental vaccine. Individuals with mental illness rated risk of both vaccines similarly to healthy individuals. Individuals with physical illness expressed less willingness to receive an experimental vaccine. Domain influences differently affected willingness by health status as well as by vaccine approval status. CONCLUSIONS Our findings are reassuring regarding the ability of people with mental disorders to appreciate risk in medical decision-making and the ability of people of varied health backgrounds to distinguish between the benefits and risks of clinical care and research, refuting the prevailing notions of psychiatric exceptionalism and therapeutic misconception. Our findings shine a light on potential paths forward to support vaccine acceptance.
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Affiliation(s)
- Laura Weiss Roberts
- Stanford University School of Medicine, Department of Psychiatry and Behavioral Sciences, 401 Quarry Road, Palo Alto, CA, USA.
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13
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Bucyibaruta G, Blangiardo M, Konstantinoudis G. Community-level characteristics of COVID-19 vaccine hesitancy in England: A nationwide cross-sectional study. Eur J Epidemiol 2022; 37:1071-1081. [PMID: 36121531 PMCID: PMC9483427 DOI: 10.1007/s10654-022-00905-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 08/12/2022] [Indexed: 11/03/2022]
Abstract
One year after the start of the COVID-19 vaccination programme in England, more than 43 million people older than 12 years old had received at least a first dose. Nevertheless, geographical differences persist, and vaccine hesitancy is still a major public health concern; understanding its determinants is crucial to managing the COVID-19 pandemic and preparing for future ones. In this cross-sectional population-based study we used cumulative data on the first dose of vaccine received by 01-01-2022 at Middle Super Output Area level in England. We used Bayesian hierarchical spatial models and investigated if the geographical differences in vaccination uptake can be explained by a range of community-level characteristics covering socio-demographics, political view, COVID-19 health risk awareness and targeting of high risk groups and accessibility. Deprivation is the covariate most strongly associated with vaccine uptake (Odds Ratio 0.55, 95%CI 0.54-0.57; most versus least deprived areas). The most ethnically diverse areas have a 38% (95%CI 36-40%) lower odds of vaccine uptake compared with those least diverse. Areas with the highest proportion of population between 12 and 24 years old had lower odds of vaccination (0.87, 95%CI 0.85-0.89). Finally increase in vaccine accessibility is associated with COVID-19 vaccine coverage (OR 1.07, 95%CI 1.03-1.12). Our results suggest that one year after the start of the vaccination programme, there is still evidence of inequalities in uptake, affecting particularly minorities and marginalised groups. Strategies including prioritising active outreach across communities and removing practical barriers and factors that make vaccines less accessible are needed to level up the differences.
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Affiliation(s)
- Georges Bucyibaruta
- Department of Epidemiology and Biostatistics, MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Marta Blangiardo
- Department of Epidemiology and Biostatistics, MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Garyfallos Konstantinoudis
- Department of Epidemiology and Biostatistics, MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
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14
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Jeon YJ, Lee Y, Yang JS, Park YS, Jung SJ. Physical and mental health characteristics related to trust in and intention to receive COVID-19 vaccination: results from a Korean community-based longitudinal study. Epidemiol Health 2022; 44:e2022064. [PMID: 35940179 PMCID: PMC9943634 DOI: 10.4178/epih.e2022064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 08/03/2022] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVES The aim of this study was to explore factors affecting attitudes toward coronavirus disease 2019 (COVID-19) vaccination, including socio-demographic characteristics and mental health status during the pandemic. METHODS This study analyzed responses from 1,768 participants who were originally included in a community cohort study and responded to 3 online surveys related to COVID-19 (March 2020 to March 2021). The k-means method was used to cluster trust in and intention to receive COVID-19 vaccination. Baseline (2013-2018) socio-demographic characteristics, physical health status, and depressive symptoms were analyzed as exposure variables, and current mental health status was included in the analyses. RESULTS Almost half of all participants were classified into the moderate trust and high intention cluster (n=838, 47.4%); those with high trust and high intention accounted only for 16.9%. They tended to be older, had high-income levels, and engaged in regular physical activity at baseline (p<0.05), and their sleep quality and psychological resilience were relatively high compared to other groups. CONCLUSIONS Our results suggest that more efforts are required to enhance the perceived need for and trust in COVID-19 vaccination.
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Affiliation(s)
- Ye Jin Jeon
- Department of Public Health, Graduate School, Yonsei University, Seoul, Korea
| | - Youngrong Lee
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Ji Su Yang
- Department of Public Health, Graduate School, Yonsei University, Seoul, Korea
| | - Young Su Park
- Department of Health Studies, Haverford College, Haverford, PA, USA
| | - Sun Jae Jung
- Department of Public Health, Graduate School, Yonsei University, Seoul, Korea,Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea,Correspondence: Sun Jae Jung Department of Preventive Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea E-mail:
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15
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Curtis HJ, Inglesby P, MacKenna B, Croker R, Hulme WJ, Rentsch CT, Bhaskaran K, Mathur R, Morton CE, Bacon SC, Smith RM, Evans D, Mehrkar A, Tomlinson L, Walker AJ, Bates C, Hickman G, Ward T, Morley J, Cockburn J, Davy S, Williamson EJ, Eggo RM, Parry J, Hester F, Harper S, O'Hanlon S, Eavis A, Jarvis R, Avramov D, Griffiths P, Fowles A, Parkes N, Evans SJ, Douglas IJ, Smeeth L, Goldacre B. Recording of 'COVID-19 vaccine declined': a cohort study on 57.9 million National Health Service patients' records in situ using OpenSAFELY, England, 8 December 2020 to 25 May 2021. Euro Surveill 2022; 27:2100885. [PMID: 35983770 PMCID: PMC9389857 DOI: 10.2807/1560-7917.es.2022.27.33.2100885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BackgroundPriority patients in England were offered COVID-19 vaccination by mid-April 2021. Codes in clinical record systems can denote the vaccine being declined.AimWe describe records of COVID-19 vaccines being declined, according to clinical and demographic factors.MethodsWith the approval of NHS England, we conducted a retrospective cohort study between 8 December 2020 and 25 May 2021 with primary care records for 57.9 million patients using OpenSAFELY, a secure health analytics platform. COVID-19 vaccination priority patients were those aged ≥ 50 years or ≥ 16 years clinically extremely vulnerable (CEV) or 'at risk'. We describe the proportion recorded as declining vaccination for each group and stratified by clinical and demographic subgroups, subsequent vaccination and distribution of clinical code usage across general practices.ResultsOf 24.5 million priority patients, 663,033 (2.7%) had a decline recorded, while 2,155,076 (8.8%) had neither a vaccine nor decline recorded. Those recorded as declining, who were subsequently vaccinated (n = 125,587; 18.9%) were overrepresented in the South Asian population (32.3% vs 22.8% for other ethnicities aged ≥ 65 years). The proportion of declining unvaccinated patients was highest in CEV (3.3%), varied strongly with ethnicity (black 15.3%, South Asian 5.6%, white 1.5% for ≥ 80 years) and correlated positively with increasing deprivation.ConclusionsClinical codes indicative of COVID-19 vaccinations being declined are commonly used in England, but substantially more common among black and South Asian people, and in more deprived areas. Qualitative research is needed to determine typical reasons for recorded declines, including to what extent they reflect patients actively declining.
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Affiliation(s)
- Helen J Curtis
- The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Peter Inglesby
- The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Brian MacKenna
- The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Richard Croker
- The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - William J Hulme
- The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | | | | | - Rohini Mathur
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Caroline E Morton
- The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Sebastian Cj Bacon
- The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Rebecca M Smith
- The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - David Evans
- The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Amir Mehrkar
- The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Laurie Tomlinson
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Alex J Walker
- The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | | | - George Hickman
- The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Tom Ward
- The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Jessica Morley
- The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | | | - Simon Davy
- The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | | | - Rosalind M Eggo
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | | | | | | | | | | | | | | | | | | | - Stephen Jw Evans
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Ian J Douglas
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Liam Smeeth
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Ben Goldacre
- The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
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16
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Fellendorf FT, Bonkat N, Platzer M, Schönthaler E, Ratzenhofer M, Bengesser SA, Dalkner N, Reininghaus EZ. Willingness to be vaccinated against COVID-19 is equal in individuals with affective disorders and healthy controls. Vaccine X 2022; 11:100186. [PMID: 35755141 PMCID: PMC9213006 DOI: 10.1016/j.jvacx.2022.100186] [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: 09/23/2021] [Revised: 03/29/2022] [Accepted: 06/15/2022] [Indexed: 10/26/2022] Open
Abstract
Affective disorders such as major depressive disorder and bipolar disorder are associated with higher infection rates and a more severe course of coronavirus disease (COVID-19). In turn, COVID-19 could trigger mental disease relapse. Vaccinations lead to a reduction of infections and the prevention of severe courses. This work aims to survey the willingness of individuals with affective disorders to get vaccinated and concerns about vaccinations. METHODS An online study (April-May 2021) assessed the current infection and vaccination rate amongst individuals with affective disorder in Austria by surveying attitudes towards the vaccination, the willingness to get vaccinated soon and possible reasons for decision. The analyses included 59 individuals with affective disorders and 59 healthy controls, matched for sex and age. RESULTS There was an overall high willingness to get vaccinated against COVID-19. Individuals with affective disorders were more skeptical about vaccinations in general but there was no significant difference between the groups in the willingness to get vaccinated against COVID-19. In both groups reasons for waiting were mainly fears of acute and/or long-term side effects and the fast development of the vaccines. LIMITATIONS It was a cross sectional design. Due to the online design, no objective rating of current psychopathological symptoms was assessed. Willingness to get vaccinated in general and against COVID-19 in particular were self-created variables, whereas item statistics and factor analysis were conducted. DISCUSSION Because of the higher risk for individuals with affective disorders, preventive strategies like vaccinating should be promoted in this group. It is important to help individuals with AD to overcome barriers such as negative beliefs and concerns about acute and/or long-term side effects.
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Affiliation(s)
- Frederike T Fellendorf
- Department of Psychiatry & Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
| | - Nina Bonkat
- Department of Psychiatry & Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
| | - Martina Platzer
- Department of Psychiatry & Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
| | - Elena Schönthaler
- Department of Psychiatry & Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
| | - Michaela Ratzenhofer
- Department of Psychiatry & Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
| | - Susanne A Bengesser
- Department of Psychiatry & Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
| | - Nina Dalkner
- Department of Psychiatry & Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
| | - Eva Z Reininghaus
- Department of Psychiatry & Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
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17
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Jayakumar S, Ilango S, Kumar K S, Alassaf A, Aljabr A, Paramasivam A, Mickeymaray S, Hawsah YM, Aldawish AS. Contrasting Association Between COVID-19 Vaccine Hesitancy and Mental Health Status in India and Saudi Arabia-A Preliminary Evidence Collected During the Second Wave of COVID-19 Pandemic. Front Med (Lausanne) 2022; 9:900026. [PMID: 35602514 PMCID: PMC9116149 DOI: 10.3389/fmed.2022.900026] [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: 03/19/2022] [Accepted: 04/04/2022] [Indexed: 11/13/2022] Open
Abstract
Background Vaccine hesitancy is a global public health threat. Understanding the role of psychological factors in vaccine hesitancy is often neglected and relatively less explored. Aim and Objectives To analyze the relationship between mental health and COVID-19 vaccine hesitancy before and after the advent of COVID-19 vaccines (AC19V) in the general population of India and Saudi Arabia (KSA) which vary in severity of the pandemic and vaccine mandates. Materials and Methods A total of 677 adult participants from India and KSA participated in this cross-sectional online web-based survey. Sociodemographic details and current COVID-19 status pertaining to infection and vaccination were collected. Depression, anxiety, post-traumatic stress disorder (PTSD) symptoms, and perceptive need for mental health support (MHS) were assessed before and after AC19V. A newly constructed and validated COVID19 vaccine hesitancy scale-12 (COVID19-VHS12) scale was used to evaluate the COVID-19 vaccine hesitancy. Results Prevalence and levels of depression and anxiety symptoms decreased significantly in Saudis but not in Indians after AC19V. PTSD symptoms showed a significant reduction in both India and KSA. Anxiety symptoms were higher in KSA than India before AC19V while PTSD was higher in India before and after AC19V. Except for the place of residence and employment status, the subgroups of sociodemographic variables which were at higher risk of negative mental health before AC19V showed improvement in their mental health after AC19V. The prevalence of COVID-19 vaccine hesitancy in India and KSA was 50.8% (95% CI 45.73–55.89%) and 55.7% (95% CI 50.16–61.31%), respectively. A bidirectional association between vaccine hesitancy and mental health was observed in KSA but not in India. Higher vaccine hesitancy favored higher levels of depression, anxiety, and perceptive need for MHS and vice versa in KSA. None of the mental health parameters predicted vaccine hesitancy in India, while higher vaccine hesitancy increased the risk of anxiety. Conclusion Vaccine hesitancy has a negative impact on mental health and vice versa over and above the impact of sociodemographic factors and COVID-19 vaccination and infection status which shows variations between India and KSA.
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Affiliation(s)
- Saikarthik Jayakumar
- Department of Basic Medical Sciences, College of Dentistry, Majmaah University, Al Majma'ah, Saudi Arabia.,Department of Medical Education, College of Dentistry, Majmaah University, Al Majma'ah, Saudi Arabia
| | - Saraswathi Ilango
- Department of Physiology, Madha Medical College and Research Institute, Chennai, India
| | - Senthil Kumar K
- Department of Physiology, Madha Medical College and Research Institute, Chennai, India
| | - Abdullah Alassaf
- Department of Preventive Dental Science, College of Dentistry, Majmaah University, Al Majma'ah, Saudi Arabia
| | - Abdullah Aljabr
- Department of Medical Education, College of Dentistry, Majmaah University, Al Majma'ah, Saudi Arabia
| | - Anand Paramasivam
- Department of Basic Medical Sciences, College of Dentistry, Majmaah University, Al Majma'ah, Saudi Arabia.,Department of Medical Education, College of Dentistry, Majmaah University, Al Majma'ah, Saudi Arabia
| | - Suresh Mickeymaray
- Department of Biology, College of Science, Majmaah University, Al Majma'ah, Saudi Arabia
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18
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Georges B, Marta B, Garyfallos K. Community-level characteristics of COVID-19 vaccine hesitancy in England: A nationwide cross-sectional study. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2022:2022.03.15.22272362. [PMID: 35313581 PMCID: PMC8936111 DOI: 10.1101/2022.03.15.22272362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
One year after the start of the COVID-19 vaccination programme in England, more than 43 million people older than 12 years old had received at least a first dose. Nevertheless, geographical differences persist, and vaccine hesitancy is still a major public health concern; understanding its determinants is crucial to managing the COVID-19 pandemic and preparing for future ones. In this cross-sectional population-based study we used cumulative data on the first dose of vaccine received by 01-01-2022 at Middle Super Output Area level in England. We used Bayesian hierarchical spatial models and investigated if the geographical differences in vaccination uptake can be explained by a range of community-level characteristics covering socio-demographics, political view, COVID-19 health risk awareness and targeting of high risk groups and accessibility. Deprivation is the covariate most strongly associated with vaccine uptake (Odds Ratio 0.55, 95%CI 0.54-0.57; most versus least deprived areas). The most ethnically diverse areas have a 38% (95%CI 36-40%) lower odds of vaccine uptake compared with those least diverse. Areas with the highest proportion of population between 12 and 24 years old had lower odds of vaccination (0.87, 95%CI 0.85-0.89). Finally increase in vaccine accessibility is associated with higher COVID-19 uptake (OR 1.07, 95%CI 1.03-1.12). Our results suggest that one year after the start of the vaccination programme, there is still evidence of inequalities in uptake, affecting particularly minorities and marginalised groups. Strategies including prioritising active outreach across communities and removing practical barriers and factors that make vaccines less accessible are needed to level up the differences.
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Affiliation(s)
- Bucyibaruta Georges
- MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Blangiardo Marta
- MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Konstantinoudis Garyfallos
- MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
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19
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Till B, Niederkrotenthaler T. Predictors of vaccine hesitancy during the COVID-19 pandemic in Austria : A population-based cross-sectional study. Wien Klin Wochenschr 2022; 134:822-827. [PMID: 35947223 PMCID: PMC9364912 DOI: 10.1007/s00508-022-02061-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 07/07/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Unwillingness to get vaccinated against the coronavirus disease 2019 (COVID-19) is a major barrier in managing the pandemic. Previous studies have explored predictors of hesitancy to be vaccinated against COVID-19, but evidence on these predictors was partly mixed, and the number of assessed predictors was often limited. This study aimed to explore a wide range of potential predictors of vaccine hesitancy in a population-based cross-sectional study. METHODS We assessed associations of vaccine hesitancy with individuals' fears about the future, social media use, and sociodemographics in a hierarchical multiple regression analysis. Data were collected via online questionnaires in a population-based cross-sectional study with 4018 respondents representative of the Austrian adult population between October and December 2020. RESULTS Vaccine hesitancy was predicted by freedom-related fears (i.e., fears regarding the political situation, particularly loss of personal freedoms), but were negatively associated with health-related fears (i.e., fears about physical or mental health) and society-related fears (i.e., fears regarding societal issues such as solidarity, distance learning, and isolation). Social media use as well as female gender, younger age, lower education, lower income, and living in rural regions were further predictors of vaccine hesitancy. CONCLUSION The study confirms that public health efforts targeting unvaccinated persons need to address freedom-related fears and social media discourse in order to improve vaccine uptake in the population. Particularly individuals in socially and economically disadvantaged groups and social media users need to be targeted to reduce vaccine hesitancy.
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Affiliation(s)
- Benedikt Till
- grid.22937.3d0000 0000 9259 8492Unit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria ,Wiener Werkstaette for Suicide Research, Vienna, Austria
| | - Thomas Niederkrotenthaler
- grid.22937.3d0000 0000 9259 8492Unit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria ,Wiener Werkstaette for Suicide Research, Vienna, Austria
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20
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COVID-19 and severe mental illness in Israel: testing, infection, hospitalization, mortality and vaccination rates in a countrywide study. Mol Psychiatry 2022; 27:3107-3114. [PMID: 35459901 PMCID: PMC9028900 DOI: 10.1038/s41380-022-01562-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 03/25/2022] [Accepted: 04/04/2022] [Indexed: 01/20/2023]
Abstract
Previous studies on psychiatric patients infected with COVID-19 have reported a more severe course of disease and higher rates of mortality compared with the general population. This cohort study linked Israeli national databases including all individuals ever hospitalized for a psychiatric disorder (cases), and COVID-19 testing, infection, hospitalization, mortality, and vaccinations, between March 1st 2020 and March 31st 2021. Cases were 125,273 individuals aged 18 and above ever hospitalized in a psychiatric facility (ICD-10 F10-F69 or F90-F99), compared to the total population, n = 6,143,802. Compared with the total population, cases were less likely to be tested for COVID-19, 51.2% (95% CI: 50.8-51.7) vs 62.3% (95% CI 62.2-62.4) and had lower rates of confirmed COVID infection, 5.9% (95% CI: 5.8-6.1) vs 8.9% (95% CI: 8.9-8.9). Among those infected, risks for COVID-19 hospitalization, COVID-19 attributed mortality and all-cause mortality were higher for cases than the total population, adjusted odds ratios were 2.10; (95% CI: 1.96-2.25), 1.76; (95% CI: 1.54-2.01) and 2.02; (95% CI: 1.80-2.28), respectively. These risks were even higher for cases with non-affective psychotic disorders and bipolar disorder. Age adjusted rates of vaccination were lower in cases, 60.4% (95% CI: 59.9-60.8) vs 74.9% (95% CI: 74.8-75.0) in the total population, and particularly low for cases with non-affective psychotic disorders, 56.9% (95% CI: 56.3-57.6). This study highlights the need to increase testing for COVID-19 in individuals ever hospitalized for a psychiatric disorder, closely monitor those found positive, and to reach out to encourage vaccination.
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Faria CGF, de Matos UMA, Llado-Medina L, Pereira-Sanchez V, Freire R, Nardi AE. Understanding and addressing COVID-19 vaccine hesitancy in low and middle income countries and in people with severe mental illness: Overview and recommendations for Latin America and the Caribbean. Front Psychiatry 2022; 13:910410. [PMID: 36177216 PMCID: PMC9513790 DOI: 10.3389/fpsyt.2022.910410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 08/22/2022] [Indexed: 11/22/2022] Open
Abstract
Despite the speedy development of vaccines for COVID-19, their rollout has posed a major public health challenge, as vaccine hesitancy (VH) and refusal are high. Addressing vaccine hesitancy is a multifactorial and context-dependent challenge. This perspective focuses on VH in the world region of Latin America and the Caribbean (LAC) and includes people suffering from severe mental illness, therefore covering populations and subpopulations often neglected in scientific literature. We present an overview of VH in LAC countries, discussing its global and historical context. Vaccine uptake has shown to widely vary across different subregions of LAC. Current data points to a possible correlation between societal polarization and vaccination, especially in countries going through political crises such as Brazil, Colombia, and Venezuela. Poor accessibility remains an additional important factor decreasing vaccination rollout in LAC countries and even further, in the whole Global South. Regarding patients with severe mental illness in LAC, and worldwide, it is paramount to include them in priority groups for immunization and monitor their vaccination coverage through public health indicators.
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Affiliation(s)
- Clara Gitahy Falcão Faria
- Laboratory of Panic and Respiration, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | | | | | - Victor Pereira-Sanchez
- Department of Psychiatry, Columbia University, New York, NY, United States.,Division of Translational Epidemiology and Mental Health Equity, New York State Psychiatric Institute, New York, NY, United States.,Department of Child and Adolescent Psychiatry, New York University Grossman School of Medicine, New York, NY, United States.,Department of Psychiatry, Amoud University, Borama, Somalia
| | - Rafael Freire
- Laboratory of Panic and Respiration, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil.,Department of Psychiatry and Center for Neuroscience Studies, Queen's University, Kingston, ON, Canada
| | - Antonio Egidio Nardi
- Laboratory of Panic and Respiration, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
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