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Gerussi V, Peghin M, Palese A, De Martino M, Graziano E, Chiappinotto S, Fonda F, Bontempo G, Semenzin T, Martini L, Isola M, Tascini C. SARS-CoV-2 and influenza vaccine hesitancy during the COVID-19 pandemic in a dynamic perspective. Hum Vaccin Immunother 2024; 20:2358565. [PMID: 38825984 DOI: 10.1080/21645515.2024.2358565] [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: 01/23/2024] [Accepted: 05/18/2024] [Indexed: 06/04/2024] Open
Abstract
To investigate the dynamic evolution of vaccine hesitancy toward both COVID-19 and influenza in a context characterized by the compresence of SARS-CoV-2 pandemic and seasonal flu epidemics, a two times repeated cross-sectional exploratory design was performed at Udine Hospital (Italy) following a cohort of 479 adult patients with a previous history of SARS-CoV-2 infection in 2020. Vaccine attitude was assessed through standardized telephone interviews performed at 12 and 18 months after the acute illness. The first interview reported the success of the 2020/21 seasonal influenza immunization with 46.8% (224/479) of the participants showing a positive attitude, especially the elderly and people with comorbidities (p < .001), but the investigation conducted at 18 months showed a drastic drop in flu shot acceptance (30/166, 18.1%). On the other hand, a great increase in vaccinations against SARS-CoV-2 occurred after the introduction of Green Pass (26.7% vs 72.9%). The major drivers of flu vaccine skepticism were represented by the feeling of protection regardless of prevention and by concerns regarding vaccines safety and efficacy; conversely compulsory strategies seemed to play a secondary role, since only a minority of the participants identified in the restrictions induced by the certification the major incentive to get immunized against SARS-CoV-2. The focus on this peculiar historical period helps to take a step forward in the comprehension of the complexity and dynamicity of the vaccine hesitancy phenomenon. Future vaccination campaigns will need to consider the role of personal opinions and emotions, interpreted according to the social and political context.
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Affiliation(s)
- Valentina Gerussi
- Infectious Diseases Division, Santa Maria Misericordia University Hospital, Udine, Italy
| | - Maddalena Peghin
- Infectious and Tropical Diseases Unit, Department of Medicine and Surgery, University of Insubria-ASST-Sette Laghi, Varese, Italy
| | - Alvisa Palese
- Department of Medicine, School of Nursing, University of Udine, Udine, Italy
| | - Maria De Martino
- Department of Medicine, Institute of Statistics, University of Udine, Udine, Italy
| | - Elena Graziano
- Infectious and Tropical Diseases Unit, Department of Medicine and Surgery, University of Insubria-ASST-Sette Laghi, Varese, Italy
| | | | - Federico Fonda
- Department of Medicine, School of Nursing, University of Udine, Udine, Italy
| | - Giulia Bontempo
- Infectious Diseases Division, Santa Maria Misericordia University Hospital, Udine, Italy
| | - Tosca Semenzin
- Infectious Diseases Division, Santa Maria Misericordia University Hospital, Udine, Italy
| | - Luca Martini
- Infectious Diseases Division, Santa Maria Misericordia University Hospital, Udine, Italy
| | - Miriam Isola
- Department of Medicine, Institute of Statistics, University of Udine, Udine, Italy
| | - Carlo Tascini
- Infectious Diseases Division, Santa Maria Misericordia University Hospital, Udine, Italy
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Pongutta S, Tangcharoensathien V, Leung K, Larson HJ, Lin L. Social Vulnerability and Compliance With World Health Organization Advice on Protective Behaviors Against COVID-19 in African and Asia Pacific Countries: Factor Analysis to Develop a Social Vulnerability Index. JMIR Public Health Surveill 2024; 10:e54383. [PMID: 39137034 DOI: 10.2196/54383] [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: 11/08/2023] [Revised: 06/03/2024] [Accepted: 07/01/2024] [Indexed: 08/15/2024] Open
Abstract
BACKGROUND COVID-19 protective behaviors are key interventions advised by the World Health Organization (WHO) to prevent COVID-19 transmission. However, achieving compliance with this advice is often challenging, particularly among socially vulnerable groups. OBJECTIVE We developed a social vulnerability index (SVI) to predict individuals' propensity to adhere to the WHO advice on protective behaviors against COVID-19 and identify changes in social vulnerability as Omicron evolved in African countries between January 2022 and August 2022 and Asia Pacific countries between August 2021 and June 2022. METHODS In African countries, baseline data were collected from 14 countries (n=15,375) during the first Omicron wave, and follow-up data were collected from 7 countries (n=7179) after the wave. In Asia Pacific countries, baseline data were collected from 14 countries (n=12,866) before the first Omicron wave, and follow-up data were collected from 9 countries (n=8737) after the wave. Countries' socioeconomic and health profiles were retrieved from relevant databases. To construct the SVI for each of the 4 data sets, variables associated with COVID-19 protective behaviors were included in a factor analysis using polychoric correlation with varimax rotation. Influential factors were adjusted for cardinality, summed, and min-max normalized from 0 to 1 (most to least vulnerable). Scores for compliance with the WHO advice were calculated using individuals' self-reported protective behaviors against COVID-19. Multiple linear regression analyses were used to assess the associations between the SVI and scores for compliance to WHO advice to validate the index. RESULTS In Africa, factors contributing to social vulnerability included literacy and media use, trust in health care workers and government, and country income and infrastructure. In Asia Pacific, social vulnerability was determined by literacy, country income and infrastructure, and population density. The index was associated with compliance with the WHO advice in both time points in African countries but only during the follow-up period in Asia Pacific countries. At baseline, the index values in African countries ranged from 0.00 to 0.31 in 13 countries, with 1 country having an index value of 1.00. The index values in Asia Pacific countries ranged from 0.00 to 0.23 in 12 countries, with 2 countries having index values of 0.79 and 1.00. During the follow-up phase, the index values decreased in 6 of 7 African countries and the 2 most vulnerable Asia Pacific countries. The index values of the least vulnerable countries remained unchanged in both regions. CONCLUSIONS In both regions, significant inequalities in social vulnerability to compliance with WHO advice were observed at baseline, and the gaps became larger after the first Omicron wave. Understanding the dimensions that influence social vulnerability to protective behaviors against COVID-19 may underpin targeted interventions to enhance compliance with WHO recommendations and mitigate the impact of future pandemics among vulnerable groups.
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Affiliation(s)
- Suladda Pongutta
- International Health Policy Program, Ministry of Public Health, Muang, Nonthaburi, Thailand
| | | | - Kathy Leung
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
- Laboratory of Data Discovery for Health Limited (D24H), Hong Kong Science Park, Hong Kong SAR, China
- The University of Hong Kong, Shenzhen Hospital, Shenzhen, China
| | - Heidi J Larson
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Centre for the Evaluation of Vaccination, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
- Department of Health Metrics Sciences, University of Washington, Seattle, WA, United States
| | - Leesa Lin
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
- Laboratory of Data Discovery for Health Limited (D24H), Hong Kong Science Park, Hong Kong SAR, China
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Bodjongo MJM. How to increase acceptance of the COVID-19 vaccine among poor people in Africa? INTERNATIONAL JOURNAL OF HEALTH ECONOMICS AND MANAGEMENT 2024; 24:173-210. [PMID: 38451447 DOI: 10.1007/s10754-024-09370-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 02/10/2024] [Indexed: 03/08/2024]
Abstract
This study aims to analyze whether good government management of the COVID-19 pandemic can increase the likelihood of vaccine uptake among poor people in Africa. The analysis is based on a sample of 18,010 people living in 34 African countries, drawn from data collected by Afrobarometer (Merged Round 8 data (34 countries), database, 2022). The econometric results, obtained using a bivariate probit regression, show that poverty significantly reduces the odds of accepting the said COVID-19 vaccine. However, acceptance of the vaccine increases among poor individuals when there is (i) trust in the government's published statistics on COVID-19, (ii) control of corruption by the government in managing the pandemic, (iii) individual confidence in the government's ability to ensure the safety of the COVID-19 vaccine, and (iv) belief that the Covid 19 vaccine will be more effective than religious prayer in the fight against this pandemic.
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Haq ZU, Yunus S, Jafri N. Building confidence in the COVID-19 vaccine in a polio-endemic country: strategic communication lessons from Pakistan. BMJ Glob Health 2024; 9:e015200. [PMID: 38599665 PMCID: PMC11015175 DOI: 10.1136/bmjgh-2024-015200] [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: 01/29/2024] [Accepted: 03/31/2024] [Indexed: 04/12/2024] Open
Abstract
In a health emergency, governments rely on public trust in their policy, and anticipate its compliance to protect health and save lives. Vaccine hesitancy compromises this process when an emergency involves infections. The prevailing discourse on vaccine hesitancy often describes it as a static phenomenon, ignoring its expanse and complexity, and neglecting the exploration of tools to address it. This article diverges from the conventional perspective by explaining the case of Pakistan and its communication strategy for the COVID-19 vaccine. Decades of polio vaccine hesitancy, rooted in the country's fight against terrorism, constitute its history. On the other hand, the first-ever launch of typhoid conjugate vaccine involving 35 million kids during 2019-2021 was a success. Against this backdrop, the country considered vaccine hesitancy as a dynamic phenomenon, interwoven with the social ecology and the responsiveness of the healthcare system. Its communication strategy facilitated those willing to receive the vaccine, while being responsive to the information needs of those still in the decision-making process. In the face of both hesitancy and a scarcity of vaccine doses, the country successfully inoculated nearly 70% (160 million) of its population in just over 1 year. People's perceptions about the COVID-19 vaccine also improved over time. This achievement offers valuable insights and tools for policymakers and strategists focused on the demand side of vaccine programmes. The lessons can significantly contribute to the global discourse on improving vaccine confidence and bolstering global health security.
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Affiliation(s)
| | | | - Naveed Jafri
- Expanded Programme on Immunisation, Pakistan Ministry of National Health Services Regulations and Coordination, Islamabad, Pakistan
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Dele-Ojo BF, Adesokan A, Fadare JO, Ajayi PO, Raimi TH, Dada SA, Ojo OD, Ogunmodede JA, Ipinnimo TM, Ariyo OE, Godman B. Short-term COVID-19 vaccine adverse effects among adults in Ekiti State, Nigeria. Curr Med Res Opin 2024; 40:621-627. [PMID: 38323854 DOI: 10.1080/03007995.2024.2316217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 02/05/2024] [Indexed: 02/08/2024]
Abstract
BACKGROUND The safety of the COVID-19 vaccines has been a topic of concern globally. This issue of safety is associated with vaccine hesitancy due to concerns about the adverse effects of the vaccines. Consequently, this study determined the short-term safety profile of the Oxford/AstraZeneca COVID-19 vaccine in Ekiti State, Nigeria. METHODS Descriptive cross-sectional study conducted between May and July 2021 among individuals who had received the first dose of the first batch of the Oxford/AstraZeneca COVID-19 vaccine at Ekiti State University Teaching Hospital (EKSUTH), Ado-Ekiti, Nigeria. A Google form was used to collect data on the adverse effects of the vaccine. RESULTS Out of over 1,000 individuals who were approached, 758 respondents completed the study. A large percentage (57.4%) of those who received the vaccines were healthcare workers. Adverse effects were reported in 70.8% of the participants with most manifesting on the first day of the vaccination. The predominant adverse effects were injection site soreness (28.5%), followed by fatigue (18.7%) and muscle pain (8.6%). There was no report of severe adverse effects such as anaphylactic reactions, thrombosis, myocarditis, transient myelitis, or Guillen-Barre syndrome. CONCLUSION This study found that self-reported adverse effects of the Oxford/AstraZeneca COVID-19 vaccine were mild and short in duration. This outcome has promising implications for improving COVID-19 vaccine uptake in the immediate environment and Nigeria.
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Affiliation(s)
- Bolade Folasade Dele-Ojo
- Department of Medicine, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria
- Department of Medicine, Ekiti State University, Ado-Ekiti, Nigeria
| | - Adedapo Adesokan
- Emergency Medicine Department, Kingsmill Hospital, Sutton-in-Ashfield, Scotland
| | | | - Paul Oladapo Ajayi
- Department of Community Medicine, Ekiti State University, Ado-Ekiti, Nigeria
| | - Taiwo Hussean Raimi
- Department of Medicine, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria
- Department of Medicine, Ekiti State University, Ado-Ekiti, Nigeria
| | - Samuel Ayokunle Dada
- Department of Medicine, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria
- Department of Medicine, Ekiti State University, Ado-Ekiti, Nigeria
| | - Owolabi Dele Ojo
- Department of Surgery, Afe Babalola University, Ado-Ekiti, Nigeria
| | | | | | - Olumuyiwa Elijah Ariyo
- Department of Medicine, Faculty of Clinical Sciences, College of Medicine and Health Sciences, Afe Babalola University, Ado-Ekiti, Nigeria
| | - Brian Godman
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, South Africa
- Department of Pharmacoepidemiology, Strathclyde Institute of Pharmacy and Biomedical Science, University of Strathclyde, Glasgow, United Kingdom
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Ayieko S, Jaoko W, Opiyo RO, Orang’o EO, Messiah SE, Baker K, Markham C. Knowledge, Attitudes, and Subjective Norms Associated with COVID-19 Vaccination among Pregnant Women in Kenya: An Online Cross-Sectional Pilot Study Using WhatsApp. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:98. [PMID: 38248561 PMCID: PMC10815556 DOI: 10.3390/ijerph21010098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/08/2024] [Accepted: 01/12/2024] [Indexed: 01/23/2024]
Abstract
COVID-19 vaccination during pregnancy has been recommended, but the perceptions related to uptake remain unexplored. This pilot study aimed to explore how perceptions influence COVID-19 vaccine uptake among a sample of 115 pregnant women in Kenya, recruited via WhatsApp. Data were collected using an adapted online questionnaire between May and October 2022. Logistic analyses assessed the relationship between COVID-19 vaccination uptake and the Theory of Reasoned Action (TRA) constructs: attitudes and subjective norms. COVID-19 vaccination coverage was 73%, with vaccine hesitancy estimated at 41.4% among the unvaccinated group. Most participants had completed college education and had good knowledge of COVID-19 vaccines. There was no significant effect of enrollment in WhatsApp pregnancy groups on attitudes toward COVID-19 vaccination. Pregnant women were concerned about vaccine effectiveness (31.1%), and almost one-half (47.3%) were discouraged from receiving COVID-19 vaccines. Positive attitudes towards vaccination were associated with COVID-19 vaccination (aOR 2.81; 95% CI 1.12-7.04; p = 0.027), but no significant relationship was found between COVID-19 vaccination and strong subjective norms (influences to get COVID-19 vaccines). Our findings suggest that strategies to improve vaccination should consider targeting attitudes and proximal social networks (friends/family) to facilitate vaccination decision-making. WhatsApp can be used for research distribution and enhance the dissemination of accurate information.
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Affiliation(s)
- Sylvia Ayieko
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX 77030, USA; (K.B.); (C.M.)
| | - Walter Jaoko
- Department of Medical Microbiology, University of Nairobi, P.O Box 19676, Nairobi 00202, Kenya;
- KAVI-Institute of Clinical Research, University of Nairobi, P.O. Box 19676, Nairobi 00202, Kenya
| | - Rose Okoyo Opiyo
- Department of Public and Global Health, University of Nairobi, P.O. Box 19676, Nairobi 00202, Kenya;
| | | | - Sarah E. Messiah
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston School of Public Health, Dallas, TX 75207, USA;
- Center for Pediatric Population Health, University of Texas Health Science Center at Houston School of Public Health, Dallas, TX 75207, USA
- Department of Pediatrics, McGovern Medical School, Houston, TX 77030, USA
| | - Kimberly Baker
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX 77030, USA; (K.B.); (C.M.)
| | - Christine Markham
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX 77030, USA; (K.B.); (C.M.)
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Wei CR, Kamande S, Lang'at GC. Vaccine inequity: a threat to Africa's recovery from COVID-19. Trop Med Health 2023; 51:69. [PMID: 38111032 PMCID: PMC10729430 DOI: 10.1186/s41182-023-00564-2] [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: 08/09/2023] [Accepted: 12/11/2023] [Indexed: 12/20/2023] Open
Abstract
BACKGROUND Vaccine inequity is a reality facing the Sub-Saharan Africa region as vaccine nationalism from high-income countries (HICs) leads to limited access to the lifesaving vaccines needed to end the pandemic. In Africa, a significant portion of the population has yet to be vaccinated against Covid-19; however, the barriers to accessing such vaccines, including capacity challenges, still persist despite the implementation of the COVAX facility meant to support the lower- and middle-income countries (LMICs) to boost vaccination. METHODS This study involved a systemic narrative review where literature search was conducted using the NCBI's PMC and BMC databases based on defined keywords. Three authors were involved in the literature search and consensus was applied to settle disagreements and validate the findings. RESULTS In this systematic narrative review, we report that vaccine nationalism remains a challenge for LMICs as HICs still hoard vaccines and even bypass COVAX to procure doses directly from the manufacturers. Factors that promote vaccine hesitancy in Africa include misinformation regarding the Covid-19 vaccine, a lack of trust in politicians and the pharmaceutical industry, and concerns about vaccine safety and efficacy. The policies implemented to enhance vaccine coverage in Africa, such as mandates, community engagement, and partnerships, all seek to promote equity of vaccination and ending Covid-19. CONCLUSION Covid-19 vaccine inequity persists and contributes to prolonged pandemic in LMICs. In response, African governments have taken certain measures to enhance vaccine uptake but more needs to be done to address resistance to vaccines.
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Affiliation(s)
- Calvin R Wei
- Department of Research and Development, Shing Huei Group, Taipei, Taiwan
| | | | - Godwin C Lang'at
- Department of Public and Global Health, University of Nairobi, Nairobi, Kenya.
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Padmanabhanunni A, Pretorius TB, Isaacs SA. Validation of the vaccination attitudes examination scale in a South African context in relation to the COVID-19 vaccine: quantifying dimensionality with bifactor indices. BMC Public Health 2023; 23:1872. [PMID: 37759186 PMCID: PMC10537843 DOI: 10.1186/s12889-023-16803-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 09/21/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic represented a global public health emergency. Existing studies support the view that vaccination and mass immunization are among the most effective means of containing the outbreak and promoting health. However, negative attitudes toward vaccination and the related vaccine hesitancy among many groups have created a significant barrier to effectively managing the health crisis. Having a valid and reliable tool to assess attitudes toward vaccination remains imperative so that factors underlying vaccine refusal can be identified and public health interventions can be facilitated. The current study examined the psychometric properties of the Vaccination Attitudes Examination Scale (VAX) in South Africa. METHODS Participants (n = 322) completed the VAX. Confirmatory factor analysis and ancillary bifactor indices were used to examine the hypothesized factor structure (a total scale and four subscales) of the scale. Inter-item correlations, factor loadings, and average variance extracted were used to examine the validity of the scale. Predictive validity was examined by comparing those who had received the COVID-19 vaccine and those who had not. The reliability of the scale was examined in terms of both Cronbach's alpha and composite reliability. RESULTS Confirmatory factor analysis provided support for the conceptualization of the scale as consisting of a total scale and four subscales, and ancillary bifactor indices indicated that the subscales accounted for a sufficient amount of variance (44%) after the variance explained by the total scale was considered. Overall, the analysis indicated that the scale had satisfactory reliability (alpha and composite reliability = 0.70) and provided evidence for the construct, convergent, and predictive validity of the VAX. CONCLUSIONS The sound psychometric qualities of the scale, when used in a low- to middle-income country, have the potential to advance research and immunization policy within these settings and facilitate more targeted interventions to promote vaccine uptake.
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Affiliation(s)
- Anita Padmanabhanunni
- Department of Psychology, University of the Western Cape, Robert Sobukwe Road, Bellville, Cape Town, 7535, South Africa
| | - Tyrone Brian Pretorius
- Department of Psychology, University of the Western Cape, Robert Sobukwe Road, Bellville, Cape Town, 7535, South Africa.
| | - Serena Ann Isaacs
- Department of Psychology, University of the Western Cape, Robert Sobukwe Road, Bellville, Cape Town, 7535, South Africa
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Njororai F, Nyaranga KC, Cholo W, Amulla W, Ndetan H. Correlates of COVID-19 Vaccine Acceptance and Hesitancy in Rural Communities in Western Kenya. Vaccines (Basel) 2023; 11:1516. [PMID: 37896920 PMCID: PMC10610933 DOI: 10.3390/vaccines11101516] [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: 07/28/2023] [Revised: 09/13/2023] [Accepted: 09/18/2023] [Indexed: 10/29/2023] Open
Abstract
Vaccine hesitancy is a significant global public health concern. This study sought to determine the correlates of acceptance and hesitancy regarding COVID-19 vaccines in rural populations of selected counties in Western Kenya and assess the strategies that can be used to improve COVID-19 vaccine acceptance in Kenya. The study used a quantitative research strategy with a sample of 806 individuals in the Kisumu, Vihiga, and Kakamega counties. Descriptive statistics, correlations and regression analyses were used. Of the 806 study participants, 55% were males and 45% females. Vaccine acceptance was significantly associated with being a male (AOR: 1.46, 95% CI: 1.24-1.59, p < 0.031), having no formal education (AOR: 2.25, 95% CI: 1.16-4.40, p < 0.02), working in the private sector (AOR: 5.78, 95% CI: 3.28-10.88 p < 0.02), and have low income (KES 0-999 (USD 0-9.16)), (AOR: 2.35, 95% CI: 1.13-3.47, p < 0.02). Conclusions: The current study suggests that male gender, no formal education, working in the private sector, and low income KES 0-999 (USD 0-9.6) are significant factors influencing awareness of and possible acceptance of COVID-19 vaccination.
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Affiliation(s)
- Fletcher Njororai
- Department of Public Health, The University of Texas at Tyler, Tyler, TX 75799, USA
| | - Kogutu Caleb Nyaranga
- Department of Public Health, South Eastern Kenya University (SEKU), Kitui 90200, Kenya
| | - Wilberforce Cholo
- Department of Public Health, Masinde Muliro University of Science and Technology, Kakamega 50100, Kenya
| | - Walter Amulla
- Department of Public Health, Kisii University, Kisii 40200, Kenya
| | - Harrison Ndetan
- School of Medicine at the Health Science Center, The University of Texas at Tyler, Tyler, TX 75799, USA
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Lalani HS, Nagar S, Sarpatwari A, Barenie RE, Avorn J, Rome BN, Kesselheim AS. US public investment in development of mRNA covid-19 vaccines: retrospective cohort study. BMJ 2023; 380:e073747. [PMID: 36858453 PMCID: PMC9975718 DOI: 10.1136/bmj-2022-073747] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
OBJECTIVE To estimate US public investment in the development of mRNA covid-19 vaccines. DESIGN Retrospective cohort study. SETTING Publicly funded science from January 1985 to March 2022. DATA SOURCES National Institutes of Health (NIH) Report Portfolio Online Reporting Tool Expenditures and Results (RePORTER) and other public databases. Government funded grants were scored as directly, indirectly, or not likely related to four key innovations underlying mRNA covid-19 vaccines-lipid nanoparticle, mRNA synthesis or modification, prefusion spike protein structure, and mRNA vaccine biotechnology-on the basis of principal investigator, project title, and abstract. MAIN OUTCOME MEASURE Direct public investment in research and vaccine development, stratified by the rationale, government funding agency, and pre-pandemic (1985-2019) versus pandemic (1 January 2020 to 31 March 2022). RESULTS 34 NIH funded research grants that were directly related to mRNA covid-19 vaccines were identified. These grants combined with other identified US government grants and contracts totaled $31.9bn (£26.3bn; €29.7bn), of which $337m was invested pre-pandemic. Pre-pandemic, the NIH invested $116m (35%) in basic and translational science related to mRNA vaccine technology, and the Biomedical Advanced Research and Development Authority (BARDA) ($148m; 44%) and the Department of Defense ($72m; 21%) invested in vaccine development. After the pandemic started, $29.2bn (92%) of US public funds purchased vaccines, $2.2bn (7%) supported clinical trials, and $108m (<1%) supported manufacturing plus basic and translational science. CONCLUSIONS The US government invested at least $31.9bn to develop, produce, and purchase mRNA covid-19 vaccines, including sizeable investments in the three decades before the pandemic through March 2022. These public investments translated into millions of lives saved and were crucial in developing the mRNA vaccine technology that also has the potential to tackle future pandemics and to treat diseases beyond covid-19. To maximize overall health impact, policy makers should ensure equitable global access to publicly funded health technologies.
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Affiliation(s)
- Hussain S Lalani
- Program On Regulation, Therapeutics, And Law (PORTAL), Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Sarosh Nagar
- Program On Regulation, Therapeutics, And Law (PORTAL), Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Harvard University Cambridge, MA, USA
| | - Ameet Sarpatwari
- Program On Regulation, Therapeutics, And Law (PORTAL), Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Rachel E Barenie
- Program On Regulation, Therapeutics, And Law (PORTAL), Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Department of Clinical Pharmacy and Translational Science, College of Pharmacy, The University of Tennessee Health Science Center, Memphis, TN, USA
| | - Jerry Avorn
- Program On Regulation, Therapeutics, And Law (PORTAL), Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Benjamin N Rome
- Program On Regulation, Therapeutics, And Law (PORTAL), Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Aaron S Kesselheim
- Program On Regulation, Therapeutics, And Law (PORTAL), Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
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