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Leung CLK, Li KK, In Wei W, Tam W, McNeil EB, Tang A, Wong SYS, Kwok KO. Temporal variations of vaccine hesitancy amid the COVID-19 outbreaks in Hong Kong. Appl Psychol Health Well Being 2024; 16:216-234. [PMID: 37549926 DOI: 10.1111/aphw.12480] [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: 03/21/2023] [Accepted: 07/19/2023] [Indexed: 08/09/2023]
Abstract
To inform the dynamic adjustments of vaccination campaigns, this study examined the transitions among vaccine hesitancy profiles over the COVID-19 pandemic progression and their predictors and outcomes. The transition patterns among hesitancy profiles over three periods were identified using a latent transition analysis with individuals from a longitudinal cohort study since the emergence of COVID-19 in Hong Kong. Four profiles (i.e., skeptics, apathetics, fence-sitters, and believers) emerged consistently over time. From Period 1 (third and fourth pandemic waves) to Period 2 (dormant period, vaccine rollout), 14.17% of believers became fence-sitters (ambivalization), and 12.11% of fence-sitters became apathetics (apathetization). From Period 2 to Period 3 (omicron surge and vaccine mandates), 20.21% of believers became fence-sitters. Lower trust in government predicted a transition to skepticism, whereas higher trust predicted the opposite. Staying as believers was associated with decreased hygienic and social distancing behavior. The stable hesitancy profiles amid the rapid vaccine uptake suggest that structural factors rather than personal agency may drive the surge. Ambivalization and apathetization may signal disengagement in preventive behaviors. Trust in the government is crucial in the pandemic response. Public health interventions may improve compliance with guidelines and prevent skepticism and apathy.
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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
| | - Kin Kit Li
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong
| | - Wan In Wei
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
| | - Wilson Tam
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Queenstown, Singapore
| | - Edward B McNeil
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
| | - Arthur Tang
- School of Science, Engineering and Technology, RMIT University Vietnam, Hanoi, Vietnam
| | - Samuel Yeung Shan Wong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
| | - Kin On Kwok
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong
- Hong Kong Institute of Asia-Pacific Studies, The Chinese University of Hong Kong, Hong Kong
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Dinga JN, Kabakama S, Njimoh DL, Chia JE, Morhason-Bello I, Lumu I. Quantitative Synthesis of Factors Associated with COVID-19 Vaccine Acceptance and Vaccine Hesitancy in 185 Countries. Vaccines (Basel) 2023; 12:34. [PMID: 38250847 PMCID: PMC10818751 DOI: 10.3390/vaccines12010034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 12/18/2023] [Accepted: 12/26/2023] [Indexed: 01/23/2024] Open
Abstract
Mass vaccination against COVID-19 is the best method to ensure herd immunity in order to curb the effect of the pandemic on the global economy. It is therefore important to assess the determinants of COVID-19 vaccine acceptance and hesitancy on a global scale. Factors were recorded from cross-sectional studies analyzed with t-Test, ANOVA, correlation, and meta-regression analyses and synthesized to identify global trends in order to inform policy. We registered the protocol (ID: CRD42022350418) and used standard Cochrane methods and PRISMA guidelines to collect and synthesize cross-sectional articles published between January 2020 and August 2023. A total of 67 articles with 576 studies from 185 countries involving 3081,766 participants were included in this synthesis. Global COVID-19 vaccine acceptance was 65.27% (95% CI; 62.72-67.84%), while global vaccine hesitancy stood at 32.1% (95% CI; 29.05-35.17%). One-Way ANOVA showed that there was no significant difference in the percentage Gross Domestic Product spent on vaccine procurement across the World Bank income levels (p < 0.187). There was a significant difference of vaccine acceptance (p < 0.001) and vaccine hesitancy (p < 0.005) across the different World Bank Income levels. World Bank income level had a strong influence on COVID-19 vaccine acceptance (p < 0.0004) and hesitancy (p < 0.003) but percentage Gross Domestic Product spent on vaccine procurement did not. There was no correlation between percentage Gross Domestic Product spent on vaccine procurement and COVID-19 vaccine acceptance (r = -0.11, p < 0.164) or vaccine hesitancy (r = -0.09, p < 0.234). Meta-regression analysis showed that living in an urban setting (OR = 4.83, 95% CI; 0.67-212.8), rural setting (OR = 2.53, 95% CI; 0.29-119.33), older (OR = 1.98, 95% CI; 0.99-4.07), higher education (OR = 1.76, 95% CI; 0.85-3.81), and being a low income earner (OR = 2.85, 95% CI; 0.45-30.63) increased the odds of high COVID-19 vaccine acceptance. Factors that increased the odds of high COVID-19 vaccine hesitancy were no influenza vaccine (OR = 33.06, 95% CI; 5.03-1395.01), mistrust for vaccines (OR = 3.91, 95% CI; 1.92-8.24), complacency (OR = 2.86, 95% CI; 1.02-8.83), pregnancy (OR = 2.3, 95% CI; 0.12-141.76), taking traditional herbs (OR = 2.15, 95% CI; 0.52-10.42), being female (OR = 1.53, 95% CI; 0.78-3.01), and safety concerns (OR = 1.29, 95% CI; 0.67-2.51). We proposed a number of recommendations to increase vaccine acceptance and ensure global herd immunity against COVID-19.
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Affiliation(s)
- Jerome Nyhalah Dinga
- Michael Gahnyam Gbeugvat Foundation, Buea P.O. Box 63, Cameroon
- Biotechnology Unit, University of Buea, Buea P.O. Box 63, Cameroon
| | - Severin Kabakama
- Humanitarian and Public Health Consultant, Mwanza P.O. Box 511, Tanzania
| | - Dieudonne Lemuh Njimoh
- Department of Biochemistry and Molecular Biology, University of Buea, Buea P.O. Box 63, Cameroon
| | - Julius Ebua Chia
- World Health Organization-Regional Office for Africa, Brazaville P.O. Box 06, Congo
| | | | - Ivan Lumu
- Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala P.O. Box 7072, Uganda
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Brosset E, Fressard L, Cogordan C, Bocquier A, Annequin M, Bourrelly M, Constance J, Michels D, Mora M, Morel S, Oliveri C, Maradan G, Berenger C, Spire B, Verger P. Gradient of vaccine hesitancy among French men having sex with men: An electronic cross-sectional survey in 2022. Hum Vaccin Immunother 2023; 19:2293489. [PMID: 38093684 PMCID: PMC10730215 DOI: 10.1080/21645515.2023.2293489] [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: 10/23/2023] [Accepted: 12/07/2023] [Indexed: 12/18/2023] Open
Abstract
In developed countries, vaccinations against hepatitis B (HBV), hepatitis A (HAV), and human papillomavirus (HPV) are often recommended to men who have sex with men (MSM) because of the risky sexual practices in which some engage. Vaccine coverage against these diseases is not optimal in France, probably due in part to vaccine hesitancy (VH). The overall aim of this survey among MSM was to estimate the prevalence of different grades of VH for these vaccines as well as of general VH (toward any vaccine). The specific objectives were to study the sociodemographic correlates of MSM specific and general VH and its association with vaccine uptake. A cross-sectional electronic survey (February-August 2022) collected information from 3,730 French MSM about their perceptions of HBV, HAV, and HPV and their related vaccines, to construct "specific VH" variables. Information about their past vaccination behaviors for any vaccine was used to construct a "general VH" variable, based on the World Health Organization definition. Almost 90% of MSM showed moderate or high specific VH for HBV, HAV, and/or HPV, and 54% general VH. A higher education level and comfortable financial situation were associated with lower grades of specific and general VH. Younger age was associated with less frequent specific VH and more frequent general VH. Specific VH, versus general, was more strongly associated with frequent self-reported non-vaccination against these three disease. Addressing their concerns about vaccines, improving their knowledge of vaccine-preventable sexually transmitted infections, and motivating them to get vaccinated are public health priorities.
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Affiliation(s)
- Emeline Brosset
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - Lisa Fressard
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - Chloé Cogordan
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - Aurélie Bocquier
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
- Université de Lorraine, APEMAC , Nancy, France
| | - Margot Annequin
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
- INSERM, IRD, SESSTIM, ISSPAM, Aix Marseille University, Marseille, France
| | - Michel Bourrelly
- INSERM, IRD, SESSTIM, ISSPAM, Aix Marseille University, Marseille, France
| | - Jean Constance
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - David Michels
- AIDES, Pantin, France
- Laboratoire de recherche communautaire, Coalition PLUS, Pantin, France
| | - Marion Mora
- INSERM, IRD, SESSTIM, ISSPAM, Aix Marseille University, Marseille, France
| | | | - Camilla Oliveri
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
- INSERM, IRD, SESSTIM, ISSPAM, Aix Marseille University, Marseille, France
| | - Gwenaëlle Maradan
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - Cyril Berenger
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - Bruno Spire
- INSERM, IRD, SESSTIM, ISSPAM, Aix Marseille University, Marseille, France
| | - Pierre Verger
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
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Pouliasi II, Hadjikou A, Kouvari K, Heraclides A. Socioeconomic Inequalities in COVID-19 Vaccine Hesitancy and Uptake in Greece and Cyprus during the Pandemic. Vaccines (Basel) 2023; 11:1301. [PMID: 37631869 PMCID: PMC10459981 DOI: 10.3390/vaccines11081301] [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: 06/27/2023] [Revised: 07/24/2023] [Accepted: 07/29/2023] [Indexed: 08/27/2023] Open
Abstract
Despite the rigorous investigation of the phenomenon of vaccine hesitancy and refusal during the COVID-19 pandemic, the socioeconomic determinants of this phenomenon remain poorly investigated on a global scale. Following proportional quota sampling, we conducted a population-based cross-sectional study. We recruited participants on-site and online from different settings, regions, and socioeconomic strata in two Eastern Mediterranean populations, Greece and Cyprus. Our approach provided a nationwide sample (n = 576) approaching the adult population structure of the two countries, with a slight underrepresentation of men and older people. Our results indicate clear socioeconomic differences in vaccine hesitancy and vaccination coverage, consistent with wider social inequalities in health. In particular, we reveal a clear socioeconomic gradient characterized by lower vaccine hesitancy and higher vaccination coverage, with increasing educational attainment and income. Additionally, participants residing in semi-urban areas show higher vaccine hesitancy and have lower vaccination coverage than those residing in urban and rural areas. Our results could inform Public Health approaches aiming to tackle the alarming phenomenon of vaccine hesitancy by enabling the targeting of population groups who are particularly vaccine-hesitant, rendering such approaches more targeted and effective while at the same time reducing inequalities in the control and prevention of infectious diseases.
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Affiliation(s)
| | | | | | - Alexandros Heraclides
- Department of Health Sciences, School of Sciences, European University Cyprus, 6 Diogenis Str., 2404 Engomi, P.O. Box 22006, 1516 Nicosia, Cyprus; (I.I.P.); (A.H.); (K.K.)
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