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Nuss H, Privor-Dumm L, Ukachukwu C, Hall LL. Building and Sustaining Flu Vaccine Acceptance and Trust in the Black Community through Partnerships with Churches, Salons, and Barbershops. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-02141-7. [PMID: 39240452 DOI: 10.1007/s40615-024-02141-7] [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: 12/21/2023] [Revised: 06/21/2024] [Accepted: 08/17/2024] [Indexed: 09/07/2024]
Abstract
Despite the benefits of flu vaccines, Black adults continue to experience lower vaccination rates in the United States. Contributing factors include lack of access to health care and trusted information about vaccines. The National Minority Quality Forum's Center for Sustainable Health Care Quality and Equity collaborated with church pastors, barbers, and hair stylists to disseminate a survey to their communities to assess barriers/facilitators to flu vaccine uptake. The population (n = 262) was mostly Black (93%), female (77%), between the age of 50-64 (39%) and vaccinated (73%). The most common reasons cited by respondents for being vaccinated were personal health, a habit of getting the shot, and a desire not to spread it to others. Among the unvaccinated (27%), the most common reasons for not vaccinating were lack of perceived need, concern the shot would make them sick, and that they do not normally get vaccinated. Vaccine knowledge and trust in health care providers' recommendations was higher amongst vaccinated individuals. Amongst the unvaccinated, trust was lower and there was a stronger belief that the vaccine would not prevent illness. Age was also associated with the likelihood of being vaccinated and greater vaccine knowledge and trust in provider recommendations. Unvaccinated individuals, particularly those under 54 years of age, did not hold strong distrust, attitudes were more neutral, and concern for others was moderate, suggesting an opportunity to target younger age groups. This study highlights the importance of trusted community messengers in conveying targeted messages on the safety and effectiveness of the flu vaccine.
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Affiliation(s)
- Henry Nuss
- New Orleans School of Public Health, LSU Health, Behavioral Community Health Sciences, New Orleans, LA, USA.
| | - Lois Privor-Dumm
- Johns Hopkins Bloomberg School of Public Health, International Vaccine Access Center, Baltimore, MD, USA
| | - Chinonso Ukachukwu
- Center for Sustainable Health Care Quality and Equity, National Minority Quality Forum, Washington, DC, USA
| | - Laura Lee Hall
- Center for Sustainable Health Care Quality and Equity, National Minority Quality Forum, Washington, DC, USA
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2
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Purvis RS, Moore R, Willis DE, Li J, Selig JP, Kraleti S, Imran T, McElfish PA. Exploring Hesitancy, Motivations, and Practical Issues for COVID-19 Vaccination Among Vaccine-Hesitant Adopter Parents Using the Increasing Vaccination Model. J Pediatr Health Care 2024; 38:456-467. [PMID: 38430095 PMCID: PMC11222047 DOI: 10.1016/j.pedhc.2024.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 12/12/2023] [Accepted: 01/28/2024] [Indexed: 03/03/2024]
Abstract
INTRODUCTION COVID-19 vaccination coverage among children remains low, and many parents report being hesitant to get their children vaccinated. This study explores factors influencing hesitancy and the facilitators that helped hesitant adopter parents choose to vaccinate their children against COVID-19 despite their hesitancy. METHOD We use a qualitative descriptive design with individual interviews (n = 20) to explore COVID-19 vaccine hesitancy and facilitators of vaccination among hesitant adopter parents. The Increasing Vaccination Model domains (thoughts and feelings, social processes, and practical issues) provided the framework for initial coding, and the research team identified nine emergent themes. RESULTS Findings document the factors influencing hesitancy and the facilitators motivating COVID-19 vaccination among hesitant adopter parents. DISCUSSION Findings fill the gap in the literature by providing hesitant adopters' lived experience, perspectives on vaccine hesitancy, and the influential factors that helped participants overcome their hesitancy and choose to vaccinate their children against COVID-19.
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Affiliation(s)
- Rachel S. Purvis
- College of Medicine, University of Arkansas for Medical
Sciences Northwest, Springdale, AR, USA
| | - Ramey Moore
- College of Medicine, University of Arkansas for Medical
Sciences Northwest, Springdale, AR, USA
| | - Don E. Willis
- College of Medicine, University of Arkansas for Medical
Sciences Northwest, Springdale, AR, USA
| | - Ji Li
- Fay W. Boozman College of Public Health, University of
Arkansas for Medical Sciences Northwest, Springdale, AR, USA
| | - James P. Selig
- Fay W. Boozman College of Public Health, University of
Arkansas for Medical Sciences Northwest, Springdale, AR, USA
| | - Shashank Kraleti
- College of Medicine, University of Arkansas for Medical
Sciences, Little Rock, AR, USA
| | - Tabasum Imran
- College of Medicine, University of Arkansas for Medical
Sciences West, Fort Smith, AR, USA
| | - Pearl A. McElfish
- College of Medicine, University of Arkansas for Medical
Sciences Northwest, Springdale, AR, USA
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Kou Y, Zhang N. Implicit theories of health predict influenza vaccination intention among elder Chinese: The mediating role of anticipated regret. J Health Psychol 2024:13591053241253067. [PMID: 38801106 DOI: 10.1177/13591053241253067] [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: 05/29/2024] Open
Abstract
Receiving influenza vaccines is the most effective public health strategy to protect people against seasonal flu infection. However, influenza vaccination rates are extremely low in China. This study investigated the association between implicit theories of health and influenza vaccination intention among elder Chinese when the vaccine is free (vs not free), and examined the mediating effect of anticipated regret. The results suggested that implicit theories of health, especially incremental theory of health, significantly predicted Chinese elders' influenza vaccination intention and this relationship was mediated by anticipated regret. Implications of the current research for promoting influenza vaccination among elder Chinese and directions for future research are discussed.
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Affiliation(s)
- Yun Kou
- School of Public Health and the Second Affiliated Hospital of Zhejiang University School of Medicine, China
| | - Ning Zhang
- School of Public Health and the Second Affiliated Hospital of Zhejiang University School of Medicine, China
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Ekow Arkorful V, Kweku Lugu B, Shuliang Z, Mamley Charway S. Investigating COVID-19 Vaccine Uptake Intention Using an Integrated Model of Protection Motivation Theory and an Extended Version of the Theory of Planned Behavior. HEALTH COMMUNICATION 2024; 39:998-1011. [PMID: 37128842 DOI: 10.1080/10410236.2023.2201730] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
As global governments continue to inoculate populations in the aftermath of the SARS-CoV-19 epidemic, health protection and related problems such as vaccination reluctance have sparked conflicting emotions and discourses. Stakeholder concerns about vaccination promotion have arisen in this context. Consequently, this research investigates vaccination uptake behavior using an integrated framework that includes protective motivation theory and an extended version of the theory of planned behavior. Except for perceived severity, empirical study results based on the structural equation modeling technique demonstrated a positive relationship between PMT factors (i.e. perceived vulnerability, reaction efficacy, self-efficacy, and cost response) and intention to vaccinate. TPB factors (attitude, perceived behavior control, subjective norm, personal moral norm, and descriptive norm) were also found to have a positive connection with intention. The model's utility and suitability are indicated by the predictive and explanatory potency score (R2 = .415). Study implications for COVID-19 vaccine uptake promotion and ideas for future investigations are explored in light of our findings.
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Affiliation(s)
| | | | - Zhao Shuliang
- School of Public Affairs, University of Science and Technology of China
| | - Susana Mamley Charway
- Department of Business Administration, Catholic Institute of Business and Technology
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5
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Weinstein N, Schwarz K, Chan I, Kobau R, Alexander R, Kollar L, Rodriguez L, Mansergh G, Repetski T, Gandhi P, Pechta L. COVID-19 Vaccine Hesitancy Among US Adults: Safety and Effectiveness Perceptions and Messaging to Increase Vaccine Confidence and Intent to Vaccinate. Public Health Rep 2024; 139:102-111. [PMID: 37924246 PMCID: PMC10905758 DOI: 10.1177/00333549231204419] [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] [Indexed: 11/06/2023] Open
Abstract
OBJECTIVE Public health agencies have a critical role in providing effective messaging about mitigation strategies during a public health emergency. The objectives of this study were (1) to understand perceptions of COVID-19 vaccines, including concerns about side effects, safety, and effectiveness and how these perceptions influence vaccine decision-making among US adults and (2) to learn what messages might motivate vaccine uptake. METHODS In April and May 2021, we conducted 14 online focus groups with non-Hispanic English-speaking and English- and Spanish-speaking Hispanic adults (N = 99) not vaccinated against COVID-19. We oversampled adults aged 18-39 years and rural residents and systematically assessed 10 test messages. Researchers used a standardized guide and an a priori codebook for focus group discussions, coding transcripts, and thematic analysis. RESULTS Vaccine hesitancy factors included fear of the unknown; long-term side effects, including infertility; and beliefs that the vaccines were developed too quickly and were not sufficiently effective. Motivating factors for receiving vaccination included the ability to safely socialize and travel. Health care providers were considered important trusted messengers. Participants were critical of most messages tested. Messages that came across as "honest" about what is not yet known about COVID-19 vaccines were perceived more positively than other messages tested. Messages were seen as ineffective if perceived as vague or lacking in data and specificity. CONCLUSIONS Messages that were simple and transparent about what is unknown about vaccines relative to emerging science were viewed most favorably. Health care providers, friends, and family were considered influential in vaccination decision-making. Findings underscore the benefits of research-informed strategies for developing and disseminating effective messages addressing critical issues in a public health emergency.
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Affiliation(s)
| | - Kelsey Schwarz
- Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Rosemarie Kobau
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Laura Kollar
- Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Gordon Mansergh
- Division of HIV Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | | | - Laura Pechta
- Division of Communications Science and Services, Office of Communication, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Rabin Y, Kohler RE. COVID-19 Vaccination Messengers, Communication Channels, and Messages Trusted Among Black Communities in the USA: a Review. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01858-1. [PMID: 37947953 PMCID: PMC11345940 DOI: 10.1007/s40615-023-01858-1] [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: 08/16/2023] [Revised: 10/26/2023] [Accepted: 10/27/2023] [Indexed: 11/12/2023]
Abstract
Black and African American adults exhibited higher levels of mistrust and vaccine hesitancy and lower levels of vaccination throughout the COVID-19 pandemic. Vaccination and booster uptake remains disproportionately low among Black adults. We conducted a systematic review of empirical research published between February 2021 and July 2022 from five electronic databases and the grey literature. We screened studies that assessed COVID-19 vaccination information needs and preferences as well as communication strategies among Black adults in the USA. We extracted data, then analyzed and synthesized results narratively. Twenty-two articles were included: 2 interventions, 3 experimental surveys, 7 observational surveys, 8 qualitative inquiries, and 2 mixed methods studies. Studies reported credible and preferred COVID-19 vaccination information sources/messengers, channels, and content. Commonly trusted messengers included personal health care providers, social network connections, and church/faith leaders. Electronic outreach (e.g., email, text messages), community events (e.g., forums, canvassing), and social media were popular. Black communities wanted hopeful, fact-based messages that address racism and mistrust; persuasive messages using collective appeals about protecting others may be more influential in changing behavior. Future communication strategies aiming to increase vaccine confidence and encourage COVID-19 booster vaccination among Black communities should be developed in partnership with community leaders and local health care providers to disseminate trauma-informed messages with transparent facts and collective action appeals across multiple in-person and electronic channels.
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Affiliation(s)
- Yael Rabin
- Department of Health Behavior Society and Policy, Rutgers School of Public Health, Piscataway, NJ, USA
| | - Racquel E Kohler
- Department of Health Behavior Society and Policy, Rutgers School of Public Health, Piscataway, NJ, USA.
- Center for Cancer Health Equity, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA.
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Osborne MT, Kenah E, Lancaster K, Tien J. Catch the tweet to fight the flu: Using Twitter to promote flu shots on a college campus. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:2470-2484. [PMID: 34519614 DOI: 10.1080/07448481.2021.1973480] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 06/18/2021] [Accepted: 08/16/2021] [Indexed: 06/13/2023]
Abstract
Objective: Over the 2018-2019 flu season we conducted a randomized controlled trial examining the efficacy of a Twitter campaign on vaccination rates. Concurrently we investigated potential interactions between digital social network structure and vaccination status. Participants: Undergratuates at a large midwestern public university were randomly assigned to an intervention (n = 353) or control (n = 349) group. Methods: Vaccination data were collected via monthly surveys. Participant Twitter data were collected through the public-facing Twitter API. Intervention impact was assessed with logistic regression. Standard network science tools examined vaccination coverage over online social networks. Results: The campaign had no effect on vaccination outcome. Receiving a flu shot the prior year had a positive impact on participant vaccination. Evidence of an interaction between digital social network structure and vaccination status was detected. Conclusions: Social media campaigns may not be sufficient for increasing vaccination rates. There may be potential for social media campaigns that leverage network structure.
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Affiliation(s)
- Matthew T Osborne
- Department of Mathematics, The Ohio State University, Columbus, Ohio, USA
| | - Eben Kenah
- College of Public Health Department of Biostatistics, The Ohio State University, Columbus, Ohio, USA
| | - Kathryn Lancaster
- College of Public Health, Department of Epidemiology, The Ohio State University, Columbus, Ohio, USA
| | - Joseph Tien
- Department of Mathematics, The Ohio State University, Columbus, Ohio, USA
- College of Public Health, Department of Epidemiology, The Ohio State University, Columbus, Ohio, USA
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Willis DE, Reece S, Gurel-Headley M, Selig JP, Li J, Zimmerman S, Cornett LE, McElfish PA. Social processes, practical issues, and COVID-19 vaccination among hesitant adults. Vaccine 2023; 41:5150-5158. [PMID: 37423799 PMCID: PMC11045247 DOI: 10.1016/j.vaccine.2023.07.006] [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: 04/06/2023] [Revised: 06/27/2023] [Accepted: 07/04/2023] [Indexed: 07/11/2023]
Abstract
INTRODUCTION The purpose of this study is to examine relationships between COVID-19 vaccination, social processes, and the practical issues of healthcare coverage and workplace requirements. We examine these relationships among individuals who expressed some degree of hesitancy towards receiving the vaccine. Assessing relationships between COVID-19 vaccination, social processes, and practical issues among vaccine-hesitant individuals has implications for public health policy and intervention. METHODS We analyzed weighted data from a random sample phone survey of Arkansas adults (N = 2,201) between March 1st and March 28th, 2022 and constrained our analytical sample to those who had reported some degree of vaccine hesitancy (N = 1,251). Statistical analyses included weighted and unweighted descriptive statistics, weighted bivariate logistic regressions, and a weighted multivariate logistic regression to obtain adjusted odds ratios for COVID-19 vaccination. RESULTS More than two-thirds (62.5 %) of respondents were vaccinated, despite their hesitancy. Adjusted odds of COVID-19 vaccination were greater among Black (OR = 2.55; 95 % CI[1.63, 3.97]) and Hispanic respondents (OR = 2.46; 95 % CI[1.53, 3.95]), respondents whose healthcare provider recommended vaccination (OR = 2.50; 95 % CI[1.66, 3.77]), and as perceptions of vaccination coverage (OR = 2.04; 95 % CI[1.71, 2.43]) and subjective social status increased (OR = 1.10; 95 % CI[1.01, 1.19]). Adjusted odds of COVID-19 vaccination were greater among respondents with a workplace that recommended (OR = 1.96; 95 % CI[1.03, 3.72]) or required vaccination (OR = 12.62; 95 % CI[4.76, 33.45]) and among respondents who were not employed (OR = 1.82; 95 % CI[1.10, 3.01]) compared to those whose workplace did not recommend or require COVID-19 vaccination. CONCLUSIONS Some hesitant individuals become vaccinated despite their hesitancy-a group we refer to as "hesitant adopters." Social processes and practical issues are important correlates of vaccination among those who are hesitant. Workplace requirements appear to be of particular importance for vaccination among hesitant individuals. Provider recommendations, norms, social status, and workplace policies may be effective points of intervention among those who express vaccine hesitancy.
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Affiliation(s)
- Don E Willis
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48(th) St., Springdale, AR 72762, USA.
| | - Sharon Reece
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave., Fayetteville, AR 72703, USA
| | - Morgan Gurel-Headley
- College of Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham St., Little Rock, AR 72205, USA
| | - James P Selig
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences Northwest, 2708 S. 48(th) St., Springdale, AR 72762, USA
| | - Ji Li
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences Northwest, 2708 S. 48(th) St., Springdale, AR 72762, USA
| | - Stacy Zimmerman
- College of Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham St., Little Rock, AR 72205, USA
| | - Lawrence E Cornett
- College of Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham St., Little Rock, AR 72205, USA
| | - Pearl A McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48(th) St., Springdale, AR 72762, USA
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Boulet SL, Stanhope KK, DeSantis C, Goebel A, Dolak J, Eze O, Gathoo A, Braun C, Sutton M, Jamieson DJ. A Descriptive Study of Maternal Vaccination Uptake, Attitudes, and Beliefs in Pregnancy Among Persons Delivering at an Urban Safety Net Hospital. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2023; 4:288-297. [PMID: 37363358 PMCID: PMC10285378 DOI: 10.1089/whr.2023.0032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 05/10/2023] [Indexed: 06/28/2023]
Abstract
Objective To estimate uptake of influenza, tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap), and COVID-19 vaccines during pregnancy and describe vaccine attitudes and beliefs among predominantly racial and ethnic minority individuals delivering at a publicly funded hospital. Methods We collected survey and electronic medical record data for English-speaking postpartum individuals who delivered a live-born infant from July 7, 2022, through August 21, 2022, and agreed to participate in our study. The 58-item survey included questions about general vaccine attitudes and beliefs as well as vaccine-specific questions. We calculated rates of influenza, Tdap, and COVID-19 vaccinations and compared distributions of survey responses by number (no vaccines, one vaccine, or two or three of the recommended vaccines) and type of vaccines received during pregnancy. Results Of the 231 eligible individuals, 125 (54.1%) agreed to participate. Rates of influenza, Tdap, and COVID-19 vaccination were 18.4%, 48.0%, and 5.6% respectively. A total of 61 (48.8%) did not receive any recommended vaccines during pregnancy, 40 (32.0%) received one vaccine, and 24 (19.0%) received two or three vaccines. Approximately 66.1% of the no vaccine group, 81.6% of the one vaccine group, and 87.5% of the two or three vaccine group strongly agreed or agreed that they trusted the vaccine information provided by their obstetrician or midwife. While most (>69.2%) agreed that the vaccine-preventable diseases were dangerous for pregnant women, only 24.0%, 29.3%, and 40.3% agreed that they were worried about getting influenza, whooping cough, or COVID-19, respectively, while pregnant. Discussion Vaccine uptake in our population was low and may be due, in part, to low perceived susceptibility to vaccine-preventable diseases. Obstetricians and midwives were trusted sources of vaccine information, suggesting that enhanced communication strategies could be critical for addressing maternal vaccine hesitancy, particularly in communities of color justifiably affected by medical mistrust.
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Affiliation(s)
- Sheree L. Boulet
- Department of Gynecology and Obstetrics, School of Medicine, Emory University, Atlanta, Georgia, USA
| | - Kaitlyn K. Stanhope
- Department of Gynecology and Obstetrics, School of Medicine, Emory University, Atlanta, Georgia, USA
| | - Carol DeSantis
- Department of Gynecology and Obstetrics, School of Medicine, Emory University, Atlanta, Georgia, USA
| | - Anna Goebel
- Department of Gynecology and Obstetrics, School of Medicine, Emory University, Atlanta, Georgia, USA
| | - Julia Dolak
- Department of Gynecology and Obstetrics, School of Medicine, Emory University, Atlanta, Georgia, USA
| | - Onyie Eze
- Department of Gynecology and Obstetrics, School of Medicine, Emory University, Atlanta, Georgia, USA
| | - Asmita Gathoo
- Department of Gynecology and Obstetrics, School of Medicine, Emory University, Atlanta, Georgia, USA
| | - Caroline Braun
- Department of Gynecology and Obstetrics, School of Medicine, Emory University, Atlanta, Georgia, USA
| | - Madeline Sutton
- Department of Obstetrics and Gynecology, Morehouse School of Medicine, Atlanta, Georgia, USA
| | - Denise J. Jamieson
- Department of Gynecology and Obstetrics, School of Medicine, Emory University, Atlanta, Georgia, USA
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Andersen JA, Gloster E, Hall S, Rowland B, Willis DE, Kraleti SS, McElfish PA. Associations between COVID-19 vaccine uptake, race/ethnicity, and political party affiliation. J Behav Med 2023; 46:525-531. [PMID: 36417011 PMCID: PMC9684822 DOI: 10.1007/s10865-022-00379-2] [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: 08/29/2022] [Accepted: 11/05/2022] [Indexed: 11/24/2022]
Abstract
Despite widespread availability of vaccines, COVID-19 is a leading cause of death in the United States (US), and sociodemographic disparities in vaccine uptake remain. Race/ethnicity, partisanship, and perception of peer vaccination status are strong predictors of vaccine uptake, but research is limited among some racial/ethnic groups with small populations. The current study used an online survey to examine the relationship between these factors among a diverse sample of US adults (n = 1,674), with oversampling of racial and ethnic minorities. Respondents provided sociodemographic information and answered questions regarding COVID-19 vaccination status, political affiliation, perception of peers' vaccination status, COVID-19 death exposure, and previous COVID-19 infection. Respondents who identified as Asian American had higher odds of being vaccinated, whereas those who identified as Black/African American or American Indian or Alaska Native (AIAN) had lower odds. Respondents who identified as Independent/Other or Republican had lower vaccination odds. Respondents who perceived anything less than nearly all of their peers were vaccinated had lower vaccination odds. Further, lack of a primary care provider, younger age, and lower educational attainment were associated with lower vaccination odds. Findings may help to determine where additional work is needed to improve vaccine uptake in the US. Results indicate the need for intentional and tailored vaccination programs in Black/African American and AIAN communities; the need to understand how media and political actors develop vaccination messaging and impact vaccine uptake; and the need for additional research on how people estimate, understand, and form decisions around peer vaccination rates.
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Affiliation(s)
- Jennifer A Andersen
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St.,, Springdale, AR, 72762, USA.
| | - Erin Gloster
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St.,, Springdale, AR, 72762, USA
| | - Spencer Hall
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St.,, Springdale, AR, 72762, USA
| | - Brett Rowland
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St.,, Springdale, AR, 72762, USA
| | - Don E Willis
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St.,, Springdale, AR, 72762, USA
| | - Shashank S Kraleti
- College of Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham St., Little Rock, AR, 72205, USA
| | - Pearl A McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St.,, Springdale, AR, 72762, USA
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11
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Sobierajski T, Rzymski P, Wanke-Rytt M. The Influence of Recommendation of Medical and Non-Medical Authorities on the Decision to Vaccinate against Influenza from a Social Vaccinology Perspective: Cross-Sectional, Representative Study of Polish Society. Vaccines (Basel) 2023; 11:vaccines11050994. [PMID: 37243098 DOI: 10.3390/vaccines11050994] [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: 04/19/2023] [Revised: 05/13/2023] [Accepted: 05/15/2023] [Indexed: 05/28/2023] Open
Abstract
Vaccination against seasonal flu is crucial to prevention of illness in modern societies. The level of influenza vaccination in Poland is low and, for many years, has hovered around a few percent of the general population. For this reason, it is crucial to understand the reasons for such a low level of vaccination and to assess the influence of medical and social authorities on the decision to vaccinate against influenza from the perspective of social vaccinology. For this purpose, a representative survey was conducted in 2022 among adult Poles (N = 805), orchestrated with the CAWI technique based on the author's questionnaire. The most significant authority in the context of influenza vaccination is held by physicians, especially among the oldest part of the population, over 65 years of age-in this group, 50.4% of respondents declare a very high level of respect for physicians on the issue of recommended influenza vaccination (p < 0.001), and the second-highest authority group for which seniors have respect in the aspect of influenza vaccination is pharmacists (p = 0.011). It was also shown that pharmacists have more authority on the issue of influenza vaccination than nurses, especially in the group that declared themselves opponents of vaccination (p < 0.001). The survey indicates the need to strengthen the authority of physicians and pharmacists regarding influenza vaccination, and, in the case of pharmacists, the need for changing the law to allow them to qualify for influenza vaccination.
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Affiliation(s)
- Tomasz Sobierajski
- The Center of Sociomedical Research, Faculty of Applied Social Sciences and Resocialization, University of Warsaw, 26/28 Krakowskie Przedmieście Str., 00-927 Warsaw, Poland
| | - Piotr Rzymski
- Department of Environmental Medicine, Poznan University of Medical Sciences, 60-806 Poznań, Poland
- Integrated Science Association (ISA), Universal Scientific Education and Research Network (USERN), 60-806 Poznań, Poland
| | - Monika Wanke-Rytt
- Department of Pediatrics with Clinical Assessment Unit, Medical University of Warsaw, 63a Żwirki i Wigury Str., 02-091 Warsaw, Poland
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Vriens E, Tummolini L, Andrighetto G. Vaccine-hesitant people misperceive the social norm of vaccination. PNAS NEXUS 2023; 2:pgad132. [PMID: 37168670 PMCID: PMC10165803 DOI: 10.1093/pnasnexus/pgad132] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 04/05/2023] [Accepted: 04/06/2023] [Indexed: 05/13/2023]
Abstract
Vaccine hesitancy is one of the main threats to global health, as became clear once more during the COVID-19 pandemic. Vaccination campaigns could benefit from appeals to social norms to promote vaccination, but without awareness of the social norm in place any intervention relying on social norms may backfire. We present a two-step approach of social norm diagnosis and intervention that identifies both whether a vaccination norm exists or develops over time and corrects misperceptions. In two studies (N = 887 and N = 412 ) conducted in Rome, Italy from June to August 2021 (during the first COVID-19 vaccination campaign), we show that vaccine-hesitant people strongly underestimated vaccine acceptance rates for COVID-19 despite increases in region-wide vaccination rates. This suggests a false consensus bias on the social norm of vaccination. We presented a subgroup of vaccine-hesitant people with the accurate vaccine acceptance rates (both planned uptake and vaccine approval) and tested if this social information would lower their vaccine hesitancy. We do not find clear effects, most likely because of the introduction of the COVID-19 health certificate (the "green pass") that was implemented during our data collection. The green pass reduced both misperceptions in the social norm and vaccine hesitancy, thus undermining our treatment effect. We conclude that to alleviate misperceptions on the social norm of vaccination in early stages of the vaccination campaign governments and media should report not just the current vaccination rate, but also about vaccination intentions and approval.
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Affiliation(s)
- Eva Vriens
- Institute of Cognitive Sciences and Technologies, Italian National Research Council, Via S. Martino della Battaglia 44, 00185 Rome, Italy
- Institute for Futures Studies, Holländargatan 13, 11136 Stockholm, Sweden
| | - Luca Tummolini
- Institute of Cognitive Sciences and Technologies, Italian National Research Council, Via S. Martino della Battaglia 44, 00185 Rome, Italy
- Institute for Futures Studies, Holländargatan 13, 11136 Stockholm, Sweden
| | - Giulia Andrighetto
- Institute of Cognitive Sciences and Technologies, Italian National Research Council, Via S. Martino della Battaglia 44, 00185 Rome, Italy
- Institute for Futures Studies, Holländargatan 13, 11136 Stockholm, Sweden
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13
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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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14
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Meng L, Masters NB, Lu PJ, Singleton JA, Kriss JL, Zhou T, Weiss D, Black CL. Cluster analysis of adults unvaccinated for COVID-19 based on behavioral and social factors, National Immunization Survey-Adult COVID Module, United States. Prev Med 2023; 167:107415. [PMID: 36596324 PMCID: PMC9804852 DOI: 10.1016/j.ypmed.2022.107415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 12/24/2022] [Accepted: 12/28/2022] [Indexed: 01/02/2023]
Abstract
By the end of 2021, approximately 15% of U.S. adults remained unvaccinated against COVID-19, and vaccination initiation rates had stagnated. We used unsupervised machine learning (K-means clustering) to identify clusters of unvaccinated respondents based on Behavioral and Social Drivers (BeSD) of COVID-19 vaccination and compared these clusters to vaccinated participants to better understand social/behavioral factors of non-vaccination. The National Immunization Survey Adult COVID Module collects data on U.S. adults from September 26-December 31,2021 (n = 187,756). Among all participants, 51.6% were male, with a mean age of 61 years, and the majority were non-Hispanic White (62.2%), followed by Hispanic (17.2%), Black (11.9%), and others (8.7%). K-means clustering procedure was used to classify unvaccinated participants into three clusters based on 9 survey BeSD items, including items assessing COVID-19 risk perception, social norms, vaccine confidence, and practical issues. Among unvaccinated adults (N = 23,397), 3 clusters were identified: the "Reachable" (23%), "Less reachable" (27%), and the "Least reachable" (50%). The least reachable cluster reported the lowest concern about COVID-19, mask-wearing behavior, perceived vaccine confidence, and were more likely to be male, non-Hispanic White, with no health conditions, from rural counties, have previously had COVID-19, and have not received a COVID-19 vaccine recommendation from a healthcare provider. This study identified, described, and compared the characteristics of the three unvaccinated subgroups. Public health practitioners, healthcare providers and community leaders can use these characteristics to better tailor messaging for each sub-population. Our findings may also help inform decisionmakers exploring possible policy interventions.
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Affiliation(s)
- Lu Meng
- CDC COVID-19 Response Team; General Dynamics Information Technology Inc., Falls Church, VA, United States of America.
| | - Nina B Masters
- CDC COVID-19 Response Team; Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC; Epidemic Intelligence Service, CDC, Atlanta, GA, United States of America
| | - Peng-Jun Lu
- CDC COVID-19 Response Team; Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, GA, United States of America
| | - James A Singleton
- CDC COVID-19 Response Team; Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, GA, United States of America
| | - Jennifer L Kriss
- CDC COVID-19 Response Team; Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, GA, United States of America
| | - Tianyi Zhou
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, GA, United States of America; Leidos Inc., Atlanta, GA, United States of America
| | - Debora Weiss
- CDC COVID-19 Response Team; Division of State and Local Readiness, Center for Preparedness and Response, CDC
| | - Carla L Black
- CDC COVID-19 Response Team; Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, GA, United States of America
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15
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Zhang L, Yang J, Cao Y, Kang W. Sociocultural-psychological predictors influencing parents' decision-making regarding HPV vaccination for their adolescent daughters in mainland China: An extended TPB model. Front Public Health 2023; 10:1035658. [PMID: 36684984 PMCID: PMC9853056 DOI: 10.3389/fpubh.2022.1035658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 12/12/2022] [Indexed: 01/09/2023] Open
Abstract
Introduction Enhancing human papillomavirus (HPV) vaccine uptake rates to protect women's health is an important public health issue worldwide. China has taken a series of measures in recent years to promote HPV vaccination among school-aged girls, but the vaccine uptake rate remains low. Investigating the factors influencing vaccination-related decision-making of adolescent girls' parents is key to solving the problem. This study aimed to examine the influence of sociocultural-psychological predictors, including exposure to HPV-related stories (positive/negative), affective reactions (pride/regret), injunctive norms on the Internet and perceived moral obligation, on parents' HPV vaccination-related decision-making for girls aged 13-15 years in mainland China. Methods A cross-sectional online survey using quota sampling was conducted in February 2022. Four hundred and five valid and qualified questionnaires were obtained. Partial least squares structural equation modeling was performed by SmartPLS 3 (i) to evaluate the reliability and validity of the measurement models of 11 constructs, and (ii) to test the effect relationships of the sociocultural-psychological predictors on parents' intention to vaccinate their daughters. Results The study findings showed that parental decision-making regarding HPV vaccination was influenced by sociocultural and psychological factors. At the level of individual psychological factors, exposure to positive stories was significantly associated with perceived vaccine effectiveness (β = 0.331, t = 8.448, p < 0.001), which strongly predicted the attitude toward vaccination (β = 0.521, t = 8.133, p < 0.001); anticipated pride had more positive influence on vaccination-related decision-making (β = 0.156, t = 2.176, p < 0.05) than anticipated regret. In terms of social influence, injunctive norms on the Internet had a significantly positive influence on vaccination intention (β = 0.127, t = 2.382, p < 0.05), similar to descriptive norms (β = 0.135, t = 3.358, p < 0.01). Perceived moral obligation at the cultural level was the strongest predictor of parental decision-making regarding HPV vaccination (β = 0.193, t = 2.139, p < 0.05). Discussion This study is the first in mainland China to systematically examine the sociocultural-psychological predictors of parents' decision-making to vaccinate their 13-15-year-old daughters against HPV. A new extended TPB model with a sociocultural-psychological approach was developed. This model can support the investigation of factors affecting HPV vaccine uptake rates in the mainland Chinese population and similar populations and help to understand the differences in vaccination-related decision-making between Eastern and Western cultures. Furthermore, the study provided some suggestions for HPV vaccination communication campaigns targeting adolescent girls' parents.
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Affiliation(s)
- Lingmin Zhang
- School of Journalism and Communication, Guangzhou University, Guangzhou, China
| | - Jian Yang
- School of Journalism and Communication, Guangzhou University, Guangzhou, China,*Correspondence: Jian Yang ✉
| | - Ye Cao
- Archives Office, Guizhou Open University, Guiyang, China
| | - Wanying Kang
- School of Media and Communication, Shenzhen University, Shenzhen, China
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16
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Shapiro JR, Privor-Dumm L, Rosser EN, Leng SX, Klein SL, Morgan R. The intersection of gender and race in older adults' decision to receive COVID-19 vaccines. Vaccine 2023; 41:211-218. [PMID: 36435705 PMCID: PMC9485425 DOI: 10.1016/j.vaccine.2022.09.043] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 08/09/2022] [Accepted: 09/13/2022] [Indexed: 02/04/2023]
Abstract
COVID-19 vaccines are essential public health tools for protecting older adults, who are at high risk of severe outcomes associated with COVID-19. Little is known, however, about how older adults approach the decision to receive a COVID-19 vaccine. We hypothesized that intersections between gender and race may provide unique insight into the decision-making process and the factors that lead to vaccine uptake among hesitant individuals. We performed in-depth interviews with 24 older adults who had been vaccinated against COVID-19 and used the framework approach with an intersectional lens to analyze data. Two typologies emerged: eager compliers did not question the need to vaccinate, whereas hesitant compliers were skeptical of the vaccine and underwent a thorough decision-making process prior to vaccination. For eager compliers, the vaccine offered protection from a disease that posed a serious threat, and few risks were perceived. In contrast, hesitant compliers perceived risks associated with the vaccine product or mistrusted the infrastructure that led to rapid vaccine development. Hesitancy was greater among Black participants, and only Black participants reported mistrust in vaccine infrastructure. At the intersection of gender and race, a 'White male effect' was observed, whereby White men perceived the fewest risks associated with the vaccine, and Black women were the most fearful of serious side effects. Nearly all hesitant compliers ultimately got vaccinated due to the threat of COVID-19. Convenient access through vaccine clinics in senior's buildings was pivotal for hesitant compliers and external and internal influences had differential impacts by race and gender. Emphasizing the risk of COVID-19, convenient and accessible opportunities for vaccination, and messages that are targeted to specific groups are likely to increase vaccine uptake among older adults.
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Affiliation(s)
- Janna R Shapiro
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Lois Privor-Dumm
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; International Vaccine Access Centre, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Erica N Rosser
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Sean X Leng
- Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA; W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Sabra L Klein
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Rosemary Morgan
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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17
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Huang Q, Abad N, Bonner KE, Baack B, Petrin R, Hendrich MA, Lewis Z, Brewer NT. Explaining demographic differences in COVID-19 vaccination stage in the United States - April-May 2021. Prev Med 2023; 166:107341. [PMID: 36372280 PMCID: PMC9650505 DOI: 10.1016/j.ypmed.2022.107341] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 10/21/2022] [Accepted: 11/05/2022] [Indexed: 11/13/2022]
Abstract
COVID-19 vaccine coverage in the US has marked demographic and geographical disparities, but few explanations exist for them. Our paper aimed to identify behavioral and social drivers that explain these vaccination disparities. Participants were a national probability sample of 3562 American adults, recruited from the Ipsos KnowledgePanel. Participants completed an online survey in spring 2021, when COVD-19 vaccination was available for higher-risk groups but not yet available to all US adults. The survey assessed COVID-19 vaccination stage (intentions and vaccine uptake), constructs from the Increasing Vaccination Model (IVM) domains (thinking and feeling, social processes, and direct behavior change), self-reported exposure to COVID-19 vaccine information, and demographic characteristics. Analyses used multiple imputation to address item nonresponse and linear regressions to conduct mediation analyses. Higher COVID-19 vaccination stage was strongly associated with older age, liberal political ideology, and higher income in adjusted analyses (all p < .001). Vaccination stage was more modestly associated with urbanicity, white race, and Hispanic ethnicity (all p < .05). Some key mediators that explained more than one-third of demographic differences in vaccination stage were perceived vaccine effectiveness, social norms, and recommendations from family and friends across most demographic characteristics (all p < .05). Other mediators included safety concerns, trust, altruism, provider recommendation, and information seeking. Access to vaccination, barriers to vaccination, and self-efficacy explained few demographic differences. One of the most reliable explanations for demographic differences in COVID-19 vaccination stage is social processes, including social norms, recommendations, and altruism. Interventions to promote COVID-19 vaccination should address social processes and other domains in the IVM.
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Affiliation(s)
- Qian Huang
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
| | - Neetu Abad
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Brittney Baack
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | | | | | - Noel T Brewer
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
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18
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Mantina NM, Block Ngaybe M, Johnson K, Velickovic S, Magrath P, Gerald LB, Krupp K, Krauss B, Perez-Velez CM, Madhivanan P. Racial/ethnic disparities in influenza risk perception and vaccination intention among Pima County residents in Arizona. Hum Vaccin Immunother 2022; 18:2154506. [PMID: 36476311 PMCID: PMC9762835 DOI: 10.1080/21645515.2022.2154506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
While influenza cases in Arizona have nearly tripled since 2018, vaccination rates continue to lag. Statewide, Hispanics and African Americans had the lowest vaccination rates despite having higher influenza infection rates than Whites. Given Arizona's racial influenza vaccination disparity and the general increase in vaccination hesitancy due to COVID-19, the purpose of this study was to better understand the influences of seasonal influenza vaccination in Arizona during the COVID-19 pandemic using qualitative methods. Findings from this study revealed that many participants were motivated to get the influenza vaccine to protect their family and close friends. The heightened concern for COVID-19 prompted some Hispanic/Latino focus group discussion participants to consider getting vaccinated. However, many Hispanic/Latino participants also expressed that they stopped getting influenza vaccine due to negative vaccination experiences or concern about sickness following immunization. African American participants primarily discussed receiving the vaccine as part of their routine health visit. Compared to other races, more White participants believed that vaccination was unimportant because they were healthy, and the people they interacted with never got sick. Distinct factors influence risk perception and vaccination intention across different racial/ethnic groups. Effective interventions can account for these factors and be tailored to the target population to maximize vaccination uptake.
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Affiliation(s)
- Namoonga M. Mantina
- Department of Health Promotion Sciences, Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA,CONTACT Namoonga M. Mantina Department of Health Promotion Sciences, Mel & Enid Zuckerman College of Public Health, University of Arizona, 1295 N Martin Avenue, Tucson, AZ85724-5209, USA
| | - Maiya Block Ngaybe
- Department of Health Promotion Sciences, Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Kerry Johnson
- Department of Health Promotion Sciences, Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Sonja Velickovic
- Department of Health Promotion Sciences, Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Priscilla Magrath
- Department of Health Promotion Sciences, Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Lynn B. Gerald
- Office of the Vice Chancellor for Health Affairs, University of Illinois Chicago, Chicago, IL, USA
| | - Karl Krupp
- Division of Public Health Practice and Translational Research, Mel & Enid Zuckerman College of Public Health, University of Arizona, Phoenix, AZ, USA
| | - Beatrice Krauss
- Department of Psychology, University of Arizona, Tucson, AZ, USA
| | - Carlos M. Perez-Velez
- Division of Epidemiology, Pima County Health Department, Tucson, AZ, USA,Division of Infectious Diseases, Department of Medicine, College of Medicine, University of Arizona, Tucson, AZ, USA
| | - Purnima Madhivanan
- Department of Health Promotion Sciences, Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA,Division of Infectious Diseases, Department of Medicine, College of Medicine, University of Arizona, Tucson, AZ, USA
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19
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Sun Y, Hamedani MF, Javidi G, Sheybani E, Hao F. Examining COVID-19 vaccine attitude using SEM-Artificial Neural Networks approach: a case from Reddit community. Health Promot Int 2022; 37:6823579. [DOI: 10.1093/heapro/daac157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Summary
As new coronavirus variants continue to emerge, in order to better address vaccine-related concerns and promote vaccine uptake in the next few years, the role played by online communities in shaping individuals’ vaccine attitudes has become an important lesson for public health practitioners and policymakers to learn. Examining the mechanism that underpins the impact of participating in online communities on the attitude toward COVID-19 vaccines, this study adopted a two-stage hybrid structural equation modeling (SEM)-artificial neural networks (ANN) approach to analyze the survey responses from 1037 Reddit community members. Findings from SEM demonstrated that in leading up to positive COVID-19 vaccine attitudes, sense of online community mediates the positive effects of perceived emotional support and social media usage, and perceived social norm mediates the positive effect of sense of online community as well as the negative effect of political conservatism. Health self-efficacy plays a moderating role between perceived emotional support and perceived social norm of COVID-19 vaccination. Results from the ANN model showed that online community members’ perceived social norm of COVID-19 vaccination acts as the most important predictor of positive COVID-19 vaccine attitudes. This study highlights the importance of harnessing online communities in designing COVID-related public health interventions and accelerating normative change in relation to vaccination.
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Affiliation(s)
- Yao Sun
- Department of Humanities and Social Sciences, College of Science and Liberal Arts, New Jersey Institute of Technology , Cullimore Hall, University Heights, Newark, New Jersey 07102 , USA
| | - Moez Farokhnia Hamedani
- School of Information Systems and Management, Muma College of Business, University of South Florida , 4202 E. Fowler Avenue, Tampa, Florida 33620 , USA
| | - Giti Javidi
- School of Information Systems and Management, Muma College of Business, University of South Florida , 4202 E. Fowler Avenue, Tampa, Florida 33620 , USA
| | - Ehsan Sheybani
- School of Information Systems and Management, Muma College of Business, University of South Florida , 4202 E. Fowler Avenue, Tampa, Florida 33620 , USA
| | - Feng Hao
- Department of Sociology, College of Arts and Sciences, University of South Florida Sarasota-Manatee , 8350 N Tamiami Trail, Sarasota, Florida 34243 , USA
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20
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Teslya A, Nunner H, Buskens V, Kretzschmar ME. The effect of competition between health opinions on epidemic dynamics. PNAS NEXUS 2022; 1:pgac260. [PMID: 36712334 PMCID: PMC9802282 DOI: 10.1093/pnasnexus/pgac260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 11/08/2022] [Indexed: 11/18/2022]
Abstract
Past major epidemic events showed that when an infectious disease is perceived to cause severe health outcomes, individuals modify health behavior affecting epidemic dynamics. To investigate the effect of this feedback relationship on epidemic dynamics, we developed a compartmental model that couples a disease spread framework with competition of two mutually exclusive health opinions (health-positive and health-neutral) associated with different health behaviors. The model is based on the assumption that individuals switch health opinions as a result of exposure to opinions of others through interpersonal communications. To model opinion switch rates, we considered a family of functions and identified the ones that allow health opinions to coexist. Finally, the model includes assortative mixing by opinions. In the disease-free population, either the opinions cannot coexist and one of them is always dominating (mono-opinion equilibrium) or there is at least one stable coexistence of opinions equilibrium. In the latter case, there is multistability between the coexistence equilibrium and the two mono-opinion equilibria. When two opinions coexist, it depends on their distribution whether the infection can invade. If presence of the infection leads to increased switching to a health-positive opinion, the epidemic burden becomes smaller than indicated by the basic reproduction number. Additionally, a feedback between epidemic dynamics and health opinion dynamics may result in (sustained) oscillatory dynamics and a switch to a different stable opinion distribution. Our model captures feedback between spread of awareness through social interactions and infection dynamics and can serve as a basis for more elaborate individual-based models.
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Affiliation(s)
- Alexandra Teslya
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, 3584 CX Utrecht, The Netherlands
| | - Hendrik Nunner
- Department of Sociology/ICS, Utrecht University, Padualaan 14, 3584 CH Utrecht, The Netherlands
- Centre for Complex System Studies (CCSS), Utrecht University, Leuvenlaan 4, 3584 CE Utrecht, The Netherlands
| | - Vincent Buskens
- Department of Sociology/ICS, Utrecht University, Padualaan 14, 3584 CH Utrecht, The Netherlands
- Centre for Complex System Studies (CCSS), Utrecht University, Leuvenlaan 4, 3584 CE Utrecht, The Netherlands
| | - Mirjam E Kretzschmar
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, 3584 CX Utrecht, The Netherlands
- Centre for Complex System Studies (CCSS), Utrecht University, Leuvenlaan 4, 3584 CE Utrecht, The Netherlands
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21
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Freeman D, Loe BS, Chadwick A, Vaccari C, Waite F, Rosebrock L, Jenner L, Petit A, Lewandowsky S, Vanderslott S, Innocenti S, Larkin M, Giubilini A, Yu LM, McShane H, Pollard AJ, Lambe S. COVID-19 vaccine hesitancy in the UK: the Oxford coronavirus explanations, attitudes, and narratives survey (Oceans) II. Psychol Med 2022; 52:3127-3141. [PMID: 33305716 PMCID: PMC7804077 DOI: 10.1017/s0033291720005188] [Citation(s) in RCA: 429] [Impact Index Per Article: 214.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 12/07/2020] [Accepted: 12/08/2020] [Indexed: 01/05/2023]
Abstract
BACKGROUND Our aim was to estimate provisional willingness to receive a coronavirus 2019 (COVID-19) vaccine, identify predictive socio-demographic factors, and, principally, determine potential causes in order to guide information provision. METHODS A non-probability online survey was conducted (24th September-17th October 2020) with 5,114 UK adults, quota sampled to match the population for age, gender, ethnicity, income, and region. The Oxford COVID-19 vaccine hesitancy scale assessed intent to take an approved vaccine. Structural equation modelling estimated explanatory factor relationships. RESULTS 71.7% (n=3,667) were willing to be vaccinated, 16.6% (n=849) were very unsure, and 11.7% (n=598) were strongly hesitant. An excellent model fit (RMSEA=0.05/CFI=0.97/TLI=0.97), explaining 86% of variance in hesitancy, was provided by beliefs about the collective importance, efficacy, side-effects, and speed of development of a COVID-19 vaccine. A second model, with reasonable fit (RMSEA=0.03/CFI=0.93/TLI=0.92), explaining 32% of variance, highlighted two higher-order explanatory factors: 'excessive mistrust' (r=0.51), including conspiracy beliefs, negative views of doctors, and need for chaos, and 'positive healthcare experiences' (r=-0.48), including supportive doctor interactions and good NHS care. Hesitancy was associated with younger age, female gender, lower income, and ethnicity, but socio-demographic information explained little variance (9.8%). Hesitancy was associated with lower adherence to social distancing guidelines. CONCLUSIONS COVID-19 vaccine hesitancy is relatively evenly spread across the population. Willingness to take a vaccine is closely bound to recognition of the collective importance. Vaccine public information that highlights prosocial benefits may be especially effective. Factors such as conspiracy beliefs that foster mistrust and erode social cohesion will lower vaccine up-take.
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Affiliation(s)
- Daniel Freeman
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - Bao S. Loe
- The Psychometrics Centre, University of Cambridge, Cambridge, UK
| | - Andrew Chadwick
- Online Civic Culture Centre, Department of Communication and Media, Loughborough University, Loughborough, UK
| | - Cristian Vaccari
- Online Civic Culture Centre, Department of Communication and Media, Loughborough University, Loughborough, UK
| | - Felicity Waite
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - Laina Rosebrock
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - Lucy Jenner
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - Ariane Petit
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | | | - Samantha Vanderslott
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK
| | - Stefania Innocenti
- Smith School of Enterprise and the Environment, University of Oxford, Oxford, UK
| | - Michael Larkin
- Department of Psychology, Life and Health Sciences, Aston University, Birmingham, UK
| | - Alberto Giubilini
- Oxford Uehiro Centre for Practical Ethics, University of Oxford, Oxford, UK
| | - Ly-Mee Yu
- Nuffield Department of Primary Care, University of Oxford, Oxford, UK
| | - Helen McShane
- Nuffield Department of Medicine, The Jenner Institute, University of Oxford, Oxford, UK
| | - Andrew J. Pollard
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK
| | - Sinéad Lambe
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
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22
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Freeman D, Loe BS, Chadwick A, Vaccari C, Waite F, Rosebrock L, Jenner L, Petit A, Lewandowsky S, Vanderslott S, Innocenti S, Larkin M, Giubilini A, Yu LM, McShane H, Pollard AJ, Lambe S. COVID-19 vaccine hesitancy in the UK: the Oxford coronavirus explanations, attitudes, and narratives survey (Oceans) II. Psychol Med 2022. [PMID: 33305716 DOI: 10.1017/s0033291720001890,1-13] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/20/2023]
Abstract
BACKGROUND Our aim was to estimate provisional willingness to receive a coronavirus 2019 (COVID-19) vaccine, identify predictive socio-demographic factors, and, principally, determine potential causes in order to guide information provision. METHODS A non-probability online survey was conducted (24th September-17th October 2020) with 5,114 UK adults, quota sampled to match the population for age, gender, ethnicity, income, and region. The Oxford COVID-19 vaccine hesitancy scale assessed intent to take an approved vaccine. Structural equation modelling estimated explanatory factor relationships. RESULTS 71.7% (n=3,667) were willing to be vaccinated, 16.6% (n=849) were very unsure, and 11.7% (n=598) were strongly hesitant. An excellent model fit (RMSEA=0.05/CFI=0.97/TLI=0.97), explaining 86% of variance in hesitancy, was provided by beliefs about the collective importance, efficacy, side-effects, and speed of development of a COVID-19 vaccine. A second model, with reasonable fit (RMSEA=0.03/CFI=0.93/TLI=0.92), explaining 32% of variance, highlighted two higher-order explanatory factors: 'excessive mistrust' (r=0.51), including conspiracy beliefs, negative views of doctors, and need for chaos, and 'positive healthcare experiences' (r=-0.48), including supportive doctor interactions and good NHS care. Hesitancy was associated with younger age, female gender, lower income, and ethnicity, but socio-demographic information explained little variance (9.8%). Hesitancy was associated with lower adherence to social distancing guidelines. CONCLUSIONS COVID-19 vaccine hesitancy is relatively evenly spread across the population. Willingness to take a vaccine is closely bound to recognition of the collective importance. Vaccine public information that highlights prosocial benefits may be especially effective. Factors such as conspiracy beliefs that foster mistrust and erode social cohesion will lower vaccine up-take.
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Affiliation(s)
- Daniel Freeman
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - Bao S Loe
- The Psychometrics Centre, University of Cambridge, Cambridge, UK
| | - Andrew Chadwick
- Online Civic Culture Centre, Department of Communication and Media, Loughborough University, Loughborough, UK
| | - Cristian Vaccari
- Online Civic Culture Centre, Department of Communication and Media, Loughborough University, Loughborough, UK
| | - Felicity Waite
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - Laina Rosebrock
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - Lucy Jenner
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - Ariane Petit
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | | | - Samantha Vanderslott
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK
| | - Stefania Innocenti
- Smith School of Enterprise and the Environment, University of Oxford, Oxford, UK
| | - Michael Larkin
- Department of Psychology, Life and Health Sciences, Aston University, Birmingham, UK
| | - Alberto Giubilini
- Oxford Uehiro Centre for Practical Ethics, University of Oxford, Oxford, UK
| | - Ly-Mee Yu
- Nuffield Department of Primary Care, University of Oxford, Oxford, UK
| | - Helen McShane
- Nuffield Department of Medicine, The Jenner Institute, University of Oxford, Oxford, UK
| | - Andrew J Pollard
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK
| | - Sinéad Lambe
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
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23
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“I Would Never Push a Vaccine on You”: A Qualitative Study of Social Norms and Pressure in Vaccine Behavior in the U.S. Vaccines (Basel) 2022; 10:vaccines10091402. [PMID: 36146480 PMCID: PMC9502292 DOI: 10.3390/vaccines10091402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 08/19/2022] [Accepted: 08/20/2022] [Indexed: 12/16/2022] Open
Abstract
Previous researchers have established the influence of social norms on vaccine behavior. However, little work has been performed contextualizing individuals’ experience with these social factors and how they operate to persuade individuals’ acceptance or refusal of a vaccine. We aimed to determine the mechanisms of familial and societal pressure or expectations that contribute to COVID-19 vaccine decision-making. We conducted four focus groups and eleven individual interviews (total n = 32) with participants from across the U.S. of different vaccination statuses. We identified three emergent themes: (1) Altruistic reasoning was particularly prevalent among initially hesitant late adopters—the desire to protect loved ones and others constituted a dominant motive, more powerful than protecting oneself. Vaccination was also reckoned as part of a joint effort to return to normal life; hence, it invoked a sense of responsibility or “obligation”; (2) expectation often became pressure; although most vaccinated participants stated that they respected others’ choices, late adopters or unvaccinated participants perceived differently and felt rushed or “forced” into choosing, and many resented being “targeted” or “bullied”; (3) vaccination status became a new label, frequently dividing families, thus producing familial mandates, exclusions, or social stratifications. This caused sadness and feelings of isolation, along with the formation of a camaraderie among the excluded unvaccinated. A vaccine decision builds from the complexities of individuals’ experiences and cultures. The vaccinated were not free of hesitancy nor were the unvaccinated all anti-vaxxers. Vigorous vaccine promotion successfully converted some undecided individuals but also fostered distrust of government; alarmingly, the push to receive the COVID-19 vaccine further triggered doubts about established vaccines. Communication strategies need to be developed and implemented carefully so as not to ostracize the unvaccinated community and strengthen their resistance.
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24
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Barteit S, Hachaturyan V, Beleites F, Kühn T, Favaretti C, Adam M, Bärnighausen T. The effect of a short, animated story-based video on COVID-19 vaccine hesitancy: A study protocol for an online randomized controlled trial. Front Public Health 2022; 10:939227. [PMID: 36081470 PMCID: PMC9448293 DOI: 10.3389/fpubh.2022.939227] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 07/22/2022] [Indexed: 01/25/2023] Open
Abstract
Introduction Exposure to a high volume of vaccine misinformation on social media can have a negative effect on vaccine confidence and rates. To counteract misinformation, we designed a collage of three short, animated story-based (SAS) videos to convey scientifically informed and accessible information about COVID-19 vaccine applicable to a social media context. Methods and analysis We will conduct an online randomized controlled trial primarily to: (1) determine the effectiveness of SAS videos in improving COVID-19 vaccine knowledge; (2) evaluate the effectiveness of SAS videos in increasing behavioral intent for COVID-19 vaccination; and (3) quantify people's interest in watching SAS videos about the COVID-19 vaccine. We also aim to identify barriers and facilitators to COIVD-19 vaccinations that have been shown to minimize vaccine hesitancy between vaccinated and unvaccinated populations. Using a web-based recruitment platform, a total of 10,000 adults from the United States will be recruited and randomly assigned to (1) a SAS video collage arm, (2) an attention placebo control video arm, or (3) no intervention arm (1:1:1). Furthermore, we will measure behavioral intent to obtain information on vaccination regarding COVID-19. At the end of the trial, participants randomized to arm 2 and arm 3 will be given the option of watching one of the intervention videos voluntarily to assess participant engagement with SAS videos. Finally, we will assess individual factors associated with vaccine hesitancy - hope, optimism, COVID-19 perceived risks and benefits, self-efficacy, perceived social norms, and trust - and compare vaccinated and unvaccinated participants across the three arms. Discussions Evidence-based information from official channels can be complex and inaccessible to the general public, whereas false information on social media is frequently shared in brief postings, images, or videos that can easily reach the general public, thereby rapidly disseminating (mis-)information. To avoid the spread of misinformation, social media may be used to deliver evidence-based and emotionally compelling information in a readily accessible format in order to pre-empt misinformation. Our findings may help inform future SAS efforts addressing COVID-19 and other important public health challenges. Ethics and dissemination The study was approved by the Heidelberg University Hospital's Ethics Committee (S-163/2022). The trial was registered with German Clinical Trials Register (www.drks.de) on 5 January 2022: number DRKS00027938. Findings of the study will be published in peer-reviewed scientific publications and possibly presented at scientific conferences.
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Affiliation(s)
- Sandra Barteit
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany,*Correspondence: Sandra Barteit
| | - Violetta Hachaturyan
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Ferdinand Beleites
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Tilman Kühn
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany,Institute for Global Food Security (IGFS), Queen's University Belfast, Belfast, United Kingdom
| | - Caterina Favaretti
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany,Professorship of Behavioral Science for Disease Prevention and Health Care, Technical University of Munich, Munich, Germany
| | - Maya Adam
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, United States
| | - Till Bärnighausen
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany,Africa Health Research Institute (AHRI), Durban, South Africa,Harvard Center for Population and Development Studies, Cambridge, MA, United States
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25
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de Vries M, Claassen L, Lambooij M, Leung KY, Boersma K, Timen A. COVID-19 Vaccination Intent and Belief that Vaccination Will End the Pandemic. Emerg Infect Dis 2022; 28:1642-1649. [PMID: 35797995 PMCID: PMC9328899 DOI: 10.3201/eid2808.212556] [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] [Indexed: 11/22/2022] Open
Abstract
High vaccination coverage is considered to be key in dealing with the coronavirus disease (COVID-19) pandemic. However, vaccine hesitancy can limit uptake. We examined the specific coronavirus beliefs that persons have regarding COVID-19 and COVID-19 vaccines and to what extent these beliefs explain COVID-19 vaccination intentions. We conducted a survey among 4,033 residents of the Netherlands that examined COVID-19 vaccination intentions and various beliefs. Random forest regression analysis explained 76% of the variance in vaccination intentions. The strongest determinant in the model was the belief the COVID-19 crisis will only end if many persons get vaccinated. Other strong determinants were beliefs about safety of vaccines, specifically in relation to vaccine development and approval process; (social) benefits of vaccination; social norms regarding vaccination behavior; and effectiveness of vaccines. We propose to address these specific beliefs in communications about COVID-19 vaccinations to stimulate vaccine uptake.
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26
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Okai GA, Abekah-Nkrumah G. The level and determinants of COVID-19 vaccine acceptance in Ghana. PLoS One 2022; 17:e0270768. [PMID: 35802742 PMCID: PMC9269973 DOI: 10.1371/journal.pone.0270768] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 06/16/2022] [Indexed: 12/11/2022] Open
Abstract
Objective
As part of the efforts to curb the COVID-19 pandemic, the government of Ghana has received several shipments of approved vaccines, and administration has begun in the country. Studies examining the determinants of COVID-19 vaccine acceptance in Ghana were mostly conducted before the vaccination exercise. Vaccine acceptance decisions however vary with time and hence, peoples’ decisions may have changed once vaccines became accessible. This study examines the level and determinants of COVID-19 vaccine acceptance among adult Ghanaians during the vaccination exercise.
Methods
The study was a cross-sectional online survey involving Ghanaian adults (18 years and above) eligible to take the COVID-19 vaccine. The study was conducted from 18th May 2021 to 14th July 2021 and the questionnaire was answered by 362 respondents. Snowball sampling technique was utilized to obtain the respondents. Probit regression analysis was used to identify factors influencing COVID-19 vaccine acceptance.
Key findings
Only 62.7% of the respondents indicated that they will accept the COVID-19 vaccine if provided. The regression results revealed that the decision to accept the COVID-19 vaccine was influenced by occupation, perceived susceptibility, perceived benefits and attitudes towards the vaccines.
Conclusion
The findings suggest that government must implement strategies to enhance positive attitudes toward vaccines, increase the risk perception of contracting the virus and also educate the populace about the benefits of the vaccine.
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Affiliation(s)
- Grace Adjei Okai
- Department of Public Administration and Health Services Management, University of Ghana Business School, Legon, Accra, Ghana
| | - Gordon Abekah-Nkrumah
- Department of Public Administration and Health Services Management, University of Ghana Business School, Legon, Accra, Ghana
- * E-mail:
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27
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Jones WD. An Ecological Theory Application and Expansion to the COVID-19 Pandemic's Impact on African Americans and Contributors to Vaccine Hesitancy. SOCIAL WORK IN PUBLIC HEALTH 2022; 37:456-467. [PMID: 34970946 DOI: 10.1080/19371918.2021.2020200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The COVID-19 pandemic has highlighted numerous social and health disparities within the United States, particularly those that impact African Americans. African Americans have been overrepresented in the number of COVID-19 hospitalizations and deaths and have demonstrated lower vaccine inoculation compared to other ethnic groups. This article applies Urie Bronfenbrenner's Ecological Theory to the disproportionate impact the COVID-19 pandemic has had on African Americans and contributors to vaccine hesitancy while offering an expansion to the theory utilizing the Health Belief Model. The Health Belief Model was utilized to address the intervention limitations of the Ecological Theory as the better determine which system(s) would be most advantageous to for health intervention(s). This article extends the social work knowledge base and application by offering implications for practice and research.
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Affiliation(s)
- Willie D Jones
- Wayne State University School of Social Work, Wayne State University, Detroit, Michigan, USA
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28
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Pourkarim M, Nayebzadeh S, Alavian SM, Hataminasab SH. Digital Marketing: A Unique Multidisciplinary Approach towards the Elimination of Viral Hepatitis. Pathogens 2022; 11:626. [PMID: 35745480 PMCID: PMC9228079 DOI: 10.3390/pathogens11060626] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/17/2022] [Accepted: 05/27/2022] [Indexed: 12/16/2022] Open
Abstract
New technologies are supported by the global implementation of the internet. These improvements have deeply affected various disciplines of sciences and consequently changed services such as daily business, particularly health sectors. Innovative digital marketing strategies utilize the channels of social media and retrieved user data to analyze and improve relevant services. These multidisciplinary innovations can assist specialists, physicians and researchers in diagnostic, prophylaxis and treatment issues in the health sector. Accordingly, compared to recent decades, health decision makers are more accurate and trustful in defining new strategies. Interestingly, using social media and mobile health apps in current pandemics of SARS-CoV-2 could be an important instance of the key role of these platforms at the local and global level of health policies. These digital technologies provide platforms to connect public health sectors and health politicians for communicating and spreading relevant information. Adding influencers and campaigns to this toolbox strengthens the implementation of public health programs. In 2016, the WHO adopted a global program to eliminate viral hepatitis by 2030. Recent constructive measures that have been used in the battle against COVID-19 could be adopted for the elimination of viral hepatitis program. The presented evidence in our narrative review demonstrates that the application of digital marketing tools to create campaigns on social media, armed with professional influencers, can efficiently consolidate this program. The application of different strategies in using these popular tools will raise the public awareness about viral hepatitis. Subsequently, the availability of an effective vaccine for HBV and antiviral medication for HCV can motivate the audience to take steps towards prophylaxis and screening methods against these infectious illnesses. The encouragement of health policy makers to apply digital communication technologies and comprehensive roadmaps to implement this global program will certainly decrease the burden of viral hepatitis worldwide.
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Affiliation(s)
- Mohammadreza Pourkarim
- Department of Management, Yazd Branch, Islamic Azad University, Yazd P.O. Box 89195/155, Iran; (M.P.); (S.H.H.)
| | - Shahnaz Nayebzadeh
- Department of Management, Yazd Branch, Islamic Azad University, Yazd P.O. Box 89195/155, Iran; (M.P.); (S.H.H.)
| | | | - Seyyed Hassan Hataminasab
- Department of Management, Yazd Branch, Islamic Azad University, Yazd P.O. Box 89195/155, Iran; (M.P.); (S.H.H.)
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29
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Galizzi MM, W. Lau K, Miraldo M, Hauck K. Bandwagoning, free-riding and heterogeneity in influenza vaccine decisions: An online experiment. HEALTH ECONOMICS 2022; 31:614-646. [PMID: 34989067 PMCID: PMC9305895 DOI: 10.1002/hec.4467] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 08/17/2021] [Accepted: 10/26/2021] [Indexed: 05/29/2023]
Abstract
'Nudge'-based social norms messages conveying high population influenza vaccination coverage levels can encourage vaccination due to bandwagoning effects but also discourage vaccination due to free-riding effects on low risk of infection, making their impact on vaccination uptake ambiguous. We develop a theoretical framework to capture heterogeneity around vaccination behaviors, and empirically measure the causal effects of different messages about vaccination coverage rates on four self-reported and behavioral vaccination intention measures. In an online experiment, N = 1365 UK adults are randomly assigned to one of seven treatment groups with different messages about their social environment's coverage rate (varied between 10% and 95%), or a control group with no message. We find that treated groups have significantly greater vaccination intention than the control. Treatment effects increase with the coverage rate up to a 75% level, consistent with a bandwagoning effect. For coverage rates above 75%, the treatment effects, albeit still positive, stop increasing and remain flat (or even decline). Our results suggest that, at higher coverage rates, free-riding behavior may partially crowd out bandwagoning effects of coverage rate messages. We also find significant heterogeneity of these effects depending on the individual perceptions of risks of infection and of the coverage rates.
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Affiliation(s)
- Matteo M. Galizzi
- Department of Psychological and Behavioral ScienceLSE Behavioral Science HubLSE Global Health InitiativeLondon School of EconomicsLondonUK
| | - Krystal W. Lau
- Department of Economics and Public PolicyCentre for Health Economics & Policy InnovationImperial College Business SchoolLondonUK
| | - Marisa Miraldo
- Department of Economics and Public PolicyCentre for Health Economics & Policy InnovationImperial College Business SchoolLondonUK
| | - Katharina Hauck
- MRC Centre for Global Infectious Disease AnalysisJameel Institute for Disease and Emergency AnalyticsSchool of Public Health, Imperial College LondonLondonUK
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30
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County Social Vulnerability and Influenza Vaccine Rates: National and Local Estimates for Medicare Recipients. Am J Prev Med 2022; 62:e1-e9. [PMID: 34548222 DOI: 10.1016/j.amepre.2021.06.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 06/09/2021] [Accepted: 06/11/2021] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Seasonal influenza vaccination among older adults is well below the recommendation of Healthy People 2020. Although geographic disparities in influenza vaccination are well documented, it remains unclear how community attributes correlate with influenza vaccination rates. Social vulnerability measures play an important role in interventions addressing vaccine equity; however, social vulnerability dimensions as corollaries of vaccination are poorly understood. To inform vaccine equity interventions, this analysis investigates spatially varying associations between county social vulnerability and influenza vaccination rate among Medicare recipients. METHODS County-level 2018 data (N=3,105) from the Centers for Disease Control and Prevention's Social Vulnerability Index were merged with the percentage of Medicare recipients vaccinated against influenza. Multilevel linear regression and geographically weighted regression generated global and local estimates, adjusted for potential confounders. Analyses were conducted in November 2020-April 2021. RESULTS A 10-percentile point increase in the overall Social Vulnerability Index was associated with an 0.87-point decrease in percentage vaccinated (p<0.001) with substantial variation by Social Vulnerability Index theme and geography. A 10-percentile point increase in socioeconomic vulnerability was associated with a 1.6-point decrease in vaccination (p<0.001) with stronger associations in higher Social Vulnerability Index quartiles and in parts of the Midwest, South, and coastal Northeast. Other Social Vulnerability Index themes had smaller associations with mixed directions: household composition and disability estimates were negative, whereas estimates for minority status and language and housing and transportation were positive. CONCLUSIONS Medicare recipients in socioeconomically vulnerable counties have low influenza vaccination rates, particularly in select regions of the country. Best practices to improve vaccine access and uptake should be targeted and should explicitly consider local socioeconomic vulnerability.
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31
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Jaffe AE, Graupensperger S, Blayney JA, Duckworth JC, Stappenbeck CA. The Role of Perceived Social Norms in College Student Vaccine Hesitancy: Implications for COVID-19 Prevention Strategies. Vaccine 2022; 40:1888-1895. [PMID: 35190209 PMCID: PMC8789646 DOI: 10.1016/j.vaccine.2022.01.038] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 01/15/2022] [Accepted: 01/19/2022] [Indexed: 12/16/2022]
Abstract
Among US adults, the highest rates of hesitancy to receive the COVID-19 vaccine are among young adults aged 18 to 25. Vaccine hesitancy is particularly concerning among young adults in college, where social interactions on densely populated campuses can lead to substantial community spread. Given that many colleges have opted not to mandate vaccines, identification of modifiable predictors of vaccine hesitancy – such as perceived social norms – is key to informing interventions to promote vaccine uptake. To address this need, we examined predictors of and explicit reasons for vaccine hesitancy among 989 students aged 18 to 25 recruited from four geographically diverse US universities in the spring of 2021. At the time of the survey, 57.3% had been vaccinated, 13.7% intended to be vaccinated as soon as possible, and 29.0% were vaccine hesitant. Common reasons for hesitancy were wanting to see how it affected others first (75.2%), not believing it was necessary (30.0%), and other reasons (17.4%), which were examined via content analysis and revealed prominent safety concerns. Despite these varied explicit reasons, logistic regressions revealed that, when controlling for demographics and pandemic-related experiences, perceived descriptive and injunctive social norms for vaccine uptake were each significant predictors of vaccine hesitancy (ORs = 0.35 and 0.78, respectively). When both norms were entered into the same model, only perceived descriptive norms uniquely predicted vaccine hesitancy (OR = 0.37; 95% CI: 0.29 – 0.46). Findings suggest perceived social norms are strongly associated with vaccine-related behavior among young adult college students. Correcting normative misperceptions may be a promising approach to increase vaccine uptake and slow the spread of COVID-19 among young adults.
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Affiliation(s)
- Anna E Jaffe
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE, United States.
| | - Scott Graupensperger
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - Jessica A Blayney
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - Jennifer C Duckworth
- Department of Human Development, Washington State University, Pullman, WA, United States
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32
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Kajikawa N, Goto R, Yokoya S. What Affected Primary Care Patients' Decisions to Receive the Seasonal Influenza Vaccine in the 2020 to 2021 Season? J Prim Care Community Health 2022; 13:21501319221076930. [PMID: 35142233 PMCID: PMC8841909 DOI: 10.1177/21501319221076930] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Introduction/objectives: A primary care patient’s decision to undergo seasonal influenza vaccination may have been different during the global COVID-19 pandemic in the 2020 to 2021 season. The purpose of this study is to investigate what affected primary care patients’ decisions to undergo seasonal influenza vaccination in the 2020 to 2021 season. Methods: Semi-structured interviews were conducted in a primary care clinic in Ibaraki, Japan. We used a purposive sampling strategy to reach individuals aged 20 years or older who underwent influenza vaccination. The transcripts were analyzed using thematic analysis. Results: Twenty-one patients completed the interview. Two main themes emerged: the desire to avoid risks to one’s health and being a part a community in coexistence with others. The first theme included desire to avoid influenza and expectations that vaccination will prevent severe disease. The second theme included concerns about the consequences of one’s own influenza infection on others in the community and necessity of vaccination based on the surroundings and others. Conclusions: Raising awareness of risk factors such as older age and comorbidities, and the expectations of community members might be effective in promoting influenza vaccination.
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Affiliation(s)
- Natsuki Kajikawa
- Department of Family Medicine, General Practice and Community Health, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.,Kitaibaraki Center for Family Medicine, Kitaibaraki, Ibaraki, Japan
| | - Ryohei Goto
- Department of Family Medicine, General Practice and Community Health, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Shoji Yokoya
- Department of Family Medicine, General Practice and Community Health, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.,Kitaibaraki Center for Family Medicine, Kitaibaraki, Ibaraki, Japan
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Wang K, Wong ELY, Cheung AWL, Yau PSY, Chung VCH, Wong CHL, Dong D, Wong SYS, Yeoh EK. Influence of Vaccination Characteristics on COVID-19 Vaccine Acceptance Among Working-Age People in Hong Kong, China: A Discrete Choice Experiment. Front Public Health 2021; 9:793533. [PMID: 34957038 PMCID: PMC8702724 DOI: 10.3389/fpubh.2021.793533] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 11/15/2021] [Indexed: 01/10/2023] Open
Abstract
Background: Along with individual-level factors, vaccination-related characteristics are important in understanding COVID-19 vaccine hesitancy. This study aimed to determine the influence of these characteristics on vaccine acceptance to formulate promotion strategies after considering differences among respondents with different characteristics. Methods: An online discrete choice experiment was conducted among people aged 18–64 years in Hong Kong, China, from 26 to 28 February 2021. Respondents were asked to make choices regarding hypothetical vaccination programmes described by vaccination-related characteristics—the attributes derived from a prior individual interview. Subgroup analysis was performed to identify the differences in vaccination-related characteristics among respondents with different personal characteristics. Results: A total of 1,773 respondents provided valid responses. The vaccine efficacy and brand were the most important factors affecting acceptance, followed by the exemption of quarantine for vaccinated travelers, safety, venue for vaccination, vaccine uptake of people in their lives, and recommendations by general physicians or government. Frequent exposure to vaccination information on social media has been associated with increasing vaccine refusal. Substantial preference heterogeneity for the attributes was found among people of different ages, incomes, chronic conditions, and previous acceptance of influenza vaccines. Conclusion: The findings provided evidence to formulate interventions to promote vaccine uptake, including the provision of vaccination at housing estate or workplaces, involvement of general physicians and interpersonal communication in vaccine promotion and information dissemination, and exemption of quarantine for vaccinated people. Moreover, social media is a significant information channel that cannot be neglected in the dissemination of official information.
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Affiliation(s)
- Kailu Wang
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.,JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Eliza Lai-Yi Wong
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.,JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Annie Wai-Ling Cheung
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.,JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Peter Sen-Yung Yau
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.,JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Vincent Chi-Ho Chung
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.,JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Charlene Hoi-Lam Wong
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Dong Dong
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.,JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Samuel Yeung-Shan Wong
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Eng-Kiong Yeoh
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.,JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
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34
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Breslin G, Dempster M, Berry E, Cavanagh M, Armstrong NC. COVID-19 vaccine uptake and hesitancy survey in Northern Ireland and Republic of Ireland: Applying the theory of planned behaviour. PLoS One 2021; 16:e0259381. [PMID: 34788330 PMCID: PMC8598022 DOI: 10.1371/journal.pone.0259381] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 10/18/2021] [Indexed: 11/19/2022] Open
Abstract
The Coronavirus Disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) first appeared in Wuhan, China in late 2019 and since then has caused unprecedented economic and social disruption as well as presenting a major challenge to public health. Despite mass progress in COVID-19 vaccination uptake, vaccine hesitancy or anti-vax information has been reported that can delay public acceptance of a vaccine. An online cross-sectional survey (n = 439) assessed COVID-19 vaccine uptake and hesitancy in adults in Northern Ireland and the Republic of Ireland. Participants completed an adapted version of the Theory of Planned Behaviour Vaccine Questionnaire, the Vaccine Attitudes Scale (VAX), Vaccine Confidence Scale, and questions on previous experience of COVID-19. Results showed that 66.7% of the sample intended to get a vaccination as soon as possible, 27.15% reported they will get a vaccine when others get theirs and when it is clear there are no side effects. 6.15% had no intention of getting a vaccine. Overall, there is a high mean intention (M = 6.12) and confidence to get a COVID-19 vaccine. There was low vaccine hesitancy (M = 2.49) as measured by the VAX scale. A further analysis of the sub factors of the VAX showed there is uncertainty and mistrust of side effects for children. The finding demonstrate that the Theory of Planned Behaviour can be useful in making recommendations for public health considerations when encouraging vaccine uptake and reducing vaccine hesitancy.
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Affiliation(s)
- Gavin Breslin
- School of Psychology, Ulster University, Coleraine, Northern Ireland
| | - Martin Dempster
- School of Psychology, The Queen’s University, Belfast, Northern Ireland
| | - Emma Berry
- School of Psychology, The Queen’s University, Belfast, Northern Ireland
| | - Matthew Cavanagh
- School of Psychology, Ulster University, Coleraine, Northern Ireland
| | - Nicola C. Armstrong
- Health and Social Care Research & Development (HSC R&D) Division, Public Health Agency, Belfast, Northern Ireland
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35
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Lim JJ, Kim YC, Koch-Weser S. Communication Infrastructure in an Asian Immigrant Community. JOURNAL OF HEALTH COMMUNICATION 2021; 26:717-727. [PMID: 34743669 DOI: 10.1080/10810730.2021.1998847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The health benefits of having a supportive community and access to community resources are well documented and for many immigrant communities, community-based organizations (CBOs) play an important role by providing culturally competent services. The current study uses communication infrastructure theory (CIT) to examine the associations between connections to CBOs, civic engagement, and protective health behaviors within the context of Boston Chinatown's Chinese immigrant community. According to CIT, neighborhood communication resources encourage residents to engage in civic activities and health-related problem-solving behaviors. To assess these associations, data from a needs assessment survey (N = 360) were analyzed. Results showed that connections to CBOs had a positive association with total number of protective health behaviors. Civic engagement was not found to be associated with health behaviors. We also found no indirect effect of connections to CBOs on the protective health behaviors via civic engagement. These results carry important theoretical and practical implications.
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Affiliation(s)
- Jean J Lim
- Department of Public Health & Community Medicine, Tufts University, Boston, USA
| | - Yong-Chan Kim
- College of Communication, Yonsei University, Seoul, Korea
| | - Susan Koch-Weser
- Department of Public Health & Community Medicine, Tufts University, Boston, USA
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36
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Individual and COVID-19-Specific Indicators of Compliance with Mask Use and Social Distancing: The Importance of Norms, Perceived Effectiveness, and State Response. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168715. [PMID: 34444465 PMCID: PMC8394116 DOI: 10.3390/ijerph18168715] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 08/02/2021] [Accepted: 08/11/2021] [Indexed: 01/22/2023]
Abstract
COVID-19 is a global pandemic that has resulted in widespread negative outcomes. Face masks and social distancing have been used to minimize its spread. Understanding who will engage in protective behaviors is crucial for continued response to the pandemic. We aimed to evaluate factors that are indicative of mask use and social distancing among current and former college students prior to vaccine access. Participants (N = 490; 67% female; 60% White) were current and former U.S. undergraduate college students. Perceived effectiveness and descriptive norms regarding COVID-19 safety measures, COVID-19-related news watching and seeking, state response timing to stay-at-home mandates, impulsivity-like traits, affect (mood), and demographic variables were assessed. Results found that greater perceived effectiveness indicated increased personal compliance within and across behaviors. Greater norms related to compliance within behaviors (e.g., indoor norms related to indoor compliance). Increased perceived stress, anxiety, and negative affect indicated greater compliance. More positive affect was associated with less compliance. Being non-White, compared to White (p < 0.001), and female, compared to male (p < 0.001), were associated with greater compliance. Overall, early implementation of stay-at-home orders, exposure to COVID-19-related news, and increased perceived effectiveness are crucial for health safety behavior compliance. Findings are important for informing response to health crises, including COVID-19.
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37
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Bonnevie E, Smith SM, Kummeth C, Goldbarg J, Smyser J. Social media influencers can be used to deliver positive information about the flu vaccine: findings from a multi-year study. HEALTH EDUCATION RESEARCH 2021; 36:286-294. [PMID: 34252187 PMCID: PMC8411386 DOI: 10.1093/her/cyab018] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 03/31/2021] [Indexed: 06/13/2023]
Abstract
Large-scale digital flu vaccine campaigns have experienced difficulty increasing vaccination coverage among African Americans and Hispanics, and are routinely inundated by negative responses from vaccine opponents. A digital campaign employing user-generated content from social media 'micro' influencers who are predominantly followed by African Americans and Hispanics was implemented during the 2018-19 and 2019-20 flu seasons to disseminate positive information about the flu vaccine. At the time, this constituted the largest influencer-driven health campaign focused on these communities in the United States. Comments on posts were qualitatively coded to determine content perceptions among those exposed to posts. Digital metrics were also analyzed. During Year 1, posts reached 9 million+ social media users and generated 64 612 likes or shares, and 1512 responses. In Year 2, posts reached 8 million+ users and generated 155 600 likes or shares, and 3122 responses. Around 94% of public responses to posts were positive, suggesting this is a promising strategy to communicate health information and could shift social norms, particularly for heavily debated topics such as vaccination. This strategy represents a more community-led and participatory approach than most large-scale vaccination campaigns have attempted, with immediate applicability to communications about the COVID-19 vaccine.
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Affiliation(s)
- Erika Bonnevie
- Research Department, The Public Good Projects, 2308 Mt Vernon Ave, Suite 758, Alexandria, VA 22301, USA
| | - Sierra M Smith
- Research Department, The Public Good Projects, 2308 Mt Vernon Ave, Suite 758, Alexandria, VA 22301, USA
| | - Caitlin Kummeth
- Marketing Department, The Public Good Projects, 2308 Mt Vernon Ave, Suite 758, Alexandria, VA 22301, USA
| | - Jaclyn Goldbarg
- Operations Department, The Public Good Projects, 2308 Mt Vernon Ave, Suite 758, Alexandria, VA 22301, USA
| | - Joe Smyser
- Operations Department, The Public Good Projects, 2308 Mt Vernon Ave, Suite 758, Alexandria, VA 22301, USA
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38
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Elekwachi O, Wingate LT, Clarke Tasker V, Aboagye L, Dubale T, Betru D, Algatan R. A Review of Racial and Ethnic Disparities in Immunizations for Elderly Adults. J Prim Care Community Health 2021; 12:21501327211014071. [PMID: 34032159 PMCID: PMC8155785 DOI: 10.1177/21501327211014071] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Vaccine preventable diseases are responsible for a substantial degree of morbidity in the United States as over 18 million annual cases of vaccine preventable disease occur in the U.S. annually. The morbidity due to vaccine preventable disease is disproportionately borne by adults as over 99% of the deaths due to vaccine preventable diseases occur within adults, and national data indicates that there racial disparities in the receipt of vaccines intended for elderly adults. A literature review was conducted by using the PubMed database to identify research articles that contained information on the vaccination rates among minority populations for selected vaccines intended for use in elderly populations including those for herpes zoster, tetanus, diphtheria, pertussis, hepatitis A, and hepatitis B. A total of 22 articles were identified, 8 of which focused on tetanus related vaccines, 2 of which focused on hepatitis related vaccines, and 12 of which focused on herpes zoster. The findings indicate that magnitude of the disparity for the receipt of tetanus and herpes related vaccines is not decreasing over time. Elderly patients having a low awareness of vaccines and suboptimal knowledge for when or if they should receive specific vaccines remains a key contributor to suboptimal vaccination rates. There is an urgent need for more intervention-based studies to enhance the uptake of vaccines within elderly populations, particularly among ethnic minorities where culturally sensitive and tailored messages may be of use.
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Affiliation(s)
| | | | | | | | - Tadesse Dubale
- Howard University College of Pharmacy, Washington, DC, USA
| | - Dagmawit Betru
- Howard University College of Pharmacy, Washington, DC, USA
| | - Razan Algatan
- Howard University College of Pharmacy, Washington, DC, USA
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39
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Latkin CA, Dayton L, Miller JR, Yi G, Jaleel A, Nwosu CC, Yang C, Falade-Nwulia O. Behavioral and Attitudinal Correlates of Trusted Sources of COVID-19 Vaccine Information in the US. Behav Sci (Basel) 2021; 11:bs11040056. [PMID: 33924118 PMCID: PMC8074305 DOI: 10.3390/bs11040056] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 04/09/2021] [Accepted: 04/16/2021] [Indexed: 12/24/2022] Open
Abstract
There is a critical need for the public to have trusted sources of vaccine information. A longitudinal online study assessed trust in COVID-19 vaccine information from 10 sources. A factor analysis for data reduction revealed two factors. The first factor contained politically conservative sources (PCS) of information. The second factor included eight news sources representing mainstream sources (MS). Multivariable logistic regression models were used. Trust in Dr. Fauci was also examined. High trust in MS was associated with intention to encourage family members to get COVID-19 vaccines, altruistic beliefs that more vulnerable people should have vaccine priority, and belief that racial minorities with higher rates of COVID-19 deaths should have priority. High trust in PCS was associated with intention to discourage friends from getting vaccinated. Higher trust in PCS was also associated with participants more likely to disagree that minorities with higher rates of COVID-19 deaths should have priority for a vaccine. High trust in Dr. Fauci as a source of COVID-19 vaccine information was associated with factors similar to high trust in MS. Fair, equitable, and transparent access and distribution are essential to ensure trust in public health systems' abilities to serve the population.
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Affiliation(s)
- Carl A. Latkin
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe St., Baltimore, MD 21205, USA; (L.D.); (G.Y.); (C.Y.)
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, 733 N. Broadway, Baltimore, MD 21205, USA;
- Correspondence:
| | - Lauren Dayton
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe St., Baltimore, MD 21205, USA; (L.D.); (G.Y.); (C.Y.)
| | - Jacob R. Miller
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe St., Baltimore, MD 21205, USA;
| | - Grace Yi
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe St., Baltimore, MD 21205, USA; (L.D.); (G.Y.); (C.Y.)
| | - Afareen Jaleel
- Institute for Computational Medicine, Johns Hopkins University, 3400 N. Charles St., Baltimore, MD 21218, USA; (A.J.); (C.C.N.)
| | - Chikaodinaka C. Nwosu
- Institute for Computational Medicine, Johns Hopkins University, 3400 N. Charles St., Baltimore, MD 21218, USA; (A.J.); (C.C.N.)
| | - Cui Yang
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe St., Baltimore, MD 21205, USA; (L.D.); (G.Y.); (C.Y.)
| | - Oluwaseun Falade-Nwulia
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, 733 N. Broadway, Baltimore, MD 21205, USA;
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40
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Graupensperger S, Abdallah DA, Lee CM. Social norms and vaccine uptake: College students' COVID vaccination intentions, attitudes, and estimated peer norms and comparisons with influenza vaccine. Vaccine 2021; 39:2060-2067. [PMID: 33741191 PMCID: PMC7965606 DOI: 10.1016/j.vaccine.2021.03.018] [Citation(s) in RCA: 105] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 02/09/2021] [Accepted: 03/04/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Vaccination may be critical to curtailing the spread of the SARS-CoV-2 virus responsible for the COVID-19 pandemic, but herd immunity can only be realized with high vaccination coverage. There is a need to identify empirically supported strategies to increase uptake, especially among young adults as this subpopulation has shown relatively poor adherence to physical distancing guidelines. Social norms - estimates of peers' behavior and attitudes - are robust predictors of health behaviors and norms-based intervention strategies may increase COVID vaccine uptake, once available. This study examined the extent that vaccination intentions and attitudes were associated with estimated social norms as an initial proof-of-concept test. METHOD In November of 2020, 647 undergraduate students (46.21% response rate) completed online surveys in which they reported intentions to get COVID and influenza vaccines, perceived importance of these vaccines for young adults, and estimated social norms regarding peers' vaccination behaviors and attitudes. RESULTS Students reported significantly greater intentions to get a COVID vaccine (91.64%) than an influenza vaccine (76.04%), and perceived COVID vaccination as significantly more important than influenza vaccination. The sample generally held strong intentions to receive a COVID vaccine and thought that doing so was of high importance, but participants, on average, perceived that other young adults would be less likely to be vaccinated and would not think vaccination was as important. Multiple regression models indicated that estimated social norms were positively associated with participants' own intentions and perceived importance of getting a COVID vaccine. CONCLUSIONS These significant associations highlight the potential value in developing and testing norms-based intervention strategies, such as personalized normative feedback, to improve uptake of forthcoming COVID vaccines among young adults.
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Affiliation(s)
- Scott Graupensperger
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States.
| | - Devon A Abdallah
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - Christine M Lee
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
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41
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Latkin CA, Dayton L, Yi G, Konstantopoulos A, Boodram B. Trust in a COVID-19 vaccine in the U.S.: A social-ecological perspective. Soc Sci Med 2021; 270:113684. [PMID: 33485008 PMCID: PMC7834519 DOI: 10.1016/j.socscimed.2021.113684] [Citation(s) in RCA: 202] [Impact Index Per Article: 67.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Revised: 12/27/2020] [Accepted: 01/03/2021] [Indexed: 01/12/2023]
Affiliation(s)
- Carl A Latkin
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, USA; Division of Infectious Diseases, Johns Hopkins University School of Medicine, USA.
| | - Lauren Dayton
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, USA
| | - Grace Yi
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, USA
| | | | - Basmattee Boodram
- Division of Community Health Sciences, University of Illinois at Chicago School of Public Health, Chicago, IL, USA
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42
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Suryadevara M. Vaccine Confidence and Vaccine Hesitancy. Vaccines (Basel) 2021. [DOI: 10.1007/978-3-030-58414-6_38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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43
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Wagner CE, Prentice JA, Saad-Roy CM, Yang L, Grenfell BT, Levin SA, Laxminarayan R. Economic and Behavioral Influencers of Vaccination and Antimicrobial Use. Front Public Health 2020; 8:614113. [PMID: 33409264 PMCID: PMC7779682 DOI: 10.3389/fpubh.2020.614113] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 12/01/2020] [Indexed: 01/07/2023] Open
Abstract
Despite vast improvements in global vaccination coverage during the last decade, there is a growing trend in vaccine hesitancy and/or refusal globally. This has implications for the acceptance and coverage of a potential vaccine against COVID-19. In the United States, the number of children exempt from vaccination for “philosophical belief-based” non-medical reasons increased in 12 of the 18 states that allowed this policy from 2009 to 2017 (1). Meanwhile, the overuse and misuse of antibiotics, especially in young children, have led to increasing rates of drug resistance that threaten our ability to treat infectious diseases. Vaccine hesitancy and antibiotic overuse exist side-by-side in the same population of young children, and it is unclear why one modality (antibiotics) is universally seen as safe and effective, while the other (vaccines) is seen as potentially hazardous by some. In this review, we consider the drivers shaping the use of vaccines and antibiotics in the context of three factors: individual incentives, risk perceptions, and social norms and group dynamics. We illustrate how these factors contribute to the societal and individual costs of vaccine underuse and antimicrobial overuse. Ultimately, we seek to understand these factors that are at the nexus of infectious disease epidemiology and social science to inform policy-making.
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Affiliation(s)
- Caroline E Wagner
- Department of Bioengineering, McGill University, Montreal, QC, Canada
| | - Joseph A Prentice
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, United States
| | - Chadi M Saad-Roy
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, United States.,Lewis-Sigler Institute for Integrative Genomics, Princeton University, Princeton, NJ, United States
| | - Luojun Yang
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, United States
| | - Bryan T Grenfell
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, United States.,Princeton School of Public and International Affairs, Princeton University, Princeton, NJ, United States.,Fogarty International Center, National Institutes of Health, Bethesda, MD, United States
| | - Simon A Levin
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, United States.,Princeton Environmental Institute, Princeton University, Princeton, NJ, United States
| | - Ramanan Laxminarayan
- Princeton Environmental Institute, Princeton University, Princeton, NJ, United States.,Center for Disease Dynamics, Economics & Policy, Washington, DC, United States
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44
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Concerns for others increases the likelihood of vaccination against influenza and COVID-19 more in sparsely rather than densely populated areas. Proc Natl Acad Sci U S A 2020; 118:2007538118. [PMID: 33443183 DOI: 10.1073/pnas.2007538118] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Vaccination yields the direct individual benefit of protecting recipients from infectious diseases and also the indirect social benefit of reducing the transmission of infections to others, often referred to as herd immunity This research examines how prosocial concern for vaccination, defined as people's preoccupation with infecting others if they do not vaccinate themselves, motivates vaccination in more and less populated regions of the United States. A nationally representative, longitudinal survey of 2,490 Americans showed that prosocial concern had a larger positive influence on vaccination against influenza in sparser regions, as judged by a region's nonmetropolitan status, lesser population density, and lower proportion of urban land area. Two experiments (total n = 800), one preregistered, provide causal evidence that drawing attention to prosocial (vs. individual) concerns interacted with social density to affect vaccination intentions. Specifically, prosocial concern led to stronger intentions to vaccinate against influenza and COVID-19 but only when social density was low (vs. high). Moderated mediation analyses show that, in low-density conditions, the benefits of inducing prosocial concern were due to greater perceived impact of one's vaccination on others. In this light, public health communications may reap more benefits from emphasizing the prosocial aspects of vaccination in sparser environments.
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45
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Fisher KA, Bloomstone SJ, Walder J, Crawford S, Fouayzi H, Mazor KM. Attitudes Toward a Potential SARS-CoV-2 Vaccine : A Survey of U.S. Adults. Ann Intern Med 2020; 173:964-973. [PMID: 32886525 PMCID: PMC7505019 DOI: 10.7326/m20-3569] [Citation(s) in RCA: 809] [Impact Index Per Article: 202.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) has rapidly instigated a global pandemic. Vaccine development is proceeding at an unprecedented pace. Once available, it will be important to maximize vaccine uptake and coverage. OBJECTIVE To assess intent to be vaccinated against COVID-19 among a representative sample of adults in the United States and identify predictors of and reasons for vaccine hesitancy. DESIGN Cross-sectional survey, fielded from 16 through 20 April 2020. SETTING Representative sample of adults residing in the United States. PARTICIPANTS Approximately 1000 adults drawn from the AmeriSpeak probability-based research panel, covering approximately 97% of the U.S. household population. MEASUREMENTS Intent to be vaccinated against COVID-19 was measured with the question, "When a vaccine for the coronavirus becomes available, will you get vaccinated?" Response options were "yes," "no," and "not sure." Participants who responded "no" or "not sure" were asked to provide a reason. RESULTS A total of 991 AmeriSpeak panel members responded. Overall, 57.6% of participants (n = 571) intended to be vaccinated, 31.6% (n = 313) were not sure, and 10.8% (n = 107) did not intend to be vaccinated. Factors independently associated with vaccine hesitancy (a response of "no" or "not sure") included younger age, Black race, lower educational attainment, and not having received the influenza vaccine in the prior year. Reasons for vaccine hesitancy included vaccine-specific concerns, a need for more information, antivaccine attitudes or beliefs, and a lack of trust. LIMITATIONS Participants' intent to be vaccinated was explored before a vaccine was available and when the pandemic was affecting a narrower swath of the United States. Questions about specific information or factors that might increase vaccination acceptance were not included. The survey response rate was 16.1%. CONCLUSION This national survey, conducted during the coronavirus pandemic, revealed that approximately 3 in 10 adults were not sure they would accept vaccination and 1 in 10 did not intend to be vaccinated against COVID-19. Targeted and multipronged efforts will be needed to increase acceptance of a COVID-19 vaccine when one becomes available. PRIMARY FUNDING SOURCE Agency for Healthcare Research and Quality.
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Affiliation(s)
- Kimberly A Fisher
- Meyers Primary Care Institute and University of Massachusetts Medical School, Worcester, Massachusetts (K.A.F., S.C., K.M.M.)
| | | | - Jeremy Walder
- University of Massachusetts Medical School, Worcester, Massachusetts (J.W.)
| | - Sybil Crawford
- Meyers Primary Care Institute and University of Massachusetts Medical School, Worcester, Massachusetts (K.A.F., S.C., K.M.M.)
| | - Hassan Fouayzi
- Meyers Primary Care Institute, Worcester, Massachusetts (S.J.B., H.F.)
| | - Kathleen M Mazor
- Meyers Primary Care Institute and University of Massachusetts Medical School, Worcester, Massachusetts (K.A.F., S.C., K.M.M.)
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Lin FY, Wang CH. Personality and individual attitudes toward vaccination: a nationally representative survey in the United States. BMC Public Health 2020; 20:1759. [PMID: 33228661 PMCID: PMC7685575 DOI: 10.1186/s12889-020-09840-w] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 11/04/2020] [Indexed: 11/10/2022] Open
Abstract
Background Although past studies have identified factors associated with individual perceptions of vaccination, limited attention has been paid to the role of personality in individual attitudes toward vaccination. This study aimed to evaluate the effect of personality as measured by the Big Five personality traits on individual attitudes toward vaccination using a nationally representative survey in the United States. Methods A cross-sectional study was conducted with a sample of 3276 American citizens who were aged 18 and above and lived in 50 U.S. states and Washington D.C. from the American National Election Studies. The survey was collected through face-to-face and online interviews using structured questionnaires in 2016. The multistage stratified cluster sampling procedure was used for face-to-face interview, whereas the USPS DSF was used to select the sample for online interview. Multivariable ordinal logistic regression was used to assess how personality traits (extraversion, agreeableness, conscientiousness, emotional stability, and openness to experience) as main explanatory variables influence the outcome variables – individual attitudes toward health benefits of vaccination and support for school vaccination. Results More than two-thirds of respondents perceive health benefit of vaccination and support vaccination requirements for school entry, whereas about one-tenth of respondents have safety concerns about vaccination and oppose the vaccination requirements. After adjusting for ideology, insurance status, and demographic variables, the traits of agreeableness, conscientiousness and emotional stability remain significantly associated with attitude toward vaccination; conscientiousness is significantly associated with support for school vaccination. The odds of reporting health benefits of vaccination associated with one-point increase in agreeableness, conscientiousness and emotional stability are 1.05 (95% confidence intervals [CI] = 1.01–1.08), 1.05 (95% CI = 1.02–1.09) and 1.03 (95% CI = 1.00–1.06), respectively. For a one-point increase in conscientiousness, the odds of supporting school vaccination increase by 1.08 (95% CI = 1.05–1.12). Conclusions People high in agreeableness, conscientiousness and emotional stability are more likely to regard vaccination as beneficial, whereas those high in conscientiousness are more likely to support school-based vaccine requirement. This study highlights the importance of personality in shaping individual attitudes toward vaccination. More research is needed to understand the role of personality in individual health attitudes and behavior.
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Affiliation(s)
- Fang-Yu Lin
- Department of Symptom Research, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1450, Houston, TX, 77030, USA
| | - Ching-Hsing Wang
- Department of Political Science, National Cheng Kung University, No.1, University Road, Tainan City, 701, Taiwan, Republic of China.
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Bazargan M, Wisseh C, Adinkrah E, Ameli H, Santana D, Cobb S, Assari S. Influenza Vaccination among Underserved African-American Older Adults. BIOMED RESEARCH INTERNATIONAL 2020; 2020:2160894. [PMID: 33224975 PMCID: PMC7671800 DOI: 10.1155/2020/2160894] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 10/30/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND Racial disparities in influenza vaccination among underserved minority older adults are a public health problem. Understanding the factors that impact influenza vaccination behaviors among underserved older African-Americans could lead to more effective communication and delivery strategies. AIMS We aimed to investigate rate and factors associated with seasonal influenza vaccination among underserved African-American older adults. We were particularly interested in the roles of demographic factors, socioeconomic status, and continuity and patient satisfaction with medical care, as well as physical and mental health status. METHODS This community-based cross-sectional study recruited 620 African-American older adults residing in South Los Angeles, one of the most under-resources areas within Los Angeles County, with a population of over one million. Bivariate and multiple regression analyses were performed to document independent correlates of influenza vaccination. RESULTS One out of three underserved African-American older adults aged 65 years and older residing in South Los Angeles had never been vaccinated against the influenza. Only 49% of participants reported being vaccinated within the 12 months prior to the interview. One out of five participants admitted that their health care provider recommended influenza vaccination. However, only 45% followed their provider's recommendations. Multivariate logistic regression shows that old-old (≥75 years), participants who lived alone, those with a lower level of continuity of care and satisfaction with the accessibility, availability, and quality of care, and participants with a higher number of depression symptoms were less likely to be vaccinated. As expected, participants who indicated that their physician had advised them to obtain a flu vaccination were more likely to be vaccinated. Our data shows that only gender was associated with self-report of being advised to have a flu shot. Discussion. One of the most striking aspects of this study is that no association between influenza vaccination and being diagnosed with chronic obstructive pulmonary disease or other major chronic condition was detected. Our study confirmed that both continuity of care and satisfaction with access, availability, and quality of medical care are strongly associated with current influenza vaccinations. We documented that participants with a higher number of depression symptoms were less likely to be vaccinated. CONCLUSION These findings highlight the role that culturally acceptable and accessible usual source of care van play as a gatekeeper to facilitate and implement flu vaccination among underserved minority older adults. Consistent disparities in influenza vaccine uptake among underserved African-American older adults, coupled with a disproportionate burden of chronic diseases, places them at high risk for undesired outcomes associated with influenza. As depression is more chronic/disabling and is less likely to be treated in African-Americans, there is a need to screen and treat depression as a strategy to enhance preventive care management such as vaccination of underserved African-American older adults. Quantification of associations between lower vaccine uptake and both depression symptoms as well as living alone should enable health professionals target underserved African-American older adults who are isolated and suffer from depression to reduce vaccine-related inequalities.
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Affiliation(s)
- Mohsen Bazargan
- Department of Family Medicine, Charles R. Drew University of Medicine and Science (CDU), Los Angeles, California, USA
- Department of Public Health, CDU, Los Angeles, California, USA
- Physician Assistant Program, CDU, Los Angeles, California, USA
- Department of Family Medicine, UCLA, Los Angeles, California, USA
| | - Cheryl Wisseh
- Department of Family Medicine, Charles R. Drew University of Medicine and Science (CDU), Los Angeles, California, USA
- Department of Clinical Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, University of California at Irvine, California, USA
| | - Edward Adinkrah
- Department of Family Medicine, Charles R. Drew University of Medicine and Science (CDU), Los Angeles, California, USA
| | - Hoorolnesa Ameli
- Department of Emergency Medicine, Qom University of Medical Sciences, Gom, Iran
| | - Delia Santana
- School of Nursing, CDU, Los Angeles, California, USA
| | - Sharon Cobb
- School of Nursing, CDU, Los Angeles, California, USA
| | - Shervin Assari
- Department of Family Medicine, Charles R. Drew University of Medicine and Science (CDU), Los Angeles, California, USA
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Bonnevie E, Rosenberg SD, Kummeth C, Goldbarg J, Wartella E, Smyser J. Using social media influencers to increase knowledge and positive attitudes toward the flu vaccine. PLoS One 2020; 15:e0240828. [PMID: 33064738 PMCID: PMC7567389 DOI: 10.1371/journal.pone.0240828] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 10/02/2020] [Indexed: 12/26/2022] Open
Abstract
Seasonal influenza affects millions of people across the United States each year. African Americans and Hispanics have significantly lower vaccination rates, and large-scale campaigns have had difficulty increasing vaccination among these two groups. This study assessed the feasibility of delivering a flu vaccination promotion campaign using influencers, and examined shifts in social norms regarding flu vaccine acceptability after a social media micro influencer campaign. Influencers were asked to choose from vetted messages and create their own original content promoting flu vaccination, which was posted to their social media pages. Content was intentionally unbranded to ensure that it aligned with the look and feel of their pages. Cross-sectional pre- and post-campaign surveys were conducted within regions that received the campaign and control regions to examine potential campaign impact. Digital metrics assessed campaign exposure. Overall, 117 influencers generated 69,495 engagements. Results from the region that received the campaign showed significant increases in positive beliefs about the flu vaccine, and significant decreases in negative community attitudes toward the vaccine. This study suggests that flu campaigns using a ground-up rather than top-down approach can feasibly reach at-risk groups with lower vaccination rates, and shows the potentials of using an influencer-based model to communicate information about flu vaccination on a large scale.
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Affiliation(s)
- Erika Bonnevie
- Department of Health Communications, The Public Good Projects, New York, NY, United States of America
| | - Sarah D. Rosenberg
- Department of Health Communications, The Public Good Projects, New York, NY, United States of America
| | - Caitlin Kummeth
- Marketing Department, The Public Good Projects, New York, NY, United States of America
| | - Jaclyn Goldbarg
- Department of Health Communications, The Public Good Projects, New York, NY, United States of America
| | - Ellen Wartella
- Northwestern University School of Communications, Evanston, IL, United States of America
| | - Joe Smyser
- Department of Health Communications, The Public Good Projects, New York, NY, United States of America
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Chan MPS, Jamieson KH, Albarracin D. Prospective associations of regional social media messages with attitudes and actual vaccination: A big data and survey study of the influenza vaccine in the United States. Vaccine 2020; 38:6236-6247. [PMID: 32792251 PMCID: PMC7415418 DOI: 10.1016/j.vaccine.2020.07.054] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 07/24/2020] [Accepted: 07/25/2020] [Indexed: 11/29/2022]
Abstract
Regional Twitter vaccine content was prospectively associated with attitudes. Regional Twitter vaccine content was prospectively associated with vaccination. Discussing the influenza vaccine with others can remove the negative effects of Twitter vaccine content.
Objective Using longitudinal methods to assess regional associations between social media posts about vaccines and attitudes and actual vaccination against influenza in the US. Methods Geolocated tweets from U.S. counties (N = 115,330) were analyzed using MALLET LDA (Latent Dirichlet allocation) topic modeling techniques to correlate with prospective individual survey data (N = 3005) about vaccine attitudes, actual vaccination, and real-life discussions about vaccines with family and friends during the 2018–2019 influenza season. Results Ten topics were common across U.S. counties during the 2018–2019 influenza season. In the overall analyses, two of these topics (i.e., Vaccine Science Matters and Big Pharma) were associated with attitudes and behaviors. The topic concerning vaccine science in November-February was positively correlated with attitudes in February-March, r = 0.09, BF10 = 3. Moreover, among respondents who did not discuss the influenza vaccine with family and friends, the topic about vaccine fraud and children in November-February was negatively correlated with attitudes in February-March and with vaccination in February-March, and April-May (rs = −0.18 to −0.25, BF10 = 4–146). However, this was absent when participants had discussions about the influenza vaccine with family and friends. Discussion Regional vaccine content correlated with prospective measures of vaccine attitudes and actual vaccination. Conclusions Social media have demonstrated strong associations with vaccination patterns. When the associations are negative, discussions with family and friends appear to eliminate them. Programs to promote vaccination should encourage real-life conversations about vaccines.
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Affiliation(s)
- Man-Pui Sally Chan
- Department of Psychology, University of Illinois at Urbana-Champaign, IL, United States.
| | | | - Dolores Albarracin
- Department of Psychology, University of Illinois at Urbana-Champaign, IL, United States; The Annenberg Public Policy Center, University of Pennsylvania, PA, United States
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Factors Associated with Antenatal Influenza Vaccination in a Medically Underserved Population. Infect Dis Obstet Gynecol 2020; 2020:5803926. [PMID: 32410818 PMCID: PMC7204164 DOI: 10.1155/2020/5803926] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 12/04/2019] [Indexed: 02/02/2023] Open
Abstract
Influenza infection in pregnant women is associated with increased risk of morbidity and mortality. Despite recommendations for all women to receive the seasonal influenza vaccine during pregnancy, vaccination rates among pregnant women in the U.S. have remained around 50%. The objective of this study was to evaluate clinical and demographic factors associated with antenatal influenza vaccination in a medically underserved population of women. We conducted a retrospective cohort study at Grady Memorial Hospital, a large safety-net hospital in Atlanta, Georgia, from July 1, 2016, to June 30, 2018. Demographic and clinical characteristics were abstracted from the electronic medical record. The Kotelchuck index was used to assess prenatal care adequacy. Relative risks and 95% confidence intervals for associations between receipt of influenza vaccine and prenatal care adequacy, demographic characteristics, and clinical characteristics were calculated using multivariable log-binominal models. Among 3723 pregnant women with deliveries, women were primarily non-Hispanic black (68.4%) and had Medicaid as their primary insurance type (87.9%). The overall vaccination rate was 49.8% (1853/3723). Inadequate prenatal care adequacy was associated with a lower antenatal influenza vaccination rate (43.5%), while intermediate and higher levels of prenatal care adequacy were associated with higher vaccination rates (66.9–68.3%). Hispanic ethnicity, non-Hispanic other race/ethnicity, interpreter use for a language other than Spanish, and preexisting diabetes mellitus were associated with higher vaccination coverage in multivariable analyses. Among medically underserved pregnant women, inadequate prenatal care utilization was associated with a lower rate of antenatal influenza vaccination. Socially disadvantaged women may face individual and structural barriers when accessing prenatal care, suggesting that evidenced-based, tailored approaches may be needed to improve prenatal care utilization and antenatal influenza vaccination rates.
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