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Bodjongo MJM. How to increase acceptance of the COVID-19 vaccine among poor people in Africa? INTERNATIONAL JOURNAL OF HEALTH ECONOMICS AND MANAGEMENT 2024; 24:173-210. [PMID: 38451447 DOI: 10.1007/s10754-024-09370-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 02/10/2024] [Indexed: 03/08/2024]
Abstract
This study aims to analyze whether good government management of the COVID-19 pandemic can increase the likelihood of vaccine uptake among poor people in Africa. The analysis is based on a sample of 18,010 people living in 34 African countries, drawn from data collected by Afrobarometer (Merged Round 8 data (34 countries), database, 2022). The econometric results, obtained using a bivariate probit regression, show that poverty significantly reduces the odds of accepting the said COVID-19 vaccine. However, acceptance of the vaccine increases among poor individuals when there is (i) trust in the government's published statistics on COVID-19, (ii) control of corruption by the government in managing the pandemic, (iii) individual confidence in the government's ability to ensure the safety of the COVID-19 vaccine, and (iv) belief that the Covid 19 vaccine will be more effective than religious prayer in the fight against this pandemic.
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Maraqa B, Nazzal Z, Baroud H, Douden M, El Hamshary Y, Jalamneh T. Healthcare workers' attitudes toward and factors influencing their acceptance of an annual COVID-19 booster vaccine: a cross-sectional study in Palestine. BMC Health Serv Res 2024; 24:624. [PMID: 38745215 PMCID: PMC11092075 DOI: 10.1186/s12913-024-11016-w] [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: 01/07/2023] [Accepted: 04/19/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND The emergence of several SARS-CoV-2 variants may necessitate an annual COVID-19 booster vaccine. This study aimed to evaluate healthcare workers' (HCWs) acceptance of a COVID-19 yearly booster vaccine if recommended and its association with their attitudes and burnout levels. METHODS We used an online self-administered questionnaire to conduct a cross-sectional study of all HCWs in the West Bank and Gaza Strip of Palestine between August and September 2022. We used the Vaccination Attitudes Examination scale to assess HCWs' vaccination attitudes and the Maslach Burnout Inventory to assess work-related Burnout. In addition, we conducted logistic regression to identify factors independently associated with the acceptance of the booster vaccine. RESULTS The study included 919 HCWs; 52.4% were male, 46.5% were physicians, 30.0% were nurses, and 63.1% worked in hospitals. One-third of HCWs (95% CI: 30.5%-36.7%) said they would accept an annual COVID-19 booster vaccine if recommended. HCWs who are suspicious of vaccine benefits [aOR = .70; 95%CI: .65-.75] and those concerned about unforeseeable future effects [aOR = .90; 95%CI: .84-.95] are less likely to accept the booster vaccine if recommended, whereas those who receive annual influenza vaccine are more likely to get it [aOR = 2.9; 95%CI: 1.7-5.0]. CONCLUSION Only about a third of HCWs would agree to receive an annual COVID-19 booster vaccine if recommended. Mistrust of the vaccine's efficacy and concerns about side effects continue to drive COVID-19 vaccine reluctance. Health officials need to address HCWs' concerns to increase their acceptance of the annual vaccine if it is to be recommended.
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Affiliation(s)
- Beesan Maraqa
- Ministry of Health, Ramallah, Palestine
- Community and Family medicine department, College of Medicine, Hebron University, Hebron, Palestine
| | - Zaher Nazzal
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine.
| | - Hassan Baroud
- Department of Family Medicine, Palestinian Medical Council, Gaza, Palestine
| | - Mahmoud Douden
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Yousef El Hamshary
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine.
- Department of Internal Medicine, An-Najah National University Hospital, Nablus, Palestine.
| | - Tala Jalamneh
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
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Wagner A, Polak P, Rudek TJ, Świątkiewicz-Mośny M, Anderson A, Bockstal M, Gariglio L, Hasmanová Marhánková J, Hilário AP, Hobson-West P, Iorio J, Kuusipalo A, Numerato D, Scavarda A, Alcântara da Silva P, Soares Moura E, Vuolanto P. Agency in urgency and uncertainty. Vaccines and vaccination in European media discourses. Soc Sci Med 2024; 346:116725. [PMID: 38432000 DOI: 10.1016/j.socscimed.2024.116725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 02/19/2024] [Accepted: 02/23/2024] [Indexed: 03/05/2024]
Abstract
Although Covid-19 was not the first pandemic, it was unique in the scale and intensity with which societies responded. Countries reacted differently to the threat posed by the new virus. The public health crisis affected European societies in many ways. It also influenced the way the media portrayed vaccines and discussed factors related to vaccine hesitancy. Europeans differed in their risk perceptions, attitudes towards vaccines and vaccine uptake. In European countries, Covid-19-related discourses were at the centre of media attention for many months. This paper reports on a media analysis which revealed significant differences as well as some similarities in the media debates in different countries. The study focused on seven European countries and considered two dimensions of comparison: between the pre-Covid period and the beginning of the Covid pandemic period, and between countries. The rich methodological approach, including linguistics, semantic field analysis and discourse analysis of mainstream news media, allowed the authors to explore the set of meanings related to vaccination that might influence actors' agency. This approach led the authors to redefine vaccine hesitancy in terms of characteristics of the "society in the situation" rather than the psychological profile of individuals. We argue that vaccine hesitancy can be understood in terms of agency and temporality. This dilemma of choice that transforms the present into an irreversible past and must be taken in relation to an uncertain future, is particularly acute under the pressure of urgency and when someone's health is at stake. As such, it is linked to how vaccine meaning is co-produced within public discourses.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Juliana Iorio
- Instituto de Ciências Sociais da Universidade de Lisboa, Portugal.
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Tunç AM, Çevirme A. Attitudes of healthcare workers toward the COVID-19 vaccine and related factors: A systematic review. Public Health Nurs 2024; 41:10-21. [PMID: 37668422 DOI: 10.1111/phn.13250] [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: 04/05/2023] [Revised: 08/01/2023] [Accepted: 08/16/2023] [Indexed: 09/06/2023]
Abstract
AIM AND OBJECTIVES This systematic review aims to examine healthcare professionals' attitudes toward the COVID-19 vaccine and related factors. BACKGROUND Healthcare workers have priority among risky groups accepted as candidates for early vaccination. Therefore, it is important to consider health professionals' attitudes toward COVID-19 vaccination to better address barriers to widespread vaccination. MATERIALS AND METHODS Six databases were searched for articles published between January 01, 2020, and February 31, 2022, and 1161 studies were reached. As a result of the evaluations, 10 studies were included in the systematic review. Nine studies are cross-sectional, and one is a descriptive study. A 9-item Critical Appraisal Checklist for Analytical Cross Sectional Studies from the Joanna Briggs Institute MAStARI Critical Assessment Tools (JBI-MAStARI) was used for quality assessment. High-quality studies with an average or higher methodological quality score were included in the systematic review. The PRISMA guideline was followed while selecting studies. RESULTS Positive attitudes of healthcare professionals toward the COVID-19 vaccine ranged from 10% to 93.7%, and negative attitudes varied between 6.3% and 41.0%. Factors such as the male gender, being a physician, advanced age, previous influenza vaccination history, and presence of chronic disease were found to be associated with vaccine acceptance. Factors such as doubt about the efficacy of the COVID-19 vaccine, safety concerns, and fear of unknown side effects of the vaccine were associated with COVID-19 vaccine hesitancy. CONCLUSION There is a need for confidence-building interventions and tailored communication strategies, including personalized training to change the ambiguous attitudes of healthcare professionals, increase vaccine uptake, and cope with the multifaceted impact of infection. PROSPERO REGISTRATION NUMBER CRD42021290482.
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Affiliation(s)
- Aylin Meşe Tunç
- Department of Public Health Nursing, Faculty of Health Science, Sakarya University, Sakarya, Turkey
| | - Ayşe Çevirme
- Department of Public Health Nursing, Faculty of Health Science, Sakarya University, Sakarya, Turkey
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Couch MA, Katoto PDMC, Cinini SF, Wiysonge CS. Integrating civil liberty and the ethical principle of autonomy in building public confidence to reduce COVID-19 vaccination inequity in Africa. Hum Vaccin Immunother 2023; 19:2179789. [PMID: 36803523 PMCID: PMC10054293 DOI: 10.1080/21645515.2023.2179789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Abstract
Concerns regarding the safety of COVID-19 vaccination have caused hesitancy and lowered uptake globally. While vaccine hesitancy is documented globally, some continents, countries, ethnic groups and age groups are disproportionately affected, resulting in significant global inequities. To date, Africa has the lowest COVID-19 coverage globally, with only 22% of its population completely vaccinated. It might be argued that the difficulty with COVID-19 vaccine acceptance in Africa was triggered by the anxiety created by misinformation on social media platforms, particularly with the misinformation regarding depopulating Africa, given the significance of maternity in the continent. In this work, we examine numerous determinants of poor vaccination coverage that have received little attention in primary research and that may need to be considered by various stakeholders engaged in the COVID-19 vaccine strategy at the national and continental levels. Our study also emphasizes the importance of a multidisciplinary team when introducing a new vaccine, for people to trust that the vaccine is truly helpful to them and to be convinced that immunization is, all things considered, worthwhile.
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Affiliation(s)
- Marilyn A Couch
- Human Sciences Research Council, Durban, South Africa
- South African Research Ethics Training Initiative (SARETI), University of KwaZulu-Natal, Pietermaritzburg, South Africa
| | - Patrick D M C Katoto
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
- Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Centre for Tropical Diseases and Global Health, Faculty of Medicine, Catholic University of Bukavu, Bukavu, Democratic Republic of Congo
| | - Samuel Fikiri Cinini
- Department of Criminology and Forensic Studies, School of Applied Human Science, University of KwaZulu-Natal/Howard Campus, Durban, South Africa
| | - Charles S Wiysonge
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
- Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- HIV and other Infectious Diseases Research Unit, South African Medical Research Council, Durban, South Africa
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Kessy SJ, Wei T, Zhou Y, Zhang W, Alwy Al‐Beity FM, Zhang S, Du J, Cui F, Lu Q. Vaccination willingness, vaccine hesitancy, and estimated coverage of SARS-CoV-2 vaccine among healthcare workers in Tanzania: A call for action. Immun Inflamm Dis 2023; 11:e1126. [PMID: 38156379 PMCID: PMC10750438 DOI: 10.1002/iid3.1126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 11/20/2023] [Accepted: 12/05/2023] [Indexed: 12/30/2023] Open
Abstract
BACKGROUND The global COVID-19 pandemic presented an immense obstacle to public health, with vaccination emerging as a crucial measure to curb transmission. This study aimed to evaluate the willingness, hesitancy, and coverage of SARS-CoV-2 vaccines among healthcare workers (HCWs) in Tanzania and reveal their concerns about SARS-CoV-2 vaccines and the reasons that might prevent them from getting vaccinated. METHODS We conducted a cross-sectional study using an anonymous online survey from October to November 2022. The multivariate logistic regression model explored the factors associated with SARS-CoV-2 vaccine willingness, hesitancy, and coverage. RESULTS The study included 560 HCWs, with the largest group being doctors (47.9%), followed by nurses (26.9%) and other HCWs (25.2%). A total of 70.5% of HCWs reported being vaccinated against SARS-CoV-2. The primary driver for SARS-CoV-2 vaccination was collective responsibility. A total of 81.4% of HCWs reported being willing to accept SARS-CoV-2 vaccines, while 62.5% of HCWs reported vaccine hesitancy. HCWs with higher educational qualifications were likelier to take the vaccine, while the respondents aged 18-30 years had the highest SARS-CoV-2 vaccination refusal (71.9%). We also investigated the role of HCWs as a source of information to promote COVID-19 vaccine uptake. 79.4% of HCWs provided information and advice on SARS-CoV-2 vaccines. CONCLUSION To increase vaccine acceptance among HCWs and the general population, targeted messaging is needed to deliver transparent information on vaccine safety, efficacy, and development.
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Affiliation(s)
- Suzan Joseph Kessy
- Department of Laboratory Science and Technology & Vaccine Research CenterSchool of Public Health, Peking UniversityBeijingChina
- Training DivisionInfection Control African Network (ICAN)Cape TownSouth Africa
| | - Tingting Wei
- Department of Laboratory Science and Technology & Vaccine Research CenterSchool of Public Health, Peking UniversityBeijingChina
| | - Yiguo Zhou
- Department of Health Policy and Management, School of Public HealthPeking UniversityBeijingChina
| | - Wan‐Xue Zhang
- Department of Epidemiology and Biostatistics, School of Public HealthPeking UniversityBeijingChina
| | - Fadhlun M. Alwy Al‐Beity
- Department of Obstetrics and Gynaecology, School of MedicineMuhimbili University of Allied Sciences (MUHAS)Dar es SalaamTanzania
| | - Shan‐Shan Zhang
- Global Center for Infectious Disease and Policy Research & Global Health and Infectious Diseases GroupPeking UniversityBeijingChina
| | - Juan Du
- Global Center for Infectious Disease and Policy Research & Global Health and Infectious Diseases GroupPeking UniversityBeijingChina
| | - Fuqiang Cui
- Department of Laboratory Science and Technology & Vaccine Research CenterSchool of Public Health, Peking UniversityBeijingChina
- Department of Health Policy and Management, School of Public HealthPeking UniversityBeijingChina
- Department of Epidemiology and Biostatistics, School of Public HealthPeking UniversityBeijingChina
- Global Center for Infectious Disease and Policy Research & Global Health and Infectious Diseases GroupPeking UniversityBeijingChina
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of EducationBeijingChina
| | - Qing‐Bin Lu
- Department of Laboratory Science and Technology & Vaccine Research CenterSchool of Public Health, Peking UniversityBeijingChina
- Department of Health Policy and Management, School of Public HealthPeking UniversityBeijingChina
- Department of Epidemiology and Biostatistics, School of Public HealthPeking UniversityBeijingChina
- Global Center for Infectious Disease and Policy Research & Global Health and Infectious Diseases GroupPeking UniversityBeijingChina
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of EducationBeijingChina
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Al Hail M, Abdulrouf P, Stewart D, Elkassem W, Singh R, Al Enany R, Mohammed Azad A, Tarannum A, Thomas B. Behaviour and associated determinants of COVID-19 vaccine acceptance and advocacy: a nationwide survey of pharmacy professionals in Qatar. J Pharm Policy Pract 2023; 16:160. [PMID: 38017533 PMCID: PMC10683145 DOI: 10.1186/s40545-023-00668-4] [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: 08/08/2023] [Accepted: 11/16/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND Vaccine hesitancy poses a global challenge and is acknowledged to be a complex, multifactorial phenomenon. Of particular concern is hesitancy among health professionals, as this may also impact their advocacy roles. There is a lack of theory-based investigations of pharmacy professionals. AIM The study aims to determine the behaviour and associated determinants influencing pharmacy professionals' attitude towards vaccine acceptance and advocacy. METHODS A cross-sectional survey of 2400 pharmacists and pharmacy technicians at government, semi-government, and private community pharmacies in Qatar. Questionnaire items captured perspectives on COVID vaccine acceptance, advocacy and associated determinants based on the domains and constructs of the Theoretical Domains Framework (TDF). Data were analysed by descriptive and inferential statistics, with TDF items subjected to principal components analysis (PCA). FINDINGS The response rate was 38.6% (927/2400). Almost all (n = 825, 89.0%) were willing to receive the vaccine, which was higher for males (p < 0.001) and those in polyclinics (p < 0.05). PCA of acceptance items gave five components, with response to 'emotions' being most negative, associated with acceptance (p < 0.001) and more negative in females (p < 0.001). The majority (n = 799, 86.2%) agreed that it was their professional duty to advocate vaccines. PCA for advocacy items gave two components, with the most negative responses for 'professional role and identity', which were more negative for those working in hospitals (p < 0.05). CONCLUSION Respondents were least positive regarding emotion-related behavioral determinants for acceptance and professional role and identity for advocacy. Behavior change technique interventions that target these issues have the potential to influence the vaccine hesitancy of pharmacy professionals and other individuals.
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Affiliation(s)
- Moza Al Hail
- Pharmacy Executive Directors Office, Hamad Medical Corporation, Doha, Qatar
| | | | | | - Wessam Elkassem
- Pharmacy Executive Directors Office, Hamad Medical Corporation, Doha, Qatar
| | - Rajvir Singh
- Pharmacy Executive Directors Office, Hamad Medical Corporation, Doha, Qatar
- Cardiology Research, Adult Cardiology Dept, Heart Hospital, Doha, Qatar
| | | | - Aftab Mohammed Azad
- Corporate Department of Emergency Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Asma Tarannum
- St John of God, Midland Public and Private Hospitals, Perth, Australia
| | - Binny Thomas
- Pharmacy Executive Directors Office, Hamad Medical Corporation, Doha, Qatar.
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Aseneh JB, Agbor VN, Kadia BM, Okolie EA, Ofomata CJ, Etombi CL, Ekaney DSM, Joko Fru YW. Factors associated with COVID-19 vaccine hesitancy among healthcare workers in Cameroon and Nigeria: a web-based cross-sectional study. Int Health 2023; 15:702-714. [PMID: 36905293 PMCID: PMC10629963 DOI: 10.1093/inthealth/ihad013] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 12/09/2022] [Accepted: 03/06/2023] [Indexed: 03/12/2023] Open
Abstract
BACKGROUND This study investigated the determinants of coronavirus disease 2019 (COVID-19) vaccine hesitancy among healthcare workers (HCWs) in Cameroon and Nigeria. METHODS This analytic cross-sectional study was conducted from May to June 2021, including consenting HCWs aged ≥18 y identified using snowball sampling. Vaccine hesitancy was defined as indecisiveness or unwillingness to receive the COVID-19 vaccine. Multilevel logistic regression yielded adjusted ORs (aORs) for vaccine hesitancy. RESULTS We included a total of 598 (about 60% women) participants. Little or no trust in the approved COVID-19 vaccines (aOR=2.28, 95% CI 1.24 to 4.20), lower perception of the importance of the vaccine on their personal health (5.26, 2.38 to 11.6), greater concerns about vaccine-related adverse effects (3.45, 1.83 to 6.47) and uncertainty about colleagues' acceptability of the vaccine (2.98, 1.62 to 5.48) were associated with higher odds of vaccine hesitancy. In addition, participants with chronic disease (aOR=0.34, 95% CI 0.12 to 0.97) and higher levels of concerns about getting COVID-19 (0.40, 0.18 to 0.87) were less likely to be hesitant to receive the COVID-19 vaccine. CONCLUSIONS COVID-19 vaccine hesitancy among HCWs in this study was high and broadly determined by the perceived risk of COVID-19 and COVID-19 vaccines on personal health, mistrust in COVID-19 vaccines and uncertainty about colleagues' vaccine acceptability.
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Affiliation(s)
- Jerry Brown Aseneh
- Department of Health Research, Health Education and Research Organization (HERO), Buea, 154, Cameroon
- Ecole de Santé Publique, Université Libre de Bruxelles, Brussel, 1070, Belgium
| | - Valirie Ndip Agbor
- Department of Health Research, Health Education and Research Organization (HERO), Buea, 154, Cameroon
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, OX3 7LF, UK
| | - Benjamin Momo Kadia
- Department of Health Research, Health Education and Research Organization (HERO), Buea, 154, Cameroon
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
| | - Elvis Anyaehiechukwu Okolie
- Department of Public Health, School of Health and Life Sciences, Teesside University, Middlesbrough, TS1 3BX, UK
| | | | - Christie Linonge Etombi
- Department of Health Research, Health Education and Research Organization (HERO), Buea, 154, Cameroon
| | - Domin Sone M Ekaney
- Department of Health Research, Health Education and Research Organization (HERO), Buea, 154, Cameroon
| | - Yvonne Walburga Joko Fru
- Cancer and Epidemiology Unit (CEU), Nuffield Department of Population Health, University of Oxford, Oxford, OX3 7LF, UK
- The African Cancer Registry Network, INCTR African Registry Programme, Oxford, OX2 7HT, UK
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Naidoo D, Meyer-Weitz A, Govender K. The Social Ecological Model: A Framework for Understanding COVID-19 Vaccine Uptake among Healthcare Workers-A Scoping Review. Vaccines (Basel) 2023; 11:1491. [PMID: 37766166 PMCID: PMC10536505 DOI: 10.3390/vaccines11091491] [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: 07/26/2023] [Revised: 09/12/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
Vaccination plays a crucial role in combating the global COVID-19 pandemic. Immunizing all healthcare workers (HCWs) is essential for increasing vaccine confidence and acceptance within the general population. Understanding the factors that hinder or facilitate vaccine uptake among HCWs is of utmost importance, considering they are among the first to be vaccinated. This review follows Arksey and O'Malley's five-stage methodological framework. We searched PubMed, Web of Science, ProQuest, WorldCat Discovery, and Google Scholar for peer-reviewed articles published from 2020 to 2023. A descriptive analysis and narrative synthesis approach were employed to collect and synthesize data. Using the social-ecological model as a framework, the literature was categorized into themes at the intrapersonal, interpersonal, organizational, community, and policy levels. We reviewed a total of fifty-three published academic articles, with the majority of studies conducted in Ethiopia and Nigeria. The intention for vaccine uptake resulted in an unsatisfactory (52%) overall uptake rate among HCWs. Individual-level determinants associated with vaccine uptake included being male, middle-aged, being a physician, having a higher level of education, and having a chronic illness. This review identified significant barriers at each level, such as safety concerns, perceived scientific uncertainty, vaccine ineffectiveness, lack of trust in stakeholders, and religious beliefs. Additionally, we identified facilitators at each level, with the most common factors promoting intention to uptake being the desire to protect oneself and others and a high perceived susceptibility to contracting COVID-19. This review highlights the existence of significant barriers to vaccine uptake on the African continent. Given that HCWs play a crucial role in guiding the public's vaccination decisions, it is imperative to prioritize education and training efforts about the safety and effectiveness of COVID-19 vaccines.
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Affiliation(s)
- Damian Naidoo
- Discipline of Psychology, School of Applied Human Sciences, Howard College, University of KwaZulu-Natal, Durban 4041, South Africa
- Health Promotion Unit, KwaZulu-Natal Department of Health, Pietermaritzburg, Private Bag X9051, Pietermaritzburg 3200, South Africa
| | - Anna Meyer-Weitz
- Discipline of Psychology, School of Applied Human Sciences, Howard College, University of KwaZulu-Natal, Durban 4041, South Africa
| | - Kaymarlin Govender
- HEARD, College of Law and Management Studies, University of Kwazulu-Natal, Durban 4041, South Africa
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Li B, Zhang J, Huang Y, Li X, Feng J, Li Y, Zhang R. A conserved N protein nano-vaccine of COVID-19 exerts potent and cross-reactive humoral and cellular immune responses in mice. J Med Virol 2023; 95:e29115. [PMID: 37750245 DOI: 10.1002/jmv.29115] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 08/14/2023] [Accepted: 09/11/2023] [Indexed: 09/27/2023]
Abstract
As severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) mutates continually, the current vaccines are unable to provide sufficient protection. It is important to develop a broad-spectrum vaccine with conserved antigens to prevent variant infection. Here we fused the SARS-CoV-2 N protein with Helicobacter pylori nonheme ferritin to construct a SARS-CoV-2 N-Ferritin nanoparticle vaccine. Compared with the monomer N protein, the N-Ferritin nanoparticles induced more lymph node dendritic cells in mice to trigger adoptive immunity. Following this, the N-Ferritin elicited more robust and long-lasting antibody responses, which had better cross-reactivity with the SARS-CoV N protein. It is also worth noting that higher levels of N-specific IgG and IgA were distributed in the lungs of N-Ferritin-immunized mice. Furthermore, the N-Ferritin nanoparticles also resulted higher proportion of interferon-γ+ CD8+ T cells, CD8+ Tcm cells, and T cells with cross-reactivity in SARS-CoV-2, SARS-CoV, and Middle East respiratory syndrome-related coronavirus. The conserved N-based nanoparticles could provide a promising vaccine developing strategy against SARS-CoV-2 variants and other coronaviruses.
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Affiliation(s)
- Bing Li
- Department of Biotechnology, School of Life Sciences and Biopharmaceutics, Guangdong Pharmaceutical University, Guangzhou, China
| | - Jing Zhang
- Department of Biotechnology, School of Life Sciences and Biopharmaceutics, Guangdong Pharmaceutical University, Guangzhou, China
| | - Yang Huang
- Department of Biotechnology, School of Life Sciences and Biopharmaceutics, Guangdong Pharmaceutical University, Guangzhou, China
| | - Xinrui Li
- Department of Biotechnology, School of Life Sciences and Biopharmaceutics, Guangdong Pharmaceutical University, Guangzhou, China
| | - Jing Feng
- Department of Biotechnology, School of Life Sciences and Biopharmaceutics, Guangdong Pharmaceutical University, Guangzhou, China
| | - Yan Li
- Department of Biotechnology, School of Life Sciences and Biopharmaceutics, Guangdong Pharmaceutical University, Guangzhou, China
| | - Rongxin Zhang
- Department of Biotechnology, School of Life Sciences and Biopharmaceutics, Guangdong Pharmaceutical University, Guangzhou, China
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Mudenda S, Daka V, Matafwali SK, Skosana P, Chabalenge B, Mukosha M, Fadare JO, Mfune RL, Witika BA, Alumeta MG, Mufwambi W, Godman B, Meyer JC, Bwalya AG. COVID-19 Vaccine Acceptance and Hesitancy among Healthcare Workers in Lusaka, Zambia; Findings and Implications for the Future. Vaccines (Basel) 2023; 11:1350. [PMID: 37631918 PMCID: PMC10459437 DOI: 10.3390/vaccines11081350] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 08/05/2023] [Accepted: 08/07/2023] [Indexed: 08/29/2023] Open
Abstract
The uptake of COVID-19 vaccines is critical to address the severe consequences of the disease. Previous studies have suggested that many healthcare workers (HCWs) are hesitant to receive the COVID-19 vaccine, further enhancing hesitancy rates within countries. COVID-19 vaccine acceptance and hesitancy levels are currently unknown among HCWs in Zambia, which is a concern given the burden of infectious diseases in the country. Consequently, this study assessed COVID-19 vaccine acceptance and hesitancy among HCWs in Lusaka, Zambia. A cross-sectional study was conducted among 240 HCWs between August and September 2022, using a semi-structured questionnaire. Multivariable analysis was used to determine the key factors associated with vaccine hesitancy among HCWs. Of the 240 HCWs who participated, 54.2% were females. A total of 72.1% of the HCWs would accept being vaccinated, while 27.9% were hesitant. Moreover, 93.3% of HCWs had positive attitudes towards COVID-19 vaccines, with medical doctors having the highest mean attitude score (82%). Encouragingly, HCWs with positive attitudes towards COVID-19 vaccines had reduced odds of being hesitant (AOR = 0.02, 95% CI: 0.01-0.11, p < 0.001). Overall, acceptance of the COVID-19 vaccine among HCWs in Lusaka, Zambia, was high, especially by those with positive attitudes. However, the current hesitancy among some HCWs is a concern. Consequently, there is a need to address this and encourage HCWs to fully promote vaccination programs going forward.
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Affiliation(s)
- Steward Mudenda
- Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka 10101, Zambia; (M.M.); (M.G.A.); (W.M.); (A.G.B.)
| | - Victor Daka
- Department of Public Health, Michael Chilufya Sata School of Medicine, Copperbelt University, Ndola 21692, Zambia; (V.D.); (R.L.M.)
| | - Scott K. Matafwali
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK;
| | - Phumzile Skosana
- Department of Clinical Pharmacy, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria 0208, South Africa;
| | - Billy Chabalenge
- Department of Medicines Control, Zambia Medicines Regulatory Authority, Lusaka 31890, Zambia;
| | - Moses Mukosha
- Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka 10101, Zambia; (M.M.); (M.G.A.); (W.M.); (A.G.B.)
| | - Joseph O. Fadare
- Department of Pharmacology and Therapeutics, Ekiti State University College of Medicine, Ado-Ekiti 362103, Nigeria;
- Department of Medicine, Ekiti State University Teaching Hospital, Ado-Ekiti 362103, Nigeria
| | - Ruth L. Mfune
- Department of Public Health, Michael Chilufya Sata School of Medicine, Copperbelt University, Ndola 21692, Zambia; (V.D.); (R.L.M.)
| | - Bwalya A. Witika
- Department of Pharmaceutical Sciences, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria 0208, South Africa;
| | - Mirriam G. Alumeta
- Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka 10101, Zambia; (M.M.); (M.G.A.); (W.M.); (A.G.B.)
| | - Webrod Mufwambi
- Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka 10101, Zambia; (M.M.); (M.G.A.); (W.M.); (A.G.B.)
| | - Brian Godman
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria 0208, South Africa;
- Department of Pharmacoepidemiology, Strathclyde Institute of Pharmacy and Biomedical Science, University of Strathclyde, Glasgow G4 0RE, UK
| | - Johanna C. Meyer
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria 0208, South Africa;
- South African Vaccination and Immunisation Centre, Sefako Makgatho Health Sciences University, Molotlegi Street, Garankuwa, Pretoria 0208, South Africa
| | - Angela G. Bwalya
- Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka 10101, Zambia; (M.M.); (M.G.A.); (W.M.); (A.G.B.)
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12
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Gonçalves BA, Matos CCDSA, Ferreira JVDS, Itagyba RF, Moço VR, Couto MT. COVID-19 vaccine hesitancy in Latin America and Africa: a scoping review. CAD SAUDE PUBLICA 2023; 39:e00041423. [PMID: 37556613 PMCID: PMC10494688 DOI: 10.1590/0102-311xpt041423] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 05/16/2023] [Accepted: 05/25/2023] [Indexed: 08/11/2023] Open
Abstract
Vaccination has played an important role in the containment of COVID-19 pandemic advances. However, SARS-CoV-2 vaccine hesitancy has caused a global concern. This scoping review aims to map the scientific literature on COVID-19 vaccine hesitancy in Latin America and Africa from a Global Health perspective, observing the particularities of the Global South and using parameters validated by the World Health Organization (WHO). The review reporting observes the recommendations of the PRISMA for Scoping Reviews (PRISMA-ScR) model. Search was conducted in PubMed, Scopus, Web of Science, and Virtual Health Library (VHL) databases, selecting studies published from January 1, 2020 to January 22, 2022. Selected studies indicate that COVID-19 vaccine hesitancy involves factors such as political scenario, spread of misinformation, regional differences in each territory regarding Internet access, lack of access to information, history of vaccination resistance, lack of information about the disease and the vaccine, concern about adverse events, and vaccine efficacy and safety. Regarding the use of conceptual and methodology references from the WHO for vaccine hesitancy, few studies (6/94) use research instruments based on these references. Then, the replication in Global South of conceptual and methodological parameters developed by experts from the Global North contexts has been criticized from the perspective of Global Health because of it may not consider political and sociocultural particularities, the different nuances of vaccine hesitancy, and issues of access to vaccines.
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13
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Maughan-Brown B, Eyal KC, Njozela L, Buttenheim AM. Predictors of COVID-19 vaccine uptake among adults in South Africa: multimethod evidence from a population-based longitudinal study. BMJ Glob Health 2023; 8:e012433. [PMID: 37541692 PMCID: PMC10407380 DOI: 10.1136/bmjgh-2023-012433] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 06/25/2023] [Indexed: 08/06/2023] Open
Abstract
BACKGROUND COVID-19 vaccine coverage remains low in many low and middle-income countries despite widespread access. To understand the dynamic decision-making process around vaccination and provide evidence for future vaccine promotion campaigns, we identified predictors of COVID-19 vaccine uptake among South African adults, including those who did not believe in the vaccine's safety or efficacy. METHODS Data from two longitudinal telephone surveys in late 2021 and early 2022 of unvaccinated South African adults were used to model COVID-19 uptake. Predictors of interest informed by the theory of planned behaviour included vaccine attitudes and beliefs, social norms, perceived behavioural control and vaccine intentions. Responses to open-ended questions provided insights into key reasons for getting vaccinated. RESULTS Among panel participants (n=1772), 19% reported being vaccinated between Survey 1 and Survey 2. Vaccine uptake was greater among participants who reported wanting to get vaccinated 'as soon as possible' (+27 percentage points, p<0.01). Vaccine uptake was greater among participants who believed that the vaccine is effective in preventing COVID-19 infection and/or death (+12 percentage points, p<0.01) and lower among those who believed that the vaccine is unsafe (-9 percentage points, p<0.01). Among participants who did not believe the vaccine is safe, living with someone already vaccinated against COVID-19 increased vaccine uptake (+6 percentage points, p<0.05). At Survey 1, the intention to get vaccinated as soon as possible was positively associated with perceived risk of illness from COVID-19 (+9.2 percentage points, p<0.05), the belief that most people in their area had been vaccinated (+7.0 percentage points, p<0.05) and living with someone already vaccinated against COVID-19 (+6.6 percentage points, p<0.05). CONCLUSION Study findings underscore the predictive power of intentions and of beliefs about disease risk, vaccine safety and vaccine efficacy. Social proof interventions hold promise for increasing vaccination intentions and overcoming concerns about vaccine safety.
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Affiliation(s)
- Brendan Maughan-Brown
- Southern Africa Labour and Development Research Unit, University of Cape Town, Cape Town, South Africa
| | - Katherine Claire Eyal
- Southern Africa Labour and Development Research Unit, School of Economics, University of Cape Town, Cape Town, South Africa
| | | | - Alison M Buttenheim
- Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
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14
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Piltch-Loeb R, Mazibuko L, Stanton E, Mngomezulu T, Gareta D, Nxumalo S, Kraemer JD, Herbst K, Siedner MJ, Harling G. COVID-19 vaccine uptake, confidence and hesitancy in rural KwaZulu-Natal, South Africa between April 2021 and April 2022: A continuous cross-sectional surveillance study. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002033. [PMID: 37368864 DOI: 10.1371/journal.pgph.0002033] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 05/17/2023] [Indexed: 06/29/2023]
Abstract
High COVID-19 vaccine hesitancy in South Africa limits protection against future epidemic waves. We evaluated how vaccine hesitancy and its correlates evolved April 2021-April 2022 in a well-characterized rural KwaZulu-Natal setting. All residents aged >15 in the Africa Health Research Institute's surveillance area were invited to complete a home-based, in-person interview. We described vaccine uptake and hesitancy trends, then evaluated associations with pre-existing personal factors, dynamic environmental context, and cues to action using ordinal logistic regression. Among 10,011 respondents, vaccine uptake rose as age-cohorts became vaccine-eligible before levelling off three months post-eligibility; younger age-groups had slower uptake and plateaued faster. Lifetime receipt of any COVID-19 vaccine rose from 3.0% in April-July 2021 to 32.9% in January-April 2022. Among 7,445 unvaccinated respondents, 47.7% said they would definitely take a free vaccine today in the first quarter of the study time period, falling to 32.0% in the last. By March/April 2022 only 48.0% of respondents were vaccinated or said they would definitely would take a vaccine. Predictors of lower vaccine hesitancy included being male (adjusted odds ratio [aOR]: 0.70, 95% confidence interval [CI]: 0.65-0.76), living with vaccinated household members (aOR:0.65, 95%CI: 0.59-0.71) and knowing someone who had had COVID-19 (aOR: 0.69, 95%CI: 0.59-0.80). Mistrust in government predicted greater hesitancy (aOR: 1.47, 95%CI: 1.42-1.53). Despite several COVID-19 waves, vaccine hesitancy was common in rural South Africa, rising over time and closely tied to mistrust in government. However, interpersonal experiences countered hesitancy and may be entry-points for interventions.
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Affiliation(s)
- Rachael Piltch-Loeb
- Emergency Preparedness Research Evaluation and Practice (EPREP) Program, Division of Policy Translation and Leadership Development, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Department of Biostatistics, Harvard TH Chan School of Public Health, Boston, Massachusetts, United States of America
| | | | - Eva Stanton
- Emergency Preparedness Research Evaluation and Practice (EPREP) Program, Division of Policy Translation and Leadership Development, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | | | - Dickman Gareta
- Africa Health Research Institute, KwaZulu-Natal, South Africa
| | | | - John D Kraemer
- Department of Health Management and Policy, Georgetown University School of Health, Washington, DC, United States of America
| | - Kobus Herbst
- Africa Health Research Institute, KwaZulu-Natal, South Africa
- DSI-MRC South African Population Research Infrastructure Network (SAPRIN), Durban, South Africa
| | - Mark J Siedner
- Africa Health Research Institute, KwaZulu-Natal, South Africa
- School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, United States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
| | - Guy Harling
- Africa Health Research Institute, KwaZulu-Natal, South Africa
- Institute for Global Health, University College London, London, United Kingdom
- MRC/Wits Rural Public Health & Health Transitions Research Unit (Agincourt), University of the Witwatersrand, Johannesburg, South Africa
- School of Nursing & Public Health, College of Health Sciences, University of KwaZulu-Natal, KwaZulu-Natal, South Africa
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15
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Takagi MA, Hess S, Gawronski K, Haddad N, Noveloso B, Zyzanski S, Ragina N. COVID-19 Virus and Vaccination Attitudes among Healthcare Workers in Michigan: A Cross-Sectional Study. Vaccines (Basel) 2023; 11:1105. [PMID: 37376494 DOI: 10.3390/vaccines11061105] [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: 05/11/2023] [Revised: 06/11/2023] [Accepted: 06/13/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Defining the characteristics of healthcare worker (HCW) attitudes toward the coronavirus disease 2019 (COVID-19) vaccine can provide insights into vaccine hesitancy. This study's goal is to determine HCWs' attitudes regarding the COVID-19 vaccination and reasons for vaccine hesitancy. METHODS This cross-sectional study surveyed HCWs working in institutions in Saginaw, Sanilac, and Wayne counties in Michigan (N = 120) using tipping-scale questions. Analysis of variance and t-test were used to measure HCWs' attitudes toward the COVID-19 virus and vaccines. RESULTS Most HCWs received (95.9%) and recommended (98.3%) a COVID-19 vaccine. The top three factors that HCWs cited for recommending a COVID-19 vaccine were: (1) efficacy of the vaccine, (2) current exposure to patients with active COVID-19 infection and risk of virus spread, and (3) safety of vaccine and long-term follow-up. Female HCWs or HCWs aged 25-54 years were more concerned about contracting COVID-19. Physicians or HCWs aged 55-64 were less concerned regarding the effectiveness and side effects of the vaccine. CONCLUSIONS Gender, age, ethnicity, provider type, and medical specialty showed statistically significant differences among COVID-19 attitudes. Focusing educational efforts on HCW demographics who are more likely to have negative attitudes can potentially decrease vaccine hesitancy.
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Affiliation(s)
- Maya Asami Takagi
- College of Medicine, Central Michigan University, Mt. Pleasant, MI 48859, USA
| | - Samantha Hess
- College of Medicine, Central Michigan University, Mt. Pleasant, MI 48859, USA
| | - Karissa Gawronski
- College of Medicine, Central Michigan University, Mt. Pleasant, MI 48859, USA
| | - Nicholas Haddad
- College of Medicine, Central Michigan University, Mt. Pleasant, MI 48859, USA
| | - Bernard Noveloso
- College of Medicine, Central Michigan University, Mt. Pleasant, MI 48859, USA
| | - Stephen Zyzanski
- Department of Family Medicine and Community Health, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Neli Ragina
- College of Medicine, Central Michigan University, Mt. Pleasant, MI 48859, USA
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Makadzange AT, Gundidza P, Lau C, Dietrich J, Myburgh N, Elose N, James W, Stanberry L, Ndhlovu C. Investigating Attitudes, Motivations and Key Influencers for COVID-19 Vaccination Uptake among Late Adopters in Urban Zimbabwe. Vaccines (Basel) 2023; 11:411. [PMID: 36851288 PMCID: PMC9958877 DOI: 10.3390/vaccines11020411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 01/24/2023] [Accepted: 01/31/2023] [Indexed: 02/15/2023] Open
Abstract
The rapid development of vaccines in response to the COVID-19 pandemic has provided an effective tool for the management of COVID-19. However, in many African countries there has been a poor uptake of COVID-19 vaccines with only 32.5% first vaccine dose coverage compared to the WHO global target of 70%. As vaccine access improves, one of the important drivers of low uptake has been vaccine hesitancy, driven by levels of confidence, convenience, and complacency. Between 4 January-11 February 2022, we conducted a survey of vaccine late adopters to assess factors that influenced adults in Harare, Zimbabwe to present for their first COVID-19 vaccine dose almost 12 months after the vaccination program began. Of the 1016 adults enrolled, 50% were female and 12.4% had HIV co-infection. Binary logistic regression models were developed to understand factors associated with vaccine confidence. Women were more likely to have negative views about the COVID-19 vaccine compared to men (OR 1.51 (95%CI 1.16, 1.97, p = 0.002). Older adults (≥40 years) compared with youth (18-25 years) were more likely to have 'major concerns' about vaccines. When asked about their concerns, 602 (59.3%) considered immediate side effects as a major concern and 520 (52.1%) were concerned about long-term health effects. People living with HIV (PLWH) were more likely to perceive vaccines as safe (OR 1.71 (95%CI: 1.07, 2.74, p = 0.025) and effective (1.68 (95%CI: 1.07, 2.64, p = 0.026). Internet users were less likely to perceive vaccines as safe (OR 0.72 (95% CI: 0.55, 0.95, p = 0.021) compared to non-Internet users; and social media was a more likely source of information for youth and those with higher education. Family members were the primary key influencers for 560 (55.2%) participants. The most important reason for receiving the COVID-19 vaccine for 715 (70.4%) participants was the protection of individual health. Improving vaccine coverage will need targeted communication strategies that address negative perceptions of vaccines and associated safety and effectiveness concerns. Leveraging normative behavior as a social motivator for vaccination will be important, as close social networks are key influences of vaccination.
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Affiliation(s)
| | - Patricia Gundidza
- Charles River Medical Group, 155 King George Avenue, Avondale, Harare, Zimbabwe
| | | | - Janan Dietrich
- Perinatal HIV Research Unit (PHRU), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2000, South Africa
- African Social Sciences Unit of Research and Evaluation (ASSURE), Division of the Wits Health Consortium, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2000, South Africa
- Health Systems Research Unit, South African Medical Research Council, Bellville 7530, South Africa
| | - Nellie Myburgh
- Wits Vaccines & Infectious Diseases Analytics (VIDA) Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2000, South Africa
| | - Nyasha Elose
- Charles River Medical Group, 155 King George Avenue, Avondale, Harare, Zimbabwe
| | - Wilmot James
- Institute for Social and Economic Research and Policy, Columbia University, IAB 118th Street, New York, NY 10025, USA
| | - Lawrence Stanberry
- Vaccine Information Network, Columbia University, 533 W 218th St., New York, NY 10032, USA
- Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
| | - Chiratidzo Ndhlovu
- Charles River Medical Group, 155 King George Avenue, Avondale, Harare, Zimbabwe
- Internal Medicine Unit, Faculty of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
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George G, Nota PB, Strauss M, Lansdell E, Peters R, Brysiewicz P, Nadesan-Reddy N, Wassenaar D. Understanding COVID-19 Vaccine Hesitancy among Healthcare Workers in South Africa. Vaccines (Basel) 2023; 11:414. [PMID: 36851290 PMCID: PMC9966714 DOI: 10.3390/vaccines11020414] [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: 01/16/2023] [Revised: 01/31/2023] [Accepted: 02/08/2023] [Indexed: 02/15/2023] Open
Abstract
Healthcare workers (HCWs) were the first population group offered coronavirus disease 2019 (COVID-19) vaccines in South Africa because they were considered to be at higher risk of infection and required protecting as they were a critical resource to the health system. In some contexts, vaccine uptake among HCWs has been slow, with several studies citing persistent concerns about vaccine safety and effectiveness. This study aimed to determine vaccine uptake among HCWs in South Africa whilst identifying what drives vaccine hesitancy among HCWs. We adopted a multimethod approach, utilising both a survey and in-depth interviews amongst a sample of HCWs in South Africa. In a sample of 7763 HCWS, 89% were vaccinated, with hesitancy highest among younger HCWs, males, and those working in the private sector. Among those who were hesitant, consistent with the literature, HCWs raised concerns about the safety and effectiveness of the vaccine. Examining this further, our data revealed that safety and effectiveness concerns were formed due to first-hand witnessing of patients presenting with side-effects, concern over perceived lack of scientific rigor in developing the vaccine, confidence in the body's immune system to stave off serious illness, and both a general lack of information and distrust in the available sources of information. This study, through discursive narratives, provides evidence elucidating what drives safety and effectiveness concerns raised by HCWs. These concerns will need to be addressed if HCWs are to effectively communicate and influence public behaviour. HCWs are key role players in the national COVID-19 vaccination programme, making it critical for this workforce to be well trained, knowledgeable, and confident if they are going to improve the uptake of vaccines among the general population in South Africa, which currently remains suboptimal.
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Affiliation(s)
- Gavin George
- Health Economics and HIV and AIDS Research Division (HEARD), University of KwaZulu-Natal, Durban 4041, South Africa
- Division of Social Medicine and Global Health, Lund University, 223 63 Lund, Sweden
| | - Phiwe Babalo Nota
- Health Economics and HIV and AIDS Research Division (HEARD), University of KwaZulu-Natal, Durban 4041, South Africa
| | - Michael Strauss
- Health Economics and HIV and AIDS Research Division (HEARD), University of KwaZulu-Natal, Durban 4041, South Africa
| | - Emma Lansdell
- Health Economics and HIV and AIDS Research Division (HEARD), University of KwaZulu-Natal, Durban 4041, South Africa
| | - Remco Peters
- Research Unit, Foundation for Professional Development, East London 5241, South Africa
| | - Petra Brysiewicz
- School of Nursing & Public Health, University of KwaZulu-Natal, Durban 4041, South Africa
| | - Nisha Nadesan-Reddy
- School of Nursing & Public Health, University of KwaZulu-Natal, Durban 4041, South Africa
| | - Douglas Wassenaar
- South African Research Ethics Training Initiative, School of Applied Human Sciences, University of KwaZulu-Natal, Pietermaritzburg 3209, South Africa
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18
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Higher COVID-19 Vaccination Rates Are Associated with Lower COVID-19 Mortality: A Global Analysis. Vaccines (Basel) 2022; 11:vaccines11010074. [PMID: 36679919 PMCID: PMC9862920 DOI: 10.3390/vaccines11010074] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 12/24/2022] [Accepted: 12/26/2022] [Indexed: 12/31/2022] Open
Abstract
Mass vaccination initiatives are underway worldwide, and a considerable percentage of the world's population is now vaccinated. This study examined the association of COVID-19 deaths per 1000 cases with a fully vaccinated population. The global median deaths per 1000 cases were 15.68 (IQR 9.84, 25.87) after 6 months of vaccinations and 11.96 (IQR 6.08, 20.63) after 12 months. Across 164 countries, we found significant variations in vaccination levels of populations, booster doses, and mortality, with higher vaccine coverage and lower mortality in high-income countries. Several regression models were performed to test the association between vaccination and COVID-19 mortality. Control variables were used to account for confounding variables. A 10-percentage-point increase in vaccination was associated with an 18.1% decrease in mortality after 6 months (95%CI, 7.4-28.8%) and a 16.8% decrease after 12 months (95%CI, 6.9-26.7%). A 10-percentage-point increase in booster vaccination rates was associated with a 33.1% decrease in COVID-19 mortality (95%CI, 16.0-50.2%). This relationship is present in most analyses by country income groups with variations in the effect size. Efforts are needed to reduce vaccine hesitancy while ensuring suitable infrastructure and supply to enable all countries to increase their vaccination rates.
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19
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Della Polla G, Miraglia del Giudice G, Folcarelli L, Napoli A, Angelillo IF. Willingness to accept a second COVID-19 vaccination booster dose among healthcare workers in Italy. Front Public Health 2022; 10:1051035. [PMID: 36568799 PMCID: PMC9780496 DOI: 10.3389/fpubh.2022.1051035] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 11/10/2022] [Indexed: 12/14/2022] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is evolving,the newly emerged Omicron variant being the dominant strain worldwide, and this has raised concerns about vaccine efficacy. The purposes of this survey were to examine the extent to which healthcare workers (HCWs) intend to receive a second booster dose of the COVID-19 vaccine and the factors that influence their willingness to accept it. Methods The study was conducted among HCWs who were randomly selected from four public hospitals in the Campania region, Southern Italy. Results A total of 496 HCWs answered the questionnaire (a response rate of 61.2%). Among the respondents, 20.8% indicated a score of 10, using a 10-point Likert-type scale, regarding the usefulness of a second COVID-19 vaccine booster dose. Physicians, HCWs who believed that COVID-19 was a severe disease, and those who have acquired information about the second booster dose from scientific journals were more likely to have this positive attitude. Slightly more than half of HCWs self-reported willingness to receive a second booster dose. Respondents who believe that HCWs are at higher risk of being infected by SARS-CoV-2, those who have a higher belief that COVID-19 is a severe disease, and those who have a higher belief that a second booster dose is useful were more willing to receive a second booster dose. The main reasons for those who had a positive intention were to protect their family members and patients, whereas, the main reasons for not getting vaccinated or for uncertainty were that the dose does not offer protection against the emerging variants and the fear of its side effects. HCWs of younger age, physicians, those who have a higher belief that a second booster dose is useful, and those who were willing to receive a second booster dose were more likely to recommend the booster dose to their patients. Conclusion This study's findings highlight the necessity for designing and implementing educational interventions for improving second booster dose uptake and beliefs among HCWs and their capacity to recommend the vaccine to the patients.
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Affiliation(s)
- Giorgia Della Polla
- Department of Public Health and Laboratory Services, Teaching Hospital, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | | | - Lucio Folcarelli
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Annalisa Napoli
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Italo Francesco Angelillo
- Department of Public Health and Laboratory Services, Teaching Hospital, University of Campania “Luigi Vanvitelli”, Naples, Italy,Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy,*Correspondence: Italo Francesco Angelillo
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20
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TWO YEARS ON AND FOUR WAVES LATER- JOHANNESBURG DIAGNOSTIC RADIOGRAPHERS’ EXPERIENCES OF COVID-19. J Med Imaging Radiat Sci 2022; 54:S77-S84. [PMCID: PMC9721282 DOI: 10.1016/j.jmir.2022.11.012] [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: 08/25/2022] [Revised: 11/17/2022] [Accepted: 11/25/2022] [Indexed: 12/12/2022]
Abstract
Introduction At the onset of COVID-19 diagnostic radiographers from Gauteng, South Africa, shared their experiences of the new workflow and operations, their well-being and their resilience during this time. They experienced emotional, physical and financial fatigue. It is now over two years later, and South Africa has experienced four waves of COVID-19. Therefore, this study explored diagnostic radiographers' experience of COVID-19 after two years and four waves. Methods A qualitative explorative, descriptive and contextual study was conducted collecting data through nine virtual individual in-depth interviews. Responses from the diagnostic radiographers in Johannesburg, Gauteng South Africa, underwent thematic analysis. Results Thematic analysis revealed two themes and related categories. Theme one: participants shared synchronistic experiences with the four COVID-19 waves, the heterogeneous vaccination ideologies and their support and coping skills. Theme two: lessons learnt and the way forward. Conclusion Participants shared feeling overwhelmed at the onset of COVID-19 and feared infecting their family, friends and colleagues. However, their anxiety and fear decreased with time. They experienced the Delta variant as the worst and felt supported by their colleagues more than by management. They recounted observations of vaccine hesitancy but acknowledged that vaccination had alleviated some of the fear and anxiety. Participants' coping skills varied, and reflecting on their experience, they shared the lessons learnt and the way forward.
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21
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Bussink-Voorend D, Hautvast JLA, Vandeberg L, Visser O, Hulscher MEJL. A systematic literature review to clarify the concept of vaccine hesitancy. Nat Hum Behav 2022; 6:1634-1648. [PMID: 35995837 DOI: 10.1038/s41562-022-01431-6] [Citation(s) in RCA: 64] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 07/13/2022] [Indexed: 11/25/2022]
Abstract
Vaccine hesitancy (VH) is considered a top-10 global health threat. The concept of VH has been described and applied inconsistently. This systematic review aims to clarify VH by analysing how it is operationalized. We searched PubMed, Embase and PsycINFO databases on 14 January 2022. We selected 422 studies containing operationalizations of VH for inclusion. One limitation is that studies of lower quality were not excluded. Our qualitative analysis reveals that VH is conceptualized as involving (1) cognitions or affect, (2) behaviour and (3) decision making. A wide variety of methods have been used to measure VH. Our findings indicate the varied and confusing use of the term VH, leading to an impracticable concept. We propose that VH should be defined as a state of indecisiveness regarding a vaccination decision.
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Affiliation(s)
- Daphne Bussink-Voorend
- Radboud University Medical Center, Radboud Institute for Health Sciences, Primary and Community Care, Nijmegen, the Netherlands.
| | - Jeannine L A Hautvast
- Radboud University Medical Center, Radboud Institute for Health Sciences, Primary and Community Care, Nijmegen, the Netherlands
| | - Lisa Vandeberg
- Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
| | - Olga Visser
- Radboud University Medical Center, Radboud Institute for Health Sciences, Primary and Community Care, Nijmegen, the Netherlands
| | - Marlies E J L Hulscher
- Radboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen, the Netherlands
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22
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Cooper S, van Rooyen H, Wiysonge CS. Addressing COVID-19 vaccine hesitancy in South Africa- moving beyond a reliance on information-based responses. Hum Vaccin Immunother 2022; 18:2107851. [PMID: 35993844 DOI: 10.1080/21645515.2022.2107851] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
It has been over a year since South Africa officially began its national COVID-19 vaccination programme. Yet, currently only half of the adult population is fully vaccinated. While supply-related challenges continue to contribute to suboptimal vaccination coverage, so too does vaccine hesitancy. Drawing on research conducted over the last year, we highlight some overarching insights around the nature and drivers of COVID-19 vaccine hesitancy in South Africa and how this complex phenomenon might be addressed. We have found multiple socio-economic and political root causes of COVID-19 vaccine hesitancy, many of which are not knowledge-related. These include inter alia fear and uncertainty, practical challenges around access, experiences of poverty and marginalization, and the ongoing geopolitics surrounding the pandemic. Intervention strategies therefore need to form part of broader development and trust-building measures that focus on relationships, transparency, inclusion, equity and justice. This is essential if we hope to bolster acceptance of and demand for vaccines during and beyond the COVID-19 pandemic.
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Affiliation(s)
- Sara Cooper
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa.,School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.,Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Heidi van Rooyen
- Impact Centre, Human Sciences Research Council, Pretoria, South Africa.,SAMRC-Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg-Braamfontein, South Africa
| | - Charles S Wiysonge
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa.,School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.,Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.,HIV and other Infectious Diseases Research Unit, South African Medical Research Council, Durban, South Africa
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23
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Abstract
OBJECTIVE To identify, describe and map the research tools used to measure COVID-19 vaccine hesitancy, refusal, acceptance and access in sub-Saharan Africa (SSA). DESIGN Scoping review. METHODS In March 2022, we searched PubMed, Scopus, Web of Science, Cochrane, Academic Search Premier, MEDLINE, Cumulative Index to Nursing and Allied Health Literature, Health Source Nursing, Africa Wide and APA PsychInfo for peer-reviewed literature in English related to COVID-19 vaccine hesitancy, refusal, acceptance and access in SSA. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews to guide evidence gathering and as a template to present the evidence retrieval process. RESULTS In the studies selected for review (n=72), several measurement tools were used to measure COVID-19 vaccine hesitancy, acceptance and refusal. These measurements were willingness and intent to vaccinate from the perspectives of the general population, special population groups such as mothers, students and staff in academic institutions and healthcare workers and uptake as a proxy for measuring assumed COVID-19 vaccine acceptance. Measurements of access to COVID-19 vaccination were cost and affordability, convenience, distance and time to travel or time waiting for a vaccine and (dis)comfort. Although all studies measured COVID-19 vaccine hesitancy, acceptance and refusal, relatively few studies (n=16, 22.2%) included explicit measurements of access to COVID-19 vaccination. CONCLUSIONS Based on the gaps identified in the scoping review, we propose that future research on determinants of COVID-19 vaccination in SSA should further prioritise the inclusion of access-related variables. We recommend the development and use of standardised research tools that can operationalise, measure and disentangle the complex determinants of vaccine uptake in future studies throughout SSA and other low- and middle-income country (LMIC) settings.
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Affiliation(s)
- Michael J Deml
- Institute of Sociological Research, Department of Sociology, University of Geneva, Geneva, Switzerland
- Division of Social and Behavioural Sciences, Faculty of Health Sciences, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Jennifer Nyawira Githaiga
- Division of Social and Behavioural Sciences, Faculty of Health Sciences, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
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24
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Njoga EO, Awoyomi OJ, Onwumere-Idolor OS, Awoyomi PO, Ugochukwu ICI, Ozioko SN. Persisting Vaccine Hesitancy in Africa: The Whys, Global Public Health Consequences and Ways-Out-COVID-19 Vaccination Acceptance Rates as Case-in-Point. Vaccines (Basel) 2022; 10:1934. [PMID: 36423029 PMCID: PMC9697713 DOI: 10.3390/vaccines10111934] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/02/2022] [Accepted: 11/11/2022] [Indexed: 08/29/2023] Open
Abstract
Vaccine hesitancy (VH) is the seventh among the WHO's top 10 threats to global public health, which has continued to perpetuate the transmission of vaccine preventable diseases (VPDs) in Africa. Consequently, this paper systematically reviewed COVID-19 vaccine acceptance rates (VARs)-including the vaccine uptake and vaccination intention-in Africa from 2020 to 2022, compared the rates within the five African regions and determined the context-specific causes of VH in Africa. Generally, COVID-19 VARs ranged from 21.0% to 97.9% and 8.2% to 92.0% with mean rates of 59.8 ± 3.8% and 58.0 ± 2.4% in 2021 and 2022, respectively. Southern and eastern African regions had the top two VARs of 83.5 ± 6.3% and 68.9 ± 6.6% in 2021, and 64.2 ± 4.6% and 61.2 ± 5.1% in 2022, respectively. Based on population types, healthcare workers had a marginal increase in their mean COVID-19 VARs from 55.5 ± 5.6% in 2021 to 60.8 ± 5.3% in 2022. In other populations, the mean VARs decreased from 62.7 ± 5.2% in 2021 to 54.5 ± 4% in 2022. As of 25 October 2022, Africa lags behind the world with only 24% full COVID-19 vaccinations compared to 84%, 79% and 63% reported, respectively, in the Australian continent, upper-middle-income countries and globally. Apart from the problems of confidence, complacency, convenience, communications and context, the context-specific factors driving COVID-19 VH in Africa are global COVID-19 vaccine inequality, lack of vaccine production/maintenance facilities, insecurity, high illiteracy level, endemic corruption, mistrust in some political leaders, the spreading of unconfirmed anti-vaccination rumors and political instability. With an overall mean COVID-19 acceptance rate of 58%, VH still subsists in Africa. The low VARs in Africa have detrimental global public health implications, as it could facilitate the emergence of immune invading SARS-CoV-2 variants of concern, which may spread globally. Consequently, there is a need to confront these challenges frontally and engage traditional and religious leaders in the fight against VH in Africa, to restore public trust in the safety and efficacy of vaccines generally. As the availability of COVID-19 vaccines improves, the vaccination of pets and zoo-animals from which reverse zoonotic transmission of SARS-CoV-2 have been reported is recommended, to limit the evolution and spread of new variants of concern and avert possible SARS-CoV-2 epizootic or panzootic diseases in susceptible animal species.
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Affiliation(s)
- Emmanuel O. Njoga
- Department of Veterinary Public Health and Preventive Medicine, Faculty of Veterinary Medicine, University of Nigeria, Nsukka 410001, Nigeria
| | - Olajoju J. Awoyomi
- Department of Veterinary Public Health and Preventive Medicine, College of Veterinary Medicine, Federal University of Agriculture, Abeokuta PMB 2240, Nigeria
| | - Onyinye S. Onwumere-Idolor
- Department of Animal Production, Faculty of Agriculture, Delta State University of Science and Technology, Ozoro PMB 005, Nigeria
| | - Priscilla O. Awoyomi
- Department of Medicine and Surgery, College of Medicine, University of Ibadan, Ibadan 200005, Nigeria
| | - Iniobong C. I. Ugochukwu
- Department of Veterinary Pathology and Microbiology, Faculty of Veterinary Medicine, University of Nigeria, Nsukka 410001, Nigeria
- Department of Veterinary Medicine, Faculty of Veterinary Medicine, Universita degli Studi di Bari, 70010 Valenzano, Italy
| | - Stella N. Ozioko
- Institute of Aquaculture, Faculty of Natural Sciences, University of Stirling, Stirling FK9 4LA, UK
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25
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Factors contributing to coronavirus disease 2019 vaccine hesitancy among healthcare workers in Iran: A descriptive-analytical study. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2022; 18:101182. [PMCID: PMC9678224 DOI: 10.1016/j.cegh.2022.101182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 11/07/2022] [Accepted: 11/12/2022] [Indexed: 11/23/2022] Open
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26
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Nchasi G, Okonji OC, Jena R, Ahmad S, Soomro U, Kolawole BO, Nawaz FA, Essar MY, Aborode AT. Challenges faced by African healthcare workers during the third wave of the pandemic. Health Sci Rep 2022; 5:e893. [PMID: 36262807 PMCID: PMC9576111 DOI: 10.1002/hsr2.893] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 09/21/2022] [Accepted: 09/23/2022] [Indexed: 12/03/2022] Open
Abstract
Africa experienced the third wave of the coronavirus disease in 2019, which caused an 18% rise in cases in most parts of the continent. As of January 2022, the region had an estimated 10.4 million cumulative cases and more than 233,000 deaths, which add up to the burden on the fragile healthcare system, which continues to face a shortage of staff and resources. In addition, the progression of the pandemic further threatens the supply of healthcare workers in Africa due to the increased risk of infection and death, where more than 10,000 healthcare workers in 40 countries have been infected with the virus. This is amid low vaccination coverage, with only 27% of healthcare workers in Africa being fully vaccinated against the disease. Despite the delayed start and slow progression of the pandemic in Africa, there are increasing concerns over the challenges on the African healthcare workers such as economic insecurity and stressful working conditions, which are associated with limited access to personal protective equipment and other vital resources such as ventilators. In addition, the pandemic further predisposes African healthcare workers to social stigma, burnout, insomnia, depression, and fear of safety in their families. The aim of this study is to highlight the challenges faced by African healthcare workers, provide recommendations for change, and emphasize the need to prioritize their physical and mental well-being.
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Affiliation(s)
- Goodluck Nchasi
- Department of MedicineCatholic University of Health and Allied ScienceMwanzaTanzania
| | | | - Rahul Jena
- Bharati Vidyapeeth Deemed University Medical CollegePuneMaharashtraIndia
| | | | - Umar Soomro
- Department of MedicineJinnah Medical and Dental CollegeKarachiPakistan
| | | | - Faisal A. Nawaz
- College of MedicineMohammed Bin Rashid University of Medicine and Health SciencesDubaiUnited Arab Emirates
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27
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Whitworth HS, Kitonsa J, Kasonia K, Tindanbil D, Kafeero P, Bangura J, Nije Y, Tetsa Teta D, Greenwood B, Kavunga-Membo H, Leigh B, Ruzagira E, Gallagher KE, Watson-Jones D. COVID-19 Vaccine Acceptability Among Healthcare Facility Workers in Sierra Leone, the Democratic Republic of Congo and Uganda: A Multi-Centre Cross-Sectional Survey. Int J Public Health 2022; 67:1605113. [PMID: 36213138 PMCID: PMC9537362 DOI: 10.3389/ijph.2022.1605113] [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: 06/10/2022] [Accepted: 09/08/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives: This cross-sectional survey explored COVID-19 vaccine acceptability among public healthcare facility workers in Kambia (Sierra Leone), Goma (Democratic Republic of Congo) and Masaka (Uganda). Methods: Questionnaire-based interviews conducted between April-October 2021 explored participants' knowledge and perceptions of, and attitudes towards, the COVID-19 pandemic and COVID-19 vaccines, as well as COVID-19 vaccine acceptability (defined as uptake of ≥1 dose or intent to get vaccinated). Results: Whilst most (n = 444; 81.8%) of the 543 participants had one or more concerns about COVID-19 vaccines, 487 (89.7%) nonetheless perceived that they were important for pandemic control. Most participants from Kambia or Masaka either were vaccinated (n = 137/355; 38.6%) or intended to get vaccinated (n = 211/355; 59.4%) against COVID-19. In Goma, all 188 participants were unvaccinated; only 81 (43.1%) participants intended to get vaccinated, and this was associated with positive perceptions about COVID-19 vaccines. In Goma, the most common reasons for not wanting a COVID-19 vaccine were concerns that the vaccines were new (n = 75/107; 70.1%) and fear of side effects (n = 74/107; 69.2%). Conclusion: Reported COVID-19 vaccine acceptability was high among healthcare facility workers in Kambia and Masaka. The lower vaccine acceptability in Goma may highlight the importance of social mobilisation and accurate, accessible information that addresses specific concerns.
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Affiliation(s)
- Hilary S. Whitworth
- London School of Hygiene and Tropical Medicine, University of London, London, United Kingdom
| | - Jonathan Kitonsa
- Medical Research Council (MRC)/Uganda Virus Research Institute (UVRI) and London School of Hygiene and Tropical Medicine (LSHTM) Uganda Research Unit, Entebbe, Uganda
| | - Kambale Kasonia
- London School of Hygiene and Tropical Medicine, University of London, London, United Kingdom
- Institut National de Recherche Biomédicale (République démocratique du Congo), Kinshasa, Democratic Republic of Congo
| | - Daniel Tindanbil
- London School of Hygiene and Tropical Medicine, University of London, London, United Kingdom
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Paddy Kafeero
- Medical Research Council (MRC)/Uganda Virus Research Institute (UVRI) and London School of Hygiene and Tropical Medicine (LSHTM) Uganda Research Unit, Entebbe, Uganda
| | - Joseph Bangura
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
- Ministry of Health and Sanitation (Sierra Leone), Freetown, Sierra Leone
| | - Yusupha Nije
- London School of Hygiene and Tropical Medicine, University of London, London, United Kingdom
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Darius Tetsa Teta
- London School of Hygiene and Tropical Medicine, University of London, London, United Kingdom
- Institut National de Recherche Biomédicale (République démocratique du Congo), Kinshasa, Democratic Republic of Congo
| | - Brian Greenwood
- London School of Hygiene and Tropical Medicine, University of London, London, United Kingdom
| | - Hugo Kavunga-Membo
- Institut National de Recherche Biomédicale (République démocratique du Congo), Kinshasa, Democratic Republic of Congo
| | - Bailah Leigh
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Eugene Ruzagira
- London School of Hygiene and Tropical Medicine, University of London, London, United Kingdom
- Medical Research Council (MRC)/Uganda Virus Research Institute (UVRI) and London School of Hygiene and Tropical Medicine (LSHTM) Uganda Research Unit, Entebbe, Uganda
| | - Katherine E. Gallagher
- London School of Hygiene and Tropical Medicine, University of London, London, United Kingdom
- KEMRI Wellcome Trust Research Programme, Kilifi, Kenya
| | - Deborah Watson-Jones
- London School of Hygiene and Tropical Medicine, University of London, London, United Kingdom
- Mwanza Intervention Trials Unit, Mwanza, Tanzania
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28
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Wang L, Wang Y, Cheng X, Li X, Yang Y, Li J. Acceptance of coronavirus disease 2019 (COVID-19) vaccines among healthcare workers: A meta-analysis. Front Public Health 2022; 10:881903. [PMID: 36187624 PMCID: PMC9525162 DOI: 10.3389/fpubh.2022.881903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 08/24/2022] [Indexed: 01/21/2023] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic has posed increasing challenges to global health systems. Vaccination against COVID-19 can effectively prevent the public, particularly healthcare workers (HCWs), from being infected by this disease. Objectives We aim to understand the factors influencing HCWs' acceptance of COVID-19 vaccines. Methods We searched PubMed, Embase and Web of Science to collect literature published before May 15, 2022, about HCWs' acceptance of COVID-19 vaccines. The Newcastle-Ottawa quality assessment scale was used to assess the risk of bias and the quality of the included studies. We utilized Stata 14.0 software for this meta-analysis with a random-effects model, and odds ratios (ORs) with 95% confidence intervals (CIs) were reported. This meta-analysis was conducted in alignment with the preferred reporting items for systematic review and meta-analysis (PRISMA) guideline. Results Our meta-analysis included 71 articles with 93,508 HCWs involved. The research showed that the acceptance of vaccines had significantly increased among HCWs compared to non-HCWs (OR = 1.91, 95% CI: 1.16-3.12). A willingness to undergo COVID-19 vaccination was observed in 66% (95% CI: 0.61-0.67) of HCWs. Among the HCWs involved, doctors showed a generally increased intention to be vaccinated compared with nurses (OR = 2.22, 95% CI: 1.71-2.89). Additionally, males were found to hold more positive attitudes toward vaccination than females (OR = 1.81, 95% CI: 1.55-2.12). When the effectiveness of COVID-19 vaccines was improved, the vaccination acceptance of HCWs was greatly increased accordingly (OR = 5.03, 95% CI: 2.77-9.11). The HCWs who were willing to vaccinate against seasonal influenza showed an increased acceptance of COVID-19 vaccines (OR = 3.52, 95% CI: 2.34-5.28). Our study also showed that HCWs who were willing to be vaccinated against COVID-19 experienced a reduced rate of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (OR = 0.78, 95% CI: 0.66-0.92). Conclusions Our analysis revealed that the five factors of occupation, gender, vaccine effectiveness, seasonal influenza vaccines, and SARS-CoV-2 infection presumably affected the acceptance of COVID-19 vaccines among HCWs. It is essential to boost the confidence of HCWs in COVID-19 vaccines for the containment of the epidemic.
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Affiliation(s)
- Linlin Wang
- Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Ye Wang
- Department of Pediatrics, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Xianbin Cheng
- Department of Gastrointestinal Colorectal and Anal Surgery, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Xingzhao Li
- Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Yanyan Yang
- Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Jun Li
- Department of Hematology and Oncology, China-Japan Union Hospital of Jilin University, Changchun, China
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29
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Zhang E, Dai Z, Wang C, Hu J, Wang S, Zhang L, Fang Q. Targeting COVID-19 vaccine hesitancy among nurses in Shanghai: A latent profile analysis. Front Public Health 2022; 10:953850. [PMID: 36187664 PMCID: PMC9515966 DOI: 10.3389/fpubh.2022.953850] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 08/23/2022] [Indexed: 01/24/2023] Open
Abstract
Objectives This study aims to clarify the profiles of the psychological antecedents of vaccine hesitancy among Shanghai nurses with a person-centered approach. Methods A population-based cross-sectional online survey was conducted on Shanghai nurses from July to August 2021 (N = 1,928). In the online survey, participants were asked to report their sociodemographic, the 5C vaccine hesitancy components, their knowledge level of COVID-19 vaccine and vaccination, and the COVID-19 vaccination uptake intention and attention to vaccine news. Latent profile analysis was used to reveal distinct profiles of vaccine hesitancy. Results The results revealed four profiles, including "believers" (68.9%; high confidence and collective responsibility), "free riders" (12.7%; similar characteristics to believers, except for a low collective responsibility), "middlemen" (14.6%; middle in all 5C constructs), and "contradictors" (3.7%; high in all 5C constructs). Compared to believers, middlemen were younger, more likely to be female, childless, less educated, held lower professional titles, had fewer years of nursing service, sometimes or never complied with recommended vaccinations, had satisfactory or poor self-assessed health status, had no work experience during the COVID-19 epidemic, and possessed greater levels of knowledge. Free riders were more likely to work in community health centers and have a lower degree than believers. Contradictors were more likely to work in community health centers, had junior college degrees or lower, and had no work experience during the COVID-19 epidemic than believers. From the highest to the lowest on vaccination intention and attention to vaccine news were believers, then free riders, contradictors, and finally middlemen. Conclusion This study could aid in the development of personalized vaccination strategies based on nurses' vaccine hesitancy profiles and predictors. In addition to vaccine believers, we identified other three profiles based on their 5C psychological antecedents, emphasizing the significance of establishing tailored vaccination campaigns. Further research into the prevalence of profile structure in other groups of healthcare workers is required.
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Affiliation(s)
- Enming Zhang
- School of Nursing, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhengyue Dai
- School of Nursing, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Caifeng Wang
- School of Nursing, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiale Hu
- College of Health Professions, Virginia Commonwealth University, Richmond, VA, United States
| | - Suxing Wang
- School of Nursing, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lin Zhang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qiong Fang
- School of Nursing, Shanghai Jiao Tong University School of Medicine, Shanghai, China,*Correspondence: Qiong Fang
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30
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Ogbuokiri B, Ahmadi A, Bragazzi NL, Movahedi Nia Z, Mellado B, Wu J, Orbinski J, Asgary A, Kong J. Public sentiments toward COVID-19 vaccines in South African cities: An analysis of Twitter posts. Front Public Health 2022; 10:987376. [PMID: 36033735 PMCID: PMC9412204 DOI: 10.3389/fpubh.2022.987376] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 07/20/2022] [Indexed: 01/26/2023] Open
Abstract
Amidst the COVID-19 vaccination, Twitter is one of the most popular platforms for discussions about the COVID-19 vaccination. These types of discussions most times lead to a compromise of public confidence toward the vaccine. The text-based data generated by these discussions are used by researchers to extract topics and perform sentiment analysis at the provincial, country, or continent level without considering the local communities. The aim of this study is to use clustered geo-tagged Twitter posts to inform city-level variations in sentiments toward COVID-19 vaccine-related topics in the three largest South African cities (Cape Town, Durban, and Johannesburg). VADER, an NLP pre-trained model was used to label the Twitter posts according to their sentiments with their associated intensity scores. The outputs were validated using NB (0.68), LR (0.75), SVMs (0.70), DT (0.62), and KNN (0.56) machine learning classification algorithms. The number of new COVID-19 cases significantly positively correlated with the number of Tweets in South Africa (Corr = 0.462, P < 0.001). Out of the 10 topics identified from the tweets using the LDA model, two were about the COVID-19 vaccines: uptake and supply, respectively. The intensity of the sentiment score for the two topics was associated with the total number of vaccines administered in South Africa (P < 0.001). Discussions regarding the two topics showed higher intensity scores for the neutral sentiment class (P = 0.015) than for other sentiment classes. Additionally, the intensity of the discussions on the two topics was associated with the total number of vaccines administered, new cases, deaths, and recoveries across the three cities (P < 0.001). The sentiment score for the most discussed topic, vaccine uptake, differed across the three cities, with (P = 0.003), (P = 0.002), and (P < 0.001) for positive, negative, and neutral sentiments classes, respectively. The outcome of this research showed that clustered geo-tagged Twitter posts can be used to better analyse the dynamics in sentiments toward community-based infectious diseases-related discussions, such as COVID-19, Malaria, or Monkeypox. This can provide additional city-level information to health policy in planning and decision-making regarding vaccine hesitancy for future outbreaks.
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Affiliation(s)
- Blessing Ogbuokiri
- Africa-Canada Artificial Intelligence and Data Innovation Consortium (ACADIC), York University, Toronto, ON, Canada
- Laboratory for Industrial and Applied Mathematics, York University, Toronto, ON, Canada
| | - Ali Ahmadi
- Faculty of Computer Engineering, K.N. Toosi University, Tehran, Iran
| | - Nicola Luigi Bragazzi
- Africa-Canada Artificial Intelligence and Data Innovation Consortium (ACADIC), York University, Toronto, ON, Canada
- Laboratory for Industrial and Applied Mathematics, York University, Toronto, ON, Canada
| | - Zahra Movahedi Nia
- Africa-Canada Artificial Intelligence and Data Innovation Consortium (ACADIC), York University, Toronto, ON, Canada
- Laboratory for Industrial and Applied Mathematics, York University, Toronto, ON, Canada
| | - Bruce Mellado
- Africa-Canada Artificial Intelligence and Data Innovation Consortium (ACADIC), York University, Toronto, ON, Canada
- School of Physics, Institute for Collider Particle Physics, University of the Witwatersrand, Johannesburg, South Africa
| | - Jianhong Wu
- Africa-Canada Artificial Intelligence and Data Innovation Consortium (ACADIC), York University, Toronto, ON, Canada
- Laboratory for Industrial and Applied Mathematics, York University, Toronto, ON, Canada
| | - James Orbinski
- Africa-Canada Artificial Intelligence and Data Innovation Consortium (ACADIC), York University, Toronto, ON, Canada
- Dahdaleh Institute for Global Health Research, York University, Toronto, ON, Canada
| | - Ali Asgary
- Africa-Canada Artificial Intelligence and Data Innovation Consortium (ACADIC), York University, Toronto, ON, Canada
- Advanced Disaster, Emergency and Rapid-Response Simulation (ADERSIM), York University, Toronto, ON, Canada
| | - Jude Kong
- Africa-Canada Artificial Intelligence and Data Innovation Consortium (ACADIC), York University, Toronto, ON, Canada
- Laboratory for Industrial and Applied Mathematics, York University, Toronto, ON, Canada
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31
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Amer SA, Shah J, Abd-Ellatif EE, El Maghawry HA. COVID-19 vaccine uptake among physicians during the second wave of COVID-19 pandemic: Attitude, intentions, and determinants: A cross-sectional study. Front Public Health 2022; 10:823217. [PMID: 35991027 PMCID: PMC9381988 DOI: 10.3389/fpubh.2022.823217] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 07/07/2022] [Indexed: 11/13/2022] Open
Abstract
Background Developed within a short period of time, the COVID-19 vaccine is not yet widely accepted among the public despite its availability, including by physicians, who are considered a vulnerable group. Methodology A descriptive cross-sectional study selected 436 governmental physicians from different specializations, representing four random administrative regions in Egypt. The data were collected through a self-administrated online questionnaire and analyzed using suitable tests. Results Out of the studied 436 physicians, 229 (52.2%) [aged 20-30, 284 (65.1%)] were women, 270 (61.9%) were residents, 219 (50.2%) were married, 398 (91.3%) were non-smokers, and 263 (60.3%) were non-frontline caregivers. The majority of the physicians, 227 (52.1%) of them, hesitated to take the vaccine, 236 (54.1%) had not decided on the preferred type of vaccine, and 101 (23.2%) were neutrally confident in the Egyptian healthcare system; 302 (96.3%) had no history of drug or food hypersensitivity. There was no statistically significant (p < 0.05) relationship between the physicians' attitude toward COVID-19 vaccine uptake and the studied demographic variables. There was a statistically significant connection between all of the doctors' intentions to get the COVID-19 vaccine and all of the four attitude domains that were looked at. Conclusion The study concluded that a low level of willingness among Egyptian physicians to take the COVID-19 vaccine is a prevalent problem. COVID-19 vaccination hesitancy and non-acceptance were linked to negative attitudes about natural immunity, mistrust of vaccine benefits, and concerns about commercial profiteering.
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Affiliation(s)
- Samar A. Amer
- Department of Public Health and Community Medicine, Faculty of Medicine Zagazig University, Zagazig, Egypt
- Member of the Royal College of General Practitioners, London, United Kingdom
- Mental Health in Primary Care, Nova University, Lisbona, Portugal
| | - Jaffer Shah
- New York State Department of Health, New York, NY, United States
| | - Eman Elsayed Abd-Ellatif
- Department of Public Health and Community Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Hala A. El Maghawry
- Department of Public Health and Community Medicine, Faculty of Medicine Zagazig University, Zagazig, Egypt
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Alobwede SM, Kidzeru EB, Katoto PDMC, Lumngwena EN, Cooper S, Goliath R, Jackson A, Wiysonge CS, Shey MS. Influenza Vaccination Uptake and Hesitancy among Healthcare Workers in Early 2021 at the Start of the COVID-19 Vaccine Rollout in Cape Town, South Africa. Vaccines (Basel) 2022; 10:1176. [PMID: 35893825 PMCID: PMC9332543 DOI: 10.3390/vaccines10081176] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 07/09/2022] [Accepted: 07/10/2022] [Indexed: 01/27/2023] Open
Abstract
Vaccination attitudes among healthcare workers (HCWs) predict their level of vaccination uptake and intention to recommend vaccinations to their patients. To our knowledge, no study has been conducted in South Africa to assess hesitancy toward influenza vaccines among HCWs. We adapted a questionnaire developed and validated by Betsch and colleagues and used it to conduct online and face-to-face interviews among HCWs at the start of the COVID-19 vaccine rollout. Multivariate logistic regression was used to assess predictors of influenza vaccine hesitancy. Of 401 participants, 64.5% were women, 49.2% were nurses, and 12.5% were physicians. A total of 54.9% were willing to accept, 20.4% were undecided, and 24.7% intended to refuse influenza vaccination. Participants who were above 25 years of age and physicians were more likely to accept the vaccine. Key predictors of vaccine acceptance were confidence in the effectiveness, consideration of benefits and risks, and willingness to be vaccinated to protect others. Influenza vaccine hesitancy was highest in those who did not trust that influenza vaccines are safe. For future flu seasons, tailored education programs on the safety and effectiveness of flu vaccines targeting younger HCWs, could be vital to improving vaccine uptake.
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Affiliation(s)
- Samuel M. Alobwede
- Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa;
- Clinical Division, Department of Research and Innovation, Partners in Sexual Health, Cape Town 7500, South Africa
| | - Elvis B. Kidzeru
- Centre for Research on Health and Priority Pathologies (CRHPP), Institute of Medical Research and Medicinal Plant Studies (IMPM), Ministry of Scientific Research and Innovation, Yaounde P.O. Box 13033, Cameroon;
- Hair and Skin Research Laboratory, Division of Dermatology, Department of Medicine and Groote Schuur Hospital, University of Cape Town, Cape Town 7925, South Africa
- Division of Radiation Oncology, Department of Radiation Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town 7925, South Africa
| | - Patrick D. M. C. Katoto
- Cochrane South Africa, South African Medical Research Council, Cape Town 7500, South Africa; (P.D.M.C.K.); (S.C.); (C.S.W.)
- Centre for General Medicine and Global Health, Department of Medicine, University of Cape Town, Cape Town 7925, South Africa
| | - Evelyn N. Lumngwena
- School of Clinical Medicine, Faculty of Health Sciences, University of Witwatersrand, Johannesburg 2193, South Africa;
- Centre for the Study of Emerging and Re-Emerging Infections (CREMER), Institute of Medical Research and Medicinal Plant Studies (IMPM), Ministry of Scientific Research and Innovation, Yaounde P.O. Box 13033, Cameroon
| | - Sara Cooper
- Cochrane South Africa, South African Medical Research Council, Cape Town 7500, South Africa; (P.D.M.C.K.); (S.C.); (C.S.W.)
- School of Public Health and Family Medicine, University of Cape Town, Cape Town 7925, South Africa
- Department of Global Health, Stellenbosch University, Francie Van Zijl Drive, Tygerberg, Cape Town 7505, South Africa
| | - Rene Goliath
- Wellcome Centre for Infectious Disease Research in Africa (CIDRI-Africa), Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa; (R.G.); (A.J.)
| | - Amanda Jackson
- Wellcome Centre for Infectious Disease Research in Africa (CIDRI-Africa), Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa; (R.G.); (A.J.)
| | - Charles S. Wiysonge
- Cochrane South Africa, South African Medical Research Council, Cape Town 7500, South Africa; (P.D.M.C.K.); (S.C.); (C.S.W.)
- School of Public Health and Family Medicine, University of Cape Town, Cape Town 7925, South Africa
- Department of Global Health, Stellenbosch University, Francie Van Zijl Drive, Tygerberg, Cape Town 7505, South Africa
- HIV and Other Infectious Diseases Research Unit, South African Medical Research Council, Durban 4091, South Africa
| | - Muki S. Shey
- Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa;
- Wellcome Centre for Infectious Disease Research in Africa (CIDRI-Africa), Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa; (R.G.); (A.J.)
- Institute of Infectious Disease and Molecular Medicine (IDM), Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa
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Kahn K, Pettifor A, Mataboge P, Kelly NK, Mashinini DP, Nair H, Campbell H, Cohen C, Gómez-Olivé FX, Tollman S. COVID-19 vaccine hesitancy in rural South Africa: Deepening understanding to increase uptake and access. J Glob Health 2022; 12:05013. [PMID: 35567586 PMCID: PMC9107307 DOI: 10.7189/jogh.12.05013] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background To date, COVID-19 vaccine coverage in the African region falls far too short of global goals. Increasing vaccination rates requires understanding barriers to vaccination so that effective interventions that sensitively and effectively address barriers to vaccination can be implemented. Methods To assess COVID-19 vaccination levels and identify major barriers to vaccine uptake we conducted a population-based, cross-sectional survey among 1662 adults 18 and older from August 25 to October 29 2021 in the Agincourt Health and Socio-Demographic Surveillance System (AHDSS) area, Mpumalanga, South Africa. Results Half of participants reported receiving a COVID-19 vaccine (50.4%) with 41.1% being fully vaccinated and 9.3% being partially vaccinated; 49.6% were unvaccinated. More women than men were vaccinated (55.5% vs 42.8%, P < 0.001), and older age groups were more likely to be vaccinated than younger age groups (P < 0.001). Among the unvaccinated, 69.0% planned to get vaccinated as soon as possible, while 14.7% reported definitely not wanting the vaccine. Major barriers to vaccination included lacking information on eligibility (12.3%) or where to get vaccinated (13.0%), concerns about side effects (12.5%), and inconvenient hours and locations for vaccination (11.0%). Confidence in the safety and efficacy of COVID-19 vaccines was higher among those vaccinated than unvaccinated (75.3% vs 51.2%, 75.8% vs 51.0%, both P < 0.001, respectively). Conclusions Increasing vaccination in South Africa beyond current levels will require a concerted effort to address concerns around vaccine safety and increase confidence in vaccine efficacy. Clarifying eligibility and ensuring access to vaccines at times and places that are convenient to younger populations, men, and other vulnerable groups is necessary.
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Affiliation(s)
- Kathleen Kahn
- MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Audrey Pettifor
- MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Palesa Mataboge
- MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Nicole K Kelly
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Duduzile P Mashinini
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Harish Nair
- College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
| | - Harry Campbell
- College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
| | - Cheryl Cohen
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
- School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - F Xavier Gómez-Olivé
- MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Stephen Tollman
- MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Yendewa SA, Ghazzawi M, James PB, Smith M, Massaquoi SP, Babawo LS, Deen GF, Russell JBW, Samai M, Sahr F, Lakoh S, Salata RA, Yendewa GA. COVID-19 Vaccine Hesitancy among Healthcare Workers and Trainees in Freetown, Sierra Leone: A Cross-Sectional Study. Vaccines (Basel) 2022; 10:757. [PMID: 35632513 PMCID: PMC9143387 DOI: 10.3390/vaccines10050757] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 05/04/2022] [Accepted: 05/09/2022] [Indexed: 02/01/2023] Open
Abstract
Despite having safe and efficacious vaccines against COVID-19, vaccine hesitancy is widespread. Although a trusted source of information, vaccine hesitancy has been reported among healthcare professionals, yet few studies have explored this phenomenon in sub-Saharan Africa. We conducted a cross-sectional survey of healthcare professionals in Sierra Leone from January to March 2022. Measures included sociodemographic/health-related information and COVID-19-related concerns. From the responses, we constructed a hesitancy (VAX) score, with higher scores implying negative attitudes or unwillingness to vaccinate. Multivariate linear regression was used to access factors associated with vaccine hesitancy. Overall, 592 participants submitted responses (67.2% female, mean age 29 years, 5.6% physicians/pharmacists, 44.3% medical students, 29.2% nurses, 20.9% nursing students). The mean VAX score was 43.27 ± 8.77, with 60.1% of respondents classified as vaccine hesitant (>50th percentile) and 13.8% as highly hesitant (>75th percentile). Worries about unforeseen future effects (76.3%), a preference for natural immunity (59.5%), and profiteering/mistrust of health authorities (53.1%) were the most common concerns. Being a medical student (β = 0.105, p = 0.011) and previously refusing a recommended vaccine (β = 0.177, p < 0.001) were predictors of COVID-19 vaccine hesitancy. Our findings call for addressing vaccine hesitancy among healthcare professionals as an essential component of strategies aimed at increasing COVID-19 vaccine uptake in this setting.
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Affiliation(s)
- Sahr A. Yendewa
- Ministry of Health and Sanitation, Freetown, Sierra Leone; (S.A.Y.); (M.S.); (S.P.M.); (G.F.D.); (J.B.W.R.); (M.S.); (F.S.); (S.L.)
- Connaught Hospital, University of Sierra Leone Teaching Hospitals Complex, Ministry of Health and Sanitation, Freetown, Sierra Leone
| | | | - Peter B. James
- Faculty of Health, Southern Cross University, Lismore, NSW 2480, Australia;
| | - Mohamed Smith
- Ministry of Health and Sanitation, Freetown, Sierra Leone; (S.A.Y.); (M.S.); (S.P.M.); (G.F.D.); (J.B.W.R.); (M.S.); (F.S.); (S.L.)
- Connaught Hospital, University of Sierra Leone Teaching Hospitals Complex, Ministry of Health and Sanitation, Freetown, Sierra Leone
| | - Samuel P. Massaquoi
- Ministry of Health and Sanitation, Freetown, Sierra Leone; (S.A.Y.); (M.S.); (S.P.M.); (G.F.D.); (J.B.W.R.); (M.S.); (F.S.); (S.L.)
| | - Lawrence S. Babawo
- Department of Nursing, School of Community Health Sciences, Njala University, Bo Campus, Bo, Sierra Leone;
| | - Gibrilla F. Deen
- Ministry of Health and Sanitation, Freetown, Sierra Leone; (S.A.Y.); (M.S.); (S.P.M.); (G.F.D.); (J.B.W.R.); (M.S.); (F.S.); (S.L.)
- Connaught Hospital, University of Sierra Leone Teaching Hospitals Complex, Ministry of Health and Sanitation, Freetown, Sierra Leone
- Department of Medicine, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - James B. W. Russell
- Ministry of Health and Sanitation, Freetown, Sierra Leone; (S.A.Y.); (M.S.); (S.P.M.); (G.F.D.); (J.B.W.R.); (M.S.); (F.S.); (S.L.)
- Connaught Hospital, University of Sierra Leone Teaching Hospitals Complex, Ministry of Health and Sanitation, Freetown, Sierra Leone
- Department of Medicine, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Mohamed Samai
- Ministry of Health and Sanitation, Freetown, Sierra Leone; (S.A.Y.); (M.S.); (S.P.M.); (G.F.D.); (J.B.W.R.); (M.S.); (F.S.); (S.L.)
- Connaught Hospital, University of Sierra Leone Teaching Hospitals Complex, Ministry of Health and Sanitation, Freetown, Sierra Leone
- Department of Medicine, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Foday Sahr
- Ministry of Health and Sanitation, Freetown, Sierra Leone; (S.A.Y.); (M.S.); (S.P.M.); (G.F.D.); (J.B.W.R.); (M.S.); (F.S.); (S.L.)
| | - Sulaiman Lakoh
- Ministry of Health and Sanitation, Freetown, Sierra Leone; (S.A.Y.); (M.S.); (S.P.M.); (G.F.D.); (J.B.W.R.); (M.S.); (F.S.); (S.L.)
- Connaught Hospital, University of Sierra Leone Teaching Hospitals Complex, Ministry of Health and Sanitation, Freetown, Sierra Leone
- Department of Medicine, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Robert A. Salata
- Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA;
- Division of Infectious Diseases and HIV Medicine, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, USA
| | - George A. Yendewa
- Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA;
- Division of Infectious Diseases and HIV Medicine, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, USA
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
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