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Chakhunashvili K, Kvirkvelia E, Chakhunashvili DG. Religious belongings and Covid-19 vaccination. BMC Public Health 2024; 24:2585. [PMID: 39334217 PMCID: PMC11428539 DOI: 10.1186/s12889-024-20133-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Accepted: 09/19/2024] [Indexed: 09/30/2024] Open
Abstract
INTRODUCTION Vaccine hesitancy poses a complex global challenge. Our study investigates correlations between COVID-19 vaccination rates, religious demographics, and educational performance. MATERIALS AND METHODS Using cross-sectional analysis, data from reputable sources were analyzed for correlations using Pearson's correlation and linear regression. RESULTS We found statistically significant positive correlations between COVID-19 vaccination rates and PISA scores, Catholic populations, non-religious, and atheist populations. Conversely, negative correlations were observed with Muslim and Eastern Orthodox populations. Our findings suggest potential influences of religious beliefs and educational attainment on vaccination rates. CONCLUSION The data reveals a positive correlation between COVID-19 vaccination rates and the percentages of Catholic, Non-Religious, and Atheist populations, while indicating a negative correlation between COVID-19 vaccination rates and the percentages of Muslim and Eastern Orthodox populations. These findings underscore the potential significance of engaging religious leaders in promoting vaccinations as a strategy to address vaccine hesitancy.
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Affiliation(s)
| | - Eka Kvirkvelia
- Department of Gynecology, Caucasus University, Tbilisi, Georgia
- Reproductive Education Hub, Tbilisi, Georgia
| | - Davit G Chakhunashvili
- Department of Pediatrics, International Black Sea University, Tbilisi, Georgia
- Reproductive Education Hub, Tbilisi, Georgia
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Thongseiratch T, Khantee P, Jaroenmark N, Nuttapasit N, Thonglua N. "Anees Has Measles": Storytelling and Singing to Enhance MMR Vaccination in Child Care Centers Amid Religious Hesitancy. Vaccines (Basel) 2024; 12:819. [PMID: 39066456 PMCID: PMC11281558 DOI: 10.3390/vaccines12070819] [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: 04/30/2024] [Revised: 07/05/2024] [Accepted: 07/16/2024] [Indexed: 07/28/2024] Open
Abstract
This study explores the enhancement of MMR vaccination rates in the deep south of Thailand through a culturally tailored intervention that incorporates storytelling and singing, aligning with local cultural and religious values. The "Anees has Measles" intervention, developed with input from community stakeholders including health workers, religious leaders, and parents, featured traditional melodies in its singing activities. The intervention comprised two main components: storytelling sessions and singing activities, both utilizing culturally resonant content and formats to effectively engage the community. Conducted from December 2019 to March 2020 across eight districts in five provinces, the study targeted children aged 18 months to 5 years in government child care centers. Results indicated a substantial increase in MMR vaccination coverage from 44.3% to 72.0% twelve months post-intervention, and further to 77.0% at 48 months post-intervention, representing a significant and sustained improvement (p < 0.001). This marked and continuous increase demonstrates the effectiveness of culturally adapted health education in areas with significant vaccine hesitancy. The findings highlight the importance of integrating culturally and religiously sensitive methods into public health strategies, significantly enhancing vaccine acceptance and coverage in diverse and conservative settings. This approach suggests a broader applicability for similar interventions in comparable contexts globally.
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Affiliation(s)
- Therdpong Thongseiratch
- Child Development Unit, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand; (N.J.); (N.N.); (N.T.)
| | - Puttichart Khantee
- Infectious Disease Unit, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand
| | - Naphat Jaroenmark
- Child Development Unit, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand; (N.J.); (N.N.); (N.T.)
| | - Napatsaree Nuttapasit
- Child Development Unit, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand; (N.J.); (N.N.); (N.T.)
| | - Nithida Thonglua
- Child Development Unit, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand; (N.J.); (N.N.); (N.T.)
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Weis KL, Trout KK, Cimiotti JP, Deupree JP, Killion C, Peter E, Polivka B, Shieh C. The nurse's role in a patient-centered approach for reducing COVID-19 vaccine hesitancy during pregnancy: An American Academy of Nursing consensus paper. Nurs Outlook 2024; 72:102196. [PMID: 38935987 DOI: 10.1016/j.outlook.2024.102196] [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: 01/02/2024] [Revised: 03/17/2024] [Accepted: 04/28/2024] [Indexed: 06/29/2024]
Abstract
The evidence shows that COVID-19 vaccines can reduce the risks of poor pregnancy outcomes. Yet, reluctance to vaccinate remains high in pregnant populations. In this paper, we take a precision health and patient-centered approach to vaccine hesitancy. We adopted the society-to-cells vaccine hesitancy framework to identify society, community, family, individual, and physiologic factors contributing to COVID-19 vaccine hesitancy in pregnancy. Nurses are particularly well-suited to impact the factors associated with vaccine hesitancy. Because of their proximity to the patient, nurses are positioned to provide individualized, timely health information, and clinical guidelines to assist patients with decision-making related to vaccinations. Recommendations are provided to bolster nurses' engagement in precision health and patient-centered models of care to mitigate COVID-19 vaccine hesitancy in pregnancy.
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Affiliation(s)
| | | | | | | | | | | | | | - Carol Shieh
- Maternal and Infant Health Expert Panel; Health Behaviors Expert Panel
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Haq ZU, Yunus S, Jafri N. Building confidence in the COVID-19 vaccine in a polio-endemic country: strategic communication lessons from Pakistan. BMJ Glob Health 2024; 9:e015200. [PMID: 38599665 PMCID: PMC11015175 DOI: 10.1136/bmjgh-2024-015200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 03/31/2024] [Indexed: 04/12/2024] Open
Abstract
In a health emergency, governments rely on public trust in their policy, and anticipate its compliance to protect health and save lives. Vaccine hesitancy compromises this process when an emergency involves infections. The prevailing discourse on vaccine hesitancy often describes it as a static phenomenon, ignoring its expanse and complexity, and neglecting the exploration of tools to address it. This article diverges from the conventional perspective by explaining the case of Pakistan and its communication strategy for the COVID-19 vaccine. Decades of polio vaccine hesitancy, rooted in the country's fight against terrorism, constitute its history. On the other hand, the first-ever launch of typhoid conjugate vaccine involving 35 million kids during 2019-2021 was a success. Against this backdrop, the country considered vaccine hesitancy as a dynamic phenomenon, interwoven with the social ecology and the responsiveness of the healthcare system. Its communication strategy facilitated those willing to receive the vaccine, while being responsive to the information needs of those still in the decision-making process. In the face of both hesitancy and a scarcity of vaccine doses, the country successfully inoculated nearly 70% (160 million) of its population in just over 1 year. People's perceptions about the COVID-19 vaccine also improved over time. This achievement offers valuable insights and tools for policymakers and strategists focused on the demand side of vaccine programmes. The lessons can significantly contribute to the global discourse on improving vaccine confidence and bolstering global health security.
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Affiliation(s)
| | | | - Naveed Jafri
- Expanded Programme on Immunisation, Pakistan Ministry of National Health Services Regulations and Coordination, Islamabad, Pakistan
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5
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Lee PP, Chan DN, Choi K, So WK. Translation and psychometric evaluation of an instrument to assess the health beliefs of Pakistani mothers regarding human papillomavirus vaccination. Asia Pac J Oncol Nurs 2024; 11:100384. [PMID: 38495642 PMCID: PMC10940890 DOI: 10.1016/j.apjon.2024.100384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 01/22/2024] [Indexed: 03/19/2024] Open
Abstract
Objective Investigating mothers' health beliefs regarding human papillomavirus (HPV) vaccination is essential for understanding their decisions regarding vaccinating their daughters against HPV. There is no available validated instrument to measure the health beliefs of Pakistani mothers regarding HPV vaccination for their daughters. The purpose of this study was to translate the Human Papillomavirus Vaccination Scale - Health Belief Model (HPVS-HBM) into Urdu and to evaluate the psychometric properties of the translated Urdu version among Pakistani mothers in Hong Kong. Methods This was a descriptive correlational study for which a convenience sample of 260 Pakistani women was recruited. The original HPVS-HBM questionnaire was translated from English to Urdu according to Brislin's model. A panel of experts reviewed the translated questionnaire and assessed the content validity of the items and the scale. Face validity was assessed in a sample of five Pakistani mothers, while structural validity was examined by an exploratory factor analysis. Internal consistency and test-retest reliability were assessed to evaluate the reliability of the translated instrument. Results The translated questionnaire demonstrated good face validity and content validity (item-level content validity index: 0.83-1.00; scale-level content validity index: 0.89-1.00). Factor analysis of the 22 items in the scale revealed a three-factor structure (perceived susceptibility, perceived severity and perceived benefits), which accounted for 77.66% of the total variance. The translated questionnaire also showed good internal consistency (Cronbach's alpha: 0.93-0.98) and acceptable test-retest reliability (weighted kappa: 0.49-0.96; intra-class correlation coefficient: 0.83-0.93). Conclusions The translated Urdu version of the HPVS-HBM demonstrated desirable psychometric properties, indicating that it could be used as a valid and reliable instrument for measuring Pakistani mothers' health beliefs regarding HPV vaccination for their daughters in Hong Kong.
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Affiliation(s)
- Pinky P.K. Lee
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Dorothy N.S. Chan
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - K.C. Choi
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Winnie K.W. So
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
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Domaradzki J, Jabkowski P, Walkowiak D. Investigating Beliefs in Anti-Vax Conspiracy Theories among Medical Students. Vaccines (Basel) 2024; 12:359. [PMID: 38675741 PMCID: PMC11054095 DOI: 10.3390/vaccines12040359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 03/22/2024] [Accepted: 03/24/2024] [Indexed: 04/28/2024] Open
Abstract
While the doctors' role in immunization is essential, their lack of knowledge or vaccine hesitancy may affect their ability to communicate effectively and educate patients about vaccination, vaccine hesitancy, and vaccine conspiracy theories. This, in turn, may hinder health policy aimed at fighting infectious diseases. Vaccine hesitancy is prevalent not only among the general population but also among healthcare workers; thus, this study is aimed at assessing future doctors' attitudes towards anti-vax conspiracy theories. A total of 441 medical students at Poznan University of Medical Sciences completed a web-based survey designed to explore their attitudes toward the six most prevalent anti-vaccine conspiracy theories. The survey showed that although over 97% of future doctors support vaccinations as an effective form of fighting infectious diseases, and 80% did not believe in any anti-vax conspiracy theory, a significant fraction of 20% of medical students either believed in at least one such theory or were unsure. It has also shown that male and younger students who had not received a flu vaccination and defined themselves as politically right-wing or conservative and religious were more likely to believe in anti-vax conspiracy theories. Our data suggest that, in order to overcome medical students' ambivalent attitudes towards anti-vax conspiracy theories, they should receive more education about the importance of vaccination in preventing disease and about effective ways to combat vaccine hesitancy and anti-vax conspiracy theories.
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Affiliation(s)
- Jan Domaradzki
- Department of Social Sciences and Humanities, Poznan University of Medical Sciences, Rokietnicka 7, 60-806 Poznań, Poland
| | - Piotr Jabkowski
- Faculty of Sociology, Adam Mickiewicz University, 60-568 Poznań, Poland
| | - Dariusz Walkowiak
- Department of Organization and Management in Health Care, Poznan University of Medical Sciences, 60-356 Poznań, Poland
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Kanan M, Abdulrahman S, Alshehri A, AlSuhaibani R, Alotaibi NM, Alsaleh A, Nasser B, Baowaydhan R, Alredaini I, Khalid T, Almukhtar F, Altoaimi N, Alhneshel A, Alanazi S, Algmaizi S. Factors Underlying Vaccine Hesitancy and Their Mitigations in Saudi Arabia: Protocol for a Systematic Review. JMIR Res Protoc 2024; 13:e54680. [PMID: 38517463 PMCID: PMC10998176 DOI: 10.2196/54680] [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: 11/18/2023] [Revised: 02/05/2024] [Accepted: 02/07/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND Vaccine hesitancy is a growing concern in Saudi Arabia, impacting even well-educated parents. The decision-making process involves various factors such as accessibility, trustworthy information, and the influence of social networks, reflecting a complex interplay of emotional, cultural, social, spiritual, and political dimensions. OBJECTIVE This review seeks to evaluate the prevalence and trends of vaccine hesitancy, identify contributing factors, and explore potential solutions to enhance immunization rates. This review aligns with global concerns, as the World Health Organization has identified vaccine hesitancy as a top global health threat. METHODS Our systematic review will follow the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and PICOS (Population, Intervention, Comparison, Outcomes, and Study) criteria for comprehensive assessment. We will conduct a thorough search across various databases, encompassing a wide range of vaccines, and pay special attention to vaccination campaigns and refusals. Inclusion criteria involve descriptive, observational, and analytical studies focusing on factors influencing vaccine acceptance or hesitancy. The study will use the Crowe Critical Appraisal Tool for quality assessment and perform a narrative synthesis to summarize findings thematically. RESULTS This systematic review is expected to unveil the prevalence and trends of vaccine hesitancy in diverse populations in Saudi Arabia, shedding light on cultural, religious, and social factors contributing to hesitancy. It aims to assess the effectiveness of implemented strategies, enable regional and global comparisons, and provide implications for tailored vaccination policies. Additionally, the review may pinpoint research gaps, guiding future investigations to address and mitigate vaccine hesitancy effectively. CONCLUSIONS The findings are expected to have direct policy implications and guide interventions to strengthen vaccination programs and improve public health outcomes. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/54680.
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Affiliation(s)
- Mohammed Kanan
- Department of Clinical Pharmacy, King Fahad Medical City, Riyadh, Saudi Arabia
| | | | | | - Renad AlSuhaibani
- Department of Medicine, Imam Mohammed Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Nawaf M Alotaibi
- Department of Clinical Pharmacy, Northern Border University, Rafha, Saudi Arabia
| | - Azhar Alsaleh
- Department of Nursing, Prince Saud Bin Jalawi Hospital, Alhasa, Saudi Arabia
| | - Bushra Nasser
- Department of Clinical Pharmacy, King Khalid University, Abha, Saudi Arabia
| | - Rana Baowaydhan
- Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | - Taif Khalid
- Department of Clinical Laboratory, Al-Jawf University, Al-Jawf, Saudi Arabia
| | - Fatima Almukhtar
- Department of Medicine, Ministry of Health, Dammam, Saudi Arabia
| | - Nourah Altoaimi
- Department of Pharmacy, Qassim University, Qassim, Saudi Arabia
| | - Almaha Alhneshel
- Department of Medicine, Suliman Alrajhi University, Qassim, Saudi Arabia
| | - Shouq Alanazi
- Department of Medicine, Northern Border University, Northern Borders, Arar, Saudi Arabia
| | - Shahad Algmaizi
- Department of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
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Wolde M, Wasihun Y, Melesse A, Tadesse T, Sharma R, Mon HS, Challa A, Simireta T, Addisu H. Assessment of willingness and determinants to receive the COVID-19 vaccine among the general population of the Somali region, Eastern Ethiopia: a 2021 cross-sectional study. BMJ Open 2023; 13:e080733. [PMID: 38114284 DOI: 10.1136/bmjopen-2023-080733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2023] Open
Abstract
OBJECTIVE This research aimed to assess COVID-19 vaccine acceptance and the factors influencing it among the population of the Somali region in Ethiopia through a cross-sectional COVID-19 survey. DESIGN Community-based cross-sectional study. SETTING The survey was conducted in eight selected districts of the Somali region in Ethiopia from 20 October 2021 to 30 October 2021. PARTICIPANTS Participants were chosen using simple random sampling and data analysis used Stata V.14. Both bivariable and multivariable binary logistic regression methods were applied, with variables having a p value below 0.2 considered for inclusion in the final model, where statistically significant factors were identified at p<0.5. PRIMARY OUTCOME MEASURE Willingness to take the vaccine. RESULTS A total of 1010 respondents participated in this study. The proportion of people's willingness to take the vaccine was 65% (95% CI 62 to 68). When you believe moderately or highly that getting a COVID-19 vaccine will protect others (AOR=6.2, 95% CI 1.43 to 26.6) and (AOR=7.2, 95% CI 1.7 to 29.7), then you will protect others as well. Whereas, a desire to get vaccinated little, moderately and highly (AOR=4.3, 95% CI 1.77 to 10.4), (AOR=20, 95% CI 8.5 to 47) and (AOR=147, 95% CI 55 to 392), respectively, was significantly associated with willingness to take the vaccine. Moreover having close family and friends who want them to get a COVID-19 vaccine (AOR=2, 95% CI 1.2 to 3.57) and religious leaders or community leaders (AOR=1.8, 95% CI 1 to 3.1) were significant factors in the multivariable logistic regression model. CONCLUSION This study found that COVID-19 vaccine acceptance was low in the Somali region. Factors positively linked to one's willingness to get vaccinated included the belief that it protects others, personal desire for vaccination and support from family, friends, community and religious leaders.
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Affiliation(s)
- Maereg Wolde
- Health Education, University of Gonder College of Medicine and Health Sciences, Gondar, Ethiopia
- Health Education and Promotion Department, Gonder Universty, Gonder, Ethiopia
| | - Yosef Wasihun
- Health Promotion and Behavioural Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Addisalem Melesse
- Public Health Department, Debre-Birhan University, Debre-Birhan, Ethiopia
| | - Trhas Tadesse
- Public Health Department, Yekatit 12 Hospital, Addis Ababa, Ethiopia
- Health Promotion Department, Ethiopian Health Education and Promotion Assosation, Addis Ababa, Ethiopia
| | - Rachana Sharma
- United Nations Children's Fund (UNICEF), Addis Ababa, Ethiopia
| | - Hnin Su Mon
- United Nations Children's Fund (UNICEF), Addis Ababa, Ethiopia
| | - Andinet Challa
- United Nations Children's Fund (UNICEF), Addis Ababa, Ethiopia
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Sanftenberg L, Keppeler S, Heithorst N, Dreischulte T, Roos M, Sckopke P, Bühner M, Gensichen J. Psychological Determinants of Vaccination Readiness against COVID-19 and Seasonal Influenza of the Chronically Ill in Primary Care in Germany-A Cross-Sectional Survey. Vaccines (Basel) 2023; 11:1795. [PMID: 38140199 PMCID: PMC10747451 DOI: 10.3390/vaccines11121795] [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: 10/18/2023] [Revised: 11/27/2023] [Accepted: 11/29/2023] [Indexed: 12/24/2023] Open
Abstract
Vaccines against COVID-19 and influenza are highly recommended for the chronically ill. They often suffer from co-morbid mental health issues. This cross-sectional observational study analyzes the associations between depression (PHQ-9) and anxiety (OASIS) with vaccination readiness (5C) against COVID-19 and influenza in chronically ill adults in primary care in Germany. Sociodemographic data, social activity (LSNS), patient activation measure (PAM), and the doctor/patient relationship (PRA) are examined as well. Descriptive statistics and linear mixed-effects regression models are calculated. We compare data from n = 795 study participants. The symptoms of depression are negatively associated with confidence in COVID-19 vaccines (p = 0.010) and positively associated with constraints to get vaccinated against COVID-19 (p = 0.041). There are no significant associations between symptoms of depression and vaccination readiness against influenza. Self-reported symptoms of a generalized anxiety disorder seem not to be associated with vaccination readiness. To address confidence in COVID-19 vaccines among the chronically ill, targeted educational interventions should be elaborated to consider mental health issues like depression. As general practitioners play a key role in the development of a good doctor/patient relationship, they should be trained in patient-centered communication. Furthermore, a standardized implementation of digital vaccination management systems might improve immunization rates in primary care.
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Affiliation(s)
- Linda Sanftenberg
- Institute of General Practice and Family Medicine, University Hospital, LMU Munich, 80336 Munich, Germany; (S.K.); (N.H.); (T.D.); (J.G.)
| | - Simon Keppeler
- Institute of General Practice and Family Medicine, University Hospital, LMU Munich, 80336 Munich, Germany; (S.K.); (N.H.); (T.D.); (J.G.)
| | - Nadine Heithorst
- Institute of General Practice and Family Medicine, University Hospital, LMU Munich, 80336 Munich, Germany; (S.K.); (N.H.); (T.D.); (J.G.)
| | - Tobias Dreischulte
- Institute of General Practice and Family Medicine, University Hospital, LMU Munich, 80336 Munich, Germany; (S.K.); (N.H.); (T.D.); (J.G.)
| | - Marco Roos
- General Practice, Medical Faculty, University of Augsburg, 86356 Neusäß, Germany;
| | - Philipp Sckopke
- Department of Psychology, LMU Munich, 80802 Munich, Germany; (P.S.); (M.B.)
| | - Markus Bühner
- Department of Psychology, LMU Munich, 80802 Munich, Germany; (P.S.); (M.B.)
| | - Jochen Gensichen
- Institute of General Practice and Family Medicine, University Hospital, LMU Munich, 80336 Munich, Germany; (S.K.); (N.H.); (T.D.); (J.G.)
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Cummings PE, Lakoh S, Yendewa SA, Massaquoi SPE, James PB, Sahr F, Deen GF, Salata RA, Gevao P, Yendewa GA. Understanding COVID-19 Vaccine Uptake and Hesitancy among People with HIV in Freetown, Sierra Leone: A Cross-Sectional Study. Vaccines (Basel) 2023; 11:1685. [PMID: 38006017 PMCID: PMC10674940 DOI: 10.3390/vaccines11111685] [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: 09/19/2023] [Revised: 11/01/2023] [Accepted: 11/01/2023] [Indexed: 11/26/2023] Open
Abstract
People with HIV (PWH) incur a higher risk of COVID-19-related morbidity and mortality rates, yet less is known about COVID-19 vaccine uptake and hesitancy in this group. We conducted a cross-sectional study in Freetown, Sierra Leone, from April to June 2022, using the VAX scale, a validated instrument, to assess attitudes towards COVID-19 vaccination and calculate the hesitancy (VAX) scores. We used generalized linear models to identify the factors associated with vaccine hesitancy. Overall, 490 PWH were enrolled (71.4% female, median age: 38 years, median CD4 count: 412 cells/mm3). About 17.3% received ≥1 dose of a COVID-19 vaccine. The mean VAX score was 43.14 ± 7.05, corresponding to 59.9% participants being vaccine-hesitant. A preference for natural immunity (65.8%) and concerns about profiteering (64.4%) were the commonest reasons for hesitancy, followed by a mistrust of vaccine benefits (61.4%) and worries about future effects (48.0%). In the adjusted regression analysis, being a Muslim (β = 2.563, p < 0.001) and having an urban residence (β = 1.709, p = 0.010) were associated with greater vaccine hesitancy, while testing for COVID-19 was associated with reduced vaccine hesitancy (β = -3.417, p = 0.027). These findings underscore the importance of addressing vaccine hesitancy as a critical element boosting COVID-19 vaccine uptake among PWH.
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Affiliation(s)
- Peterlyn E. Cummings
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown 00232, Sierra Leone; (P.E.C.); (S.L.); (F.S.); (G.F.D.); (P.G.)
| | - Sulaiman Lakoh
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown 00232, Sierra Leone; (P.E.C.); (S.L.); (F.S.); (G.F.D.); (P.G.)
- Connaught Hospital, University of Sierra Leone Teaching Hospitals Complex, Ministry of Health and Sanitation, Freetown 00232, Sierra Leone
- Ministry of Health and Sanitation, Freetown 00232, Sierra Leone; (S.A.Y.); (S.P.E.M.)
| | - Sahr A. Yendewa
- Ministry of Health and Sanitation, Freetown 00232, Sierra Leone; (S.A.Y.); (S.P.E.M.)
| | | | - Peter B. James
- Faculty of Health, Southern Cross University, Lismore, NSW 2480, Australia;
| | - Foday Sahr
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown 00232, Sierra Leone; (P.E.C.); (S.L.); (F.S.); (G.F.D.); (P.G.)
- Connaught Hospital, University of Sierra Leone Teaching Hospitals Complex, Ministry of Health and Sanitation, Freetown 00232, Sierra Leone
| | - Gibrilla F. Deen
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown 00232, Sierra Leone; (P.E.C.); (S.L.); (F.S.); (G.F.D.); (P.G.)
- Connaught Hospital, University of Sierra Leone Teaching Hospitals Complex, Ministry of Health and Sanitation, Freetown 00232, Sierra Leone
- Ministry of Health and Sanitation, Freetown 00232, Sierra Leone; (S.A.Y.); (S.P.E.M.)
| | - 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
| | - Pelema Gevao
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown 00232, Sierra Leone; (P.E.C.); (S.L.); (F.S.); (G.F.D.); (P.G.)
- Republic of Sierra Leone Armed Forces, Department of Defense, Freetown 00232, Sierra Leone
| | - 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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CUMMINGS PE, LAKOH S, YENDEWA SA, MASSAQUOI SAMUELP, JAMES PB, SAHR F, DEEN GF, GEVAO P, YENDEWA GA. Understanding COVID-19 Vaccine Uptake and Hesitancy Among People With HIV in Freetown, Sierra Leone: A Cross-sectional Study. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.05.11.23289882. [PMID: 37292603 PMCID: PMC10246027 DOI: 10.1101/2023.05.11.23289882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Objectives People living with HIV (PWH) are at increased risk of COVID-19 related morbidity and mortality, yet less is known about COVID-19 vaccination uptake and hesitancy, especially in sub-Saharan Africa. We aimed to evaluate COVID-19 vaccine uptake and hesitancy among PWH in Sierra Leone. Methods We conducted a cross-sectional study in a convenience sample of PWH in routine care at Connaught Hospital in Freetown, Sierra Leone from April through June 2022. We collected sociodemographic and health-related data. We used the VAX Scale, a validated instrument to assess attitudes towards COVID-19 vaccination. From the responses, we constructed hesitancy (VAX) scores, with higher scores implying negative attitudes towards vaccination. We used generalized linear models to identify factors associated with vaccine hesitancy. Results A total of 490 PWH were enrolled (71.4% female, median age 38 years, median CD4 count 412 cells/mm3, 83.9% virologically suppressed). About 17.3% had received at least one dose of a COVID-19 vaccine. The mean VAX score was 43.14 ± 7.05, corresponding to 59.9% participants classified as vaccine hesitant. Preference for natural immunity (65.8%) and concerns about commercial profiteering (64.4%) were the commonest reasons for hesitancy, followed by mistrust of vaccine benefits (61.4%) and worries about future side effects (48.0%). In adjusted regression analysis, being Muslim (β = 2.563, p < 0.001) and residence in urban areas (β = 1.709, p = 0.010) were associated with greater vaccine hesitancy, while having tested ever for COVID-19 was associated with lesser vaccine hesitancy (β = -3.417, p = 0.027). Conclusion We observed a low COVID-19 vaccine uptake and high hesitancy among PWH in Sierra Leone. Our findings underscore the need to address vaccine hesitancy as a critical element of efforts to boost COVID-19 vaccine uptake among this population in Sierra Leone.
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Affiliation(s)
- Peterlyn E. CUMMINGS
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Sulaiman LAKOH
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
- Connaught Hospital, University of Sierra Leone Teaching Hospitals Complex, Ministry of Health and Sanitation, Freetown, Sierra Leone
- Ministry of Health and Sanitation, Freetown, Sierra Leone
| | | | | | - Peter B. JAMES
- Faculty of Health, Southern Cross University, Lismore, Australia
| | - Foday SAHR
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
- Connaught Hospital, University of Sierra Leone Teaching Hospitals Complex, Ministry of Health and Sanitation, Freetown, Sierra Leone
| | - Gibrilla F. DEEN
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
- Connaught Hospital, University of Sierra Leone Teaching Hospitals Complex, Ministry of Health and Sanitation, Freetown, Sierra Leone
- Ministry of Health and Sanitation, Freetown, Sierra Leone
| | - Pelema GEVAO
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
- Republic of Sierra Leone Armed Forces, Department of Defense, Freetown, Sierra Leone
| | - George A. YENDEWA
- Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
- Division of Infectious Diseases and HIV Medicine, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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