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Howard B, Gorman G. Worth a Shot: Experience and Lessons From an Unsuccessful Pediatric Immunization Quality Improvement Effort in a Large Health System During the COVID-19 Pandemic. Mil Med 2024:usae323. [PMID: 38935398 DOI: 10.1093/milmed/usae323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 06/07/2024] [Accepted: 06/17/2024] [Indexed: 06/28/2024] Open
Abstract
INTRODUCTION During the coronavirus disease of 2019 (COVID-19) pandemic, routine childhood immunization rates dropped dramatically across the world, and the Military Health System (MHS) was no exception. In the MHS, which is a large, universally covered, low-to-no-cost health system, the immunization rates with the measles, mumps, and rubella (MMR) vaccine remain below the rate necessary to prevent community transmission of measles. We aimed to improve childhood immunization rates in the MHS with an expansive quality improvement project. MATERIALS AND METHODS Measles, mumps, and rubella immunization rates served as proxy outcome measures for routine immunization rates tracked by the Center for Disease Control multi-immunization combination measures. The tracked measure was the percentage of 16- to 18-month olds and 6-year olds who had received MMR #1 and MMR #2, respectively. Various countermeasures were implemented throughout the study period, and standard quality improvement analyses informed the effect of countermeasures. RESULTS By January 2023, the percentage of 16- to 18-month olds and 6-year olds who had received MMR #1 and MMR #2 was 85% and 91%, respectively, with no positive shift in immunization rates despite various countermeasures introduced during the study period. For reference, the MMR immunization rates of commercial health maintenance organization and commercial preferred provider organization for 24-month-old populations were 92% and 90.3%, respectively. On chart review, the most common cause for under-immunization (55%) was vaccine abandonment. MMR #1 rates rose to 92% in 24-month olds. CONCLUSIONS Measles, mumps, and rubella immunization rates within the MHS remained below commercial health system rates and below public health standards required for herd immunity despite various countermeasures throughout the COVID-19 pandemic. Immunization rates increased with age, suggesting that children within the MHS eventually catch up despite potential barriers.
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Affiliation(s)
- Bailey Howard
- Department of Pediatrics, Walter Reed National Military Medical Center, Bethesda, MD 20814, USA
| | - Gregory Gorman
- Department of Pediatrics, Walter Reed National Military Medical Center, Bethesda, MD 20814, USA
- Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
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Li Y, Lee KC, Bressington D, Liao Q, He M, Law KK, Leung AYM, Molassiotis A, Li M. A Theory and Evidence-Based Artificial Intelligence-Driven Motivational Digital Assistant to Decrease Vaccine Hesitancy: Intervention Development and Validation. Vaccines (Basel) 2024; 12:708. [PMID: 39066346 PMCID: PMC11281439 DOI: 10.3390/vaccines12070708] [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: 05/25/2024] [Revised: 06/13/2024] [Accepted: 06/20/2024] [Indexed: 07/28/2024] Open
Abstract
Vaccine hesitancy is one of the top ten threats to global health. Artificial intelligence-driven chatbots and motivational interviewing skills show promise in addressing vaccine hesitancy. This study aimed to develop and validate an artificial intelligence-driven motivational digital assistant in decreasing COVID-19 vaccine hesitancy among Hong Kong adults. The intervention development and validation were guided by the Medical Research Council's framework with four major steps: logic model development based on theory and qualitative interviews (n = 15), digital assistant development, expert evaluation (n = 5), and a pilot test (n = 12). The Vaccine Hesitancy Matrix model and qualitative findings guided the development of the intervention logic model and content with five web-based modules. An artificial intelligence-driven chatbot tailored to each module was embedded in the website to motivate vaccination intention using motivational interviewing skills. The content validity index from expert evaluation was 0.85. The pilot test showed significant improvements in vaccine-related health literacy (p = 0.021) and vaccine confidence (p = 0.027). This digital assistant is effective in improving COVID-19 vaccine literacy and confidence through valid educational content and motivational conversations. The intervention is ready for testing in a randomized controlled trial and has high potential to be a useful toolkit for addressing ambivalence and facilitating informed decision making regarding vaccination.
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Affiliation(s)
- Yan Li
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong 999077, China; (Y.L.); (K.-C.L.); (M.H.); (K.-K.L.); (A.Y.M.L.)
| | - Kit-Ching Lee
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong 999077, China; (Y.L.); (K.-C.L.); (M.H.); (K.-K.L.); (A.Y.M.L.)
| | | | - Qiuyan Liao
- School of Public Health, The University of Hong Kong, Hong Kong 999077, China;
| | - Mengting He
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong 999077, China; (Y.L.); (K.-C.L.); (M.H.); (K.-K.L.); (A.Y.M.L.)
| | - Ka-Kit Law
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong 999077, China; (Y.L.); (K.-C.L.); (M.H.); (K.-K.L.); (A.Y.M.L.)
| | - Angela Y. M. Leung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong 999077, China; (Y.L.); (K.-C.L.); (M.H.); (K.-K.L.); (A.Y.M.L.)
- Research Institute for Smart Aging (RISA), The Hong Kong Polytechnic University, Hong Kong 999077, China
| | - Alex Molassiotis
- College of Arts, Humanities and Education, University of Derby, Derby DE22 1GB, UK;
| | - Mengqi Li
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong 999077, China; (Y.L.); (K.-C.L.); (M.H.); (K.-K.L.); (A.Y.M.L.)
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Byerley CO, Horne D, Gong M, Musgrave S, Valaas LA, Rickard B, Yoon H, Park MS, Mirin A, Joshua S, Lavender H, You S. An effective COVID-19 vaccine hesitancy intervention focused on the relative risks of vaccination and infection. Sci Rep 2024; 14:7419. [PMID: 38548828 PMCID: PMC10978892 DOI: 10.1038/s41598-024-57841-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 03/22/2024] [Indexed: 04/01/2024] Open
Abstract
We designed the Relative Risk Tool (RRT) to help people assess the relative risks associated with COVID-19 vaccination and infection. In May 2022 (N = 400) and November 2022 (N = 615), U.S. residents participated in a survey that included questions about the risks of vaccination and infection. In both cohorts, we found an association between relative risk perception and vaccine hesitancy. Participants in the May cohort were randomly assigned an intervention: to see information from the RRT or the Centers for Disease Control and Prevention (CDC). After the intervention, participants answered the same questions about risk perception and vaccination intent again. The RRT was more effective than the CDC at changing risk perception and increasing vaccination intent. In November, the survey structure was the same, but the RRT was the only intervention included, and we confirmed that the RRT was effective at changing opinions in this new sample. Importantly, the RRT provided accurate information about the risks of serious adverse outcomes to vaccination and still increased vaccination intent. Our work suggests that the RRT helps people assess relative risk, which can in turn help empower them to make informed decisions and ultimately reduce vaccine hesitancy.
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Affiliation(s)
- Cameron O'Neill Byerley
- Department of Mathematics, Science, and Social Studies Education, University of Georgia, Athens, 30606, USA.
| | - Dru Horne
- Department of Mathematics, Science, and Social Studies Education, University of Georgia, Athens, 30606, USA
| | - Mina Gong
- Department of Mathematics, Science, and Social Studies Education, University of Georgia, Athens, 30606, USA
| | - Stacy Musgrave
- Department of Mathematics and Statistics, Cal Poly Pomona, Pomona, 91768, USA
| | - Laura A Valaas
- Department of Dermatology, University of Washington, Seattle, 98195, USA
| | - Brian Rickard
- Department of Mathematical Sciences, University of Arkansas, Fayetteville, 72701, USA
| | - Hyunkyoung Yoon
- Department of Mathematics and Statistics, Cal Poly Pomona, Pomona, 91768, USA
| | - Min Sook Park
- Department of Information Studies, University of Wisconsin-Milwaukee, Milwaukee, 53201, USA
| | - Alison Mirin
- Department of Mathematics, University of Arizona, Tucson, 85721, USA
| | | | - Heather Lavender
- Department of Mathematics, Science, and Social Studies Education, University of Georgia, Athens, 30606, USA
| | - Sukjin You
- Department of Information Studies, University of Wisconsin-Milwaukee, Milwaukee, 53201, USA
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Nguyen KH, Mansfield KA, Xie CY, Corlin L, Niska RW. COVID-19 Adult, Childhood, and Adolescent Vaccination Coverage Among Military and Civilian Families, United States. Mil Med 2023; 188:e2651-e2660. [PMID: 36695337 PMCID: PMC10362994 DOI: 10.1093/milmed/usac435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 11/23/2022] [Accepted: 12/30/2022] [Indexed: 01/26/2023] Open
Abstract
INTRODUCTION The COVID-19 pandemic affected the lives of military members and their families, with over 400,000 cases among U.S. military members since the start of the pandemic. The objective of this study is to examine and compare COVID-19 vaccination coverage of military members (active duty and Reserve/National Guard) and their family members (spouses, children, and adolescents) to that of their civilian counterparts using a large, nationally representative study. METHODS Data from March 2 to May 9, 2022, of the Household Pulse Survey were analyzed for this study (n = 207,758). COVID-19 vaccination status (≥1 dose) was assessed for military members and their spouses, civilians, and children (aged 5 to 11 and 12 to 17 years) from both military and civilian families. Differences between military members, spouses, and their children compared to civilian adults and children were assessed using chi-squared and t-tests. Multivariable logistic regression was used to examine the association between military status and COVID-19 vaccination after controlling for sociodemographic characteristics. Reasons for not getting vaccinated for adults and children from military and civilian families were assessed. RESULTS Compared to civilian adults and adjusted for sociodemographic characteristics, military members were more likely to be vaccinated (adjusted prevalence ratio = 1.07, 95% CI: 1.01-1.13). Vaccination coverage between active duty and civilian adults differed by subgroups. For example, among military members, COVID-19 vaccination coverage decreased with increasing age, from 87.5% among those aged 18 to 39 years to 56.0% among those aged ≥55 years. In contrast, among civilian adults, vaccination coverage increased with increasing age, from 78.5% among those aged 18 to 39 years to 91.2% among those aged ≥55 years. Military members were also less likely to be vaccinated than their civilian counterparts if they were Hispanic (68.5% vs. 85.2%), had a Bachelor's degree or higher (87.5% vs. 93.8%), or had $100,000 or more in annual household income (76.7% vs. 92.6%). Military members who had anxiety or depression (70.1%) were less likely to be vaccinated compared to civilian adults (84.4%). Military spouses (74.4%) were less likely to be vaccinated than civilian adults (84.7%). Children and adolescents who were homeschooled (35.1%) or had no preventive checkups in the past year (32.4%) were less likely to be vaccinated than their respective counterparts (52.5% and 54.0%, respectively). Military adults compared to civilian adults were more likely to report lack of trust in the government (47.5% vs. 35.2%) and, for children/adolescents, the belief that the vaccine is not needed (42.1% vs. 28.1%) as reasons for non-vaccination. CONCLUSIONS Despite vaccine mandates and the high vaccination coverage found among the majority of military members, disparities exist in some subgroups. Educational interventions and increased communication from trusted leaders, such as medical providers and commanders, could increase confidence in vaccines among military families. Ensuring access to vaccines, empowering healthcare providers to recommend vaccines, and reminding parents of missed vaccinations or preventive checkups can help improve vaccination coverage. Achieving high vaccination among military members and their families is essential in protecting those in the forefront of the pandemic response and promoting the safety and security of the nation.
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Affiliation(s)
- Kimberly H Nguyen
- Department of Public Health & Community Medicine, Tufts University School of Medicine, Boston, MA 02111, USA
| | - Kathrine A Mansfield
- Department of Public Health & Community Medicine, Tufts University School of Medicine, Boston, MA 02111, USA
| | - Christina Y Xie
- Department of Public Health & Community Medicine, Tufts University School of Medicine, Boston, MA 02111, USA
| | - Laura Corlin
- Department of Public Health & Community Medicine, Tufts University School of Medicine, Boston, MA 02111, USA
- Department of Civil and Environmental Engineering, Tufts University School of Engineering, Medford, MA 02155, USA
| | - Richard W Niska
- Department of Public Health & Community Medicine, Tufts University School of Medicine, Boston, MA 02111, USA
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Kobayashi T, Tomoi H, Nishina Y, Harada K, Tanaka K, Sasaki S, Inaba K, Mitaka H, Takahashi H, Passanante A, Lau EHY, Naito T, Larson H, Wu J, Lin L, Yamada Y. Effect of a mobile app chatbot and an interactive small-group webinar on COVID-19 vaccine intention and confidence in Japan: a randomised controlled trial. BMJ Glob Health 2023; 8:bmjgh-2022-010370. [PMID: 37247873 DOI: 10.1136/bmjgh-2022-010370] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 05/09/2023] [Indexed: 05/31/2023] Open
Abstract
INTRODUCTION We investigated the effect of social media-based interventions on COVID-19 vaccine intention (VI) and confidence in Japan. METHODS We conducted a three-arm randomised controlled trial between 5 November 2021 and 9 January 2022 during a low incidence (<1000/day) of COVID-19 in Japan in the midst of the second and the third waves. Japanese citizens aged ≥20 who had not received any COVID-19 vaccine and did not intend to be vaccinated were randomly assigned to one of the following three groups: (1) a control group, (2) a group using a mobile app chatbot providing information on COVID-19 vaccines and (3) a group using interactive webinars with health professionals. VI and predefined Vaccine Confidence Index (VCI) measuring confidence in the importance, safety and effectiveness were compared before and after the interventions under intention-to-treat principle. Logistic regression models were used to investigate the effect of each intervention on postintervention VI and changes of VCI compared with control. RESULTS Among 386 participants in each group, 359 (93.0%), 231 (59.8%) and 207 (53.6%) completed the postsurvey for the control, chatbot and webinar groups, respectively. The average duration between the intervention and the postsurvey was 32 days in chatbot group and 27 days in webinar group. VI increased from 0% to 18.5% (95% CI 14.5%, 22.5%) in control group, 15.4% (95% CI 10.8%, 20.1%) in chatbot group and 19.7% (95% CI 14.5%, 24.9%) in webinar group without significant difference (OR for improvement=0.8 (95% CI 0.5, 1.3), p=0.33 between chatbot and control, OR=1.1 (95% CI 0.7, 1.6), p=0.73 between webinar and control). VCI change tended to be larger in chatbot group compared with control group without significant difference (3.3% vs -2.5% in importance, OR for improvement=1.3 (95% CI 0.9, 2.0), p=0.18; 2.5% vs 1.9% in safety, OR=1.1 (95% CI 0.7, 1.9), p=0.62; -2.4% vs -7.6% in effectiveness, OR=1.4 (95% CI 0.9, 2.1), p=0.09). Improvement in VCI was larger in webinar group compared with control group for importance (7.8% vs -2.5%, OR=1.8 (95% CI 1.2, 2.8), p<0.01), effectiveness (6.4% vs -7.6%, OR=2.2 (95% CI 1.4, 3.4), p<0.01) and safety (6.0% vs 1.9%, OR=1.6 (95% CI 1.0, 2.6), p=0.08). CONCLUSION This study demonstrated that neither the chatbot nor the webinar changed VI importantly compared with control. Interactive webinars could be an effective tool to change vaccine confidence. Further study is needed to identify risk factors associated with decreased vaccine confidence and investigate what intervention can increase VI and vaccine confidence for COVID-19 vaccines. TRIAL REGISTRATION NUMBER UMIN000045747.
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Affiliation(s)
- Takaaki Kobayashi
- Division of Infectious Diseases, Department of Internal Medicine, University of Iowa Hospitals & Clinics, Iowa City, Iowa, USA
- Department of General Medicine, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Hana Tomoi
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine Faculty of Epidemiology and Public Health, London, UK
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Yuka Nishina
- Department of General Medicine, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Ko Harada
- Department of Medicine, Mount Sinai Beth Israel Hospital, New York, New York, USA
| | - Kyuto Tanaka
- Division of Pulmonary Medicine, Department of Internal Medicine, Nippon Kokan Hospital, Kawasaki, Kanagawa, Japan
| | - Shugo Sasaki
- Department of General Internal Medicine, Saitama Medical University Hospital, Iruma-gun, Saitama, Japan
| | - Kanako Inaba
- Department of Obstetrics and Gynecology, Kanto Central Hospital of the Mutual Aid Association of Public School Teachers, Setagaya-ku, Tokyo, Japan
| | - Hayato Mitaka
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Hiromizu Takahashi
- Department of General Medicine, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Aly Passanante
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine Faculty of Epidemiology and Public Health, London, UK
| | - Eric H Y Lau
- Laboratory of Data Discovery for Health (D24H), Hong Kong SAR, China
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Toshio Naito
- Department of General Medicine, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Heidi Larson
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine Faculty of Epidemiology and Public Health, London, UK
- Institute for Health Metrics & Evaluation, University of Washington, Seattle, Washington, USA
| | - Joseph Wu
- Laboratory of Data Discovery for Health (D24H), Hong Kong SAR, China
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
- The University of Hong Kong - Shenzhen Hospital, Shenzhen, China
| | - Leesa Lin
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine Faculty of Epidemiology and Public Health, London, UK
- Laboratory of Data Discovery for Health (D24H), Hong Kong SAR, China
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Yuji Yamada
- Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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Fontán-Vela M, Gullón P, Bilal U, Franco M. Social and ideological determinants of COVID-19 vaccination status in Spain. Public Health 2023; 219:139-145. [PMID: 37178560 PMCID: PMC10080268 DOI: 10.1016/j.puhe.2023.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 03/27/2023] [Accepted: 04/02/2023] [Indexed: 05/15/2023]
Abstract
OBJECTIVES This study analysed the association between social and ideological determinants with COVID-19 vaccine accessibility and hesitancy in the Spanish adult population. STUDY DESIGN This was a repeated cross-sectional study. METHODS The data analysed are based on monthly surveys conducted by the Centre for Sociological Research between May 2021 and February 2022. Individuals were classified according to their COVID-19 vaccination status into (1) vaccinated (reference group); (2) willing to vaccinate but not vaccinated, proxy of lack of vaccine accessibility; and (3) hesitant, proxy of vaccine hesitancy. Independent variables included social (educational attainment, gender) and ideological determinants (voting in the last elections, importance attached to the health vs the economic impact of the pandemic, and political self-placement). We estimated odds ratio (OR) and 95% confidence interval (CI) conducting one age-adjusted multinomial logistic regression model for each determinant and then stratified them by gender. RESULTS Both social and ideological determinants had a weak association with the lack of vaccine accessibility. Individuals with medium educational attainment had higher odds of vaccine hesitancy (OR = 1.44, CI 1.08-1.93) compared with those with high educational attainment. People self-identified as conservative (OR = 2.90; CI 2.02-4.15) and those who prioritised the economic impact (OR = 3.80; CI 2.62-5.49) and voted for parties opposed to the Government (OR = 2.00; CI 1.54-2.60) showed higher vaccine hesitancy. The stratified analysis showed a similar pattern for both men and women. CONCLUSIONS Considering the determinants of vaccine uptake and hesitancy could help to design strategies that increase immunisation at the population level and minimise health inequities.
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Affiliation(s)
- M Fontán-Vela
- Universidad de Alcalá, Facultad de Medicina y Ciencias de La Salud, Departamento de Cirugía, Ciencias Médicas y Sociales, Grupo de Investigación en Epidemiología y Salud Pública, Alcalá de Henares, Madrid, Spain; Instituto de Lengua, Literatura y Antropología, Centro Superior de Investigaciones Sociológicas, Ministerio de Ciencia e Innovación, Spain
| | - P Gullón
- Universidad de Alcalá, Facultad de Medicina y Ciencias de La Salud, Departamento de Cirugía, Ciencias Médicas y Sociales, Grupo de Investigación en Epidemiología y Salud Pública, Alcalá de Henares, Madrid, Spain; Centre for Urban Research, RMIT University, Melbourne, Australia.
| | - U Bilal
- Universidad de Alcalá, Facultad de Medicina y Ciencias de La Salud, Departamento de Cirugía, Ciencias Médicas y Sociales, Grupo de Investigación en Epidemiología y Salud Pública, Alcalá de Henares, Madrid, Spain; Urban Health Collaborative, Drexel Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA; Department of Epidemiology and Biostatistics, Drexel Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - M Franco
- Universidad de Alcalá, Facultad de Medicina y Ciencias de La Salud, Departamento de Cirugía, Ciencias Médicas y Sociales, Grupo de Investigación en Epidemiología y Salud Pública, Alcalá de Henares, Madrid, Spain; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205-2217, USA
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7
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Ejchman-Pac E, Wójtowicz J, Zawadzka M. Analysis of Non-Compulsory Influenza and COVID-19 Vaccination among Polish Soldiers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3304. [PMID: 36833996 PMCID: PMC9960228 DOI: 10.3390/ijerph20043304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 02/09/2023] [Accepted: 02/10/2023] [Indexed: 06/18/2023]
Abstract
The COVID-19 pandemic posed many challenges in epidemiology, health care, and vaccinology. Pharmaceutical and biotechnology companies had to develop effective vaccines as soon as possible in order to halt the spread of infection outbreaks and enable the start of the National Vaccination Program. Firstly, medical services and security services (the army, fire brigade, and police), i.e., those most involved in the fight against the effects of the COVID-19 pandemic, were included in the aforementioned program. The presented publication analyzes the amount and type of vaccination against COVID-19 and influenza among Polish soldiers. Influenza, like COVID-19, is a viral disease that can vary in its course (from mild to acute and life-threatening). Both coronaviruses and influenza viruses are characterized by high genetic variability, resulting in the need for repeated vaccination during each autumn and winter season. Acquired data comes from the Central Register of Vaccination of Professional Soldiers. The collected material was statistically processed. The average level of the phenomenon was presented as a time series using a chronological average. In the analyzed period (December 2020-December 2021), the lowest vaccinations against COVID-19 were performed in December 2020, which is due to the schedule of the National Vaccination Program in Poland. In contrast, the highest number of vaccinations were administered between April and June 2021, or approximately 70.5% of all vaccines administered. In the case of influenza, there is a clear increase in the number of vaccinations during the autumn and winter seasons, which coincides with peaks in disease during these periods. Between August 2020 and January 2021, there is a noticeable increase in the number of flu injections given, nearly 50% compared to the previous period, which may be related to the simultaneous persistence of the COVID-19 pandemic and greater attention to one's own health. Non-mandatory vaccination is an important point in the vaccination schedule for soldiers. Numerous public campaigns combating misinformation and raising awareness of the need for immunization will help convince even more people, not only among soldiers but also the civilian population, to vaccinate.
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Affiliation(s)
- Ewelina Ejchman-Pac
- Independent Department of Epidemiology, Military Institute of Hygiene and Epidemiology, 01-163 Warsaw, Poland
| | - Julian Wójtowicz
- Department of Medical Law Lodz, Medical University of Lodz Faculty of Health Sciences, 90-419 Lodz, Poland
| | - Magdalena Zawadzka
- Independent Department of Epidemiology, Military Institute of Hygiene and Epidemiology, 01-163 Warsaw, Poland
- Department of Epidemiology and Public Health Lodz, Medical University of Lodz, 90-419 Lodz, Poland
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8
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Mashinini DP, Lagerwey MD, Fogarty KJ, Potter RC. Methods of Current Practice: Qualitative Analysis of Intervention Strategies Utilized by Vaccine Waiver Educators in Michigan. Policy Polit Nurs Pract 2022; 23:249-258. [PMID: 35950242 PMCID: PMC9647316 DOI: 10.1177/15271544221114293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
By enacting administrative rule 325.176 (12), Michigan added a vaccine education component as a precondition to granting vaccine waivers to vaccine-hesitant parents wishing to file a nonmedical vaccine exemption for their school-aged child. The purpose of the study was to identify best practices for reaching vaccine-hesitant parents during face-to-face vaccine education sessions conducted by vaccine waiver educators in Michigan. This study utilized qualitative descriptive content analysis of semi-structured phone interviews with vaccine waiver educators from local health departments (LHDs) in Michigan. Participants were vaccine waiver educators who were employed by a local health department in Michigan and had conducted at least 30 vaccine waiver education sessions. Strategies, resources, and techniques identified by educators as beneficial included using and providing information from a variety of sources, compiling their own educational materials, creating a positive experience, holding personalized sessions, and streamlining exemption and vaccination sessions. However, unexpected themes that emerged from the interviews revealed that vaccine waiver educators need additional training in discussing vaccine ingredients with parents, handling religious vaccine exemption requests, and assessing the role of schools. Implementing successful vaccine education interventions targeting vaccine-hesitancy is crucial to public health. Charging LHDs with overseeing vaccine education via a face-to-face discussion is a novel intervention strategy, the effective implementation of which may inform vaccine education intervention nationwide and may even be translated into international contexts and prove useful to current COVID-19 vaccination efforts.
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Affiliation(s)
- Duduzile P. Mashinini
- College of Health and Human Services, Interdisciplinary Health
Sciences Ph.D. Program, Western Michigan University, Kalamazoo, MI, USA
- Duduzile P. Mashinini, College of Health
and Human Services, Interdisciplinary Health Sciences Ph.D. Program, 1903 West
Michigan Ave, Western Michigan University, Kalamazoo, MI, 49008, USA.
| | - Mary D. Lagerwey
- College of Health and Human Services, Bronson School of Nursing, Western Michigan University, Kalamazoo, MI, USA
| | - Kieran J. Fogarty
- College of Health and Human Services, Interdisciplinary Health
Sciences Ph.D. Program, Western Michigan University, Kalamazoo, MI, USA
| | - Rachel C. Potter
- Michigan Department of Health and Human
Service (MDHHS), Division of Immunizations, Lansing, MI, USA
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Bakır N, Gün Kakaşçı Ç, Demir C. The effect of training with the Pecha Kucha method on the attitudes of chronically ill women toward COVID-19 vaccination. Women Health 2022; 62:809-817. [PMID: 36377268 DOI: 10.1080/03630242.2022.2146834] [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: 11/17/2022]
Abstract
In this study, it was aimed to plan a training program regarding vaccination chronically ill women group and investigate the effects of providing this training with the Pecha Kucha method on attitudes toward vaccination. This study was carried out between August 2021 and September 2021 using a pretest-posttest, prospective, randomized-controlled experimental design with an effect size (Cohen's d) of 1.005. The study was completed with 35 patients in each of the experimental and control groups. An introductory information form and the Attitudes toward the COVID-19 Vaccine Scale were used to collect data. While vaccination training was given to the experimental group via smartphones using the Pecha Kucha method, it was given to the control group with the classical verbal instruction method. The data were collected before the training, right after the training, and 3 months after the training. The statistical analyses included Pearson's chi-squared test, the Mann-Whitney U test, the Friedman test, and the Wilcoxon signed-rank test. In the second and third measurements, the rate of positive attitudes toward the vaccine and the rate of vaccination were higher in the experimental group (p < .05, p < .05). Training regarding vaccination via smartphones using the Pecha Kucha method may play a role in the development of positive attitudes toward the vaccine and the improvement of vaccination rates.
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Affiliation(s)
- Nazife Bakır
- Department of Nursing, Bucak School of Health, Burdur Mehmet Akif Ersoy University, Burdur, Türkiye
| | - Çiğdem Gün Kakaşçı
- Department of Midwifery, Faculty of Health Sciences, Süleyman Demirel University, Isparta, Türkiye
| | - Cuma Demir
- Institute of Health Sciences, Kafkas University, Kars, Türkiye
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10
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Meysamie A, Ghasemi E, Moshksar S, Askarian M. "Intention to receive COVID-19 vaccine among healthcare workers: a comparison between two surveys". BMC Health Serv Res 2022; 22:982. [PMID: 35915483 PMCID: PMC9342594 DOI: 10.1186/s12913-022-08379-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 07/27/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Considering the importance of intention to receive COVID-19 vaccine among healthcare workers and its role in maintaining their health and inhibiting the epidemic spread of Covid-19, the present study was done to identify the changes in intention to receive COVID-19 vaccine rate in two different time points and it's determinants based on the dimensions of the health belief model among healthcare workers in Iran. METHODS Two cross-sectional surveys performed to investigate COVID-19 vaccination intent and associated factors based on the health belief model. The first conducted on 1244 participants from August 18 to 23, 2020, and the second on 1514 participants from February 5 to April 29, 2021, both using a questionnaire of intent to accept COVID-19 vaccination. The questionnaire distribution platform in both surveys was similarly, WhatsApp and Telegram social and working virtual groups of HCWs. Data were analyzed with SPSS-16 software for descriptive and analytical statistics. RESULTS In the first survey, 58.4% (95% CI: 0.55-0.61%) of healthcare workers intended to receive the COVID-19 vaccine, the rate dropped to 45.7% (95% CI: 0.43-0.48%) in the second survey (P < 0.001). The regression analysis indicated six factors that were significantly associated with higher intention to receive COVID-19 vaccine: being a female (OR = 1.84, 95% CI (1.11-3.03)), history of Covid-19 infection (OR = 1.54, 95% CI (1.09-2.18), perceptions of Covid-19 disease (OR = 1.13, 95% CI (1.01-1.28)), perceived benefits of COVID-19 vaccine (OR = 1.34, 95% CI (1.22-1.47)), prosocial norms for COVID-19 vaccination (OR = 1.25, 95% CI (1.21-1.29)), and COVID-19 vaccine safety/cost concerns (OR = 1.25, 95% CI (1.17-1.33)). CONCLUSIONS Present study showed an undesirable rate of intention to receive COVID-19 vaccine among healthcare workers, especially decreasing over the time, emphasize the need of interventions to promote healthcare workers' intention to receive the vaccine and reduce the spread of COVID-19 disease.
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Affiliation(s)
- Alipasha Meysamie
- Department of Community and Preventive Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Community-Based Participatory Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Ghasemi
- Community-Based Participatory Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Shadi Moshksar
- Department of Community Medicine, School of Medicine, Shiraz University of Medical Sciences, Karimkhan-e Zand Avenue, Shiraz, 7134845794, Iran
| | - Mehrdad Askarian
- Department of Community Medicine, School of Medicine, Shiraz University of Medical Sciences, Karimkhan-e Zand Avenue, Shiraz, 7134845794, Iran. .,Health Behavior Science Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
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11
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Glendening J, Bickford B, Markert R, Yuhas J, Berglund A, Kelly D, Scott J, Burtson K. Addressing Persistent Vaccine Hesitancy in a Military Community Through a Physician-Led Intervention. Mil Med 2022; 188:928-931. [PMID: 35762461 PMCID: PMC9384368 DOI: 10.1093/milmed/usac176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 04/04/2022] [Accepted: 06/13/2022] [Indexed: 11/25/2022] Open
Abstract
Introduction Following the identification of coronavirus disease 2019 (COVID-19) in China, the virus has spread rapidly around the world causing severe illness and death. Several vaccines were found to be safe and effective and made available first to those most at risk and then to the general public. Despite the safety and efficacy profiles, vaccine hesitancy remains a significant barrier to widespread immunity. Within the military community at Wright-Patterson Air Force Base, we provided multiple physician-led educational seminars to address vaccination concerns and decrease vaccine hesitancy. Materials and Methods The authors presented a PowerPoint presentation of the available vaccinations, their safety data, and efficacy, followed by a town hall-style question-and-answer period where questions were presented from the previous submission, as well as real-time submissions through Facebook Live. The questions were fielded by specialists in Internal Medicine, Infectious Disease, Pulmonary-Critical Care, Obstetrics and Gynecology, and Rheumatology. The entire presentation was streamed through Facebook Live and was freely available. Following the presentation, an online survey was provided for willing participants to complete which included demographic data and addressed their previous and current attitudes toward COVID-19 vaccinations and their opinions on the presentation. Data from the survey were then analyzed through IBM SPSS Statistics 25.0 to find any associations or risk factors for hesitancy. Results There were 73 respondents to the assessment, most of which were nonmedical. Of the 73, the majority (45) had already received a vaccine for COVID-19. Of those unvaccinated, 17 did not want a vaccination before or after the seminar. Two did change their mind about being receptive to vaccination, and one changed from receptive to hesitant. The only statistically significant risk factors for vaccine hesitancy were those with a moderate to great amount of trust in their health care provider compared to those with little to no trust (73% vs. 4%, P < .001). Conclusions Our intervention was limited in its effectiveness to address vaccine hesitancy late in the pandemic, with our study limited by our small sample size. Regardless, it identified a peculiar discrepancy with those with the most trust in health care providers being the most likely to be vaccine-hesitant. This highlights the importance of the information that trusted health care providers are providing to their patients and may identify more effective routes to address vaccine hesitancy in the future.
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Affiliation(s)
- Joseph Glendening
- USAF Internal Medicine, Wright-Patterson Medical Center, WPAFB, OH 45433, USA
| | - Brant Bickford
- USAF Internal Medicine, Wright-Patterson Medical Center, WPAFB, OH 45433, USA
| | - Ronald Markert
- Department of Internal Medicine, Wright State University, Dayton, OH 45409, USA
| | - Joseph Yuhas
- USAF Internal Medicine, Wright-Patterson Medical Center, WPAFB, OH 45433, USA
| | - Andrew Berglund
- USAF Internal Medicine, Wright-Patterson Medical Center, WPAFB, OH 45433, USA
| | - Devin Kelly
- USAF Internal Medicine, Wright-Patterson Medical Center, WPAFB, OH 45433, USA
| | - Joshua Scott
- USAF Internal Medicine, Wright-Patterson Medical Center, WPAFB, OH 45433, USA
| | - Kathryn Burtson
- USAF Internal Medicine, Wright-Patterson Medical Center, WPAFB, OH 45433, USA
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12
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Alrabadi N, Bany-Melhem S, Alzoubi KH, Alzoubi OO, Masadeh M, Abuhammad S, Harun SN. COVID-19 Vaccination Hesitancy: A Review of the Literature and Recommendations. Curr Rev Clin Exp Pharmacol 2022; 19:CRCEP-EPUB-123426. [PMID: 35549859 DOI: 10.2174/2772432817666220512112913] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 01/24/2022] [Accepted: 01/24/2022] [Indexed: 11/22/2022]
Abstract
Vaccines are important to improve immunity against pathogens and diseases. The current COVID-19 disease is rapidly evolving and spreading among people; therefore, it is important to utilize a proper vaccination strategy against it. Currently, many approved vaccines are available and accessible; however, there is a reported hesitancy against taking them among the public and even the health care workers. Mainly, this is attributed to the fear of the possible side effects and complications. Moreover, inaccurate knowledge disseminated through the media/social media especially by those who lack proper expertise adds confusion and more fear that affects the vaccination decision. For such reasons, it is essential to find strategies to increase the acceptability of vaccines and to enhance confidence in the vaccination process. This should be accompanied by sufficient efforts and proper clinical studies to confirm the value and the safety of the vaccines. Those strategies are important to avoid the further spread of the COVID-19 disease and to abort the pandemic worldwide, especially when considering the likely approach towards a COVID-19 booster vaccination program, in which booster vaccines are re-taken along intervals to adequately contain the rapidly evolving nature of the virus. This review article highlights the factors influencing the acceptability of the COVID-19 vaccination and enrollment in clinical trials among the public and some specific populations. Furthermore, it summarizes the suggested strategies and recommendations that can improve the attitudes towards COVID-19 vaccination programs.
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Affiliation(s)
- Nasr Alrabadi
- Department of Pharmacology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan, 22110
| | - Shouq Bany-Melhem
- Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan, 22110
| | - Karem H Alzoubi
- Department of Pharmacy Practice and Pharmacotherapeutics, University of Sharjah, Sharjah, UAE
- Deparment of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan, 22110
| | - Osama O Alzoubi
- Faculty of Medicine, The University of Jordan, Amman, Jordan
| | - Majd Masadeh
- Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan, 22110
| | - Sawsan Abuhammad
- Department of Maternal and Child Health Nursing, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan, 22110
| | - Sabariah Noor Harun
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800, Penang, Malaysia
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13
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Pengid S, Peltzer K, de Moura Villela EF, Fodjo JNS, Siau CS, Chen WS, Bono SA, Jayasvasti I, Hasan MT, Wanyenze RK, Hosseinipour MC, Dolo H, Sessou P, Ditekemena JD, Colebunders R. Using Andersen's model of health care utilization to assess factors associated with COVID-19 testing among adults in nine low-and middle-income countries: an online survey. BMC Health Serv Res 2022; 22:265. [PMID: 35227263 PMCID: PMC8882718 DOI: 10.1186/s12913-022-07661-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 02/21/2022] [Indexed: 12/23/2022] Open
Abstract
Background This study aimed to investigate, using Andersen’s model of health care utilization, factors associated with COVID-19 testing among adults in nine low- and middle- income countries. Methods In between 10 December 2020 and 9 February 2021, an online survey was organized in nine low- and middle-income countries. In total 10,183 adults (median age 45 years, interquartile range 33–57 years, range 18–93 years), including 6470 from Brazil, 1738 Malaysia, 1124 Thailand, 230 Bangladesh, 219 DR Congo, 159 Benin, 107 Uganda, 81 Malawi and 55 from Mali participated in the study. COVID-19 testing/infection status was assessed by self-report. Results Of the 10,183 participants, 40.3% had ever tested for COVID-19, 7.3% tested positive, and 33.0% tested negative. In an adjusted logistic regression model, predisposing factors (residing in Brazil, postgraduate education), enabling/disabling factors (urban residence, higher perceived economic status, being a student or worker in the health care sector, and moderate or severe psychological distress), and need factors (having at least one chronic condition) increased the odds of COVID-19 testing. Among those who were tested, participants residing in Bangladesh, those who had moderate to severe psychological distress were positively associated with COVID-19 positive diagnosis. Participants who are residing in Malaysia and Thailand, and those who had higher education were negatively associated with a COVID-19 positive diagnosis. Considering all participants, higher perceived economic status, being a student or worker in the health sector, and moderate or severe psychological distress were positively associated with a COVID-19 positive diagnosis, and residing in Malaysia, Thailand or five African countries was negatively associated with a COVID-19 positive diagnosis. Conclusion A high rate of COVID-19 testing among adults was reported in nine low-and middle-income countries. However, access to testing needs to be increased in Africa. Moreover, COVID-19 testing programmes need to target persons of lower economic status and education level who are less tested but most at risk for COVID-19 infection.
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Affiliation(s)
- Supa Pengid
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, 10400, Thailand.,Department of Research Administration and Development, University of Limpopo, Polokwane, South Africa
| | - Karl Peltzer
- Department of Research Administration and Development, University of Limpopo, Polokwane, South Africa. .,Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan.
| | - Edlaine Faria de Moura Villela
- Disease Control Coordination, São Paulo State Health Department, São Paulo, 01246-000, Brazil.,Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, 74690-900, Brazil
| | | | - Ching Sin Siau
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300, Kuala Lumpur, Malaysia
| | - Won Sun Chen
- Department of Health Science and Biostatistics, Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, VIC, 3122, Australia
| | - Suzanna A Bono
- School of Social Science, Universiti Sains Malaysia, 11800, Gelugor, Malaysia
| | | | - M Tasdik Hasan
- Jeeon Bangladesh Ltd., Dhaka, Bangladesh.,Department of Public Health, State University of Bangladesh (SUB), Dhaka, Bangladesh.,Department of Primary Care & Mental Health, University of Liverpool, Liverpool, L69 3BX, UK
| | - Rhoda K Wanyenze
- School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | | | - Housseini Dolo
- International Center of Excellence in Research, Faculty of Medicine and OdontoStomatology, Bamako, Mali.,Lymphatic Filariasis Research Unit/International Center of Excellence in Research, Bamako, Mali
| | - Philippe Sessou
- Research Unit on Communicable Diseases, Polytechnic School of Abomey-Calavi, University of Abomey-Calavi, Cotonou 01, BP, 526, Benin
| | - John D Ditekemena
- Kinshasa School of Public Health, University of Kinshasa, Kinshasa, 7948, Democratic Republic of the Congo
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14
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Cyberchondria, Fear of COVID-19, and Risk Perception Mediate the Association between Problematic Social Media Use and Intention to Get a COVID-19 Vaccine. Vaccines (Basel) 2022; 10:vaccines10010122. [PMID: 35062783 PMCID: PMC8779372 DOI: 10.3390/vaccines10010122] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 01/05/2022] [Accepted: 01/10/2022] [Indexed: 12/24/2022] Open
Abstract
Vaccination is the most effective way to control the COVID-19 pandemic, but vaccination hesitancy threatens this effort worldwide. Consequently, there is a need to understand what influences individuals’ intention to get a COVID-19 vaccine. Restriction of information gathering on societal developments to social media may influence attitudes towards COVID-19 vaccination through exposure to disinformation and imbalanced arguments. The present study examined the association between problematic social media use and intention to get the COVID-19 vaccine, taking into account the mediating roles of cyberchondria, fear of COVID-19, and COVID-19 risk perception. In a cross-sectional survey study, a total of 10,843 residents of Qazvin City, Iran completed measures on problematic social media use, fear of COVID-19, cyberchondria, COVID-19 risk perception, and intention to get a COVID-19 vaccine. The data were analyzed using structural equation modeling (SEM). The results showed that there was no direct association between problematic social media use and intention to get a COVID-19 vaccine. Nonetheless, cyberchondria, fear of COVID-19, and COVID-19 risk perception (each or serially) mediated associations between problematic social media use and intention to get a COVID-19 vaccine. These results add to the understanding of the role of problematic social media use in COVID-19 vaccine hesitancy, i.e., it is not the quantity of social media use per se that matters. This knowledge of the mediating roles of cyberchondria, fear of COVID-19, and COVID-19 risk perception can be used by public health experts and policymakers when planning educational interventions and other initiatives in COVID-19 vaccination programs.
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15
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Bloom M, Verma S, Ram D, Roberton T, Pacheco C, Goldman RE, Lima K, Faith Vera Cruz M, Szkwarko D. COVID-19 Vaccine Concerns and Acceptability by Language in a Marginalized Population in Rhode Island. J Prim Care Community Health 2021; 12:21501327211058976. [PMID: 34854328 PMCID: PMC8646824 DOI: 10.1177/21501327211058976] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION We need to understand the continued concerns and acceptability of COVID-19 vaccines within marginalized communities in the United States. Our study explores the concerns and acceptability of COVID-19 vaccines, by language group, at a Federally Qualified Health Center (FQHC) in Rhode Island. METHODS We conducted an exploratory, mixed data collection telephone survey in languages spoken in the community (Spanish, Cape Verdean (CV) Creole/Portuguese, and English). Participants were asked about their COVID-19 vaccination status, as well as vaccine concerns and acceptability via 9 closed-ended and 2 open-ended questions. Chi squared and multivariate analysis was used to compare concerns and acceptability across languages. Coding and immersion/crystallization techniques were used to identify qualitative data themes. RESULTS The overall response rate was 58%. Side effects were cited as the most frequent (66%) concern among all language groups. Concern about the speed of vaccine development, vaccine ingredients, and being in a research trial varied significantly by language. Qualitative findings included concerns about chronic medical conditions and generalized fear of vaccine safety. English speakers were the most likely to report concerns and CV Creole/Portuguese speakers were the least likely to report concerns about the vaccine. Spanish and CV Creole/Portuguese participants who were not yet vaccinated reported higher acceptability to receive the vaccine compared to English speakers, with odds ratios of 2.00 (95% CI: 1.00-4.00) and 1.27 (95% CI: 0.62-2.60), respectively. CONCLUSION To mitigate the effects of the COVID-19 pandemic and prepare for future pandemics, strategies must be based on understanding the beliefs and perceptions of marginalized communities.
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Affiliation(s)
- Molly Bloom
- The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Shelly Verma
- The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Deepika Ram
- The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Timothy Roberton
- Johns Hopkins Bloomberg School of Public Health, Baltimore MD, USA
| | | | - Roberta E Goldman
- The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Kevin Lima
- Blackstone Valley Community Health Care, Pawtucket, RI, USA
| | | | - Daria Szkwarko
- The Warren Alpert Medical School of Brown University, Providence, RI, USA
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