While studies on COVID-19 vaccine is ongoing, the public's thoughts and attitudes to the future COVID-19 vaccine

Parental intention on getting children COVID-19 vaccinations: Invariance evaluation across parenting roles and COVID-19-like symptoms experiences among Iranians during the pandemic period

Countries worldwide are facing challenges with increasing the COVID-19 vaccination rates for children. This study examined associations between perceived knowledge, coping appraisal, threat appraisal, adaptive response, maladaptive response, and intention, and possible variance across parents (mother or father) and COVID-19-like symptoms experiences regarding parental intentions to vaccinate their children. A total of 836 Iranian parents with children between the ages of 6 and 12 y completed measures assessing perceived knowledge, coping appraisals, threat appraisals, intentions, adaptive responses, and maladaptive responses. Multigroup structural equation modeling revealed that perceived knowledge was positively associated with both coping and threat appraisals, coping appraisals positively associated with adaptive responses, maladaptive responses, and intentions to vaccinate, threat appraisals positively associated with adaptive and maladaptive responses, and adaptive responses positively associated with intentions to vaccinate. The invariance evaluation revealed no differences across parents or COVID-19-like symptoms experiences in parental intentions to get their children vaccinated. The findings suggest that cogent information regarding childhood COVID-19 vaccination may boost parents' knowledge influencing their appraisals, adaptive responses and intentions to vaccinate their children. Specifically, coping appraisals and adaptive responses appeared to be important mediators between knowledge and intentions to vaccinate. Furthermore, intentions to vaccinate children may not be strongly influenced by parental roles or COVID-19-like symptoms experiences. These findings may help multiple stakeholders promote COVID-19 vaccination rates among children, and countries should further examine ways of increasing rates based on their specific needs.

Predictors of COVID-19 vaccine uptake among youth with bipolar disorder spectrum disorders and their caregivers

BACKGROUND

Little is known about rates of COVID-19 vaccine uptake among youth with bipolar spectrum disorders (BSD). As such, the aim of this study is to assess rates and predictors of COVID-19 vaccine uptake among youth with BSD and their caregivers in the United States.

METHODS

Youth and their main caregiver were recruited from a large pragmatic study cohort. Youth who were aged 8-22 at the time of this data collection, had a bipolar-spectrum disorder diagnosis, had overweight or obesity, and were treated with a second-generation antipsychotic were invited to participate in an online survey and interview assessing the impact of the COVID-19 pandemic.

RESULTS

A total of 453 surveys and 341 interviews were completed 07/2021-05/2022 by youth and their caregivers. Sixty-seven percent of caregivers and 63 % of youth reported receiving the COVID-19 vaccine. Vaccine uptake rates among youth and caregivers were highly correlated. Predictors of vaccine uptake among youth were older age and living in the Northeast Region of the United States. Predictors of caregiver vaccine uptake were male sex, higher annual household income and not having to quarantine due to COVID-19.

LIMITATIONS

The sample was small and not a full representation of a population with bipolar-spectrum disorders therefore, the results may not be generalizable. The study design and statistical method do not allow for causal inferences to be made.

CONCLUSIONS

These findings may aid in targeting interventions to maximize COVID-19 and other vaccine uptake in youth with bipolar disorders and their families.

The individual and ecological characteristics of parental COVID-19 vaccination decisions

Vaccination is a highly effective method to prevent the spread of COVID-19 and mitigate severe disease. In Germany, adult vaccination rates are relatively high at 85.5%, but rates are significantly lower for adolescents (69.6%) and children (20.0%). This discrepancy indicates that not all vaccinated parents choose to vaccinate their children. Analyzing data from a January 2022 online survey of 1,819 parents with children and adolescents, we explore the socio-economic factors influencing parents' willingness to vaccinate themselves and their children. Our results show that individuals who vote for either side of the political extremes are less likely to vaccinate their children. This pattern is particularly strong for voters on the far right. In addition, we find that better educated parents are more likely to vaccinate both themselves and their children. Parents who vaccinate both themselves and their children demonstrate greater confidence in the vaccine's effectiveness, while those who vaccinate only themselves are often motivated by a desire to regain personal freedoms. These insights highlight the need for targeted public health strategies to address specific concerns and improve vaccination rates among children and adolescents.

COVID-19 vaccination rates and factors affecting vaccination in children with rheumatic disease

Objectives

This study aimed to investigate coronavirus disease 2019 (COVID-19) vaccination rates and factors affecting vaccination in children with rheumatic diseases.

Patients and methods

This multicenter cross-sectional survey-based study was conducted between July 2022 and September 2022. Four hundred seventy-four patients (256 females, 218 males; median age: 15 years; interquartile range, 13 to 16 years) were included in the patient group, and 211 healthy children (124 females, 87 males; median age: 15 years; interquartile range, 13 to 16 years) were included in the control group. A questionnaire was administered to the parents face-to-face during routine outpatient visits.

Results

Of the patients, 220 were followed up with the diagnosis of autoinflammatory disease, 174 with juvenile idiopathic arthritis, 48 with connective tissue disease, 23 with vasculitis, eight with uveitis, and one with sarcoidosis. In the study group, 256 (54%) patients and 115 (54.5%) healthy children received at least one dose of COVID-19 vaccine. Parents' concern regarding potential side effects of the vaccine was the most common reason for COVID-19 vaccination hesitancy in both groups. The median patient age, follow-up period, colchicine treatment rates, childhood vaccination and influenza vaccination rates, median parental age, parental vaccination rate, and parental education level were higher in vaccinated patients (p<0.001).

Conclusion

Parents' concerns about safety and side effects were found to be the most important factors affecting vaccination success. Identification of the underlying causes of parental vaccine hesitancy will facilitate the development of effective vaccination strategies for potential future outbreaks.

Survival Analysis and Socio-Cognitive Factors in the Timing of COVID-19 Vaccination Among Mexican-Origin Youth

OBJECTIVE

The COVID-19 pandemic disproportionately affected ethnic minority populations and exacerbated preexisting health disparities. The current study aims to promote vaccine uptake among Mexican-origin youth from immigrant families by examining their time to COVID-19 vaccine uptake and assessing the influence of demographic, cognitive, and social factors on the incidence of COVID-19 vaccination.

METHODS

The study conducted Survival Analysis using a Cox proportional hazards model based on a sample of 202 Mexican-origin youth (61.39% female; Mage = 20.41) with data collected from August 2021 to January 2023 in central Texas.

RESULTS

The results show a critical time period for vaccine uptake (i.e., in the first six months after the vaccines were publicly available), evidenced by a surge decrease in COVID-19 unvaccination probability. In addition, more positive attitudes toward the COVID-19 vaccine (Hazard ratio/HR = 1.89, 95% Confidence Interval/CI = [1.64, 2.18]), greater motivation (HR = 2.29, 95% CI = [1.85, 2.85]), higher education levels (HR = 1.52, 95% CI = [1.24, 1.86]), and fewer general barriers to COVID-19 vaccine knowledge (HR = 0.75, 95% CI = [0.60, 0.94]) were associated with greater incidences of receiving COVID-19 vaccines at any given time point during the pandemic.

CONCLUSION

The findings suggest that COVID-19 vaccine uptake among Mexican-origin youth occurred primarily within the initial months of vaccines being publicly distributed. To encourage vaccination among Mexican-origin youth, sustained COVID-19 vaccine promotion efforts are needed by targeting their motivation and positive attitudes and reducing barriers to vaccine information, particularly for youth with lower education levels.

Marginalisation and distrust in the context of the COVID-19 vaccination programme: experiences of communities in a northern UK city region

BACKGROUND

There are clear inequalities in COVID - 19 vaccination rates amongst marginalised groups, with lower rates for some minoritised ethnic and religious groups, younger people, those living in more deprived areas, and with lower socio-economic status. Existing research focuses on psychological and socio-economic factors that influence vaccine uptake and does not explore broader social and historical contexts. Understanding inequalities in COVID-19 vaccine uptake requires a critical examination of the drivers of, and barriers to, vaccination.

METHODS

We present findings from a co-designed qualitative research study undertaken during the COVID-19 pandemic. Focus groups and interviews were used to examine the context underpinning responses to the COVID-19 vaccination in Greater Manchester, particularly focussing on experiences of marginalisation. Thematic framework analysis was used to analyse the data.

RESULTS

We found that the public's responses to the COVID-19 vaccination programme are intertwined with a longstanding history of institutional distrust and disenfranchisement, resulting from experiences of marginalisation and social inequalities. This was exacerbated further by the disproportionate impacts of the COVID-19 pandemic on minoritised ethnic groups, younger people, and those with existing health conditions.

CONCLUSIONS

Histories of structural inequalities experienced by minoritised groups invoked feelings of suspicion and scepticism at the motivations of the agencies behind the vaccination rollout. This highlights the need for a contextualised analysis of attitudes to vaccines, considering pre-existing inequalities, which may be especially relevant for conceptualising public responses to the vaccination programme. Finally, our study shows the important ways in which public (dis)trust can impact public health policies. We recommend this should be incorporated into responses to future public health crises.

Longitudinal parental perception of COVID-19 vaccines for children in a multi-site, cohort study

OBJECTIVES

Pediatric COVID-19 vaccine hesitancy and uptake is not well understood. Among parents of a prospective cohort of children aged 6 months-17 years, we assessed COVID-19 vaccine knowledge, attitudes, and practices (KAP), and uptake over 15 months.

METHODS

The PROTECT study collected sociodemographic characteristics of children at enrollment and COVID-19 vaccination data and parental KAPs quarterly. Univariable and multivariable logistic regression models were used to test the effect of KAPs on vaccine uptake; McNemar's test for paired samples was used to evaluate KAP change over time.

RESULTS

A total of 2,837 children were enrolled, with more than half (61 %) vaccinated by October 2022. Positive parental beliefs about vaccine safety and effectiveness strongly predicted vaccine uptake among children aged 5-11 years (aOR 13.1, 95 % CI 8.5-20.4 and aOR 6.4, 95 % CI 4.3-9.6, respectively) and children aged 12+ years (aOR 7.0, 95 % CI 3.8-13.0 and aOR 8.9, 95 % CI 4.4-18.0). Compared to enrollment, at follow-up parents (of vaccinated and unvaccinated children) reported higher self-assessed vaccine knowledge, but more negative beliefs towards vaccine safety, effectiveness, and trust in government. Parents unlikely to vaccinate their children at enrollment reported more positive beliefs on vaccine knowledge, safety, and effectiveness at follow-up.

CONCLUSION

The PROTECT cohort allows for an examination of factors driving vaccine uptake and how beliefs about COVID-19 and the COVID-19 vaccines change over time. Findings of the current analysis suggest that these beliefs change over time and policies aiming to increase vaccine uptake should focus on vaccine safety and effectiveness.

Understanding the role of risk preferences and perceptions in vaccination decisions and post-vaccination behaviors among U.S. households

COVID-19 vaccines play a critical role in protecting against infection and transmission of the virus. Therefore, understanding public perceptions of COVID-19 vaccines is essential for successful vaccine promotion. Previous literature reported strong associations between vaccination decisions and several sociodemographic variables. However, knowledge about how behavioral factors, including risk perceptions and preferences, impact individuals' attitudes towards receiving COVID-19 vaccination is currently lacking. Using data from a nationally representative survey of 1050 US adults, this study investigates the correlation between individuals' decisions to receive COVID-19 vaccination and both their risk perceptions and preferences. Additionally, we investigate post-vaccination behavior by measuring individuals' participation in three different groups of activities that vary by their degree of social exposure. We find strong correlations between vaccination decisions and four measures of risk preference and risk perception. We also find associations between the four risk measures and individuals' behaviors post-vaccination. We shed light on the main factors discouraging the uptake of COVID-19 vaccines, as well as public opinions regarding the performance of different organizations in addressing the COVID-19 pandemic, and grocery store policies to prevent COVID-19 infections. Our study provides critical information that can help policymakers communicate more effectively with the public and promote vaccine uptake among population groups and geographic areas with higher anti-vaccine sentiments.

Global COVID-19 vaccine acceptance level and its determinants: an umbrella review

BACKGROUND

The COVID-19 vaccination is essential for reducing disease burden on a worldwide scale. The success of this strategy will largely depend on how well vaccines are received. Previous reviews had produced contradictory results, and there had been no umbrella review. Therefore, the objective of this umbrella review was to combine the contradictory data regarding the COVID-19 vaccination's global acceptance rate and its contributing factors.

METHODS

Using PRISMA guideline, PubMed, Embase, Scopus, Web of Sciences, Cochrane Database of Systematic Reviews, Scopus and Google Scholar which reported COVID-19 vaccine acceptance and/or its determinants were searched. The quality of the included studies was assessed using Assessment of Multiple Systematic Reviews (AMSTAR). A weighted inverse variance random-effects model was applied to find the pooled estimates. The subgroup analysis, heterogeneity, publication bias and sensitivity analysis were also assessed.

RESULT

Twenty-two SRM with 10,433,306 study participants were included. The pooled COVID-19 vaccine acceptance rate globally is found to be 60.23 (95% CI: 58.27, 62.18). In low-income countries, the pooled level of COVID-19 vaccine acceptance was found to be 54.07(50.31, 57.83) while this magnitude is 64.32 (62.24,66.40) among studies across the globe. Higher level of education (AOR =1.96; 95% CI:1.20, 2.73), good level of knowledge (2.20; 95% CI:1.36, 3.03), favourable attitude (AOR =4.50; 95% CI:2.89, 6.12), previous history of COVID-19 infection (AOR =3.41; 95% CI:1.77, 5.06), male sex (AOR =1.62; 95% CI:1.47, 1.77), and chronic disease (AOR =1.54; 95% CI:1.18, 1.90) were predictors of COVID-19 vaccine acceptance.

CONCLUSION

The pooled level of COVID-19 vaccine acceptance highly varied and found to be unacceptably low particularly in low-income countries. Higher level of education, good level of knowledge, favourable attitude, previous history of COVID-19, male sex, and chronic disease were factors of COVID-19 vaccine acceptance rate. A collaborative effort of stakeholders such as policymakers, and vaccine campaign program planners is needed to improve the acceptance rate of COVID-19 vaccine.

Healthcare professionals' acceptance of COVID-19 vaccination for their children: A cross-sectional study at a tertiary care hospital in Western India

Background and Aims

Establishing a transparent and forthright dialog between healthcare professionals (HCPs) and the public is paramount in promoting the effective acceptance of COVID-19 vaccination for children. Hence, this study aimed to assess the COVID-19 vaccine acceptance, knowledge, and perception among HCPs for their children.

Methods

A cross-sectional study was conducted among HCPs at a tertiary care teaching hospital in Western India. A structured questionnaire was designed and validated to collect data. Descriptive statistics were used for data analysis.

Results

The study found that more than 80% of HCPs had good knowledge about COVID-19 vaccines, and 92.74% of them were willing to accept the vaccine for their children. Doctors were more likely to vaccinate their children, and 73% of HCPs had a favorable attitude toward immunizing their children if a new COVID-19 vaccine was available. Academic/peer-reviewed publications were considered the most reliable source of information for COVID-19 vaccination, followed by government sources.

Conclusion

This study found that parental vaccine hesitancy was significantly lower among the HCP group. The majority of HCPs were in favor of vaccinating their children against COVID-19, indicating that they can serve as an effective channel for promoting parental acceptance of COVID-19 vaccines in the community.

Determinants of parents' intention to vaccinate their children aged 12-17 years against COVID-19 in North Kivu (Democratic Republic of Congo)

Parents are facing tremendous stress in relation to the COVID-19 pandemic and the effectiveness of the COVID-19 vaccination program for children. We aimed to investigate parents' willingness to vaccinate their children against COVID-19 in North Kivu province, (Democratic Republic of Congo). A cross-sectional survey between 1 December 2021 to 20 January 2022 in six health zones (Goma, Karisimbi, Butembo, Beni, Kamango, and Katwa) was conducted in the province of North Kivu. In each health zone, we selected five clusters (Health area) using the method of probabilistic selection proportional to population size. In total, 522 parents participated in our study. Results: Overall, 32.8% of parents intended to vaccinate their children. In the multivariate analysis, a younger age of parents (aOR: 2.40, CI: [1.50-3.83]), a higher level of fear that "a member of my family" could contract COVID-19 (aOR: 2.35, CI: [1.38-4.02]), a higher level of perceived vulnerability to COVID-19 within the family (aOR: 1.70, CI: [1.005-2.2881]), a higher level of perceived susceptibility to COVID-19 within the family (aOR: 3.07, CI: [1.80-5.23]), and a history of vaccination against COVID-19 among parents (aOR: 16.47, CI: [8.39-32.33]), were all significantly associated with the intention of parents to have their children or adolescents vaccinated. According to the different explanatory factors of the will to have their children vaccinated, an emphasis on the health education of parents who are prone to refusal or hesitation of the vaccine, by addressing the common reasons for the refusal of the vaccine and highlight the vaccine's benefits.

Parental motivated helplessness in vaccinating children against COVID-19: Its association with fear, effectiveness and willingness to vaccinate

According to the motivated helplessness hypothesis, parental feelings of helplessness regarding vaccinating children against COVID-19 may serve a protective function against vaccine fear and hesitancy. Two correlational studies conducted among Israelis (Study 1) and an international sample (Study 2), examined whether self-reported perceived helplessness in vaccinating children may be related to lower vaccine-fear, and higher perceived vaccine-effectiveness, trust in authorities' recommendations and willingness to vaccinate. Results indicated parents who felt they had no other choice but to vaccinate their children, exhibited less vaccine-fear, higher vaccine-effectiveness and greater intentions to vaccinate. Additionally, the relationships between vaccine-helplessness, vaccine-effectiveness and willingness to vaccinate were partially mediated by vaccine-fear. In Study 2, vaccine-helplessness was found related to higher trust in authorities' recommendations, which was partially mediated by vaccine-fear. The implications of these findings for research on the psychological function of helplessness in the parental decision-making process of vaccinating children during a pandemic are discussed.

Parents' willingness to pay for COVID-19 vaccination for children in Malaysia using the contingent valuation method

Children are susceptible and a potential source of transmission for coronavirus disease 2019 (COVID-19). However compulsory COVID-19 vaccination programs among children have not been a focus in Malaysia. The aim of this study was to measure parents' willingness to pay (WTP) for the COVID-19 vaccine and analyze the effects of socioeconomic variables on parents' WTP. An online cross-sectional study was conducted in Malaysia with two waves of surveys (i.e., different samples for each wave), March and June 2021. The study participants were Malaysian parents above 18 years old. Parents were randomized between two vaccine effectiveness profiles (95% and 50% effectiveness) and two risk levels of an adverse event (5% and 20% risk of fever). The WTP was estimated using a double-bounded dichotomous choice. Socioeconomic variables such as age of parent, gender, insurance, income, and education were examined. A total of 292 parents in March 2021 and 271 in June 2021 were included in the study. The vaccine safety and effectiveness profile did not significantly impact the WTP. In March 2021, the estimated WTP ranged from RM344.74 to RM399.64 (US$82.5 to US$95.6) across vaccine profiles and between RM377.55 and RM444.33 (US$90.3 to US$106.3) in June. Insurance status was associated with the parents' WTP, and during the June wave, the age of parents influenced the WTP. Implementing subsidies or free vaccinations is considerable to increase herd immunity and prevent transmission of COVID-19 in Malaysia.

Lessons Learned from the Pandemic in the UAE: Children COVID-19 Vaccine Hesitancy and Its Impact on the Choice of Distance versus Face-to-Face Learning Modalities: An In-Depth Analysis of a National Study

This study addresses the crucial aspect of childhood COVID-19 vaccination and its impact on parental decisions concerning learning modalities during the pandemic. This study aimed to gauge parental hesitancy towards vaccinating their children and its influence on choosing between distance and face-to-face learning options. Following STROBE guidelines for cross-sectional studies, this study surveyed 1973 parents in the United Arab Emirates using Google Forms during the COVID-19 pandemic. The results revealed that while more than half of the parents (51.6%) were willing to vaccinate their children if the COVID-19 vaccine was accessible and affordable, a significant majority (91.2%) expressed concerns about the rapid vaccine development process, which was the primary reason for vaccine rejection. Interestingly, a sizable portion (55.3%) had experienced online learning in the previous academic term, and, of those, 59.6% believed it negatively influenced their children's academic performance. Consequently, 66.4% expressed intent to shift their children back to face-to-face learning once feasible. Significantly, parents with medical backgrounds were more inclined (91.6%) to opt for face-to-face schooling compared to those without such backgrounds. Logistic regression analysis indicated associations between sociodemographic characteristics, educational level and background, and the decision to return children to face-to-face learning. Interestingly, when it comes to vaccine hesitancy, a noteworthy connection exists between the parents' reluctance to vaccinate their children and their preference for distance learning. In fact, parents who responded negatively to vaccinating their children against COVID-19, if the vaccine was available, showed a clear preference for the distance learning modality (p-value < 0.0001). This study underscores the complex interplay of factors and community perspectives shaping parental acceptance of childhood COVID-19 vaccination. The development pace of vaccines significantly influences parents' attitudes and beliefs about vaccination programs. Parents' medical backgrounds exhibit a clear correlation with their perceptions of sending children back to school safely. This highlights the potential impact of parental medical knowledge on decision making, emphasizing the need to consider parents' professional backgrounds when devising education- and vaccination-related policies.

Profiling Hesitancy to COVID-19 Vaccinations in Six European Countries: Behavioral, Attitudinal and Demographic Determinants

Vaccination hesitancy is an important barrier for the effective control of the COVID-19 pandemic. Identifying determinants of COVID-19 vaccination hesitancy is essential in order to reduce mortality rates. Further, given the variability of the factors and the different recommendations used in each country, it is important to conduct cross-country research to profile individuals who are hesitant toward COVID-19 vaccinations. This cross-sectional study aimed to examine cross-country differences and the behavioral, attitudinal and demographic characteristics of vaccine hesitant individuals. Adults living in six European countries (Cyprus, France, Germany, Italy, Poland, and Spain) were eligible to participate. A total of 832 individuals completed the online survey, with 17.9% reporting being hesitant to COVID-19 vaccination. Vaccine accepters were significantly older (M = 38.9, SD = 14.3), more educated (master/postgraduate studies) and lived in a place with a higher number of residents (>500,000 people) compared to those hesitant to COVID-19 vaccination. Discriminant analysis confirmed that the hesitant profile includes a person of younger age, living alone in smaller communities, and without children. Additionally, hesitant participants reported COVID-19-specific characteristics such as lower institutional trust, less adherence to COVID-19 protective behaviors and higher pandemic fatigue. When tackling COVID-19 vaccination hesitancy both socio-demographic and behavioral/attitudinal aspects should be taken into account. Stakeholders are advised to implement targeted vaccination programs while at the same time building trust with population illness cognitions addressed in order to reduce hesitancy rates. Further, stakeholders and public health authorities in each country are suggested to target interventions according to different population characteristics as behavioral and attitudinal determinants of COVID-19 vaccination hesitancy differed between countries.

Factors in Vaccine Refusal by Patients Applying for COVID-19 PCR Test

Objective

This study was designed to determine the reasons for vaccine rejection in patients who applied for the coronavirus disease-2019 (COVID-19) polymerase chain reaction (PCR) test but did not receive the vaccine.

Methods

The study was conducted prospectively in the emergency department of a tertiary hospital between 31.01.2022 and 31.05.2022. 1000 patients who applied for the COVID-19 PCR test and refused to be vaccinated were included. The COVID-19 status of the participants, reasons for their application, number of PCR tests, methods of obtaining information about the vaccine, and reasons for the rejection of the vaccine were questioned.

Results

54.6% of the participants were male and 45.4% were female. 60.7% of the patients applied for testing due to symptoms, 25.4% due to contact with people with symptoms, and 23.9% due to travel. 43.3% of the cases had COVID-19 infection; 53.6% of them had tested an average of 2-5 times in the last year. Most of the information about the vaccine was taken from social media, television, medical publications, and people around, respectively. Of the participants, 62.0% believed that COVID-19 vaccines had side effects, 47.3% believed that it had no protection, and 30.9% believed that there was not enough study on the subject. As the age grew, the rate of learning information from social media increased.

Conclusions

The most common reasons for COVID-19 vaccine rejection were vaccine side effects, doubtful vaccine protection, and concerns about the lack of sufficient studies on the vaccine. The higher the education level, the higher the vaccine rejection rate.

Parents' intention to vaccinate their preschool children against COVID-19: Combining the health belief model and the theory of planned behavior

The vaccination rate of COVID-19 in preschool children is low, and parents' intention to vaccinate their children is also low due to multiple factors. This study aimed to establish an integrated model based on the Health Belief Model (HBM)and Theory of Planned Behavior (TPB), to explore the factors influencing parents' intention to vaccinate their preschool children with the first and second doses of COVID-19 vaccines. A total of 1264 parents of preschool children from 10 kindergartens participated in this study. Hierarchical multiple logistic regression was used to analyze the intention separately. For the integrated model with the first dose of vaccine of COVID-19, introducing the HBM variable in model 1 explained 33.98% of the variance (F = 398.71, p < .001), then upon adding the TPB variable in model 2, the explanation of variance increased to 41.93% (F = 491.94, p < .001) and parents' intention were associated with their perceived barriers, cues to action, and subjective norms. For the integrated model with the second dose of vaccine of COVID-19, introducing the HBM variable in Model 1 explained 23.76% of the variance (F = 68.82, p < .001), then upon adding the TPB variable in model 2, the explanation of variance increased to 26.67% (F = 77.24, p < .001), and parents' intention was associated with cues to action and subjective norms. The combination of the two theories improves the explanatory power of parents' intention to vaccinate their preschool children against COVID-19, and provides a basis for the development of effective interventions for vaccination of COVID-19 for preschool children.

Anti-Vaccination Attitude and Vaccination Intentions Against Covid-19: A Retrospective Cross-Sectional Study Investigating the Role of Media Consumption

Objective

The present study explores, retrospectively, the link between anti-vaccination attitude and vaccination intentions and extends this relationship to the effect of media consumption style on attitude.

Method

Generalized linear mixed-models were used to estimate vaccination intentions (related to each of the four available vaccines at the time of the survey) relying on anti-vaccination attitude measured using the Italian translation of the Vaccination Attitude Examination (VAX) scale. Multiple linear regression was used to estimate which media type and which consumption frequency were responsible for variation in the anti-vaccination attitude.

Results

Greater anti-vaccination attitude led to lower vaccination intention (b=-8.33, p<.0001) confirming the attitude-intention link. Crucially, consuming vaccination related information via printed press weekly (b=-0.74, p=.0001) or daily (b=-0.96, p<.0001) were the only protective factors against developing anti-vaccination attitudes. On the other hand, discussing vaccination with the family physician weekly (b=0.66, p=.002) or even daily (b=0.52, p=.026), and actively looking for vaccination related information on specialized websites and blogs every day (b=0.64, t=2.78, p=.006) were risk factors related to increased anti-vaccination attitude. No effects of social media on anti-vaccination attitude were found.

Conclusions

The results confirm that vaccination intentions can be linked to the underlying anti-vaccination attitude. Moreover, our results suggest that the web and the blog sphere, but not social media, are the most anti-vaccination fuelling media and that health practitioners engage with the most vaccination-hesitant individuals. Further interventions could leverage these insights to tackle the vaccination hesitancy issue.

Credibility of vaccine-related content on Twitter during COVID-19 pandemic

During national COVID-19 vaccine campaigns, people continuously engaged on Twitter to receive updates on the latest public health information, and to discuss and share their experiences. During this time, the spread of misinformation was widespread, which threatened the uptake of vaccines. It is therefore critical to understand the reasons behind vaccine misinformation and strategies to mitigate it. The current research aimed to understand the content of misleading tweets and the characteristics of their corresponding accounts. We performed a machine learning approach to identify misinformation in vaccine-related tweets, and calculated the demographic, engagement metrics and bot-like activities of corresponding accounts. We found critical periods where high amounts of misinformation coincided with important vaccine announcements, such as emergency approvals of vaccines. Moreover, we found Asian countries had a lower percentage of misinformation shared compared to Europe and North America. Our results showed accounts spreading misinformation had an overall 10% greater likelihood of bot activity and 15% more astroturf bot activity than accounts spreading accurate information. Furthermore, we found that accounts spreading misinformation had five times fewer followers and three times fewer verified badges than fact-sharing accounts. The findings of this study may help authorities to develop strategies to fight COVID-19 vaccine misinformation and improve vaccine uptake.

Acceptance of COVID-19 Vaccine and Related Factors in Iran: A Cross-sectional Study

Introduction

One of the most important strategies to control COVID-19 pandemic is vaccination. Effective vaccination coverage is necessary to control this pandemic. Therefore, in this study we investigated acceptance of COVID-19 vaccine and associated factors among Iranian population.

Methods

A cross-sectional study conducted through Pors Line in South Khorasan Province of Iran. 1043 people participated in this study. Results were analyzed with SPSS software version 13.

Results

85.2% of the participants wanted to receive the vaccine. Vaccine acceptance was higher in participants that were over 41 years old. Moreover, rate of vaccine acceptance was higher in men than women. Major concern about vaccination was fear of its side effects. Vaccine acceptance increased with increasing education level.

Conclusion

Results of this study showed that one of the most important reasons for vaccine rejection is the fear of vaccine side effects.

Multi-Perspective Views and Hesitancy toward COVID-19 Vaccines: A Mixed Method Study

The worldwide uptake of COVID-19 vaccines was suboptimal throughout the pandemic; vaccine hesitancy played a principle role in low vaccine acceptance both globally and in Armenia. In order to understand the factors behind the slow vaccine uptake in Armenia, we aimed to explore the prevailing perceptions and experiences of healthcare providers and the general public related to COVID-19 vaccines. The study applied a convergent parallel mixed-methods study design (QUAL-quant) through in-depth interviews (IDI) and a telephone survey. We completed 34 IDIs with different physician and beneficiary groups and a telephone survey with 355 primary healthcare (PHC) providers. The IDIs found that physicians held variable views on the need for COVID-19 vaccination which, combined with mixed messaging in the media landscape, fueled the public’s vaccine hesitancy. The survey results were mostly consistent with the qualitative findings as 54% of physicians hypothesized that COVID-19 vaccines were rushed without appropriate testing and 42% were concerned about the safety of those vaccines. Strategies to improve vaccination rates must target the main drivers of hesitancy, such as physicians’ poor knowledge of specific vaccines and spiraling misconceptions about them. Meanwhile, timely educational campaigns with targeted messaging for the general public should address misinformation, promote vaccine acceptance, and empower their capacity to make decisions about their health.

Willingness and attitudes of parents towards COVID-19 vaccines for children in Vietnam

BACKGROUND

With an increasing need for COVID-19 vaccination around the globe, we aim to investigate willingness and attitudes of parents regarding COVID-19 vaccines for children in Vietnam.

METHOD

A 24-item online survey was conducted among 602 parents and legal guardians of children under 18 years of age.

RESULTS

There were 82.6% of parents willing to vaccinate their children. The principal reasons for willingness were: the need for vaccination to control the COVID-19 pandemic and to reduce the risk of SARS-CoV-2 transmission when children return to school. The most common reason for refusing COVID-19 vaccine was the concern about vaccine side effects in children (73.3%), followed by perceived lack of scientific research on COVID-19 vaccines in children (31.4%). The main associated factors with increased willingness of parents towards childhood COVID-19 vaccine were: willingness to allow children to participate in a clinical vaccine trial (aOR = 3.58); possible increase in COVID-19-related mortality (aOR = 3.69); and positive media information regarding COVID-19 vaccine (aOR = 2.04). Noteworthy, higher educational status of parents was associated with decreased willingness for childhood COVID-19 vaccine (aOR = 0.26).

CONCLUSION

Understanding reasons of parents to accept childhood COVID-19 vaccines will help future plans in COVID-19 vaccination program. A larger sample size study at a national level is needed to verify the results.

Implications for COVID-19 vaccine uptake: A systematic review

BACKGROUND

Globally, increasing coronavirus disease (COVID-19) vaccination coverage remains a major public health concern in the face of high rates of COVID-19 hesitancy among the general population. We must understand the impact of the determinants of COVID-19 vaccine uptake when designing national vaccination programmes. We aimed to synthesise nationwide evidence regarding COVID-19 infodemics and the demographic, psychological, and social predictors of COVID-19 vaccination uptake.

METHODS

We systematically searched seven databases between July 2021 and March 2022 to retrieve relevant articles published since COVID-19 was first reported on 31 December 2019 in Wuhan, China. Of the 12,502 peer-reviewed articles retrieved from the databases, 57 met the selection criteria and were included in this systematic review. We explored COVID-19 vaccine uptake determinants before and after the first COVID-19 vaccine roll-out by the Food and Drug Authority (FDA).

RESULTS

Increased COVID-19 vaccine uptake rates were associated with decreased hesitancy. Concerns about COVID-19 vaccine safety, negative side effects, rapid development of the COVID-19 vaccine, and uncertainty about vaccine effectiveness were associated with reluctance to be vaccinated. After the US FDA approval of COVID-19 vaccines, phobia of medical procedures such as vaccine injection and inadequate information about vaccines were the main determinants of COVID-19 vaccine hesitancy.

CONCLUSION

Addressing effectiveness and safety concerns regarding COVID-19 vaccines, as well as providing adequate information about vaccines and the impacts of pandemics, should be considered before implementation of any vaccination programme. Reassuring people about the safety of medical vaccination and using alternative procedures such as needle-free vaccination may help further increase vaccination uptake.

The effect of COVID-19 on patients recieving omalizumab treatment

Background and aim

Although exposure during drug administration and susceptibility to coronavirus disease-19 (COVID-19) infection secondary to immunomodulatory effects constitute potential risks for patients with chronic spontaneous urticaria (CSU) or asthma on omalizumab (OMZ), there is a risk of loss of response following discontinuation of OMZ. There are few studies describing the clinical course of COVID-19 in patients receiving OMZ.

Materials and methods

A total of 103 patients on OMZ were included in the study between February 2021 and January 2022.

Results

Fourteen (13.6%) of the patients participating in the study had SARS-CoV-2 infection, of whom 3 (21.4%) required hospitalization and 11 (78.6%) were treated in an outpatient clinic. During the pandemic, 17 (16.5%) of the patients interrupted their OMZ treatment. Patients on OMZ for six months or less had a lower rate of interruption (2.5%) than those on OMZ for more than 6 months (25.4%). Patients interrupted treatment for the following reasons: 3 (17.6%) had COVID-19, 10 (58.9%) did not attend the hospital visit due to concern about contamination with SARS-CoV-2, and 4 (23.5%) thought that OMZ treatment would facilitate contamination with SARS-CoV-2. After interrupting OMZ, 3 (25%) female patients and 5 (100%) male patients presented no worsening of their symptoms. Three (13%) of the patients on OMZ for asthma and 11 (13.8%) of those on the drug for urticaria had COVID-19 infection. Patients presenting CSU and severe asthma are completely different, with different potential consequences of OMZ interruption. Nine (52.9%) patients had aggravated symptoms following interruption of OMZ treatment. Three of them described worsening of asthma symptoms and a need to increment their maintenance therapy due to asthma exacerbation after nearly three weeks of interruption, and 6 of them had hives and pruritus as urticaria exacerbation nearly four weeks after interruption of OMZ. The asthma patients did not stop their other treatments, including inhaled corticosteroids.

Conclusion

Use of OMZ does not increase the risk of SARS-CoV-2 infection, COVID-19-related pneumonia, or COVID-19-related hospitalization. We advise patients not to interrupt OMZ treatment during the COVID-19 pandemic unless advised to do so by their doctors, and we recommend that they receive instruction concerning self-administration of OMZ to avoid visiting hospitals in the event of a pandemic.

COVID-19 Vaccination Perception and Acceptance Among Female Medical and Nursing Students at Al-Azhar University, Egypt

Background

There are still many concerns related to various types of COVID-19 vaccines, which may result in individuals' hesitancy presenting a problem for public health authorities to achieve coverage for population immunity. As trustworthy health-care workers, medical and nursing students' perception towards COVID-19 vaccines may greatly influence the future population's uptake of vaccines; however, studies related to the vaccine acceptance rates among them are limited.

Objective

To identify the perception of medical and nursing students toward COVID-19 vaccines and the factors acting either as motivators or barriers to be vaccinated.

Methods

A cross-sectional comparative study was conducted on 500 undergraduate students aged ≥18 years from medical and nursing faculties. Data were collected via a semi-structured self-administered questionnaire that consisted of questions on general characteristics of the participants and source of information about the vaccine. Also, it includes items assessing the perception and acceptance of COVID-19 vaccines. Descriptive statistics, chi-squared, t-test and multiple logistic regressions were performed using SPSS version 22.

Results

Positive perception was detected among more than half of overall students. Although medical students had significant higher positive perception toward COVID-19 vaccines than nursing students (54.9% vs. 41.1%, p <0.05), they were more hesitant to get vaccinated than nursing students (25.7% vs. 19.6%, p >0.05). While, medical students had a higher intention to encourage family members or friends to get vaccinated than did nursing students (47.7% vs .43.8%, respectively) (p >0:05). Furthermore, participants were more likely to accept vaccination if they reported higher levels of positive perception especially for vaccine safety and increasing recovery rate.

Conclusion

Academic medical and nursing leaders should consider female students' vaccine concerns, and future efforts are needed to reduce their hesitancy and raise awareness about vaccinations that may eventually improve perception and acceptance of COVID-19 vaccines.

The percentage of hesitation and factors associated with acceptance or refusal for COVID-19 vaccine: Does training about vaccines by allergist affect personal decision?

Background and aim

As the impact of coronavirus disease (COVID)-19 arises worldwide, the effect of vaccines is protecting its importance. The aim of this study was to investigate the vaccination perspectives of patients and learn how many patients were persuaded to get vaccinated with the effect of the education provided by allergists.

Materials and methods

A cross-sectional study was carried out among 200 adult patients in the outpatient clinic between February 2021 and January 2022. Patients filled out the anti-vaccination scale form and a questionnaire form developed by allergists. The training about COVID-19 vaccines has been given to the patients who did not consider getting vaccinated. The patients were called by phone and questioned whether they have been vaccinated or not, after 22 weeks.

Results

Out of 200 patients participants, 60.5% were considering getting vaccinated. Patients who did not consider getting vaccinated comprised 45.7% of women and 31% of men. While 52.4% of primary school graduates considered getting vaccinated, 75% of high school graduates and 60.8% of higher education graduates were considering getting vaccinated. Major reasons for rejecting vaccination were concerns about side effects and allergy. While the majority of women (47.2%) who did not want to get vaccinated were concerned about vaccine side effects, the majority of men (34.6%) did not want to get vaccinated because they did not trust the efficacy of the vaccine. Vaccination rates have been increased with the training we provided to our patients who did not consider getting the vaccine. 76 patients could be reached by phone and 81.6% of them were vaccinated, and 18.4% were not.

Conclusion

The vaccination rates of allergy patients who did not consider getting vaccinated were increased with the information provided by allergists. So, the allergists should give more attention for giving information and increasing the vaccination rates of covid-19.

COVID-19 vaccine acceptance in sub-Saharan African countries: A systematic review and meta-analysis

Vaccination is the most effective intervention for the primary prevention of COVID-19. Several studies have been conducted in sub-Saharan African countries on the acceptance and associated factors of COVID-19 vaccine. This review and meta-analysis aimed to recapitulate the pooled magnitude of vaccine acceptance and its favoring factors in sub-Saharan African countries. PUBMED, MEDLINE, Science Direct, Web of Science, and SCOPUS were the main databases searched from 15 March to 5 June 2022; and all the articles written in the English language were included. Also, some articles were retrieved from biomedical peer-reviewed journal sites and Google scholar. The quality of thirty-five selected articles was evaluated using an adapted scale for evaluating cross-sectional studies based on the Newcastle-Ottawa Scale. The result of the review and meta-analysis revealed that COVID-19 vaccine acceptance rate varied across studies. In a pooled analysis, factors such as; higher-level perception of infection risk (OR (95% CI (2.7 (2.1, 3.4))), perceived vaccine safety (13.9 (9.2, 20.9)), virus-related good knowledge (2.7 (2.3, 3.2)) and appropriate attitude (5.9 (4.4, 7.8)), adherence to safety precautions (5.5 (4.8, 6.2)), and infection experience (4.4 (2.8, 6.9)) were positively affected the COVID-19 vaccine acceptance. Also, vaccine acceptance was found to be high among males and chronically ill individuals. Thus, understanding factors that enhance vaccine acceptance would support planners to augment vaccine uptake in the region.

The Reasons behind COVID-19 Vaccination Hesitancy among the Parents of Children Aged between 5 to 11 Years Old in Saudi Arabia

Simultaneously with the development of the COVID-19 vaccination plan for minors, it is critical to understand the reasons related to parental COVID-19 vaccination hesitancy. This study aims to determine the reasons associated with vaccination hesitancy among parents, and the prevalence and the characteristics of the parents who are hesitant to allow their children aged between 5 to 11 years old to be administered the COVID-19 vaccines. A web-based questionnaire was used to perform this study between May 2022 to September 2022 in Saudi Arabia (SA). Several factors, personal and social, affected the participants' willingness to vaccinate their children with the COVID-19 vaccines. The age of the parents was found to have a significant impact on their decision to vaccinate their children. Those between the age of 40-49 years of age were the most willing to vaccinate (almost 41%) compared to those 50 years or older who were most resistant to vaccination. Female participants were more resistant to vaccinating their children compared to their male counterparts. Saudis were more resistant to vaccinating their children compared to the non-Saudi participants. Those private sector-employed parents were the most willing to vaccinate (16.6%), followed by those working in the governmental sector (13.8%). About 40.7% of non-healthcare workers were resistant to vaccinating their minor compared to healthcare workers (8.7%). In conclusion, the study presents several factors that affect the parental willingness to vaccinate their children in SA. These factors should be properly addressed when developing public health strategies to promote the COVID-19 vaccination of children in SA.

Israeli parents` views on coronavirus (COVID-19) vaccinations for children: A cross-sectional study

BACKGROUND

Parents play the decisive role in children's vaccination. Our study aimed as assessing attitudes of parents toward the COVID-19 vaccine for children aged 5-18 and to define sources of influence on these attitudes, the barriers and reasons for hesitation.

METHODS

In this cross-sectional study, 138 Israeli parents of 5-18 aged children completed a self-administered structured questionnaire.

FINDINGS

More than a quarter of parents reported that they did not intend to vaccinate their children. Independent of other demographic characteristics, parents who do not vaccinate their children accordingly to the routine vaccinations have five-fold significant odds not to vaccinate with COVID-19 vaccine (OR = 4.8, 95% CI: 1.8-12.7). Greater social influence was significantly and negatively associated with intentions not to vaccinate a child. Among parents who do not intend to vaccinate their children, the most frequent reasons were fear of possible side effects (92%), vaccine novelty (92%) and lack of belief in its effectiveness (69%).

DISCUSSION

This study found that vaccination in the past as part of routine government immunization programs predict a tendency to vaccinate children during the pandemic. Among the factors associated with the intention not to vaccinate, concerns and uncertainty about the necessity of the vaccine, its side effects and reliability have been emphasized.

APPLICATION TO PRACTICE

Cultural-religious adjustments should be applied when implementing interventions aiming to promote vaccination in routines and emergencies. Social influence is important in adopting a positive attitude toward vaccines. Public health professionals should incorporate those parents who have vaccinated their children and have a positive attitude toward vaccination.

Talking about the Vaccine after the Pandemic: A Cross-Sectional Study among Youth in Turkey and Ethical Issues

Examining the factors that affect the vaccination rate among young people in an ethical frame can support vaccination promotion. Therefore, this study will elaborate, through an ethical lens, on young people's hesitation about and decisions regarding getting vaccinated. The cross-sectional study was conducted with 2428 people aged 15-30 in Turkey in June 2022. The questionnaire included the following subtitles: psycho-social situation, health services and health policies, COVID-19 vaccine, and predictions about life and health after the pandemic. The average age was 22.9 years. In the study sample, 80% were vaccinated, while 20% were not. Vaccinated participants acted more cautiously to protect their health. Receiving accurate and sufficient information on proposed vaccines affects vaccination status. The primary reason for getting vaccinated was "to protect their health, families, and relatives", and the primary reason for not getting vaccinated was "not trusting the vaccine content or the country where the vaccine was produced". Specifically, those vaccinated felt more relaxed physically, psychologically, and socially. In addition, the expectations for the future of those vaccinated were significantly higher. Accurate and adequate information is essential for reducing vaccine hesitancy. In addition, promoting prosocial behaviors in young people and highlighting related values will support vaccination.

Status of COVID-19 Infection and Vaccination in People Aged 18 Years and over in a Town: A Cross-Sectional Study in Turkey

Objective. The objective of this study was to evaluate the cases of COVID-19 infection in people >18 years old and to investigate attitudes against vaccination and vaccine hesitancy and the factors affecting them. Methods. The data collection form used in the study was prepared by the researchers by screening the relevant literature. People over the age of 18 who agreed to participate in the study were invited to the family health center, and a questionnaire was applied by face-to-face interview method. The application time of a survey was 5-10 minutes. A total of 229 people were reached. Percentage of reaching was 95,4%. Results. The mean age of the participants was $44,13\pm 14,18$ years. 31,9% of the participants in the study had COVID-19 infections. 69,9% of those who had COVID-19 infection caught the disease in the last year, and 93,2% were followed at home. Among the people with whom the participants lived, 21,6% of those who had COVID-19 infection were hospitalized and 5,7% died. Of the participants who expressed their opinion, 32,1% think that COVID-19 vaccines have serious side effects. Postvaccine side effects developed in 32,9% of the participants who had the COVID-19 vaccine, and 11,0% had a postvaccine infection. Conclusion. The results of our study revealed that the COVID-19 vaccine was highly accepted among the adult population in Turkey during the pandemic period. However, through this study, we found concerns about the side effects of the vaccine, the lack of confidence in the vaccine ingredient, and the effectiveness of the vaccine.

Global COVID-19 vaccine acceptance rate: Systematic review and meta-analysis

Background

A vaccine against COVID-19 is a vital tool in managing the current pandemic. It is becoming evident that an effective vaccine would be required to control COVID-19. Effective use of vaccines is very important in controlling pandemics and paving the way for an acceptable exit strategy. Therefore, this systematic review and meta-analysis aims to determine the global COVID-19 acceptance rate that is necessary for better management of COVID-19 pandemic.

Methods

This review was conducted based on Preferred Reporting Items for Systematic Reviews and Meta-Analysis protocols and considered the studies conducted on acceptance and/or hesitancy of COVID-19 vaccine. Articles were searched using electronic databases including PubMed, Scopus, Web of Science, Embase, CINAHL, and Google Scholar. The quality of the study was assessed using the Joanna Briggs Institute (JBI) critical assessment tool to determine the relevance of each included article to the study.

Results

Of the 6,021 articles identified through the electronic database search, 68 articles were included in the systematic review and meta-analysis. The global pooled acceptance rate of the COVID-19 vaccine was found to be 64.9% [95% CI of 60.5 to 69.0%]. Based on the subgroup analysis of COVID-19 vaccine acceptance rate by the World Health Organization's region, the countries where the study was conducted, occupation, and survey period, the prevalence of COVID-19 vaccine acceptance rate was 60.8% [95% CI: 56.3, 65.2%], 61.9% [95% CI: 61.3, 62.4%], 81.6% [95% CI: 79.7, 83, 2%] and 64.5% [95% CI: 60.3, 68.5%], respectively.

Conclusions

This review revealed the variation in the level of COVID-19 vaccine acceptance rate across the world. The study found that the overall prevalence of COVID-19 vaccine acceptance was 64.9%. This finding indicated that even if the COVID-19 vaccine is developed, the issue of accepting or taking the developed vaccine and managing the pandemic may be difficult.

Factors affecting the willingness of mental health staff to get vaccinated against COVID-19

RATIONALE AND OBJECTIVE

At the beginning of vaccination against coronavirus disease 2019 (COVID-19), information about the effects of the vaccine was not known and hesitancy was observed among the population. The mental health staff members in our center in Israel had to decide whether to get vaccinated or not. The objective of this study was to evaluate the differences in demographic characteristics of vaccinated and nonvaccinated mental health care workers (HCWs), and to identify their reasons for or against vaccination.

METHOD

Data on characteristics of 357 staff members at a mental health center (MHCS) in Israel and their attitudes regarding COVID-19 vaccination, those who were nonvaccinated, were collected via anonymous questionnaires, from 1 January to 10 January 2021. The groups were then compared using χ2 , Fisher's exact tests, t test or Mann-Whitney nonparametric test as appropriate. A logistic regression was then performed using the significant variables and odd ratios presented.

RESULTS

Eighty-one per cent of the sample received at least the first dose of the vaccine. Results indicated differences in seniority (p < 0.001), profession (p < 0.001), department (p < 0.001), risk groups (p < 0.05), religion (p < 0.001), religiosity (p < 0.001), previous care for COVID-19 patients (p < 0.05) and level of interaction with patients (p < 0.01), between the vaccinated and nonvaccinated staff. The factor that was found to be most influential regarding vaccination and which convinced those originally against the vaccine to become vaccinated was the level of scientific knowledge about the vaccine.

CONCLUSION

Efforts and resources should focus on the dissemination of reliable scientific data about the vaccine, to increase vaccination rates among mental HCWs.

Determinants of the willingness of medical staff to vaccinate their children with a booster dose of the COVID-19 vaccine in Taizhou, China

The study aimed to determine the willingness of medical staff to have their children vaccinated with a COVID-19 booster in Taizhou, China. From March 21 to April 19, 2022, an online questionnaire survey was conducted to assess the willingness of medical staff to vaccinate their children with a booster dose of the COVID-19 vaccine. Of the 1,252 medical staff in a tertiary grade hospital in Taizhou who were invited to answer the structured questionnaire, 514 (41.1%) samples had valid information for further data analysis. Four hundred thirty-seven medical staff (85.0%) were willing to have their children receive vaccine boosters. After adjustments for confounding factors, the opinion ('Do you think your child needs a booster vaccination against COVID-19?') (yes vs. no, OR = 6.91, 95% CI: 3.29-14.54), the viewpoint ('What are your thoughts the effectiveness of COVID-19 vaccine boosters for children?' (≥12 vs. <12, OR = 13.81, 95% CI: 4.03-), and the attitude ('Your attitude to whether your child is boosting the Covid-19 vaccine?') (yes vs. no, OR = 4.66, 95% CI: 2.30-9.44) were significantly associated with their willingness to have their children receive a COVID-19 vaccine booster. A moderate percentage of the respondents expressed willingness to have their children receive booster vaccines. The findings implied that factors affecting medical staffs' willingness to vaccinate their children with a COVID-19 vaccine booster included viewpoint, opinion, and attitudes.

Assessment of COVID-19 vaccination among healthcare workers in Iraq; adverse effects and hesitancy

Several messenger ribonucleic acid (mRNA) and inactivated COVID-19 vaccines are available to the global population as of 2022. The acceptance of the COVID-19 vaccine will play a key role in combating the worldwide pandemic. Public confidence in this vaccine is largely based on its safety and effectiveness. This study was designed to provide independent evidence of the adverse effects associated with COVID-19 vaccines among healthcare workers in Iraq and to identify the attitudes of healthcare workers who rejected the vaccination. We conducted a cross-sectional study to collect data on the adverse effects of the Pfizer, AstraZeneca, and Sinopharm vaccines. Data were collected between October 2021 and February 2022. A total of 2,202 participants were enrolled in the study: (89.97%) received injections of the COVID-19 vaccines and (10.03%) were hesitant to receive the vaccination. Participants received either the Pfizer vaccine (62.9%), AstraZeneca vaccine (23.5%) or Sinopharm vaccine (13.6%). Most adverse effects were significantly less prevalent in the second dose than in the first dose. Notably, the adverse effects associated with the Pfizer vaccine were significantly more prevalent in females than in males. Following the first dose, the participants experienced more adverse effects with the AstraZeneca vaccine. Following the second dose, more adverse effects were associated with the Pfizer vaccine. Interestingly, the prevalence of COVID-19 infection in participants who received two doses of the Pfizer vaccine was significantly reduced compared to those who received two doses of either the AstraZeneca or Sinopharm vaccines. According to vaccine-hesitated participants, insufficient knowledge (29.9%), expeditious development (27.6%) and lack of trust in the vaccines (27.1%) were the three major reasons for refusing the vaccines. The results of our study indicated that these adverse effects do not present a significant problem and should not prevent successful control of the COVID-19 pandemic.

A typology of Jordanian consumers after Covid-19: The rational, the suspicious, and the cautious consumer

This study presents a detailed typology of Jordanian consumers that identifies the effects of Covid-19 on their personal, social, and purchase and consumption patterns following the pandemic. Based on a qualitative approach using a sample of Jordanian consumers (N = 71), this study identifies three main types of consumers: the rational, suspicious, and cautious. All were distinguished by cognitive, emotional, and behavioral differences: the rational consumers viewed the pandemic as a natural occurrence, were willing to vaccinate, and took the opportunity to improve their lives and consumption behavior; the suspicious consumers viewed the pandemic as a man-made virus and refused to rationalize their behaviors and follow the social-distancing rules or vaccinate; and the cautious consumers were generally somewhere in between, and while they improved some aspects of their consumption, social, and personal lives, other aspects either remained the same or worsened. The findings have implications for managers and governmental bodies.

Predictors of unwillingness to receive COVID -19 vaccines among Ethiopian Medical students

Introduction

Medical students are among the potential risky population for the transmission of COVID 19 infections; their willingness to receive COVID 19 vaccine is not well studied. Thus, this study assessed Predictors of Unwillingness to receive COVID -19 vaccines among Ethiopian Medical students.

Methods

From the 25^th of May, 2020 to the 26^th of June, 2021, an institution-based cross-sectional study was done at Mizan-Tepi University Teaching Hospital,On 313 medical students from each department and batch were chosen using a multistage sampling approach. A bivariate and multivariable logistic regression were done to identify the predictors of Unwillingness to receive COVID -19 vaccines. Figures, tables, and graphs were used to present the findings. The adjusted odds ratio and its 95% confidence interval were provided.

Results

In this study 124 (40.7%) 95% CI (35.1,46.4) medical students were not willing to receive the COVID-19 vaccine. And also increased in the age of the student[AOR 0.43, 95% CI; (.29,.63)], Knowledge status about COVID 19 infection transmission, risk factors and control behavior[AOR 1.45, 95% CI; (1.14, 1.85)], perceived susceptibility to COVID 19 infection [AOR 1.70 (1.15, 2.51)], perceived severity of COVID 19 infection[AOR 1.26 (1.01, 1.57)], perceived benefit of COVID 19 vaccine [AOR .58(.38, .88)], positive attitude towards COVID 19 vaccines [AOR .46(.35, .62)], and confidence in safety and efficacy of the vaccine and public authorities decissin in the best interest of the community [AOR 1.93(1.24, 2.99)] were predictors of non-willingness to receive COVID 19 vaccine.

Conclusion

Non-willingness to accept the COVID 19 vaccine was predicted by student age, elements in the Health belief model such as anticipated susceptibility, severity, and benefit, and a positive attitude and trust in the vaccine.

Factors associated with diphtheria vaccination completion among children under five years old in Peru 2010-2019: A cross-sectional population-based study

The World Health Organization (WHO) recommends a minimum of 90% coverage of diphtheria three-dose complete vaccination scheme (DPT) as part of routine immunization programs in children. However, diphtheria coverage in Peru has not reached the minimum recommended during the last decades. Our study aimed to determine the complete three-dose DPT coverage and factors associated with compliance towards complete vaccination in Peru between 2010-2019. We conducted a secondary cross-sectional study using the "Encuesta Demográfica y de Salud Familiar (ENDES)"- Demographic and Family Health Survey, which is a survey that targets mothers between 15 and 49 years of age. DPT vaccination coverage was 72.4% and several factors were associated with the DPT scheme completion. Women in the age groups 18 to 24 (ORa = 2.31, 95%CI: 2.11-2.52), 25 to 34 (ORa = 3.37, 95% CI: 3.08-3.69), and 35 to 49 (ORa = 4.74, 95% CI: 4.29-5.22) were more likely to complete their children's DPT vaccination scheme compared to those between 15 to 17 years of age. Both Spanish (ORa = 1.39, 95% CI: 1.31-1.48) and Quechua (ORa = 1.34, 95% CI: 1.25-1.43) as first spoken language were associated with DPT completion compared to native language speaking mothers. Women who worked (ORa = 1.72, 95% CI: 1.57-1.88), studied (ORa = 1.47, 95% CI: 1.33-1.62), or were housewives (ORa = 1.41, 95% CI: 1.29-1.54) during the previous week were more likely to complete their children's DPT scheme compared to participants that did not work during the previous week. Women with the financial capability to access health care were less likely to complete the DPT scheme (ORa = 0.95, 95% CI: 0.92-0.97). Considering the accessibility to health care centers, women who knew the nearest location (ORa = 1.07, 95% CI: 1.03-1.11), had geographic accessibility (ORa = 1.09, 95% CI: 1.06-1.13) or a current transport (ORa = 1.06, 95% CI: 1.02-1.09) were more likely to complete their children 's DPT scheme. Our results highlight low diphtheria vaccine coverage levels in Peru, with values lower than what is recommended by the WHO. Results may serve as a baseline for future studies to improve vaccination programs, reduce barriers and increase DPT coverage in Peru.

Healthcare Workers and Nonhealthcare Workers Pro-Vaccination Attitude and Its Associated Factors towards COVID-19 Vaccine Globally: A Systematic Review and Meta-Analysis

Introduction

Coronavirus disease 2019 (COVID-19) pandemic has not been managed and controlled globally. The aim of this systematic review and meta-analysis were to determine the global pro-vaccination attitude and associated factors towards COVID-19 vaccine among healthcare workers (HCWs) and nonhealthcare workers (non-HCWs).

Methods

Different databases such as PubMed, Scopus, EMBASE, and Google Scholar were used. Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) 2020 flowchart diagram and PRISMA checklist were used for study screening, selection, and inclusion into this systematic review and meta-analysis. Newcastle-Ottawa Scale (NOS) quality assessment criteria for cross-sectional studies were used to assess the included articles.

Results

A total of 51 studies were included into this systematic review and meta-analysis. The meta-analysis revealed that the global pooled prevalence of pro-vaccination attitude towards COVID-19 vaccine among both HCWs and non-HCWs was 61.30% (95%CI: 56.12, 66.47, I 2 = 99.8%: p=0.000). Subgroup analysis showed that the global pooled prevalence of pro-vaccination attitude towards COVID-19 vaccine was the lowest (59.77%, 95%CI (51.56, 67.98); I 2 = 99.6%, p=0.000) among the HCWs participants and the highest (62.53%, 95%CI (55.39, 69.67); I 2 = 99.8%, p=0.000) among the non-HCWs participants and the lowest (54.31%, 95%CI (43, 65.63); I 2 = 99.5%, p=0.000) for sample size <700 and the highest (66.49%, 95%CI (60.01, 72.98); I 2 = 99.8%, p=0.000) for sample size >700; the lowest (60.70%, 95%CI (54.08, 67.44); I 2 = 93.0%, p=0.000) for studies published in 2020 year and the highest (61.31%, 95%CI (55.93, 66.70); I 2 = 99.8%, p=0.000) for the studies published after 2020 years. From this systematic review, factors significantly associated with pro-vaccination attitude towards COVID-19 vaccine among HCWs were such as age, gender, race, work experience, home location, having no fear of injections, being a non-smoker, profession, presence of chronic illnesses, allergies, confidence in pharmaceutical companies, history of taking influenza vaccine, vaccine recommendation, perceived risk of new vaccines, perceived utility of vaccine, receiving a seasonal flu vaccination in the last 5 years, working in a private hospital, a high perceived pandemic risk index, low vaccine harm index, high pro-socialness index, being in close contact with a high-risk group, knowledge about the virus, confidence in and expectations about personal protective equipment, and behaviors. The level of positive attitude towards COVID-19 vaccine among non-HCWs ranged from 21.40% to 91.99%. Factors associated with the attitude towards COVID-19 vaccine among non-HCWs were such as age, gender, educational level, occupation, marital status, residency, income, ethnicity, risk for severe course of COVID-19, direct contact with COVID-19 at work, being a health profession, being vaccinated against seasonal flu, perceived benefits, cues to actions, having previous history of vaccination, fear of passing on the disease to relatives, and the year of medical study, studying health-related courses, COVID-19 concern, adherence level to social distancing guidelines, history of chronic disease, being pregnant, perceived vaccine safety, having more information about vaccine effectiveness, mandatory vaccination, being recommended to be vaccinated, lack of confidence in the healthcare system to control epidemic, and belief in COVID-19 vaccines protection from COVID-19 infection.

Conclusion

This meta-analysis revealed that the global estimated pooled prevalence of pro-vaccination attitude towards COVID-19 vaccine among both HCWs and non-HCWs was unsatisfactory. Globally, there is a need for a call for action to cease the crisis of this pandemic.

The Influence of SARS-CoV-2 Infection on Lipid Metabolism—The Potential Use of Lipid-Lowering Agents in COVID-19 Management

Several studies have indicated lipid metabolism alterations during COVID-19 infection, specifically a decrease in high-density lipoprotein (HDL) and low-density lipoprotein (LDL) concentrations and an increase in triglyceride (TG) levels during the infection. However, a decline in triglycerides can also be observed in critical cases. A direct correlation can be observed between a decrease in serum cholesterol, HDL-C, LDL-C and TGs, and the severity of the disease; these laboratory findings can serve as potential markers for patient outcomes. The transmission of coronavirus increases proportionally with rising levels of cholesterol in the cell membrane. This is due to the fact that cholesterol increases the number of viral entry spots and the concentration of angiotensin-converting enzyme 2 (ACE2) receptor, crucial for viral penetration. Studies have found that lower HDL-C levels correspond with a higher susceptibility to SARS-CoV-2 infection and infections in general, while higher HDL-C levels were related to a lower risk of developing them. However, extremely high HDL-C levels in serum increase the risk of infectious diseases and is associated with a higher risk of cardiovascular events. Low HDL-C levels are already accepted as a marker for risk stratification in critical illnesses, and higher HDL-C levels prior to the infection is associated with a lower risk of death in older patients. The correlation between LDL-C levels and disease severity is still unclear. However, TG levels were significantly higher in non-surviving severe patients compared to those that survived; therefore, elevated TG-C levels in COVID-19 patients may be considered an indicator of uncontrolled inflammation and an increased risk of death.

The Willingness to get Vaccinated Against SARS-CoV-2 Virus among Southeast Asian Countries: Does the Vaccine Brand Matter?

The current study uses data surveyed with 2,500 respondents during August and September 2021 in Vietnam, Indonesia, the Philippines and Malaysia to examine the willingness to get vaccinated against SARS-CoV-2 virus with six COVID-19 vaccines. The willingness to get vaccinated varies according to the vaccine brands and selected influential factors. Particularly, the percentage of respondents who are willing to get vaccinated with Pfizer, Moderna and AstraZeneca dominates that of those who are willing to get vaccinated with Sinopharm, Janssen and Sputnik V vaccines. Results generated from the binary logistic regressions show that the impact of the selected influential factors on the willingness to get vaccinated varies in terms of magnitude and direction, and depending on the vaccine brands. The results indicate that additional scientific evidence on the efficacy and safety of the vaccines is essential for the respondents to decide whether to vaccinate or not. Such evidence can be made available in multiple formats and provided through appropriate channels and vaccination communication campaigns.

Mapping the Prevalence of COVID-19 Vaccine Acceptance at the Global and Regional Level: A Systematic Review and Meta-Analysis

Despite the availability of effective and safe vaccines, the acceptance of COVID-19 vaccination is suboptimal. In this meta-analysis we quantified the prevalence estimates of COVID-19 vaccine acceptance with a specific focus on worldwide geographical differences. We searched PubMed, Scopus, Web of Science and PsycInfo up to April 2021 (PROSPERO ID: CRD42021235328). Generalized random-effects linear models with a logit link were used to calculate the pooled estimated rate of vaccine acceptance at both the global and regional level. A meta-regression analysis was performed to assess the association between COVID-19 vaccine acceptance and various characteristics of the studies. Overall, 71 articles yielding 128 prevalence estimates were included. The pooled prevalence of COVID-19 vaccination acceptance rate was 66% (95% CI: 61-71%). This varied by geographic area, ranging from 36% (95% CI: 18-60%) in Africa to 83% (95% CI: 82-84%) in Oceania, and there was high variability between countries (15.4% Cameroon-100% Bhutan). Meta-regression analysis showed that studies that investigated COVID-19 vaccination intentions using multiple choice/scoring gave a vaccine acceptance prevalence lower than studies with only two possible answers (yes/no) (ß: -1.02 95% CI: -1.41 to -0.63). Despite some variation in the estimates, the results showed that one in three people may refuse/delay COVID-19 vaccination.

Covid-19 vaccine hesitancy and resistance amongst parents of children under 18 years of age in Ireland

As COVID-19 vaccination for children becomes commonplace in Ireland, it is important to understand parent’s willingness to vaccinate their children and factors associated with hesitancy and resistance. Amongst a nationally representative sample of parents from Ireland, surveyed in March/April 2021, 52.1% had, or were intending to have their child vaccinated; 30.1% reported they might vaccine their child; and 17.8% reported they would not vaccinate their child. Compared to vaccine-accepting parents, hesitant parents were more likely to be younger, less educated, poorer, to not know somebody who was sick from COVID-19, to believe the COVID-19 vaccines were unsafe, and to hold negative beliefs about scientists and healthcare professionals. Vaccine-resistant parents were more likely to be younger, living alone, to distrust scientists, and to believe the COVID-19 vaccines were unsafe. Public health messaging should target younger, lower income parents with clear information about the safety of COVID-19 vaccines for children.

Standing alone: experiences of vaccine-hesitant Danish healthcare professionals during COVID-19

AIM

The aim of the study was to explore the experiences of Danish healthcare professionals who were hesitant about the COVID-19 vaccine.

METHODS

Interviews were conducted over the telephone in January and February 2021.

RESULTS

Healthcare professionals experienced the need to avoid impossible conversations about vaccine hesitancy with their colleagues. They felt a lack of knowledge of long-term experience with the vaccine and a need to balance trust in themselves and the authorities.

CONCLUSIONS

Healthcare professionals who were hesitant towards the COVID-19 vaccine felt they had to keep their concerns to themselves and felt isolated and pressured by their managers. This study is especially important for managers, who must ensure a trusting working environment in which employees can discuss their concerns without feeling pressured.

Are Fear of COVID-19 and Vaccine Hesitancy Associated with COVID-19 Vaccine Uptake? A Population-Based Online Survey in Nigeria

This study examined the association between COVID-19 and fear of contracting COVID-19 and reasons for vaccination refusal. A population-based online survey was conducted via social media in Nigeria using the Fear of COVID-19 scale and items related to vaccination refusal/hesitancy items. Individuals aged 13 years and older were invited to participate. Data were analysed using binary logistic regression to calculate odds ratios (ORs) and associated 95% confidence intervals (CIs) at a p-value of less than 0.05. The study enrolled 577 individuals with a mean age of 31.86 years, 70% of whom were male and 27.7% of whom had received at least one dose of the vaccine against COVID-19. None of the variables on the Fear of COVID-19 scale significantly predicted vaccine uptake in multivariate analysis. However, individuals who were fearful of COVID-19 were more likely to be vaccinated in bivariate analysis (OR: 1.7, 95% CI: 1.06-2.63). The most significant factors among the vaccination refusal items associated with COVID-19 vaccination were doubts about vaccination (adjusted OR: 2.56, 95% CI: 1.57-4.17) and misconceptions about vaccine safety/efficacy (adjusted OR: 2.15, 95% CI: 1.24-3.71). These results suggest that uptake of the vaccine against COVID-19 in Nigeria can be predicted by factors associated with vaccination refusal, but not by fear of COVID-19. To contain the pandemic COVID-19 in Nigeria, efforts should be made to educate people about the efficacy of the vaccine and to increase their confidence in vaccination.

Interventions to increase COVID-19 vaccine uptake: a scoping review

BACKGROUND

Vaccines are effective in preventing severe COVID-19, a disease for which few treatments are available and which can lead to disability or death. Widespread vaccination against COVID-19 may help protect those not yet able to get vaccinated. In addition, new and vaccine-resistant mutations of SARS-CoV-2 may be less likely to develop if the spread of COVID-19 is limited. Different vaccines are now widely available in many settings. However, vaccine hesitancy is a serious threat to the goal of nationwide vaccination in many countries and poses a substantial threat to population health. This scoping review maps interventions aimed at increasing COVID-19 vaccine uptake and decreasing COVID-19 vaccine hesitancy.

OBJECTIVES

To scope the existing research landscape on interventions to enhance the willingness of different populations to be vaccinated against COVID-19, increase COVID-19 vaccine uptake, or decrease COVID-19 vaccine hesitancy, and to map the evidence according to addressed populations and intervention categories.

SEARCH METHODS

We searched Cochrane COVID-19 Study Register, Web of Science (Science Citation Index Expanded and Emerging Sources Citation Index), WHO COVID-19 Global literature on coronavirus disease, PsycINFO, and CINAHL to 11 October 2021.

SELECTION CRITERIA

We included studies that assess the impact of interventions implemented to enhance the willingness of different populations to be vaccinated against COVID-19, increase vaccine uptake, or decrease COVID-19 vaccine hesitancy. We included randomised controlled trials (RCTs), non-randomised studies of intervention (NRSIs), observational studies and case studies with more than 100 participants. Furthermore, we included systematic reviews and meta-analyses. We did not limit the scope of the review to a specific population or to specific outcomes assessed. We excluded interventions addressing hesitancy towards vaccines for diseases other than COVID-19.

DATA COLLECTION AND ANALYSIS

Data were analysed according to a protocol uploaded to the Open Science Framework. We used an interactive scoping map to visualise the results of our scoping review. We mapped the identified interventions according to pre-specified intervention categories, that were adapted to better fit the evidence. The intervention categories were: communication interventions, policy interventions, educational interventions, incentives (both financial and non-financial), interventions to improve access, and multidimensional interventions. The study outcomes were also included in the mapping. Furthermore, we mapped the country in which the study was conducted, the addressed population, and whether the design was randomised-controlled or not.

MAIN RESULTS

We included 96 studies in the scoping review, 35 of which are ongoing and 61 studies with published results. We did not identify any relevant systematic reviews. For an overview, please see the interactive scoping map (https://tinyurl.com/2p9jmx24) STUDIES WITH PUBLISHED RESULTS Of the 61 studies with published results, 46 studies were RCTs and 15 NRSIs. The interventions investigated in the studies were heterogeneous with most studies testing communication strategies to enhance COVID-19 vaccine uptake. Most studies assessed the willingness to get vaccinated as an outcome. The majority of studies were conducted in English-speaking high-income countries. Moreover, most studies investigated digital interventions in an online setting. Populations that were addressed were diverse. For example, studies targeted healthcare workers, ethnic minorities in the USA, students, soldiers, at-risk patients, or the general population.  ONGOING STUDIES Of the 35 ongoing studies, 29 studies are RCTs and six NRSIs. Educational and communication interventions were the most used types of interventions. The majority of ongoing studies plan to assess vaccine uptake as an outcome. Again, the majority of studies are being conducted in English-speaking high-income countries. In contrast to the studies with published results, most ongoing studies will not be conducted online. Addressed populations range from minority populations in the USA to healthcare workers or students. Eleven ongoing studies have estimated completion dates in 2022.   AUTHORS' CONCLUSIONS: We were able to identify and map a variety of heterogeneous interventions for increasing COVID-19 vaccine uptake or decreasing vaccine hesitancy. Our results demonstrate that this is an active field of research with 61 published studies and 35 studies still ongoing. This review gives a comprehensive overview of interventions to increase COVID-19 vaccine uptake and can be the foundation for subsequent systematic reviews on the effectiveness of interventions to increase COVID-19 vaccine uptake.  A research gap was shown for studies conducted in low and middle-income countries and studies investigating policy interventions and improved access, as well as for interventions addressing children and adolescents. As COVID-19 vaccines become more widely available, these populations and interventions should not be neglected in research.

AUTHORS CONCLUSIONS

We were able to identify and map a variety of heterogeneous interventions for increasing COVID-19 vaccine uptake or decreasing vaccine hesitancy. Our results demonstrate that this is an active field of research with 61 published studies and 35 studies still ongoing. This review gives a comprehensive overview of interventions to increase COVID-19 vaccine uptake and can be the foundation for subsequent systematic reviews on the effectiveness of interventions to increase COVID-19 vaccine uptake.  A research gap was shown for studies conducted in low and middle-income countries and studies investigating policy interventions and improved access, as well as for interventions addressing children and adolescents. As COVID-19 vaccines become more widely available, these populations and interventions should not be neglected in research.

Evaluation of the Acceptance Rate of Covid-19 Vaccine and its Associated Factors: A Systematic Review and Meta-analysis

Covid-19 has caused various problems in the world in terms of health, economy, social and political therefore, the purpose of the present systematic review and meta-analysis is to determine the acceptance rate of Covid-19 vaccine and its related factors. To find related studies, PubMed, Embase, Scopus, Web of Science (WoS) and Google Scholar databases with no time limit until May 2021 using the keywords Related to the purpose of the research and all possible combinations were explored. I2 test was used to calculate the heterogeneity of studies and Begg and Mazumdar rank correlation test was used to investigate publication bias. Finally, 98 articles related to inclusion criteria with a sample size of 660,604 people were included in the study. Overall estimate of the worldwide acceptance of Covid-19 vaccine; 63.9% (95% CI: 59.1-68.4) was obtained, with the highest percentage of acceptance reported in the Australian continent, 76.4% (95% CI: 72.6-79.8). In the majority of studies, vaccine acceptance was significantly more reported in the elderly and the young people, medical staff, employees, higher education level and socioeconomic status, with trust in vaccine and positive vaccination history. The results of this systematic review and meta-analysis demonstrate that the acceptance rate of Covid-19 vaccine is higher among young people and the elderly, medical staff, employees, higher education level and socioeconomic status, with trust in vaccine and positive vaccination history, which can be considered by experts and policymakers in this field.

Second Wave of COVID-19 Pandemic in Argentinian Population: Vaccination Is Associated With a Decrease in Depressive Symptoms

Background

Since the irruption of the coronavirus disease 2019 (COVID-19) the planet has submerged in a time of concern and uncertainty, with a direct impact on people's mental health. Moreover, the recurrent outbreaks that periodically harry different regions of the world constantly refocus people's concerns to the pandemic. Yet, each new wave heats the diverse countries in different situations, including the advances in their vaccination campaigns. In this research, we studied the levels of the general anxiety disorder (GAD) and depression in the Argentine population across the first and second waves of infections that occurred in our country.

Methods

We conducted an on-line survey, within each peak of the pandemic. People were asked to self-report GAD and depression symptoms using the GAD-7 and PHQ-9 questioners, inform their vaccination status, the frequency they performed physical activity as well as working condition and modality. Here, we identified the more vulnerable groups and evaluated factors that could mitigate the rise of these mental disorders, focusing on vaccination.

Results

Our data shows that reported GAD and depression levels were higher during the second wave than during the first one. More importantly, vaccinated people were less depressed than non-vaccinated people, while GAD levels remained equivalent in both groups. Other factors directly associated with lower GAD and depression levels were performing frequent physical activity and being employed, regardless of the employment modality. These observations were replicated in different age ranges and genders.

Conclusion

This work evidences GAD and depression in different pandemic waves in Argentina, as well the factors that may contribute to reducing the magnitude of these disorders, including vaccination.

The effect of health literacy on COVID-19 vaccine hesitancy among community population in China: The moderating role of stress

Background

The public’s hesitant attitude is a major subjective barrier in promoting vaccination against COVID-19 to build herd immunity. The current study aimed to address how individual factors such as health literacy and perceived stress affect people’s vaccine hesitancy of COVID-19 vaccine, and to provide insights for tailoring vaccine-promotion strategies.

Methods

With structured questionnaires, an online survey was conducted to address the relationship between the health literacy, perceived stress, and COVID-19 vaccine hesitancy among community population in mainland, China. Moderated analysis was conducted to test the effect of health literacy on vaccine hesitancy among people with different levels of perceived stress.

Results

560 responses were collected in total. 39.8% of the participants reported vaccine hesitancy, and this rate was higher among younger people and female. Moreover, people with higher level of health literacy showed reduced vaccine hesitancy, while this effect was only significant among those with low or moderate level of stress. For people with high level of stress, no significant effect of health literacy was found.

Conclusions

The findings suggest that increasing people’s health literacy could lead to reduced vaccine hesitancy in community sample. However, this effect disappeared when the stress level was high, suggesting other promotion services may need to be developed to increase the acceptance of COVID-19 vaccine. In conclusion, vaccine promotion strategies should be tailored for different populations, with taking account of individual’s health literacy and perceived stress.