Should vaccination be mandated? Individuals' perceptions on mandatory vaccination in Greece

Attitudes towards mandatory vaccination and sanctions for vaccination refusal

AIMS

Investigating attitudes towards mandatory vaccination and sanctions for vaccination refusal in an area with insufficient vaccination coverage may help health authorities to assess which strategies for increasing vaccination coverage are appropriate. This study examines attitudes to vaccine mandates and asks questions regarding what kinds of sanctions could legitimately result from vaccination refusal. It seeks to find out if people's attitudes towards mandates and towards sanctions for vaccination refusal are related to their attitudes to vaccines and the degree of trust they feel towards health care professionals and health care authorities. The study also discusses how the observed attitudes towards mandates may be related to perceptions of autonomy, responsibility, and equitability.

METHODS

Data collection was carried out in Finland through an online survey in a region with suboptimal vaccine uptake. Statistical analysis was conducted on a sample of 1101 respondents, using confirmatory factor analysis and structural regression analysis.

RESULTS

Persons hold different views on mandates and sanctions. Importantly, the persons who support vaccination mandates and sanctions for vaccination refusal are to a great degree the same people who have positive attitudes to vaccines and high trust in health care professionals and health authorities.

CONCLUSION

Trust is a key factor which has a bearing on people's attitudes towards mandates and sanctions for noncompliance. A focus on the reasons for lack of trust, and on how to enhance trust, is a more feasible long-term way (than mandates) to promote large- scale compliance with childhood vaccine programmes in the studied country context.

Determinants of COVID-19 vaccine uptake among healthcare professionals and the general population in Cyprus: A web-based cross-sectional survey

OBJECTIVE

This study aims to examine the factors influencing COVID-19 vaccine uptake among healthcare professionals (HCPs) and the general population in Cyprus.

METHODS

A web-based cross-sectional study was conducted (November 2021-January 2022), using a self-administered, anonymous questionnaire to collect information covering a wide range of potential determinants including sociodemographic and health-related characteristics, trust in the healthcare system, satisfaction with it, utilization of preventive healthcare services, COVID-19 vaccination information and general vaccination knowledge.

RESULTS

A total of 2582 participants completed the survey. Overall, 53.5% of participants representing the general population, and 70.0% of the HCPs received the COVID-19 vaccination. We found that as the age increases by 1 year among the general population, the odds of being vaccinated against COVID-19 increase by 1.02 units (95% 1.00, 1.03, p= 0.035). In addition, participants among the general population with increased trust in national healthcare authorities' guidelines (OR = 3.96, 95% CI: 3.41, 4.61), and increased vaccination knowledge scores (OR = 1.11, 95% CI: 1.05, 1.18) were significantly more likely to be vaccinated, while those who had underage children living in the household were significantly less likely to be vaccinated against COVID-19 (OR = 0.68, 95% CI: 0.50, 0.91). Furthermore, male HCPs (OR = 1.91, 95% CI: 1.01, 3.59), and those who reported increased trust in national healthcare authorities' guidelines (OR = 5.38, 95% CI: 3.65, 7.95) were significantly more likely to be vaccinated.

CONCLUSION

Public health policymakers can use national campaigns and long-term planning to build public trust in national healthcare authorities and raise awareness about the benefits of vaccination. Such strategies could pave the way for adequate vaccine uptake and prepare the public for unfavourable scenarios, such as future pandemics.

Mandatory COVID-19 Vaccination for Healthcare Professionals and Its Association With General Vaccination Knowledge: A Nationwide Cross-Sectional Survey in Cyprus

COVID-19 compulsory vaccination for healthcare professionals (HCPs) is a sensitive and controversial topic, with different support rates worldwide. Previous studies in Cyprus identified a low COVID-19 vaccination acceptance among HCPs, however, no studies have investigated their perceptions toward mandatory COVID-19 vaccination. This is the first study to investigate the attitudes of HCPs toward mandatory COVID-19 vaccination and its association with general vaccination knowledge. A cross-sectional study was conducted, using an online self-administered, anonymous questionnaire to collect data on sociodemographic and health-related characteristics, trust and satisfaction with the healthcare system, utilization of preventive healthcare services, COVID-19 vaccination information, vaccination knowledge, and attitudes among HCPs toward mandatory COVID-19 vaccination. A total of 504 HCPs participated in the survey, with 34% being in favor of mandatory COVID-19 vaccination. A sufficient vaccination knowledge score was identified among the HCPs, with higher scores being associated with mandatory vaccination support (p < 0.001). As age increases by one year, the odds of supporting mandatory vaccination increase by 1.03 units (95% CI: 1.01-1.06). In addition, as the general vaccination knowledge score increases by one unit, the odds of supporting mandatory COVID-19 vaccination increase by 1.55 units (95% CI: 1.33-1.81). Our findings show that about two-thirds of the HCPs in Cyprus were opposed to a mandatory COVID-19 vaccination policy. Older age and general vaccination knowledge were found to be the strongest predictors of mandatory vaccination support. To avoid unforeseen outcomes, mandatory vaccination policies should be implemented with caution and consultation.

Attitudes and Determinants of Mandatory Vaccination against COVID-19 among the General Population of Cyprus: A Nationwide Cross-Sectional Study

Vaccinations for the prevention of coronavirus disease (COVID-19) are important to control the ongoing pandemic. A much-discussed strategy to increase vaccination coverage is mandatory vaccination; however, its legitimacy and effectiveness as a measure are doubtful. This study aims to investigate the attitudes of the general population of Cyprus towards COVID-19 mandatory vaccination and to identify the factors influencing individuals' attitudes towards such policy. An online cross-sectional study was conducted, using a self-administered, anonymous questionnaire to collect information on sociodemographic and health-related characteristics, trust, and satisfaction about the healthcare system and utilization of preventive healthcare services, COVID-19 vaccination information, general vaccination knowledge, and attitudes towards mandatory vaccination. A total of 2140 participants completed the survey, with 27.8% being in favor of mandatory vaccination. We found that as the age increases by one year, the odds of supporting mandatory vaccination increase by 1.04 units (OR 1.04, 95% CI: 1.02-1.05). In addition, those who reported increased trust in national healthcare authorities' guidelines and recommendations (OR 3.74, 95% CI: 3.11-4.49) and those satisfied with the healthcare system (OR 1.38, 95% CI: 1.16-1.65) and follow doctor's instructions (OR 1.29, 95% CI: 1.03-1.61), were significantly more likely to support mandatory vaccination while those who had underage children living in the household were significantly less likely to support mandatory vaccination (OR 0.69, 95% CI: 0.50-0.94). Public health authorities need to develop well-organized vaccination campaigns in which accurate evidence-based information would be disseminated with respect to individuals' autonomy.

Mandatory vaccination support and intentions to get vaccinated for COVID-19: Results from a nationally representative general population survey in October 2020 in Greece

OBJECTIVES

To explore rates and factors associated with mandatory vaccination support overall and intentions to get vaccinated specifically for COVID-19 among individuals in Greece.

METHODS

Using data from a nationally representative cross-sectional survey conducted in October 2020 among 855 adults (≥18 years) in Greece, we estimated support rates for mandatory vaccination and respondents' intention to get vaccinated for COVID-19 as well as associations thereof with individual sociodemographic, clinical and contextual characteristics.

RESULTS

About 74% of respondents supported mandatory vaccination and 62% intended to get vaccinated for COVID-19. The most prevalent reasons against COVID-19 vaccination were safety concerns related to the duration of clinical trials and potential side effects. Individuals who reported increased trust in healthcare authorities' recommendations, who revealed that their trust in the State increased due to the way the COVID-19 pandemic was handled, who used preventive services more often, and those with higher income were more likely to both support mandatory vaccination and to indicate intention to get vaccinated for COVID-19. Participants with worse or better self-reported health status (compared to average), younger adults, and females were less likely to intend to get vaccinated for COVID-19.

CONCLUSION

The survey revealed that the majority of the Greek citizens favour mandatory vaccination overall and intend to get vaccinated for COVID-19, driven mostly by utilization of preventive services and trust in healthcare authorities. However, intention to get vaccinated for COVID-19 was lower relative to mandatory vaccination support. This suggests a need to intensify evidence-based yet simplified messaging by esteemed healthcare providers to inform the public on the risks and benefits of vaccines.