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Uribe-Carvajal R, Pelcastre-Villafuerte BE, Díaz-Castro L, Gómez-Dantés H. [Opportunities and challenges in vaccination implementation against COVID-19: A systematic review]. Aten Primaria 2024; 56:103047. [PMID: 39024921 DOI: 10.1016/j.aprim.2024.103047] [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: 04/16/2024] [Revised: 06/03/2024] [Accepted: 06/10/2024] [Indexed: 07/20/2024] Open
Abstract
OBJECTIVE To analyze the experiences regarding the implementation of COVID-19 vaccination strategies, emphasizing the opportunities and challenges identified during its implementation. DESIGN A systematic review of the literature published between 2020 and 2022. DATA SOURCES The study was conducted across four databases: PubMed, ScienceDirect, Scielo, and Lilacs. SELECTION OF STUDIES Publications selection followed the PRISMA methodology (Preferred Reporting Items for Systematic Review and Meta-Analysis). DATA EXTRACTION A database was created where key elements of the selected study were identified and recorded, such as results, discussion, and conclusions. In addition, analysis categories were created such as: stages of the implementation plan, challenges identified and opportunity areas. RESULTS AND CONCLUSIONS 292 publications were found, of which 25 were selected for analysis. Of these, 64% came from high-income countries and 32% from upper-middle-income countries. According to the stages of the implementation plan, 20% of the studies focused on regulations, planning and coordination; 28% in prioritization of the population to be vaccinated; 16% in acceptance, demand, and risk communication; and 16% in administration and information systems. Reflection on the response to the pandemic invites us to consider various aspects, such as the organization and function of health systems, the importance of collaborative work, efforts to achieve equity, communication strategies, as well as ethical dilemmas when seeking preserve health.
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Affiliation(s)
- Rebeca Uribe-Carvajal
- Centro de Investigación en Evaluación y Encuestas, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
| | | | - Lina Díaz-Castro
- Dirección de Investigaciones Epidemiológicas y Psicosociales, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, México
| | - Héctor Gómez-Dantés
- Centro de Investigación en Sistemas de Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
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Xia S, Nan X. Motivating COVID-19 Vaccination through Persuasive Communication: A Systematic Review of Randomized Controlled Trials. HEALTH COMMUNICATION 2024; 39:1455-1478. [PMID: 37254940 DOI: 10.1080/10410236.2023.2218145] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Vaccination is a vital defense against COVID-19 infections and outbreaks, yet vaccine hesitancy poses a significant threat to pandemic response and recovery. We conducted a systematic review of published randomized controlled trials (N = 47) assessing the persuasive effects of COVID-19 communication on COVID-19 vaccine acceptance. Individual vs. collective appeals and gain vs. loss frames are among the most frequently assessed message features, but they generally do not make a difference in persuasion. Normative messages that highlight higher (vs. lower) prevalence of vaccine acceptance are more persuasive. Message sources overall have limited impact on COVID-19 vaccine acceptance, but sources that have a shared identity with the message receivers tend to be persuasive. More engaging message channels such as interactive chatbots and videos are promising communication tools but are generally under-utilized and under-studied. Compared to no communication or irrelevant communication, COVID-19 vaccine messages generally have a small advantage in increasing COVID-19 vaccine acceptance. Messages that include 1) vaccine safety and/or efficacy information; 2) collective appeals combined with embarrassment appeals; and 3) political leaders' vaccine endorsement are among the most effective messaging strategies. There is no evidence of any backfire effects of COVID-19 vaccine messages. We discuss the implications of our findings for persuasive message design in pandemic vaccine communication.
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Affiliation(s)
- Shilin Xia
- Department of Communication, University of Maryland
| | - Xiaoli Nan
- Department of Communication, University of Maryland
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Morbée S, Vansteenkiste M, Waterschoot J, Klein O, Luminet O, Schmitz M, Van den Bergh O, Van Oost P, Yzerbyt V. The Role of Communication Style and External Motivators in Predicting Vaccination Experiences and Intentions: An Experimental Vignette Study. HEALTH COMMUNICATION 2023; 38:2894-2903. [PMID: 36162986 DOI: 10.1080/10410236.2022.2125012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
This vignette-based study examined in a sample of unvaccinated Belgian citizens (N = 1918; Mage = 45.99) how health care workers could foster reflection about and intentions to get vaccinated against COVID-19 by experimentally varying their communication style (i.e., autonomy-supportive vs. controlling) and the reference to external motivators (i.e., use of a monetary voucher or corona pass vs. the lack thereof). Each participant was randomly assigned to one of six conditions and rated a vignette in terms of anticipated autonomy satisfaction, perceived effectiveness, reflection, and vaccination intention. An autonomy-supportive, relative to a controlling, communication style predicted greater autonomy need satisfaction, which in turn related positively to perceived effectiveness, reflection, and vaccination intention. External motivators failed to generate positive effects compared to the control condition. The findings highlight the critical role of autonomy support in promoting a self-endorsed decision to get vaccinated.
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Affiliation(s)
- Sofie Morbée
- Department of Developmental, Personality and Social Psychology, Ghent University
| | | | - Joachim Waterschoot
- Department of Developmental, Personality and Social Psychology, Ghent University
| | - Olivier Klein
- Faculty of Psychological Sciences and Education, Université libre de Bruxelles
| | - Olivier Luminet
- Institute for Research in Psychological Sciences, Université catholique de Louvain
| | - Mathias Schmitz
- Institute for Research in Psychological Sciences, Université catholique de Louvain
| | | | - Pascaline Van Oost
- Institute for Research in Psychological Sciences, Université catholique de Louvain
| | - Vincent Yzerbyt
- Institute for Research in Psychological Sciences, Université catholique de Louvain
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Terrell R, Alami A, Krewski D. Interventions for COVID-19 Vaccine Hesitancy: A Systematic Review and Narrative Synthesis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6082. [PMID: 37372669 PMCID: PMC10298220 DOI: 10.3390/ijerph20126082] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 05/25/2023] [Accepted: 06/02/2023] [Indexed: 06/29/2023]
Abstract
Vaccines effectively protect against COVID-19, but vaccine hesitancy and refusal hinder vaccination rates. This systematic review aimed to (1) review and describe current interventions for addressing COVID-19 vaccine hesitancy/refusal and (2) assess whether these interventions are effective for increasing vaccine uptake. The protocol was registered prospectively on PROSPERO and comprehensive search included Medline, Embase, CINAHL, PsycInfo, and Web of Science databases. Only studies that evaluated the effectiveness of non-financial interventions to address COVID-19 vaccine hesitancy were included, while those focusing intentions or financial incentive were excluded. Risk of bias for all included studies was evaluated using Cochrane risk of bias tools. In total, six articles were included in the review (total participants n = 200,720). A narrative synthesis was performed due to the absence of common quantitative metrics. Except for one randomized controlled trial, all studies reported that interventions were effective, increasing COVID-19 vaccination rates. However, non-randomized studies were subject to confounding biases. Evidence on the effectiveness of COVID-19 vaccine hesitancy interventions remains limited and further evidence is needed for the development of clear guidance on effective interventions to increase vaccine uptake.
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Affiliation(s)
- Rowan Terrell
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1S 5B6, Canada
| | - Abdallah Alami
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1S 5B6, Canada
| | - Daniel Krewski
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1S 5B6, Canada
- Risk Sciences International, Ottawa, ON K1P 5J6, Canada
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Angerer S, Glätzle-Rützler D, Lergetporer P, Rittmannsberger T. How does the vaccine approval procedure affect COVID-19 vaccination intentions? EUROPEAN ECONOMIC REVIEW 2023; 158:104504. [PMID: 37360583 PMCID: PMC10246308 DOI: 10.1016/j.euroecorev.2023.104504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 03/24/2023] [Accepted: 05/26/2023] [Indexed: 06/28/2023]
Abstract
People's willingness to vaccinate is critical to combating the COVID-19 pandemic. We devise a representative experiment to study how the design of the vaccine approval procedure affects trust in newly developed vaccines and consequently public attitudes towards vaccination. Compared to an Emergency Use Authorization, choosing the more thorough Conditional Marketing Authorization approval procedure increases vaccination intentions by 13 percentage points. The effects of the increased duration of the approval procedure are positive and significant only for Emergency Use Authorization. Treatment effects do not differ between relevant subgroups, such as respondents who had (did not have) COVID-19, or between vaccinated and unvaccinated respondents. Increased trust in the vaccine is the key mediator of treatment effects on vaccination intentions.
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Affiliation(s)
- Silvia Angerer
- UMIT TIROL, Private University for Health Sciences and Health Technology, Hall in Tirol
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Wijayanti SPM, Rejeki DSS, Rizqi YNK, Octaviana D, Nurlaela S. Assessing the user satisfaction on COVID-19 vaccination service in Indonesia. J Public Health Res 2023; 12:22799036231181852. [PMID: 37361237 PMCID: PMC10285437 DOI: 10.1177/22799036231181852] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 05/24/2023] [Indexed: 06/28/2023] Open
Abstract
Background The implementation of the COVID-19 vaccination is still being carried out in Indonesia to enhance immunity against SARS Cov-2 infection. However, the information about vaccination service satisfaction is still very limited. This study aims to assess how satisfied Covid-19 vaccination service users are in Indonesia. Design and methods This is an analytic study with a cross-sectional design was conducted through an online survey in the third week of June 2022. People with a minimum age of 17 years, having received at least one COVID-19 vaccination, and residing in Indonesia were allowed to participate in this study. We used the SERVQUAL model as an instrument, measuring five aspects covering tangibility, responsiveness, reliability, assurance, and empathy. The analysis carried out included univariate analysis and bivariate test using chi-square statistical test. Results A total of 509 respondents were included in this study. The findings of this study revealed that there was not much of a difference between the satisfied (50.1%) and dissatisfied categories (49.9%) of vaccination users. Of the five dimensions measured, the highest level of dissatisfaction is in tangibility particularly on facility (48.7%), while the highest level of satisfaction is in reliability (the vaccination service following applicable procedures; 59.7%). We find out that vaccination location (p = 0.038), provision of refreshment/reward/incentives (p = 0.001), providing emergency contact post-vaccination (p = 0.000), and observation time post-vaccination (p = 0.000) were associated with the satisfaction of users. Conclusion Many respondents in this study are still dissatisfied with the COVID-19 vaccination services, so it is necessary for taking continuous efforts to raise the quality of vaccination services to increase user satisfaction.
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Affiliation(s)
- Siwi Pramatama Mars Wijayanti
- Siwi Pramatama Mars Wijayanti, Public Health Department, Faculty of Health Sciences, Jenderal Soedirman University, B Building, Jl. Dr. Soeparno, Karangwangkal, Purwokerto 53123, Jawa Tengah, Indonesia.
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Zhou Y, Li R, Shen L. Targeting COVID-19 vaccine-hesitancy in college students: An audience-centered approach. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-10. [PMID: 36853986 DOI: 10.1080/07448481.2023.2180988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 12/27/2022] [Accepted: 02/10/2023] [Indexed: 06/18/2023]
Abstract
Objective: The study tested potential factors that differentiated the COVID-19 vaccine-hesitant and -inclined college students and, based on these factors, identified subgroups of the vaccine-hesitant students. Participants: Participants were 1,183 U.S. college students attending four-year universities or community colleges recruited through Qualtrics between January 25 and March 3, 2021. Methods: Participants completed an online survey assessing their COVID-19 vaccination intention, perceived risks of COVID-19 and the COVID-19 vaccines, efficacy beliefs regarding COVID-19 and the COVID-19 vaccines, and emotions toward taking the COVID-19 vaccines. Results: Vaccine-hesitant and -inclined college students varied in their emotions, risk perceptions, and efficacy beliefs regarding the virus and the vaccines. Using these factors as indicators, vaccine-hesitant college students were classified into five latent subgroups with distinct characteristics. Conclusions: In identifying subgroups of the vaccine-hesitant college students, the study has important insights to offer regarding the design of vaccine-promotion messaging strategies targeting the college student population.
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Affiliation(s)
- Yanmengqian Zhou
- Department of Communication Studies, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Ruobing Li
- School of Communication & Journalism, Stony Brook University, Stony Brook, New York, USA
| | - Lijiang Shen
- Department of Communication Arts & Sciences, Pennsylvania State University, University Park, Pennsylvania, USA
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Shmueli L. Parents' intention to vaccinate their 5- to 11-year-old children with the COVID-19 vaccine: rates, predictors and the role of incentives. BMC Public Health 2023; 23:328. [PMID: 36788509 PMCID: PMC9926441 DOI: 10.1186/s12889-023-15203-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 02/03/2023] [Indexed: 02/16/2023] Open
Abstract
INTRODUCTION Immediately after Pfizer announced encouraging effectiveness and safety results from their COVID-19 vaccine clinical trials in 5- to 11-year-old children, this study aimed to assess parents' perceptions and intention to vaccinate their 5-11-year-old children and to determine socio-demographic, health-related, behavioral factors, as well as the role of incentives. METHODS A cross-sectional online survey of parents of children between 5 and 11 years of age among the Jewish population in Israel (n = 1,012). The survey was carried out between September 23 and October 4, 2021, at a critical time, immediately after Pfizer's announcement. Two multivariate regressions were performed to determine predictors of parents' intention to vaccinate their 5-11-year-old children against COVID-19. RESULTS Overall, 57% of the participants reported that they intend to vaccinate their 5-11-year-old children against COVID-19 in the winter of 2022. 27% noted that they would vaccinate their 5-11-year-old children immediately; 26% within three months; and 24% within more than three months. Perceived susceptibility, benefits, barriers and cues to action, as well as two incentives - vaccine availability and receiving a "Green Pass" - were all significant predictors. However, Incentives such as monetary rewards or monetary penalties did not increase the probability of parents' intention to vaccinate their children. Parental concerns centered around the safety of the vaccine, fear of severe side effects, and fear that clinical trials and the authorization process were carried out too quickly. CONCLUSION This study provides data on the role of incentives in vaccinating 5-11-year-old children, how soon they intend to do so, and the predictors of those intentions, which is essential knowledge for health policy makers planning vaccination campaigns.
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Affiliation(s)
- Liora Shmueli
- Department of Management, Bar-Ilan University, 52900, Ramat-Gan, Israel.
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Sprengholz P, Henkel L, Böhm R, Betsch C. Different Interventions for COVID-19 Primary and Booster Vaccination? Effects of Psychological Factors and Health Policies on Vaccine Uptake. Med Decis Making 2023; 43:239-251. [PMID: 36404766 PMCID: PMC9679322 DOI: 10.1177/0272989x221138111] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 10/21/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND Mitigation of the COVID-19 pandemic requires continued uptake of SARS-CoV-2 vaccines. To increase vaccination intention and uptake, key determinants of primary and booster vaccination need to be understood and potential effects of vaccination policies examined. DESIGN Using experimental data collected in Germany in February 2022 (N = 2701), this study investigated 1) predictors of primary and booster vaccination and 2) potential effects of policies combining vaccination mandates and monetary incentives. RESULTS Compared with unvaccinated participants, those with primary vaccination were less complacent, more often understood the collective protection afforded by vaccination, and less often endorsed conspiracy-based misinformation. Compared with participants with primary vaccination, boosted individuals were even less complacent, exhibited fewer conspiracy-based beliefs, perceived fewer constraints by prioritizing vaccination over other things, and more often favored compliance with official vaccination recommendations. Support for and reactance about vaccination mandates depended on vaccination status rather than policy characteristics, regardless of mandate type or incentives (up to 500 EUR). While unvaccinated individuals rejected policy provisions and declined vaccination, boosted individuals indicated mid-level support for mandates and showed high vaccination intention. Among vaccinated individuals, higher incentives of up to 2000 EUR had a considerable positive effect on the willingness to get boosted, especially in the absence of a mandate. CONCLUSIONS While mandates may be needed to increase primary vaccination, our results indicate that financial incentives could be an alternative to promote booster uptake. However, combining both measures for the same target group seems inadvisable in most cases. HIGHLIGHTS Unvaccinated individuals and people with primary and booster vaccinations differ on psychological dimensions, calling for tailored immunization campaigns.Vaccination intentions depend on vaccination status rather than on mandatory or incentivizing policies.Incentives are unlikely to persuade unvaccinated individuals but may increase booster uptake.Positive effects of incentives decrease when vaccination is mandatory, advising against combination.
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Affiliation(s)
- Philipp Sprengholz
- Media and Communication Science, University of
Erfurt, Germany
- Health Communication, Bernhard Nocht Institute
for Tropical Medicine, Hamburg, Germany
| | - Luca Henkel
- Department of Economics, University of Bonn,
Germany
| | - Robert Böhm
- Faculty of Psychology, University of Vienna,
Austria
- Department of Psychology, University of
Copenhagen, Denmark
- Copenhagen Center for Social Data Science,
University of Copenhagen, Denmark
| | - Cornelia Betsch
- Media and Communication Science, University of
Erfurt, Germany
- Health Communication, Bernhard Nocht Institute
for Tropical Medicine, Hamburg, Germany
- Center for Empirical Research in Economics and
Behavioral Sciences, University of Erfurt, Germany
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Naeim A, Guerin RJ, Baxter-King R, Okun AH, Wenger N, Sepucha K, Stanton AL, Rudkin A, Holliday D, Rossell Hayes A, Vavreck L. Strategies to increase the intention to get vaccinated against COVID-19: Findings from a nationally representative survey of US adults, October 2020 to October 2021. Vaccine 2022; 40:7571-7578. [PMID: 36357290 PMCID: PMC9464582 DOI: 10.1016/j.vaccine.2022.09.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 09/01/2022] [Accepted: 09/04/2022] [Indexed: 01/28/2023]
Abstract
OBJECTIVES We examined COVID-19 vaccination status, intention, and hesitancy and the effects of five strategies to increase the willingness of unvaccinated adults (≥18 years) to get a COVID vaccine. METHODS Online surveys were conducted between October 1-17, 2020 (N = 14,946), December 4-16, 2020 (N = 15,229), April 8-22, 2021 (N = 14,557), June 17-July 6, 2021 (N = 30,857), and September 3-October 4, 2021 (N = 33,088) with an internet-based, non-probability opt-in sample of U.S. adults matching demographic quotas. Respondents were asked about current COVID-19 vaccination status, intention and hesitancy to get vaccinated, and reasons for vaccine hesitancy. Unvaccinated respondents were assigned to treatment groups to test the effect of five strategies (endorsements, changing social restrictions, financial incentives, vaccine requirements for certain activities, and vaccine requirements for work). Chi-square tests of independence were performed to detect differences in the response distributions. RESULTS Willingness to be vaccinated (defined as being vaccinated or planning to be) increased over time from 47.6 % in October 2020 to 81.1 % in October 2021. By October 2021, across most demographic groups, over 75 % of survey respondents had been or planned to be vaccinated. In terms of strategies: (1) endorsements had no positive effect, (2) relaxing the need for masks and social distancing increased Intention to Get Vaccinated (IGV) by 6.4 % (p < 0.01), (3) offering financial incentives increased the IGV between 12.3 and 18.9 % (p <.001), (4) vaccine requirements for attending sporting events or traveling increased IGV by 7.8 % and 9.1 %, respectively (p = 0.02), and vaccine requirement for work increased IGV by 35.4 %. The leading causes (not mutually exclusive) for hesitancy were concerns regarding vaccine safety (52.5 %) or side effects (51.6 %), trust in the government's motives (41.0 %), and concerns about vaccine effectiveness (37.6 %). CONCLUSIONS These findings suggest that multiple strategies may be effective and needed to increase COVID-19 vaccination among hesitant adults during the pandemic.
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Affiliation(s)
- Arash Naeim
- Center for SMART Health, Clinical and Translational Science Institute, University of California, Los Angeles, United States.
| | - Rebecca J Guerin
- Division of Science Integration, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, United States
| | - Ryan Baxter-King
- Department of Political Science, University of California, Los Angeles, United States
| | - Andrea H Okun
- Division of Science Integration, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, United States
| | - Neil Wenger
- Division of General Internal Medicine and Health Sciences Research, David Geffen School of Medicine at UCLA, United States
| | - Karen Sepucha
- Health Decision Sciences Center, Massachusetts General Hospital, Harvard Medical School, United States
| | - Annette L Stanton
- Departments of Psychology and Psychiatry/Biobehavioral Sciences, UCLA, United States
| | - Aaron Rudkin
- Departments of Political Science, Trinity College, Dublin, Ireland; Department of Political Science, University of California, Los Angeles, United States
| | - Derek Holliday
- Department of Political Science, University of California, Los Angeles, United States
| | | | - Lynn Vavreck
- Departments of Political Science and Communication, University of California, Los Angeles, United States
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Schwalbe N, Hanbali L, Nunes MC, Lehtimaki S. Use of financial incentives to increase adult vaccination coverage: A narrative review of lessons learned from COVID-19 and other adult vaccination efforts. Vaccine X 2022; 12:100225. [PMID: 36217357 PMCID: PMC9535879 DOI: 10.1016/j.jvacx.2022.100225] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 07/29/2022] [Accepted: 09/29/2022] [Indexed: 10/25/2022] Open
Abstract
To encourage COVID-19 vaccination, governments have offered a wide range of incentives to their populations ranging from cash to cows. Often these programs were rolled out at scale before assessing potential effectiveness. To inform future policy, we conducted a narrative review to understand the evidence base informing these programs and the extent to which they are effective. While we found evidence on cash transfers increasing both the coverage and intention to be vaccinated for COVID-19 and other adult vaccines, improvements in coverage were limited. With mixed evidence, lottery programs did not appear to have a consistent meaningful impact on vaccination for COVID-19, and no evidence was identified on the positive effects of other non-cash incentives for COVID-19 or other adult vaccines. We conclude that the impact of cash transfers in incentivizing adult vaccination is marginal and their effectiveness in addressing vaccine hesitancy remains inconclusive.
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Affiliation(s)
- Nina Schwalbe
- School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa,Spark Street Advisors, New York, NY, United States,Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, NY, United States,Corresponding author at: 722 W 168th St, New York, NY 10032, USA.
| | | | - Marta C. Nunes
- Department of Science and Technology/National Research Foundation, South African Research Chair Initiative in Vaccine Preventable Diseases; and South African Medical Research Council, Vaccines & Infectious Diseases Analytics Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Mardi P, Djalalinia S, Kargar R, Jamee M, Esmaeili Abdar Z, Qorbani M. Impact of incentives on COVID-19 vaccination; A systematic review. Front Med (Lausanne) 2022; 9:810323. [PMID: 36160125 PMCID: PMC9492889 DOI: 10.3389/fmed.2022.810323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 08/09/2022] [Indexed: 11/13/2022] Open
Abstract
IntroductionAlthough vaccination is the most effective way to limit and overcome the COVID-19 pandemic, a considerable fraction of them are not intended to get vaccinated. This study aims to investigate the existing research evidence and evaluate the effectiveness and consequences of all incentives provided for increasing the uptake of COVID-19 vaccination.MethodsA systematic search in PubMed, Web of Science (WoS), and SCOPUS from 2020 until October 10, 2021, was conducted on experimental studies evaluating the effects of incentives including cash, lottery voucher, and persuasive messages on COVID-19 vaccination intention and uptake. The study selection process, data extraction, and quality assessment were conducted independently by two investigators using Consolidated Standards of Reporting Trials (CONSORT 2010) checklist.ResultsTwenty-four records were included in the qualitative analysis. Most of the included studies assessed the effect of financial incentives. In 14 studies (58%) the assessed outcome was vaccination uptake and in nine (37.5%) others it was vaccination intention. One study considered self-reported vaccination status as the outcome. This study shows that high financial incentives and the Vax-a-million lottery are attributed to a higher vaccination rate, while the low amount of financial incentives, other lotteries, and persuasive messages have small or non-significant effects.ConclusionPaying a considerable amount of cash and Vax-a-million lottery are attributed to a higher vaccination. Nevertheless, there is a controversy over the effect of other incentives including other lotteries, low amount of cash, and messages on vaccination. It is noteworthy that, inconsistency and imprecision of included studies should be considered.
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Affiliation(s)
- Parham Mardi
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran
| | - Shirin Djalalinia
- Development of Research and Technology Center, Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran
| | - Reza Kargar
- Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran
| | - Mahnaz Jamee
- Pediatric Nephrology Research Center, Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Esmaeili Abdar
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Mostafa Qorbani
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- *Correspondence: Mostafa Qorbani
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Andreas M, Iannizzi C, Bohndorf E, Monsef I, Piechotta V, Meerpohl JJ, Skoetz N. Interventions to increase COVID-19 vaccine uptake: a scoping review. Cochrane Database Syst Rev 2022; 8:CD015270. [PMID: 35920693 PMCID: PMC9347311 DOI: 10.1002/14651858.cd015270] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
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.
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Affiliation(s)
- Marike Andreas
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Claire Iannizzi
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Emma Bohndorf
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Ina Monsef
- Faculty of Medicine and University Hospital Cologne, University of Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Cochrane Haematology, Cologne, Germany
| | - Vanessa Piechotta
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Joerg J Meerpohl
- Institute for Evidence in Medicine (for Cochrane Germany Foundation), Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Nicole Skoetz
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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Sprengholz P, Henkel L, Betsch C. Payments and freedoms: Effects of monetary and legal incentives on COVID-19 vaccination intentions in Germany. PLoS One 2022; 17:e0268911. [PMID: 35609052 PMCID: PMC9129024 DOI: 10.1371/journal.pone.0268911] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 05/10/2022] [Indexed: 11/19/2022] Open
Abstract
Monetary and legal incentives have been proposed to promote COVID-19 vaccination uptake. To evaluate the suitability of incentives, an experiment with German participants examined the effects of payments (varied within subjects: 0 to 10,000 EUR) and freedoms (varied between subjects: vaccination leading vs. not leading to the same benefits as a negative test result) on the vaccination intentions of previously unvaccinated individuals (n = 782) in April 2021. While no effect could be found for freedoms, the share of participants willing to be vaccinated increased with the payment amount. However, a significant change required large rewards of 3,250 EUR or more. While monetary incentives could increase vaccination uptake by a few percentage points, the high costs of implementation challenge the efficiency of the measure and call for alternatives. As the data suggest that considering vaccination as safe, necessary, and prosocial increases an individual's likelihood of wanting to get vaccinated without payment, interventions should focus on these features when promoting vaccination against COVID-19.
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Affiliation(s)
- Philipp Sprengholz
- Media and Communication Science, University of Erfurt, Erfurt, Germany
- Health Communication, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Luca Henkel
- Center for Empirical Research in Economics and Behavioral Sciences, University of Erfurt, Erfurt, Germany
| | - Cornelia Betsch
- Media and Communication Science, University of Erfurt, Erfurt, Germany
- Center for Empirical Research in Economics and Behavioral Sciences, University of Erfurt, Erfurt, Germany
- University of Bonn, Bonn, Germany
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Sargent RH, Laurie S, Moncada L, Weakland LF, Lavery JV, Salmon DA, Orenstein WA, Breiman RF. Masks, money, and mandates: A national survey on efforts to increase COVID-19 vaccination intentions in the United States. PLoS One 2022; 17:e0267154. [PMID: 35446922 PMCID: PMC9022841 DOI: 10.1371/journal.pone.0267154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 04/03/2022] [Indexed: 11/19/2022] Open
Abstract
Various efforts to increase COVID-19 vaccination rates have been employed in the United States. We sought to rapidly investigate public reactions to these efforts to increase vaccination, including self-reported responses to widespread reduced masking behavior, monetary incentive programs to get vaccinated, and work vaccination requirements. Using a unique method for data collection (Random Domain Intercept Technology), we captured a large (N = 14,152), broad-based sample of the United States Web-using population (data collected from June 30 -July 26, 2021). About 3/4 of respondents reported being vaccinated. The likelihood of vaccination and vaccination intention differed across various demographic indicators (e.g., gender, age, income, political leaning). We observed mixed reactions to efforts aimed at increasing vaccination rates among unvaccinated respondents. While some reported that specific efforts would increase their likelihood of getting vaccinated (between 16% and 32%), others reported that efforts would decrease their likelihood of getting vaccinated (between 17% and 42%). Reactions differed by general vaccination intention, as well as other demographic indicators (e.g., race, education). Our results highlight the need to fully understand reactions to policy changes, programs, and mandates before they are communicated to the public and employed. Moreover, the results emphasize the importance of understanding how reactions differ across groups, as this information can assist in targeting intervention efforts and minimizing potentially differential negative impact.
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Affiliation(s)
| | | | | | - Leo F. Weakland
- Center for Global Health Innovation, Atlanta, Georgia, United States of America
| | - James V. Lavery
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
- Center for Ethics, Emory University, Atlanta, Georgia, United States of America
| | - Daniel A. Salmon
- Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Walter A. Orenstein
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
- School of Medicine, Emory University, Atlanta, Georgia, United States of America
| | - Robert F. Breiman
- Center for Global Health Innovation, Atlanta, Georgia, United States of America
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
- School of Medicine, Emory University, Atlanta, Georgia, United States of America
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Batteux E, Mills F, Jones LF, Symons C, Weston D. The Effectiveness of Interventions for Increasing COVID-19 Vaccine Uptake: A Systematic Review. Vaccines (Basel) 2022; 10:386. [PMID: 35335020 PMCID: PMC8949230 DOI: 10.3390/vaccines10030386] [Citation(s) in RCA: 47] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 02/21/2022] [Accepted: 02/22/2022] [Indexed: 12/24/2022] Open
Abstract
Vaccination is vital to protect the public against COVID-19. The aim of this systematic review is to identify and evaluate the effectiveness of interventions to increase COVID-19 vaccine uptake. We searched a range of databases (Embase, Medline, Psychology & Behavioral Science, PsycInfo, Web of Science and NIH Preprints Portfolio) from March 2020 to July 2021 for studies which reported primary quantitative or qualitative research on interventions to increase COVID-19 vaccine uptake. Outcome measures included vaccination uptake and reported intention to vaccinate. Reviews, position papers, conference abstracts, protocol papers and papers not in English were excluded. The NHLBI quality assessment was used to assess risk of bias. In total, 39 studies across 33 papers met the inclusion criteria. A total of 28 were assessed as good quality. They included interventions relating to communication content, communication delivery, communication presentation, policy or vaccination delivery, with 7 measuring vaccination uptake and 32 measuring vaccination intention. A narrative synthesis was conducted, which highlighted that there is reasonable evidence from studies investigating real behaviour suggesting that personalising communications and sending booking reminders via text message increases vaccine uptake. Findings on vaccination intention are mixed but suggest that communicating uncertainty about the vaccine does not decrease intention, whereas making vaccination mandatory could have a negative impact. Although much of the research used experimental designs, very few measured real behavioural outcomes. Understanding which interventions are most effective amongst vaccine-hesitant populations and in the context of booster vaccinations will be important as vaccine roll outs continue across the world.
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Affiliation(s)
- Eleonore Batteux
- Behavioural Science and Insights Unit, UK Health Security Agency, Salisbury SP4 0JG, UK; (E.B.); (L.F.J.); (C.S.); (D.W.)
- Centre for the Study of Decision-Making Uncertainty, University College London, London WC1E 6BT, UK
| | - Freya Mills
- Behavioural Science and Insights Unit, UK Health Security Agency, Salisbury SP4 0JG, UK; (E.B.); (L.F.J.); (C.S.); (D.W.)
| | - Leah Ffion Jones
- Behavioural Science and Insights Unit, UK Health Security Agency, Salisbury SP4 0JG, UK; (E.B.); (L.F.J.); (C.S.); (D.W.)
| | - Charles Symons
- Behavioural Science and Insights Unit, UK Health Security Agency, Salisbury SP4 0JG, UK; (E.B.); (L.F.J.); (C.S.); (D.W.)
| | - Dale Weston
- Behavioural Science and Insights Unit, UK Health Security Agency, Salisbury SP4 0JG, UK; (E.B.); (L.F.J.); (C.S.); (D.W.)
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Patzina A, Dietrich H. The social gradient in COVID-19 vaccination intentions and the role of solidarity beliefs among adolescents. SSM Popul Health 2022; 17:101054. [PMID: 35229013 PMCID: PMC8865935 DOI: 10.1016/j.ssmph.2022.101054] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 01/23/2022] [Accepted: 02/18/2022] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Vaccines against COVID-19 play a prominent role in the policies enacted to combat the pandemic. However, vaccination rates are lowest among adolescents and young adults. Therefore, research on younger individuals is needed to provide a deeper understanding of social disparities and the motives behind vaccination intentions. METHODS This study draws on a sample (N = 4079) of German high school students and graduates. Based on cross-sectional data from March to July 2021 and linear regression models, which are conditioned on personality, risk preferences, and trust, the study analyses social disparities (i.e., gender, parental education and migration background) in vaccination intentions. RESULTS We do not find heterogeneity by gender. Individuals with low-educated parents and a migration background indicate below-average levels of vaccination intention. Differences in solidarity beliefs entirely explain the heterogeneity between individuals with low-educated parents and those with high-educated parents. While differences in beliefs explain a substantial part of the heterogeneity in vaccination intentions, cultural and monetary resources also constitute an important source of difference in vaccination intentions between individuals with and without a migration background. These results are important because our data indicate higher infection risks among individuals with a migration and low education background. Additionally, individuals from lower social origins and with migration backgrounds report higher levels of perceived burdens associated with COVID-19-related policies. The migration results differ between first- and second-generation migrants and by region of origin. CONCLUSION Polarization in solidarity explains social gradients in vaccination intention. A solidarity narrative may not motivate a significant share of young individuals to be vaccinated.
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Affiliation(s)
| | - Hans Dietrich
- Institute for Employment Research, Germany (IAB), Germany
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18
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Tolia V, Renin Singh R, Deshpande S, Dave A, Rathod RM. Understanding Factors to COVID-19 Vaccine Adoption in Gujarat, India. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:2707. [PMID: 35270399 PMCID: PMC8909936 DOI: 10.3390/ijerph19052707] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 02/21/2022] [Indexed: 02/06/2023]
Abstract
The COVID-19 pandemic has posed threats to human life across the globe, including India. Vaccinating is an effective means of addressing the pandemic threat. The government of India has implemented a massive vaccination drive to save its citizens from the deadly virus. However, the effort has faced multiple challenges, including vaccine hesitancy. This research understands respondents' perspectives on factors contributing to the lower vaccination uptake in Gujarat, India. Forty-four semi-structured interviews were conducted through convenience sampling representing different demographic backgrounds. Factors influencing vaccine adoption included religious leadership, political leadership and the government, and fear of side effects, especially among children and those with co-morbidities, resulting primarily from fake news and misinformation circulated through social media. Compared with nine countries from across the world, the study found similarities to vaccine hesitancy from misinformation and the fear of side effects among children. In contrast, the role of government and the influence of religious and political leaders was considered positive. The study recommends strategies to overcome people's apprehensions about the adoption of vaccination. These include offering incentives, providing positive peer-to-peer communication, recruiting influencers such as religious and community leaders and early adopters such as the elderly population to endorse vaccination, targeting youth through social media, and reaching rural sections by involving NGOs and social service groups.
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Affiliation(s)
- Viral Tolia
- Post Graduate Department of Business Management, Sardar Patel University, Anand 388120, Gujarat, India; (V.T.); (R.M.R.)
| | | | - Sameer Deshpande
- Social Marketing @ Griffith, Griffith Business School, Nathan Campus, Griffith University, Brisbane, QLD 4111, Australia
| | - Anupama Dave
- School of Business and Law, Navrachana University, Vadodara 391410, Gujarat, India;
| | - Raju M. Rathod
- Post Graduate Department of Business Management, Sardar Patel University, Anand 388120, Gujarat, India; (V.T.); (R.M.R.)
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Haman M, Khakimova A. Money for a vaccine? Pay incentives as a solution to increase vaccination rates during the COVID-19 pandemic. Public Health 2022; 205:e23-e24. [PMID: 35232579 PMCID: PMC8808713 DOI: 10.1016/j.puhe.2022.01.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Accepted: 01/20/2022] [Indexed: 11/28/2022]
Affiliation(s)
- M Haman
- Department of Political Science, University of Hradec Králové, Rokitanského 62, Hradec Králové, 500 03, Czech Republic.
| | - A Khakimova
- Institute of Information Systems and Engineering Computer Technologies, Russian New University, Radio St. 22, 105005 Moscow, Russia.
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Geniole SN, Bird BM, Witzel A, McEvoy J, Proietti V. Preliminary evidence that brief exposure to vaccination-related internet memes may influence intentions to vaccinate against COVID-19. COMPUTERS IN HUMAN BEHAVIOR 2022; 131:107218. [PMID: 35125639 PMCID: PMC8803897 DOI: 10.1016/j.chb.2022.107218] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 01/27/2022] [Accepted: 01/29/2022] [Indexed: 11/05/2022]
Abstract
Despite global efforts to rapidly distribute COVID-19 vaccines, early estimates suggested that 29–35% of the population were hesitant/unwilling to receive them. Countering such vaccine hesitancy is thus an important priority. Across two sets of online studies (total n = 1584) conducted in the UK before (August–October 2020) and immediately after the first effective vaccine was publicly announced (November 10–19, 2020), brief exposure (<1 min) to vaccination memes boosted the potentially life-saving intention to vaccinate against COVID-19. These intention-boosting effects, however, weakened once a COVID-19 vaccine became a reality (i.e., after the announcement of a safe/effective vaccine), suggesting meme-based persuasion may be context-dependent. These findings thus represent preliminary evidence that naturally circulating memes may—under certain circumstances—influence public intentions to vaccinate, although more research regarding this context-specificity, as well as the potential psychological mechanisms through which memes act, is needed.
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The Role of Incentives in Deciding to Receive the Available COVID-19 Vaccine in Israel. Vaccines (Basel) 2022; 10:vaccines10010077. [PMID: 35062738 PMCID: PMC8778303 DOI: 10.3390/vaccines10010077] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 12/29/2021] [Accepted: 12/31/2021] [Indexed: 11/29/2022] Open
Abstract
This study aimed to assess the Israeli public’s intention to get vaccinated immediately after the COVID-19 vaccine became available, and to determine the role of incentives beyond socio-demographic, health-related and behavioral factors, in predicting this intention. An online survey was conducted among adults in Israel (n = 461), immediately after the first COVID-19 vaccine became available (22 December 2020 to 10 January 2021). Two regressions were performed to investigate determinants of intention to receive the available COVID-19 vaccine and sense of urgency to receive the vaccine. Although many adults were willing to receive available COVID-19 vaccine, only 65% were willing to immediately receive the vaccine, 17% preferred to wait 3 months and 18% preferred to wait a year. The sense of urgency to get vaccinated differed by age, periphery level, perceived barriers, cues to action and availability. Incentives such as monetary rewards or the green pass did not increase the probability of getting vaccination immediately. Providing data on the role of incentives in increasing the intention to immediately receive the available COVID-19 vaccine is important for health policy makers and healthcare providers. Our findings underscore the importance of COVID-19 vaccine accessibility. Health policy makers should consider allocating funds for making the vaccine accessible and encourage methods of persuasion, instead of investing funds in monetary incentives.
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Gandjour A. Financial Incentives in the Path to Recovery from the COVID-19 Pandemic. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2022; 20:5-8. [PMID: 34719753 PMCID: PMC8557961 DOI: 10.1007/s40258-021-00689-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 10/06/2021] [Indexed: 06/13/2023]
Affiliation(s)
- Afschin Gandjour
- Frankfurt School of Finance and Management, Adickesallee 32-34, 60322, Frankfurt am Main, Germany.
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23
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Carpio CE, Coman IA, Sarasty O, García M. COVID-19 Vaccine Demand and Financial Incentives. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2021; 19:871-883. [PMID: 34608611 PMCID: PMC8489978 DOI: 10.1007/s40258-021-00687-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/12/2021] [Indexed: 05/12/2023]
Abstract
BACKGROUND Public health experts estimate that only very high COVID-19 vaccine uptake levels can result in herd immunity. OBJECTIVE This study's main objective was to evaluate the impact of vaccine price levels, including payments, and the efficacy levels on COVID-19 vaccine demand. METHODS Data for this study were collected from an online survey of 2000 US individuals aged 18 years and older, which included a set of contingent valuation questions. Parametric and nonparametric procedures were used to estimate the distribution of willingness-to-pay and willingness-to-accept values for the vaccine and to assess its association with vaccine efficacy levels (50, 70, and 95%). RESULTS Most of the individuals (60%) indicated they were willing to pay a positive amount for the vaccine; 13.7% said they would only accept the vaccine if it were free; 14.1% were willing to take the vaccine only if they were paid; and 12.2% were not willing to accept the vaccine. The vaccine efficacy level was found to affect an individual's demand for the vaccine. Estimated mean willingness-to-pay values were: US$594, US$706, and US$723 for vaccines with efficacy levels of 50, 70, and 95%, respectively. CONCLUSIONS US individuals highly value the COVID-19 vaccine, and about 88% of the US population would accept the vaccination; however, 14% indicated they would get vaccinated if compensated. Payments of about US$500 or more would be needed to sufficiently incentivize 50% or more of this group vaccinated.
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Affiliation(s)
- Carlos E Carpio
- Department of Agricultural and Applied Economics, Texas Tech University, Lubbock, TX, 79409-2132, USA.
| | - Ioana A Coman
- Department of Public Relations, Texas Tech University, Lubbock, TX, USA
| | - Oscar Sarasty
- Department of Agricultural and Applied Economics, Texas Tech University, Lubbock, TX, 79409-2132, USA
| | - Manuel García
- Department of Agricultural and Applied Economics, Texas Tech University, Lubbock, TX, 79409-2132, USA
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Cascini F, Pantovic A, Al-Ajlouni Y, Failla G, Ricciardi W. Attitudes, acceptance and hesitancy among the general population worldwide to receive the COVID-19 vaccines and their contributing factors: A systematic review. EClinicalMedicine 2021; 40:101113. [PMID: 34490416 PMCID: PMC8411034 DOI: 10.1016/j.eclinm.2021.101113] [Citation(s) in RCA: 210] [Impact Index Per Article: 70.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 08/06/2021] [Accepted: 08/13/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND High rates of vaccination worldwide are required to establish a herd immunity and stop the current COVID-19 pandemic evolution. Vaccine hesitancy is a major barrier in achieving herd immunity across different populations. This study sought to conduct a systematic review of the current literature regarding attitudes and hesitancy to receiving COVID-19 vaccination worldwide. METHODS A systematic literature search of PubMed and Web of Science was performed on July 5th, 2021, using developed keywords. Inclusion criteria required the study to (1) be conducted in English; (2) investigate attitudes, hesitancy, and/or barriers to COVID-19 vaccine acceptability among a given population; (3) utilize validated measurement techniques; (4) have the full text paper available and be peer-reviewed prior to final publication. FINDINGS Following PRISMA guidelines, 209 studies were included. The Newcastle Ottawa (NOS) scale for cross-sectional studies was used to assess the quality of the studies.Overall, vaccine acceptance rates ranged considerably between countries and between different time points, with Arabian countries showing the highest hesitancy rates compared with other parts of the world. INTERPRETATION A variety of different factors contributed to increased hesitancy, including having negative perception of vaccine efficacy, safety, convenience, and price. Some of the consistent socio-demographic groups that were identified to be associated with increased hesitancy included: women, younger participants, and people who were less educated, had lower income, had no insurance, living in a rural area, and self-identified as a racial/ethnic minority.
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Affiliation(s)
- Fidelia Cascini
- Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Ana Pantovic
- Faculty of Biology, University of Belgrade, Belgrade, Serbia
| | - Yazan Al-Ajlouni
- New York Medical College School of Medicine, Valhalla, New York, United States
| | - Giovanna Failla
- Department of Public Health, University of Verona, Verona, Italy
| | - Walter Ricciardi
- Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome 00168, Italy
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Aw J, Seng JJB, Seah SSY, Low LL. COVID-19 Vaccine Hesitancy-A Scoping Review of Literature in High-Income Countries. Vaccines (Basel) 2021; 9:900. [PMID: 34452026 PMCID: PMC8402587 DOI: 10.3390/vaccines9080900] [Citation(s) in RCA: 249] [Impact Index Per Article: 83.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 07/25/2021] [Accepted: 08/10/2021] [Indexed: 12/21/2022] Open
Abstract
Vaccine hesitancy forms a critical barrier to the uptake of COVID-19 vaccine in high-income countries or regions. This review aims to summarize rates of COVID-19 hesitancy and its determinants in high-income countries or regions. A scoping review was conducted in Medline®, Embase®, CINAHL®, and Scopus® and was reported in accordance with the PRISMA-SCr checklist. The search was current as of March 2021. Studies which evaluated COVID-19 vaccine hesitancy and its determinants in high-income countries (US$12,536 or more GNI per capita in 2019) were included. Studies conducted in low, lower-middle, and upper-middle income countries or regions were excluded. Factors associated with vaccine hesitancy were grouped into four themes (vaccine specific, individual, group, or contextual related factors). Of 2237 articles retrieved, 97 articles were included in this review. Most studies were conducted in U.S. (n = 39) and Italy (n = 9). The rates of vaccine hesitancy across high-income countries or regions ranged from 7-77.9%. 46 studies (47.4%) had rates of 30% and more. Younger age, females, not being of white ethnicity and lower education were common contextual factors associated with increased vaccine hesitancy. Lack of recent history of influenza vaccination, lower self-perceived risk of contracting COVID-19, lesser fear of COVID-19, believing that COVID-19 is not severe and not having chronic medical conditions were most frequently studied individual/group factors associated with increased vaccine hesitancy. Common vaccine-specific factors associated with increased vaccine hesitancy included beliefs that vaccine are not safe/effective and increased concerns about rapid development of COVID-19 vaccines. Given the heterogeneity in vaccine hesitancy definitions used across studies, there is a need for standardization in its assessment. This review has summarized COVID-19 vaccine hesitancy determinants that national policymakers can use when formulating health policies related to COVID-19 vaccination.
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Affiliation(s)
- Junjie Aw
- Outram Community Hospital, SingHealth Community Hospitals, 10 Hospital Boulevard, Singapore 168582, Singapore; (S.S.Y.S.); (L.L.L.)
| | | | - Sharna Si Ying Seah
- Outram Community Hospital, SingHealth Community Hospitals, 10 Hospital Boulevard, Singapore 168582, Singapore; (S.S.Y.S.); (L.L.L.)
| | - Lian Leng Low
- Outram Community Hospital, SingHealth Community Hospitals, 10 Hospital Boulevard, Singapore 168582, Singapore; (S.S.Y.S.); (L.L.L.)
- MOH Holdings Pte Ltd., 1 Maritime Square, Singapore 099253, Singapore;
- Department of Family Medicine and Continuing Care, Singapore General Hospital, Singapore, Outram Rd, Singapore 169608, Singapore
- SingHealth Duke-NUS Family Medicine Academic Clinical Program, Outram Rd, Singapore 169608, Singapore
- SingHealth Regional Health System PULSES Centre, Singapore Health Services, Outram Rd, Singapore 169608, Singapore
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Boyd K. Science, politics, ethics and the pandemic. JOURNAL OF MEDICAL ETHICS 2021; 47:529-530. [PMID: 34312218 PMCID: PMC8327316 DOI: 10.1136/medethics-2021-107706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- Kenneth Boyd
- Biomedical Teaching Organisation, Edinburgh University, Edinburgh, Scotland, UK
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Freeman D, Loe BS, Yu LM, Freeman J, Chadwick A, Vaccari C, Shanyinde M, Harris V, Waite F, Rosebrock L, Petit A, Vanderslott S, Lewandowsky S, Larkin M, Innocenti S, Pollard AJ, McShane H, Lambe S. Effects of different types of written vaccination information on COVID-19 vaccine hesitancy in the UK (OCEANS-III): a single-blind, parallel-group, randomised controlled trial. Lancet Public Health 2021; 6:e416-e427. [PMID: 33991482 PMCID: PMC8116130 DOI: 10.1016/s2468-2667(21)00096-7] [Citation(s) in RCA: 160] [Impact Index Per Article: 53.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 04/07/2021] [Accepted: 04/15/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND The effectiveness of the COVID-19 vaccination programme depends on mass participation: the greater the number of people vaccinated, the less risk to the population. Concise, persuasive messaging is crucial, particularly given substantial levels of vaccine hesitancy in the UK. Our aim was to test which types of written information about COVID-19 vaccination, in addition to a statement of efficacy and safety, might increase vaccine acceptance. METHODS For this single-blind, parallel-group, randomised controlled trial, we aimed to recruit 15 000 adults in the UK, who were quota sampled to be representative. Participants were randomly assigned equally across ten information conditions stratified by level of vaccine acceptance (willing, doubtful, or strongly hesitant). The control information condition comprised the safety and effectiveness statement taken from the UK National Health Service website; the remaining conditions addressed collective benefit, personal benefit, seriousness of the pandemic, and safety concerns. After online provision of vaccination information, participants completed the Oxford COVID-19 Vaccine Hesitancy Scale (outcome measure; score range 7-35) and the Oxford Vaccine Confidence and Complacency Scale (mediation measure). The primary outcome was willingness to be vaccinated. Participants were analysed in the groups they were allocated. p values were adjusted for multiple comparisons. The study was registered with ISRCTN, ISRCTN37254291. FINDINGS From Jan 19 to Feb 5, 2021, 15 014 adults were recruited. Vaccine hesitancy had reduced from 26·9% the previous year to 16·9%, so recruitment was extended to Feb 18 to recruit 3841 additional vaccine-hesitant adults. 12 463 (66·1%) participants were classified as willing, 2932 (15·6%) as doubtful, and 3460 (18·4%) as strongly hesitant (ie, report that they will avoid being vaccinated for as long as possible or will never get vaccinated). Information conditions did not alter COVID-19 vaccine hesitancy in those willing or doubtful (adjusted p values >0·70). In those strongly hesitant, COVID-19 vaccine hesitancy was reduced, in comparison to the control condition, by personal benefit information (mean difference -1·49, 95% CI -2·16 to -0·82; adjusted p=0·0015), directly addressing safety concerns about speed of development (-0·91, -1·58 to -0·23; adjusted p=0·0261), and a combination of all information (-0·86, -1·53 to -0·18; adjusted p=0·0313). In those strongly hesitant, provision of personal benefit information reduced hesitancy to a greater extent than provision of information on the collective benefit of not personally getting ill (-0·97, 95% CI -1·64 to -0·30; adjusted p=0·0165) or the collective benefit of not transmitting the virus (-1·01, -1·68 to -0·35; adjusted p=0·0150). Ethnicity and gender were found to moderate information condition outcomes. INTERPRETATION In the approximately 10% of the population who are strongly hesitant about COVID-19 vaccines, provision of information on personal benefit reduces hesitancy to a greater extent than information on collective benefits. Where perception of risk from vaccines is most salient, decision making becomes centred on the personal. As such, messaging that stresses the counterbalancing personal benefits is likely to prove most effective. The messaging from this study could be used in public health communications. Going forwards, the study highlights the need for future health campaigns to engage with the public on the terrain that is most salient to them. FUNDING National Institute for Health Research (NIHR) Oxford Biomedical Research Centre and NIHR Oxford Health Biomedical Research Centre.
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Affiliation(s)
- Daniel Freeman
- Department of Psychiatry, University of Oxford, Oxford, UK; Oxford Health NHS Foundation Trust, Oxford, UK; NIHR Oxford Health Biomedical Research Centre, Oxford, UK.
| | - Bao Sheng Loe
- The Psychometrics Centre, University of Cambridge, Cambridge, UK
| | - Ly-Mee Yu
- Nuffield Department of Primary Care and Health Sciences, University of Oxford, Oxford, UK
| | - Jason Freeman
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Andrew Chadwick
- Online Civic Culture Centre, Department of Communication and Media, Loughborough University, Loughborough, UK
| | - Cristian Vaccari
- Online Civic Culture Centre, Department of Communication and Media, Loughborough University, Loughborough, UK
| | - Milensu Shanyinde
- Nuffield Department of Primary Care and Health Sciences, University of Oxford, Oxford, UK
| | - Victoria Harris
- Nuffield Department of Primary Care and Health Sciences, University of Oxford, Oxford, UK
| | - Felicity Waite
- Department of Psychiatry, University of Oxford, Oxford, UK; Oxford Health NHS Foundation Trust, Oxford, UK; NIHR Oxford Health Biomedical Research Centre, Oxford, UK
| | - Laina Rosebrock
- Department of Psychiatry, University of Oxford, Oxford, UK; Oxford Health NHS Foundation Trust, Oxford, UK
| | - Ariane Petit
- Department of Psychiatry, University of Oxford, Oxford, UK; Oxford Health NHS Foundation Trust, Oxford, UK
| | - Samantha Vanderslott
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK
| | | | - Michael Larkin
- Department of Psychology, Life and Health Sciences, Aston University, Birmingham, UK
| | - Stefania Innocenti
- Smith School of Enterprise and the Environment, University of Oxford, Oxford, UK
| | - Andrew J Pollard
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK; NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Helen McShane
- The Jenner Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK; NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Sinéad Lambe
- Department of Psychiatry, University of Oxford, Oxford, UK; Oxford Health NHS Foundation Trust, Oxford, UK
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