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Parsons Leigh J, FitzGerald EA, Moss SJ, Cherak MS, Brundin-Mather R, Dodds A, Stelfox HT, Dubé È, Fiest KM, Halperin DM, Ahmed SB, MacDonald SE, Straus SE, Manca T, Ng Kamstra J, Soo A, Longmore S, Kupsch S, Sept B, Halperin SA. The evolution of vaccine hesitancy through the COVID-19 pandemic: A semi-structured interview study on booster and bivalent doses. Hum Vaccin Immunother 2024; 20:2316417. [PMID: 38390696 PMCID: PMC10896168 DOI: 10.1080/21645515.2024.2316417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 02/06/2024] [Indexed: 02/24/2024] Open
Abstract
We sought in-depth understanding on the evolution of factors influencing COVID-19 booster dose and bivalent vaccine hesitancy in a longitudinal semi-structured interview-based qualitative study. Serial interviews were conducted between July 25th and September 1st, 2022 (Phase I: univalent booster dose availability), and between November 21st, 2022 and January 11th, 2023 (Phase II: bivalent vaccine availability). Adults (≥18 years) in Canada who had received an initial primary series and had not received a COVID-19 booster dose were eligible for Phase I, and subsequently invited to participate in Phase II. Twenty-two of twenty-three (96%) participants completed interviews for both phases (45 interviews). Nearly half of participants identified as a woman (n = 11), the median age was 37 years (interquartile range: 32-48), and most participants were employed full-time (n = 12); no participant reported needing to vaccinate (with a primary series) for their workplace. No participant reported having received a COVID-19 booster dose at the time of their interview in Phase II. Three themes relating to the development of hesitancy toward continued vaccination against COVID-19 were identified: 1) effectiveness (frequency concerns; infection despite vaccination); 2) necessity (less threatening, low urgency, alternate protective measures); and 3) information (need for data, contradiction and confusion, lack of trust, decreased motivation). The data from interviews with individuals who had not received a COVID-19 booster dose or bivalent vaccine despite having received a primary series of COVID-19 vaccines highlights actionable targets to address vaccine hesitancy and improve public health literacy.
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Affiliation(s)
- Jeanna Parsons Leigh
- Faculty of Health, School of Health Administration, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada
- Canadian Center for Vaccinology & IWK Health Center, Halifax, Nova Scotia, Canada
| | - Emily A FitzGerald
- Faculty of Health, School of Health Administration, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Stephana Julia Moss
- Faculty of Health, School of Health Administration, Dalhousie University, Halifax, Nova Scotia, Canada
- CRISMA Center, Department of Critical Care, University of Pittsburgh, Pittsburgh, USA
| | - Michal S Cherak
- Faculty of Health, School of Health Administration, Dalhousie University, Halifax, Nova Scotia, Canada
- Canadian Center for Vaccinology & IWK Health Center, Halifax, Nova Scotia, Canada
| | | | - Alexandra Dodds
- Faculty of Health, School of Health Administration, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Henry T Stelfox
- Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Ève Dubé
- Centre de Recherche du CHU de Québec, Université Laval, Québec, Canada
- Département d'anthropologie, Université Laval, Québec, Canada
| | - Kirsten M Fiest
- Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada
- O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
- Department of Psychiatry & Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Donna M Halperin
- Canadian Center for Vaccinology & IWK Health Center, Halifax, Nova Scotia, Canada
- Rankin School of Nursing, St. Francis Xavier University, Antigonish, Nova Scotia, Canada
| | - Sofia B Ahmed
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Shannon E MacDonald
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Sharon E Straus
- Li Ka Shing Knowledge Institute of St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Terra Manca
- Faculty of Health Disciplines, Athabasca University, Athabasca, Alberta, Canada
- Sociology and Social Anthropology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Josh Ng Kamstra
- Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Andrea Soo
- Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada
- Alberta Health Services, Calgary, Alberta, Canada
| | - Shelly Longmore
- Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Shelly Kupsch
- Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Bonnie Sept
- Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Scott A Halperin
- Canadian Center for Vaccinology & IWK Health Center, Halifax, Nova Scotia, Canada
- Department of Pediatrics, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Microbiology and Immunology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
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Miao Y, Shen Z, Li Q, Ma M, Xu D, Tarimo CS, Gu J, Wei W, Zhou X, Zhao L, Feng Y, Wu J, Wang M. Understanding the impact of chronic diseases on COVID-19 vaccine hesitancy using propensity score matching: Internet-based cross-sectional study. J Clin Nurs 2024; 33:2165-2177. [PMID: 38291345 DOI: 10.1111/jocn.16958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 01/16/2023] [Accepted: 11/26/2023] [Indexed: 02/01/2024]
Abstract
AIMS AND OBJECTIVES To investigate whether chronic diseases are associated with higher COVID-19 vaccine hesitancy and explore factors that influence COVID-19 vaccine hesitancy in patients with chronic diseases. BACKGROUND Vaccine hesitancy has been acknowledged as one of the greatest hazards to public health. However, little information is available about COVID-19 vaccine hesitancy among patients with chronic diseases who may be more susceptible to COVID-19 infection, severe disease or death. METHODS From 6 to 9 August 2021, we performed an internet-based cross-sectional survey with 22,954 participants (14.78% participants with chronic diseases). Propensity score matching with 1:1 nearest neighbourhood was used to reduce confounding factors between patients with chronic diseases and the general population. Using a multivariable logistic regression model, the factors impacting COVID-19 vaccine hesitancy were identified among patients with chronic diseases. RESULTS Both before and after propensity score matching, patients with chronic diseases had higher COVID-19 vaccine hesitancy than the general population. In addition, self-reported poor health, multiple chronic diseases, lower sociodemographic backgrounds and lower trust in nurses and doctors were associated with COVID-19 vaccine hesitancy among patients with chronic diseases. CONCLUSIONS Patients with chronic diseases were more hesitant about the COVID-19 vaccine. Nurses should focus on patients with chronic diseases with poor health conditions, low socioeconomic backgrounds and low trust in the healthcare system. RELEVANCE TO CLINICAL PRACTICE Clinical nurses are recommended to not only pay more attention to the health status and sociodemographic characteristics of patients with chronic diseases but also build trust between nurses and patients by improving service levels and professional capabilities in clinical practice. PATIENT OR PUBLIC CONTRIBUTION Patients or the public were not involved in setting the research question, the outcome measures, or the design or implementation of the study. However, all participants were invited to complete the digital informed consent and questionnaires.
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Affiliation(s)
- Yudong Miao
- Department of Health management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- Henan Province Engineering Research Center of Health Economy & Health Technology Assessment, Zhengzhou, China
| | - Zhanlei Shen
- Department of Health management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- Henan Province Engineering Research Center of Health Economy & Health Technology Assessment, Zhengzhou, China
| | - Quanman Li
- Department of Health management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- Henan Province Engineering Research Center of Health Economy & Health Technology Assessment, Zhengzhou, China
| | - Mingze Ma
- Department of Health management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- Henan Province Engineering Research Center of Health Economy & Health Technology Assessment, Zhengzhou, China
| | - Dongyang Xu
- Henan Provincial Center for Disease Control and Prevention, Zhengzhou, China
| | - Clifford Silver Tarimo
- Department of Health management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- Henan Province Engineering Research Center of Health Economy & Health Technology Assessment, Zhengzhou, China
- Department of Science and Laboratory Technology, Dar es salaam Institute of Technology, Dar es Salaam, Tanzania
| | - Jianqin Gu
- School of Medicine, Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - Wei Wei
- Henan Provincial People's Hospital, Zhengzhou, Henan, China
- People's Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Xue Zhou
- College of Health Management, Mudanjiang Medical University, Mudanjiang, Heilongjiang, China
| | - Lipei Zhao
- Department of Health management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- Henan Province Engineering Research Center of Health Economy & Health Technology Assessment, Zhengzhou, China
| | - Yifei Feng
- Department of Health management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- Henan Province Engineering Research Center of Health Economy & Health Technology Assessment, Zhengzhou, China
| | - Jian Wu
- Department of Health management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- Henan Province Engineering Research Center of Health Economy & Health Technology Assessment, Zhengzhou, China
| | - Meiyun Wang
- Henan Provincial People's Hospital, Zhengzhou, Henan, China
- People's Hospital of Zhengzhou University, Zhengzhou, Henan, China
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Pristov Z, Lobe B, Sočan M. Factors Influencing COVID-19 Vaccination among Primary Healthcare Nurses in the Pandemic and Post-Pandemic Period: Cross-Sectional Study. Vaccines (Basel) 2024; 12:602. [PMID: 38932331 PMCID: PMC11209193 DOI: 10.3390/vaccines12060602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Revised: 05/25/2024] [Accepted: 05/29/2024] [Indexed: 06/28/2024] Open
Abstract
The decision to vaccinate against COVID-19 is primarily a personal choice influenced by numerous factors. Vaccine acceptance and a positive attitude towards vaccination among nurses have an impact on patients' willingness to vaccinate. To assess COVID-19 vaccination coverage among primary healthcare nurses and to associate socio-demographic factors, comorbidity, self-rated health, and unhealthy lifestyle with the decision to be vaccinated, we conducted an online cross-sectional study from March to May 2023 using a self-administrated questionnaire. Probability sampling was used to select 32 health centers and nurses were invited via email. Among the 560 participants who completed survey, 78.3% and 50.8% received the primary two-dose course and at least one booster dose of COVID-19 vaccine, respectively. Primary care nurses who were ≥41 years of age, physically less active, and those who were overweight opted statistically significantly more often for the primary vaccination scheme (p = 0.00, 0.015 and 0.017, respectively). Education and the living environments of primary care nurses did not significantly influence the decision to receive two primary COVID-19 doses. Likewise, good self-rated health and comorbidity did not contribute significantly to the vaccination decision. Nurses that were vaccinated with booster doses were significantly more often overweight (p = 0.034) and ≥41 year of age (p = 0.000).
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Affiliation(s)
- Zorica Pristov
- Community Health Centre Ljubljana, 1000 Ljubljana, Slovenia;
| | - Bojana Lobe
- Faculty of Social Sciences, University of Ljubljana, 1000 Ljubljana, Slovenia;
| | - Maja Sočan
- National Institute of Public Health, 1000 Ljubljana, Slovenia
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Kong L, Wang X, Yang Z, Tang Y, Wang Z, Ma Y, Li J, Zhang Z, Gu J. Trends in Intention to Take the Second Booster COVID-19 Vaccination and Associated Factors in China: Serial Cross-Sectional Surveys. Vaccines (Basel) 2024; 12:502. [PMID: 38793753 PMCID: PMC11126054 DOI: 10.3390/vaccines12050502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 04/26/2024] [Accepted: 04/27/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND The escalating complexity of the COVID-19 epidemic underscores the need for heightened attention to booster vaccinations. This study aims to examine the changing trend in the public's intention to receive the second COVID-19 booster vaccination over time and the associated factors following the COVID-19 policy optimization in China. METHOD Eight cross-sectional surveys utilizing SMS questionnaire links were conducted in Guangzhou, China, from December 2022 to April 2023. The Mann-Kendall test was employed to analyze the trend in intentions to receive the second booster vaccination across the survey time. Adjusted and multivariate logistic analyses were used to analyze the factors associated with vaccination intention. Parallel analyses were performed for two subgroups with different COVID-19 infection statuses. RESULTS A total of 9860 respondents were surveyed in the eight rounds, of which 8048 completed the first booster vaccination and were included in the analysis. The overall COVID-19 infection rate was 60.0% (4832/8048), while the overall vaccination intention was 72.2% (5810/8048) among respondents. The vaccination intention exhibited a significant declining trend over time, decreasing from 81.5% in December 2022 to 52.2% in April 2023. An adjusted logistic regression analysis revealed that anxiety and depression were negatively associated with an intention to receive the second booster vaccination, while COVID-19-related preventive behaviors and a high engagement in COVID-19-related information were positively associated with an intention to receive the second booster vaccination. A subgroup analysis revealed that the association between psychological and behavioral characteristics and vaccination intention remained relatively stable among individuals with different histories of COVID-19 infections. CONCLUSION There was a significant decline in the intention to receive the second booster vaccination following the optimization of the COVID policy in China. Our findings emphasize the urgency of the second booster vaccination and provide a foundation for the development of tailored interventions to enhance and sustain vaccination intention among the public.
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Affiliation(s)
- Lingyu Kong
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (L.K.); (X.W.); (Z.Y.); (Y.T.); (J.L.)
| | - Xu Wang
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (L.K.); (X.W.); (Z.Y.); (Y.T.); (J.L.)
| | - Ziying Yang
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (L.K.); (X.W.); (Z.Y.); (Y.T.); (J.L.)
| | - Yihan Tang
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (L.K.); (X.W.); (Z.Y.); (Y.T.); (J.L.)
| | - Zhiwei Wang
- Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China (Y.M.)
| | - Yu Ma
- Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China (Y.M.)
| | - Jinghua Li
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (L.K.); (X.W.); (Z.Y.); (Y.T.); (J.L.)
| | - Zhoubin Zhang
- Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China (Y.M.)
| | - Jing Gu
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (L.K.); (X.W.); (Z.Y.); (Y.T.); (J.L.)
- Sun Yat-sen Global Health Institute, School of Public Health and Institute of State Governance, Sun Yat-sen University, Guangzhou 510080, China
- Key Laboratory of Health Informatics of Guangdong Province, Sun Yat-sen University, Guangzhou 510080, China
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Lorent D, Nowak R, Figlerowicz M, Handschuh L, Zmora P. Anti-SARS-CoV-2 Antibodies Level and COVID-19 Vaccine Boosters among Healthcare Workers with the Highest SARS-CoV-2 Infection Risk-Follow Up Study. Vaccines (Basel) 2024; 12:475. [PMID: 38793726 PMCID: PMC11126039 DOI: 10.3390/vaccines12050475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 04/26/2024] [Accepted: 04/27/2024] [Indexed: 05/26/2024] Open
Abstract
During the COVID-19 pandemic, several vaccines were developed to limit the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, due to SARS-CoV-2 mutations and uneven vaccination coverage among populations, a series of COVID-19 waves have been caused by different variants of concern (VOCs). Despite the updated vaccine formulations for the new VOC, the benefits of additional COVID-19 vaccine doses have raised many doubts, even among high-risk groups such as healthcare workers (HCWs). We examined the factors underlying hesitancy to receive COVID-19 booster vaccine doses and analysed the anti-SARS-CoV-2 IgG antibody response after booster vaccination among HCWs. Our study found that 42% of the HCWs were hesitant about the second booster dose, while 7% reported no intent to get vaccinated with any additional doses. As reasons for not vaccinating, participants most frequently highlighted lack of time, negative experiences with previous vaccinations, and immunity conferred by past infections. In addition, we found the lowest post-vaccination antibody titres among HCWs who did not receive any vaccine booster dose and the highest among HCWs vaccinated with two booster doses.
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Affiliation(s)
- Dagny Lorent
- Institute of Bioorganic Chemistry Polish Academy of Sciences, 61-704 Poznan, Poland; (D.L.); (R.N.); (L.H.)
| | - Rafał Nowak
- Institute of Bioorganic Chemistry Polish Academy of Sciences, 61-704 Poznan, Poland; (D.L.); (R.N.); (L.H.)
| | - Magdalena Figlerowicz
- Department of Infectious Diseases and Child Neurology, Poznan University of Medical Sciences, 61-701 Poznan, Poland;
| | - Luiza Handschuh
- Institute of Bioorganic Chemistry Polish Academy of Sciences, 61-704 Poznan, Poland; (D.L.); (R.N.); (L.H.)
| | - Paweł Zmora
- Institute of Bioorganic Chemistry Polish Academy of Sciences, 61-704 Poznan, Poland; (D.L.); (R.N.); (L.H.)
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Qin C, Du M, Wang Y, Liu Q, Yan W, Tao L, Liu M, Liu J. Assessing acceptability of the fourth dose against COVID-19 among Chinese adults: A population-based survey. Hum Vaccin Immunother 2023; 19:2186108. [PMID: 36892289 PMCID: PMC10026929 DOI: 10.1080/21645515.2023.2186108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) has wreaked havoc across the globe for approximately three years. Vaccination is a key factor to ending this pandemic, but its protective effect diminishes over time. A second booster dose at the right time is needed. To explore the willingness to receive the fourth dose of the COVID-19 vaccine and its influencing factors, we commenced a national, cross-sectional and anonymous survey in mainland China among people aged 18 and above from October 24 to November 7, 2022. A total of 3,224 respondents were eventually included. The acceptance rate of the fourth dose was 81.1% (95% CI: 79.8-82.5%), while it was 72.6% (95% CI: 71.1-74.2%) for a heterologous booster. Confidence in current domestic situation and the effectiveness of previous vaccinations, and uncertainty about extra protection were the main reasons for vaccine hesitancy. Perceived benefit (aOR = 1.29, 95% CI: 1.159-1.40) and cues to action (aOR = 1.73, 95% CI: 1.60-1.88) were positively associated with the vaccine acceptance, whereas perceived barriers (aOR = 0.78, 95% CI: 0.72-0.84) and self-efficacy (aOR = 0.79, 95% CI: 0.71-0.89) were both negatively associated with it. Additionally, sex, age, COVID-19 vaccination history, time for social media, and satisfaction with the government's response to COVID-19 were also factors affecting vaccination intention. Factors influencing the intention of heterologous booster were similar to the above results. It is of profound theoretical and practical significance to clarify the population's willingness to vaccinate in advance and explore the relevant influencing factors for the subsequent development and promotion of the fourth-dose vaccination strategies.
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Affiliation(s)
- Chenyuan Qin
- School of Public Health, Peking University, Beijing, China
| | - Min Du
- School of Public Health, Peking University, Beijing, China
| | - Yaping Wang
- School of Public Health, Peking University, Beijing, China
| | - Qiao Liu
- School of Public Health, Peking University, Beijing, China
| | - Wenxin Yan
- School of Public Health, Peking University, Beijing, China
| | - Liyuan Tao
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China
| | - Min Liu
- School of Public Health, Peking University, Beijing, China
| | - Jue Liu
- School of Public Health, Peking University, Beijing, China
- Institute for Global Health and Development, Peking University, Beijing, China
- Key Laboratory of Reproductive Health, National Health and Family Planning Commission of the People's Republic of China, Peking University, Beijing, China
- Global Center for Infectious Disease and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing, China
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George G, Nota P, Strauss M, Lansdell E, Peters RPH, Brysiewicz P, Nadesan-Reddy N, Wassenaar D. Examining the uptake of COVID-19 vaccine booster doses among healthcare workers in South Africa: A mixed-methods study. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002639. [PMID: 37983237 PMCID: PMC10659170 DOI: 10.1371/journal.pgph.0002639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 10/20/2023] [Indexed: 11/22/2023]
Abstract
This study aimed examin the factors associated with the uptake and non-acceptance of COVID-19 vaccine booster doses among healthcare workers (HCWs) in South Africa. We used a mixed-methods design with data from a web-based self-administered survey followed by semi-structured in-depth interviews (IDIs) with selected participants. Of the 6235 HCWs included in our analysis who had fully vaccinated, 3470 (56%) had taken their booster dose with a further 17% intending to get the booster. HCWs aged 35 to 49 years (OR = 1.30 [95% CI: 1.15-1.46]), and those aged 50 years or older (OR = 2.66 [95% CI: 2.32-3.05]) were more likely to get the booster dose. Females were less likely to have received the booster dose (OR = 0.88 [95% CI: 0.79-0.98]) with doctors more likely (OR = 1.58 [95% CI: 1.35-1.84]) than Nurses to have received the booster dose. HCWs in direct contact with patients (OR = 1.17 [95% CI: 1.00-1.38]) and who had previously received a flu vaccine (OR = 1.99 [95% CI: 1.56-2.55]) were more likely to have received the booster dose. Four themes emerged from the qualitative data analysis: (1) Vaccination as routine practice among HCWs; (2) Emergence of new COVID-19 variants necessitating vaccine boosters; (3) Fear of potential side-effects; and (4) Limited value of COVID-19 vaccine boosters. Some HCWs broadly accepted the value of vaccination, and believed that boosters were necessary to effectively combat emergent new virus strains, which contrasted with peers who believed that boosters offered little defence against virus mutations. Fear prohibited some HCWs from getting the booster, with some having experienced adverse side effects from their initial vaccination, whilst others were concerned about future complications. Waning booster uptake rates could be arrested through invigorated communication strategies, while effective evidence-based training can potentially create positive normative vaccination practices amongst HCWs.
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Affiliation(s)
- Gavin George
- Health Economics and HIV and AIDS Research Division (HEARD), University of KwaZulu-Natal, Durban, South Africa
- Division of Social Medicine and Global Health, Lund University, Lund, Sweden
| | - Phiwe Nota
- Health Economics and HIV and AIDS Research Division (HEARD), University of KwaZulu-Natal, Durban, South Africa
| | - Michael Strauss
- Health Economics and HIV and AIDS Research Division (HEARD), University of KwaZulu-Natal, Durban, South Africa
| | - Emma Lansdell
- Health Economics and HIV and AIDS Research Division (HEARD), University of KwaZulu-Natal, Durban, South Africa
| | - Remco P. H. Peters
- Research Unit, Foundation for Professional Development, East London, South Africa
| | - Petra Brysiewicz
- School of Nursing & Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Nisha Nadesan-Reddy
- School of Nursing & Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Douglas Wassenaar
- South African Research Ethics Training Initiative, School of Applied Human Sciences, University of KwaZulu-Natal, Pietermaritzburg, South Africa
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Leung CLK, Wei WI, Li KK, McNeil EB, Tang A, Wong SYS, Kwok KO. Revisiting Vaccine Hesitancy in Residential Care Homes for the Elderly for Pandemic Preparedness: A Lesson from COVID-19. Vaccines (Basel) 2023; 11:1700. [PMID: 38006032 PMCID: PMC10675220 DOI: 10.3390/vaccines11111700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 10/28/2023] [Accepted: 11/01/2023] [Indexed: 11/26/2023] Open
Abstract
Residents in residential care homes for the elderly (RCHEs) are at high risk of severe illnesses and mortality, while staff have high exposure to intimate care activities. Addressing vaccine hesitancy is crucial to safeguard vaccine uptake in this vulnerable setting, especially amid a pandemic. In response to this, we conducted a cross-sectional survey to measure the level of vaccine hesitancy and to examine its associated factors among residents and staff in RCHEs in Hong Kong. We recruited residents and staff from 31 RCHEs in July-November 2022. Of 204 residents, 9.8% had a higher level of vaccine hesitancy (scored ≥ 4 out of 7, mean = 2.44). Around 7% of the staff (n = 168) showed higher vaccine hesitancy (mean = 2.45). From multi-level regression analyses, higher social loneliness, higher anxiety, poorer cognitive ability, being vaccinated with fewer doses, and lower institutional vaccination rates predicted residents' vaccine hesitancy. Similarly, higher emotional loneliness, higher anxiety, being vaccinated with fewer doses, and working in larger RCHEs predicted staff's vaccine hesitancy. Although the reliance on self-report data and convenience sampling may hamper the generalizability of the results, this study highlighted the importance of addressing the loneliness of residents and staff in RCHEs to combat vaccine hesitancy. Innovative and technology-aided interventions are needed to build social support and ensure social interactions among the residents and staff, especially amid outbreaks.
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Affiliation(s)
- Cyrus Lap Kwan Leung
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; (C.L.K.L.); (W.I.W.); (E.B.M.); (S.Y.S.W.)
| | - Wan In Wei
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; (C.L.K.L.); (W.I.W.); (E.B.M.); (S.Y.S.W.)
| | - Kin-Kit Li
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong, China;
| | - Edward B. McNeil
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; (C.L.K.L.); (W.I.W.); (E.B.M.); (S.Y.S.W.)
| | - Arthur Tang
- School of Science, Engineering and Technology, RMIT University, Ho Chi Minh City 700000, Vietnam;
| | - Samuel Yeung Shan Wong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; (C.L.K.L.); (W.I.W.); (E.B.M.); (S.Y.S.W.)
| | - Kin On Kwok
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; (C.L.K.L.); (W.I.W.); (E.B.M.); (S.Y.S.W.)
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong, China
- Hong Kong Institute of Asia-Pacific Studies, The Chinese University of Hong Kong, Hong Kong, China
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