Participating in a vaccine trial for COVID-19 in Senegal: trust and information

The relationship between trust in federal oversight of vaccine safety and willingness to participate in COVID-19 clinical trials: a repeated measures study of Philadelphia residents (September 2021 - March 2023)

BACKGROUND

The Coronavirus Disease 2019 (COVID-19) pandemic precipitated an urgent need for clinical trials to discover safe and efficacious treatments. We examined how COVID-19 experiences, clinical trial awareness, and trust in the vaccine safety process were associated with willingness to participate in COVID-19 clinical trials. The objective was to investigate the relationship between trust in federal oversight of vaccine safety and willingness to participate in clinical trials for COVID-19 treatment across four distinct time points over an 18-month period during the COVID-19 pandemic.

METHODS

We used four waves of data collected from September 2021 to March 2023 among 582 Philadelphia residents (with a missing data rate of 0.9%). Generalized estimating equations estimated the association between willingness to participate in COVID-19 clinical trials and participants' trust in the federal government's oversight of COVID-19 vaccine safety, COVID-19-related variables (COVID-19 related health challenges, history of COVID-19 infection), awareness of clinical trials and how to enroll in them, and sociodemographic characteristics (age, race/ethnicity, sexual orientation, gender, parental status, education, and insurance).

RESULTS

On average, willingness to participate in a COVID-19 clinical trial was positively associated with greater trust in the federal government's oversight of vaccine safety [β = 0.34, 95% confidence interval (CI): 0.15-0.53], having COVID-19 (β = 0.40, 95% CI: 0.08-0.73), awareness of clinical trials (β = 0.38, 95% CI: 0.04-0.73), and knowledge of how to enroll (β = 0.83, 95% CI: 0.44-1.23). Among sociodemographic characteristics, race/ethnicity (p = 0.001) and gender (p = 0.018) were identified as predictors for COVID-19 trial willingness.

CONCLUSION

Willingness to participate in clinical trials may be bolstered by strengthening the public's trust in the federal government's role within vaccine safety oversight, increasing the perceived relevance of clinical trials to individuals' health and well-being, and offering tailored information to educate diverse communities about ongoing trials and how to enroll in them.

Vaccine inequity: a threat to Africa's recovery from COVID-19

BACKGROUND

Vaccine inequity is a reality facing the Sub-Saharan Africa region as vaccine nationalism from high-income countries (HICs) leads to limited access to the lifesaving vaccines needed to end the pandemic. In Africa, a significant portion of the population has yet to be vaccinated against Covid-19; however, the barriers to accessing such vaccines, including capacity challenges, still persist despite the implementation of the COVAX facility meant to support the lower- and middle-income countries (LMICs) to boost vaccination.

METHODS

This study involved a systemic narrative review where literature search was conducted using the NCBI's PMC and BMC databases based on defined keywords. Three authors were involved in the literature search and consensus was applied to settle disagreements and validate the findings.

RESULTS

In this systematic narrative review, we report that vaccine nationalism remains a challenge for LMICs as HICs still hoard vaccines and even bypass COVAX to procure doses directly from the manufacturers. Factors that promote vaccine hesitancy in Africa include misinformation regarding the Covid-19 vaccine, a lack of trust in politicians and the pharmaceutical industry, and concerns about vaccine safety and efficacy. The policies implemented to enhance vaccine coverage in Africa, such as mandates, community engagement, and partnerships, all seek to promote equity of vaccination and ending Covid-19.

CONCLUSION

Covid-19 vaccine inequity persists and contributes to prolonged pandemic in LMICs. In response, African governments have taken certain measures to enhance vaccine uptake but more needs to be done to address resistance to vaccines.

Calculation, knowledge, and identity: Dimensions of trust when making COVID-19 vaccination choices in China

Vaccine hesitancy threatens the response to the COVID-19 pandemic and to other infectious disease outbreaks globally. Fostering trust has been highlighted as a critical factor in addressing vaccine hesitancy and expanding vaccine coverage, but qualitative exploration of trust in the context of vaccination remains limited. We contribute to filling this gap by providing a comprehensive qualitative analysis of trust in the context of COVID-19 vaccination in China. We conducted 40 in-depth interviews with Chinese adults in December 2020. During data collection, trust emerged as a highly salient topic. Interviews were audio-recorded, transcribed verbatim, translated into English, and analyzed with a combination of inductive and deductive coding. Following established trust literature, we differentiate between three types of trust - calculation-based trust, knowledge-based trust, and identity-based trust - which we grouped across components of the health system, as informed by the WHO's building blocks. Our results highlight how participants attributed their level of trust in COVID-19 vaccines to their trust in the medical technology itself (based on assessing risks and benefits or previous vaccination experiences), the service delivery and health workforce (informed by past experiences with health providers and their role throughout the pandemic), and leadership and governance (drawing on notions of government performance and patriotism). Reducing negative impact from past vaccine controversies, increasing the credibility of pharmaceutical companies, and fostering clear communication are identified as important channels for facilitating trust. Our findings emphasize a strong need for comprehensive information on COVID-19 vaccines and increased promotion of vaccination by credible figures.

Management of the COVID crisis in Reunion Island (SW Indian Ocean): representations of COVID-19 and acceptance of public health measures

Context

The coronavirus pandemic (COVID-19) has caused a major health crisis, requiring the implementation of various public health measures in order to slow the spread of the virus and reduce the associated mortality. However, the success of these measures depends on people's acceptance of them. This research aimed at understanding people's representations of COVID-19 and its crisis management, and ultimately at understanding their attitudes toward health measures for counteracting the spread of COVID-19 in Reunion Island together with the behaviours expected of them.

Method

Using Random Digit Dialling, a qualitative study was conducted with 53 inhabitants between February and May 2021. The COREQ checklist was followed. A dual textometric and manual thematic analysis was adopted in order to identify representations of COVID and the management of the crisis.

Results

Some respondents perceived COVID-19 as a serious disease, while others saw it as a banal virus or even doubted its existence. A perceived ineffectiveness of public health measures and the incompetency of public actors predominated in the participants' discourse.

Conclusions

Thus, there was a considerable lack of trust and negative attitudes toward health measures, possibly influencing people's acceptance and explaining numerous controversies. This research examines the importance of considering people's representations of the health situation in order to improve people's acceptance of protective measures.

Use of interviewer-administered telephone surveys during infectious disease outbreaks, epidemics and pandemics: a scoping review

INTRODUCTION

During the COVID-19 crisis, researchers had to collect data remotely. Telephone surveys and interviews can quickly gather data from a distance without heavy expense. Although interviewer-administered telephone surveys (IATS) can accommodate the needs of international public health research, the literature on their use during infectious disease outbreaks is scarce. This scoping review aimed to map the characteristics of IATS during infectious disease outbreaks.

METHODS

IATS conducted principally during infectious disease outbreaks and answered by informants at least 18 years old were searched from PubMed and EBSCO. There was a manual addition of relevant documents identified during an initial search. Overall trends were reported using different groupings, including WHO regions, and study details were compared before and during the COVID-19 pandemic.

RESULTS

70 IATS published between 2003 and 2022 were identified. 57.1% were conducted during the COVID-19 pandemic. Among 30 IATS conducted before the COVID-19 pandemic in the world, only 3.3% were carried out in low-income and middle-income countries (LMICs). This percentage of studies in LMICs out of all the IATS rose to 32.5% during the pandemic. The share of qualitative studies grew from 6.7% before the COVID-19 outbreak to 32.5% during the outbreak. IATS performed during the COVID-19 pandemic focused on more diverse, specific population groups, such as patients and healthcare professionals. Mobile phones are increasingly used for IATS over time.

CONCLUSION

IATS are used globally with high frequency in the Western Pacific Region and high-income countries. Technical and financial challenges continue to exist, and assessments of inclusiveness and representativeness should be carefully conducted. A lack of details related to methods was observed, and this scoping review urges researchers using this data collection method in the future to specify how they executed IATS for better use and more efficient deployment.

Jordanian Undergraduate Students' Views of Participation in Clinical Trials: The COVID-19 Example

The emergence of the COVID-19 pandemic has necessitated broad public participation in clinical trials. Knowledge of the attitudes of the relatively young would provide a perspective on future representative public enrollment in clinical trials. This study investigated the attitudes of undergraduate university students toward participation in COVID-19 clinical trials and determined the predictors of their attitudes. Using a validated, web-based questionnaire, 61.2% of the 425 respondents had heard about clinical trials before. Web-based media were the main sources of this knowledge. Less than 20% expressed willingness to participate in COVID-19 clinical trials or support the participation of a family member. The predictors were personal and family protection from the disease. On the contrary, being a female, possible political exploitation of the vaccine or drug, and their potential inefficacy were predictors of unwillingness to participate. This study may inform different stakeholders in developing effective study recruitment strategies to combat current and emerging pathogens.

Factors associated with COVID-19 vaccine intention in Benin in 2021: A cross-sectional study

Introduction

The development of COVID-19 vaccines has brought considerable hope for the control of the pandemic. With a view to promoting good vaccine coverage, this study aimed to measure vaccine intention against COVID-19 and to understand the factors that promote it.

Method

In April 2021, we conducted a cross-sectional and analytical study at the national level through a telephone survey of Beninese aged 18 years or older. We used a marginal quota sampling method (n = 865) according to age, gender, and department. We constructed the questionnaire using a theoretical framework of health intention. We determined the factors associated with intention to vaccinate against COVID-19 in Benin using a multinomial logistic regression at the 5 % significance level.

Results

The intention to vaccinate was 64.7 %; 10.9 % of the population were hesitant, and 24.4 % did not want to vaccinate. Thinking that it was important to get vaccinated (AOR = 0.274; CI = 0.118-0.638) or that getting vaccinated will help protect loved ones from the virus (AOR = 0.399; CI = 0.205-0.775) increased the intention to vaccinate. Having a high level of education (AOR = 1.988; CI = 1.134-3.484), thinking that the vaccine could put one's health at risk (AOR = 2.259; CI = 1.114-4.578), and hearing something negative about the vaccine (AOR = 1.765; CI = 1.059-2.941) reduced intention to vaccinate. In addition, believing that the creators of the vaccine had ensured its safety (AOR = 0.209; CI = 0.101-0.430), and believing that it was unlikely to be infected after vaccination (AOR = 0.359; CI = 0.183-0.703) decreased hesitancy in favour of the intention to vaccinate.

Conclusion

In April 2021, vaccine intention was high, but maintaining this high rate requires building confidence in the vaccine and combating misinformation about the vaccine.

Factors associated with COVID-19 vaccine hesitancy in Senegal: A mixed study

This study was an explanatory, sequential, mixed-methods design conducted in Senegal. We collected quantitative data from December 24, 2020, to January 16, 2021, and qualitative data from February 19 to March 30, 2021. We conducted a telephone survey among a marginal quota sample of 607 people over 18 years old. We performed descriptive, bivariate, and multivariate analyses with R software for the quantitative phase; and performed manual content analyses for the qualitative phase. We surveyed 607 people for the quantitative phase and interviewed 30 people for the qualitative phase. Individuals who hesitated or refused to be vaccinated represented 12.9% and 32.8%, respectively. Vaccine hesitancy was related to gender, living in large cities, having a poor attitude toward the vaccine, thinking that the vaccine would not help protect them from the virus, being influenced by people important to them, and lacking information from health professionals. Vaccine refusal was related to living in large cities, having a poor attitude toward the vaccine, thinking that the vaccine would not help protect them from the virus, thinking that the vaccine could endanger their health, trusting opinions of people who were important to them, and lacking information from health professionals. The results of the study show that the factors associated with COVID-19 vaccine hesitancy and refusal are diverse and complex. Addressing these factors will help to ensure better vaccination coverage. Governments and health authorities should intensify their efforts to promote vaccine confidence and reduce misinformation.