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Abd El Maksoud EA, Rady MH, Mahmoud AGT, Hamza D, Seadawy MG, Essa EE. Potential therapeutic biomolecules of hymenopteran venom against SARS-CoV-2 from Egyptian patients. Sci Rep 2024; 14:15363. [PMID: 38965389 PMCID: PMC11224265 DOI: 10.1038/s41598-024-65038-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Accepted: 06/17/2024] [Indexed: 07/06/2024] Open
Abstract
The therapeutic potential of insect-derived bioactive molecules as anti-SARS-CoV-2 agents has shown promising results. Hymenopteran venoms, notably from Apis mellifera (honeybee) and Vespa orientalis (oriental wasp), were examined for the first time in an in vitro setting for their potential anti-COVID-19 activity. This assessment utilized an immunodiagnostic system to detect the SARS-CoV-2 nucleocapsid antigen titer reduction. Further analyses, including cytotoxicity assays, plaque reduction assays, and in silico docking-based screening, were performed to evaluate the efficacy of the most potent venom. Results indicated that bee and wasp venoms contain bioactive molecules with potential therapeutic effects against SARS-CoV-2.Nevertheless, the wasp venom exhibited superior efficacy compared to bee venom, achieving a 90% maximal (EC90) concentration effect of antigen depletion at 0.184 mg/mL, in contrast to 2.23 mg/mL for bee venom. The cytotoxicity of the wasp venom was assessed on Vero E6 cells 48 h post-treatment using the MTT assay. The CC 50 of the cell growth was 0.16617 mg/mL for Vero E6 cells. The plaque reduction assay of wasp venom revealed 50% inhibition (IC50) at a 0.208 mg/mL concentration. The viral count at 50% inhibition was 2.5 × 104 PFU/mL compared to the initial viral count of 5 × 104 PFU/mL. In silico data for the wasp venom revealed a strong attraction to binding sites on the ACE2 protein, indicating ideal interactions. This substantiates the potential of wasp venom as a promising viral inhibitor against SARS-CoV-2, suggesting its consideration as a prospective natural preventive and curative antiviral drug. In conclusion, hymenopteran venoms, particularly wasp venom, hold promise as a source of potential therapeutic biomolecules against SARS-CoV-2. More research and clinical trials are needed to evaluate these results and investigate their potential for translation into innovative antiviral therapies.
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Affiliation(s)
- Eman A Abd El Maksoud
- Armed Forces Laboratories of Medical Research, El-Khalifa El-Maamoun, Mansheya El-Bakry, Heliopolis, Cairo Governorate, Egypt
| | - Magda H Rady
- Entomology Department Faculty of Science, Ain Shams University, Cairo, 11566, Egypt
| | - Ahmed Gad Taha Mahmoud
- Microbiology Department, Armed Forces Laboratories of Medical Research, El-Khalifa El-Maamoun, Mansheya El-Bakry, Heliopolis, Cairo Governorate, Egypt
| | - Dalia Hamza
- Zoonoses Department, Faculty of Veterinary Medicine, Cairo University, Giza, Egypt
| | - Mohamed G Seadawy
- Biological Prevention Department, Chemical Warfare, Egypt Army, Cairo, Egypt
- Entomology Department, Faculty of Science, Ain Shams University, Cairo, Egypt
| | - Eman E Essa
- Entomology Department Faculty of Science, Ain Shams University, Cairo, 11566, Egypt.
- Entomology Department, Faculty of Science, Ain Shams University, Cairo, Egypt.
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Razai MS, Berendes S, Nagraj S, Oakeshott P, Khalil A. As whooping cough rates rise, we urgently need to increase maternal vaccination rates. BMJ 2024; 385:q1289. [PMID: 38871363 DOI: 10.1136/bmj.q1289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/15/2024]
Affiliation(s)
| | - Sima Berendes
- London School of Hygiene and Tropical Medicine, London
| | - Shobhana Nagraj
- Department of Public Health and Primary Care, University of Cambridge
- East London NHS Foundation Trust
| | - Pippa Oakeshott
- Population Health Research, St George's University of London
| | - Asma Khalil
- Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London
- Royal College of Obstetricians and Gynaecologists, London
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3
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Freeman EE, Strahan AG, Smith LR, Judd AD, Samarakoon U, Chen G, King AJ, Blumenthal KG. The impact of COVID-19 vaccine reactions on secondary vaccine hesitancy. Ann Allergy Asthma Immunol 2024; 132:630-636.e1. [PMID: 38232816 DOI: 10.1016/j.anai.2024.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 12/05/2023] [Accepted: 01/08/2024] [Indexed: 01/19/2024]
Abstract
BACKGROUND Primary and booster vaccinations are critical for mitigating COVID-19 transmission, morbidity, and mortality. Future booster vaccine campaigns rely on an increased understanding of vaccine hesitancy. OBJECTIVE To evaluate self-reported allergic and skin vaccine reactions as factors potentially associated with vaccine hesitancy in a nationwide vaccine allergy registry. METHODS Responses to survey questions concerning COVID-19 vaccine perceptions, coded from free text by 2 independent reviewers. Multivariable logistic regression models were used to determine the association between changed negative perception and respondent demographics, vaccination history, and reaction characteristics. RESULTS A total of 993 individuals (median of 46 years [IQR, 36-59], 88% female, 82% White) self-reported reactions to COVID-19 vaccination. Reactions included the following: delayed large local skin reaction (40%), hives/urticaria (32%), immediate large local skin reaction (3%), swelling (3%), anaphylaxis (2%), and other or unspecified (20%). Most respondents were initially unconcerned about the safety of COVID-19 vaccines (56%). After reactions, 401 of 993 (40%) report negative change in perception of vaccination, with more than half of these respondents (n = 211, 53%) citing their reasoning as a negative experience with adverse effects. Of 102 individuals asked about future vaccination, 79 (77%) indicated that they were unlikely or very unlikely to receive future COVID-19 vaccinations. Increased negative perception after reaction was associated with younger age, later COVID-19 vaccination dose number, and reaction type. CONCLUSION Our findings reveal that an individual's experience with allergic or cutaneous adverse effects after COVID-19 vaccination affects attitudes and decision-making regarding future vaccination, even in initially non-hesitant individuals. Further investigation of secondary vaccine hesitancy is necessary for adapting public health messaging to this important population.
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Affiliation(s)
- Esther E Freeman
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; The Mongan Institute, Boston, Massachusetts
| | - Alexis G Strahan
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts
| | - Liam R Smith
- The Mongan Institute, Boston, Massachusetts; Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Allen D Judd
- The Mongan Institute, Boston, Massachusetts; Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Upeka Samarakoon
- The Mongan Institute, Boston, Massachusetts; Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | | | - Andrew J King
- Harvard Medical School, Boston, Massachusetts; The Mongan Institute, Boston, Massachusetts; Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Kimberly G Blumenthal
- Harvard Medical School, Boston, Massachusetts; The Mongan Institute, Boston, Massachusetts; Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts.
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4
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Midzi N, Mutsaka-Makuvaza MJ, Charimari LS, Mangwiro P, Manengureni T, Mugadza G. Understanding facilitators and barriers to COVID-19 vaccination in the Zimbabwean population: a qualitative analysis. BMC Public Health 2024; 24:1174. [PMID: 38679733 PMCID: PMC11057155 DOI: 10.1186/s12889-024-18650-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 04/18/2024] [Indexed: 05/01/2024] Open
Abstract
BACKGROUND Vaccines are effective biological interventions that reduce health burdens. However, during the COVID-19 pandemic, there were concerns about varying levels of COVID-19 vaccination coverage in the Zimbabwean population. This study aimed to understand facilitators and barriers to COVID-19 vaccine uptake in the Zimbabwean population. METHODS In September-October 2023, key informant interviews (KIIs) and focus group discussions (FGDs) were conducted with a sample comprising health workers, village health workers, church leaders, traditional healers, teachers, youth leaders and the general population selected across the country. At each site, the participant sample was homogeneous. Data were collected using audiotapes, transcribed verbatim, and translated into English. Data were analysed manually using thematic analysis. RESULTS Ten FGDs and 30 KIIs were conducted across the country. Among the facilitators of COVID-19 vaccine uptake were the perceived benefits of COVID-19 vaccination, such as protection from infection, severe disease and death. People also complied with COVID-19 vaccination because of the government's call for mandatory vaccination, travel restrictions, restrictions when entering some premises for services, visiting, working, learning and functions. Barriers to COVID-19 vaccine uptake included low-risk perception, negative attitudes emanating from concerns about the origins of the vaccines, COVID-19 cases or death of vaccinated people, negative peer influence, religious doctrines, cultural beliefs and misconceptions circulating through social media. Other barriers included knowledge gaps on COVID-19 vaccines, safety, effectiveness, side effects, access-related challenges to COVID-19 services and concerns over the changing policy on COVID-19 vaccination. CONCLUSIONS The study has shown the importance of community engagement and data-driven public health communication strategies to facilitate behaviour change for increased uptake of a vaccine. In future epidemics, public health campaigns should focus on the timely provision of information explaining the benefits of an intervention, addressing safety concerns more effectively. To build trust and hence improve vaccine uptake by the public, there is a need for continuous engagement with people and to provide platforms for dialogue to address issues contributing to low vaccine uptake.
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Affiliation(s)
- Nicholas Midzi
- National Institute of Health Research, Ministry of Health and Child Care, Harare, Zimbabwe
| | - Masceline Jenipher Mutsaka-Makuvaza
- National Institute of Health Research, Ministry of Health and Child Care, Harare, Zimbabwe.
- Department of Microbiology and Parasitology, School of Medicine and Pharmacy, University of Rwanda, Butare, Rwanda.
| | | | | | - Tonderai Manengureni
- National Institute of Health Research, Ministry of Health and Child Care, Harare, Zimbabwe
| | - Gladys Mugadza
- College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
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Souto EP, Fernandez MV, Rosário CA, Petra PC, Matta GC. [Childhood vaccine hesitancy and COVID-19: an analysis based on the perception of health professionals]. CAD SAUDE PUBLICA 2024; 40:e00061523. [PMID: 38477727 DOI: 10.1590/0102-311xpt061523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 10/17/2023] [Indexed: 03/14/2024] Open
Abstract
This article presents the results of a study on health professionals' perceptions of childhood vaccine hesitancy related to COVID-19. Based on the theoretical construct of vaccine hesitancy, a qualitative study was conducted with 86 primary health care (PHC) workers in four municipalities in four Brazilian states and in the Federal District. A thematic analysis was performed and three categories were obtained: fear, misinformation about vaccines, and the role of health professionals. Fear as a reason for vaccine hesitancy has led to reflections on the Brazilian Federal Government's management of the pandemic, especially regarding governability and the consequences of the use of digital platforms on the population. Fear was related to the vaccine still being perceived as experimental; to the adverse reactions it may cause; to the lack of long-term studies; to the false perception of reduced risk of COVID-19 in children; and to the Federal Government's behavior, which creates uncertainty about the effects of the vaccine. Vaccine misinformation was related to fake news about the vaccine and its reactions; the phenomenon of infodemic and misinformation; and the lack of guidance and knowledge about vaccines. Finally, the article discusses the fundamental role of PHC workers in increasing vaccination coverage due to the trust among the population and proximity to the territories, factors that enable the reversal of fear and misinformation about vaccines. Throughout the study, authors' sought to show the convergences between the content of the themes outlined and the determinants of vaccine hesitancy and to consider possibilities for rebuilding high adherence to childhood vaccines.
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Affiliation(s)
- Ester Paiva Souto
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | - Michelle Vieira Fernandez
- Universidade de Brasília, Brasília, Brasil
- Instituto Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, Brasil
| | - Celita Almeida Rosário
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | - Priscila Cardia Petra
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | - Gustavo Correa Matta
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
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Manu E, Douglas M, Kushitor MK, Komesuor J, Ampomah MA, Opoku NO. Lay beliefs of COVID-19 vaccine refusal among intercity commercial drivers in the Volta region of Ghana: recommendations for improved vaccine uptake. Trop Dis Travel Med Vaccines 2024; 10:5. [PMID: 38424622 PMCID: PMC10905786 DOI: 10.1186/s40794-023-00214-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 12/13/2023] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND The COVID-19 vaccine has faced increased hesitancy in Ghana and the Volta region in particular since its rollout. Acceptance of the vaccine among intercity commercial drivers is crucial, especially in the Volta region, as they transport people within and outside the country and could fuel the transmission of the virus if not vaccinated. OBJECTIVE We therefore established lay beliefs surrounding COVID-19 vaccine refusal among intercity commercial drivers in the Volta region of Ghana, as well as their recommendations for improved vaccine uptake. METHODS We purposively interviewed twenty-five (25) intercity commercial drivers who had not been vaccinated for COVID-19 in the Volta region of Ghana using a semi-structured interview guide and analysed their responses thematically using the ATLAS.ti software. RESULTS Various (ten) beliefs surrounding COVID-19 vaccine refusal were identified. These include the nonexistence of COVID-19, being immune to COVID-19, and the belief in the nonexistence of vaccines and vaccines being meant for the sick. Other beliefs identified were the belief that the COVID-19 vaccine is meant to reduce Africa's population, that the vaccine triggers other health complications leading to death, the belief that vaccination could cause financial loss, political mistrust, that the COVID-19 vaccine is not permitted by God, and the belief that prayer prevents COVID-19 infection. They also suggested that the adoption of persuasive communication techniques, the publication of information on those who died of COVID-19, providing evidence of tests conducted on the vaccine, testing people before vaccination, provision of care to those who may experience side effects from the vaccine, and being able to explain why varied vaccines are used for the same virus could help improve vaccine uptake. CONCLUSION Our findings show that there is a general lack of understanding and mistrust surrounding the COVID-19 vaccine among intercity commercial drivers in the Volta region. Hence, health promotion officers and communicators in the region need to be knowledgeable on the vaccine as well as on the conspiracy theories thwarting its uptake to provide comprehensive education to the public and intercity commercial drivers to improve its uptake.
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Affiliation(s)
- Emmanuel Manu
- Department of Population and Behavioural Sciences, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana.
| | - Mbuyiselo Douglas
- Department of Public Health, Faculty of Health Sciences, Walter Sisulu University, Private Bag X1, Mthatha, 5117, South Africa
| | - Mawuli Komla Kushitor
- Department of Health Policy Planning and Management, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Joyce Komesuor
- Department of Population and Behavioural Sciences, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Mary Akua Ampomah
- Department of Family and Community Health, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Nicholas Obuobisa Opoku
- Department of Epidemiology and Biostatistics, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
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Aldakhlan HA, Khan AS, Alabdulbaqi D. Hesitancy Over the COVID-19 Vaccine Among Various Healthcare Workers: An International Narrative Review. Cureus 2024; 16:e53059. [PMID: 38410316 PMCID: PMC10896459 DOI: 10.7759/cureus.53059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2024] [Indexed: 02/28/2024] Open
Abstract
Healthcare workers (HCWs) are role models in their communities. If they receive the COVID-19 vaccine, many people are likely to follow and have the vaccine. If HCWs are hesitant or resistant to taking the vaccine, this may impede the efforts to implement the vaccine, reach herd immunity, and eliminate the pandemic. In this narrative review, we reviewed previous studies on hesitancy over COVID-19 vaccination among different healthcare professions and people in the medical field, such as primary HCWs, dentists, nurses, and medical students. We reviewed the common reasons and associated factors for hesitancy toward the COVID-19 vaccine among different healthcare professions. The following keywords were used in the database search: COVID-19 AND vaccine AND hesitancy AND healthcare workers. We searched for articles using the PubMed, Scopus, and Google Scholar databases. We found HCW professions with various rates of hesitancy, including primary healthcare center (PHC) workers (50%), medical students (45%), nurses (21%), and dentists (18%). Hesitancy toward booster doses was also found in HCWs who had taken primary doses (2.8% to 26%). Race and ethnicity also influenced hesitancy rates, with Black individuals being the most hesitant group. The most common reasons were concerns about the safety and adverse effects of the vaccine, insufficient information, and a lack of confidence in healthcare policies. Despite varying rates of HCW hesitancy after the vaccine's release, this hesitancy is expected to negatively affect efforts to achieve widespread vaccination. The recommendations to policymakers to address these concerns are raising the awareness of PHC doctors because they are the easiest to reach and are the first line for patient information, improving communication with the HCWs through all channels (e.g., webinars, e-mails, and social media), and inviting HCWs to online meetings or workshops with the healthcare policymakers so the policymakers can listen to their concerns and recommendations. Correctly addressing the issue of HCWs' vaccination hesitancy can support efforts to contain the pandemic.
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Affiliation(s)
| | - Abdul S Khan
- Familly Medicine, King Faisal University, Alhsa, SAU
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Razai MS, Mansour R, Goldsmith L, Freeman S, Mason-Apps C, Ravindran P, Kooner P, Berendes S, Morris J, Majeed A, Ussher M, Hargreaves S, Oakeshott P. Interventions to increase vaccination against COVID-19, influenza and pertussis during pregnancy: a systematic review and meta-analysis. J Travel Med 2023; 30:taad138. [PMID: 37934788 PMCID: PMC10755181 DOI: 10.1093/jtm/taad138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 10/19/2023] [Accepted: 10/22/2023] [Indexed: 11/09/2023]
Abstract
BACKGROUND Pregnant women and their babies face significant risks from three vaccine-preventable diseases: COVID-19, influenza and pertussis. However, despite these vaccines' proven safety and effectiveness, uptake during pregnancy remains low. METHODS We conducted a systematic review (PROSPERO CRD42023399488; January 2012-December 2022 following PRISMA guidelines) of interventions to increase COVID-19/influenza/pertussis vaccination in pregnancy. We searched nine databases, including grey literature. Two independent investigators extracted data; discrepancies were resolved by consensus. Meta-analyses were conducted using random-effects models to estimate pooled effect sizes. Heterogeneity was assessed using the I2 statistics. RESULTS From 2681 articles, we identified 39 relevant studies (n = 168 262 participants) across nine countries. Fifteen studies (39%) were randomized controlled trials (RCTs); the remainder were observational cohort, quality-improvement or cross-sectional studies. The quality of 18% (7/39) was strong. Pooled results of interventions to increase influenza vaccine uptake (18 effect estimates from 12 RCTs) showed the interventions were effective but had a small effect (risk ratio = 1.07, 95% CI 1.03, 1.13). However, pooled results of interventions to increase pertussis vaccine uptake (10 effect estimates from six RCTs) showed no clear benefit (risk ratio = 0.98, 95% CI 0.94, 1.03). There were no relevant RCTs for COVID-19. Interventions addressed the 'three Ps': patient-, provider- and policy-level strategies. At the patient level, clear recommendations from healthcare professionals backed by text reminders/written information were strongly associated with increased vaccine uptake, especially tailored face-to-face interventions, which addressed women's concerns, dispelled myths and highlighted benefits. Provider-level interventions included educating healthcare professionals about vaccines' safety and effectiveness and reminders to offer vaccinations routinely. Policy-level interventions included financial incentives, mandatory vaccination data fields in electronic health records and ensuring easy availability of vaccinations. CONCLUSIONS Interventions had a small effect on increasing influenza vaccination. Training healthcare providers to promote vaccinations during pregnancy is crucial and could be enhanced by utilizing mobile health technologies.
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Affiliation(s)
- Mohammad S Razai
- Population Health Research Institute, St George’s University of London, London, UK
| | - Rania Mansour
- Population Health Research Institute, St George’s University of London, London, UK
| | - Lucy Goldsmith
- Population Health Research Institute, St George’s University of London, London, UK
| | - Samuel Freeman
- Primary Care Unit, University Hospitals Sussex NHS Foundation Trust, Sussex, UK
| | - Charlotte Mason-Apps
- Population Health Research Institute, St George’s University of London, London, UK
| | - Pahalavi Ravindran
- Department of Respiratory Medicine, University Hospitals of Leicester NHS Foundation Trust, Leicester, UK
| | | | - Sima Berendes
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Joan Morris
- Population Health Research Institute, St George’s University of London, London, UK
| | - Azeem Majeed
- Department of Primary Care and Public Health, Imperial College London, London, UK
| | - Michael Ussher
- Population Health Research Institute, St George’s University of London, London, UK
- Institute of Social Marketing and Health, University of Stirling, Stirling, UK
| | - Sally Hargreaves
- Population Health Research Institute, St George’s University of London, London, UK
- The Migrant Health Research Unit, Institute for Infection and Immunity, St George’s, University of London, London, UK
| | - Pippa Oakeshott
- Population Health Research Institute, St George’s University of London, London, UK
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Cavillot L, van Loenhout JAF, Devleesschauwer B, Wyndham-Thomas C, Van Oyen H, Ghattas J, Blot K, Van den Borre L, Billuart M, Speybroeck N, De Pauw R, Stouten V, Catteau L, Hubin P. Sociodemographic and socioeconomic disparities in COVID-19 vaccine uptake in Belgium: a nationwide record linkage study. J Epidemiol Community Health 2023; 78:jech-2023-220751. [PMID: 38148149 PMCID: PMC11045363 DOI: 10.1136/jech-2023-220751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 12/04/2023] [Indexed: 12/28/2023]
Abstract
BACKGROUND Recent studies have identified important social inequalities in SARS-CoV-2 infections and related COVID-19 outcomes in the Belgian population. The aim of our study was to investigate the sociodemographic and socioeconomic characteristics associated with the uptake of COVID-19 vaccine in Belgium. METHODS We conducted a cross-sectional analysis of the uptake of a first COVID-19 vaccine dose among 5 342 110 adults (≥18 years) in Belgium on 31 August 2021. We integrated data from four national data sources: the Belgian vaccine register (vaccination status), COVID-19 Healthdata (laboratory test results), DEMOBEL (sociodemographic/socioeconomic data) and the Common Base Register for HealthCare Actors (individuals licensed to practice a healthcare profession in Belgium). We used multivariable logistic regression analysis for identifying characteristics associated with not having obtained a first COVID-19 vaccine dose in Belgium and for each of its three regions (Flanders, Brussels and Wallonia). RESULTS During the study period, 10% (536 716/5 342 110) of the Belgian adult population included in our study sample was not vaccinated with a first COVID-19 vaccine dose. A lower COVID-19 vaccine uptake was found among young individuals, men, migrants, single parents, one-person households and disadvantaged socioeconomic groups (with lower levels of income and education, unemployed). Overall, the sociodemographic and socioeconomic disparities were comparable for all regions. CONCLUSIONS The identification of sociodemographic and socioeconomic disparities in COVID-19 vaccination uptake is critical to develop strategies guaranteeing a more equitable vaccination coverage of the Belgian adult population.
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Affiliation(s)
- Lisa Cavillot
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
- Health and Society Research Institute, Université Catholique de Louvain, Brussels, Belgium
| | | | - Brecht Devleesschauwer
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
- Department of Translational Physiology, Infectiology and Public Health, Ghent University, Merelbeke, Belgium
| | | | - Herman Van Oyen
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Jinane Ghattas
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
- Health and Society Research Institute, Université Catholique de Louvain, Brussels, Belgium
| | - Koen Blot
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Laura Van den Borre
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
- Department of Sociology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Matthieu Billuart
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Niko Speybroeck
- Health and Society Research Institute, Université Catholique de Louvain, Brussels, Belgium
| | - Robby De Pauw
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Veerle Stouten
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Lucy Catteau
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Pierre Hubin
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
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Taruvinga T, Chingono RS, Marambire E, Larsson L, Olaru ID, Sibanda S, Nzvere F, Redzo N, Ndhlovu CE, Rusakaniko S, Mujuru H, Sibanda E, Chonzi P, Siamuchembu M, Chikodzore R, Mahomva A, Ferrand RA, Dixon J, Kranzer K. Exploring COVID-19 vaccine uptake among healthcare workers in Zimbabwe: A mixed methods study. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002256. [PMID: 38127934 PMCID: PMC10734954 DOI: 10.1371/journal.pgph.0002256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 11/02/2023] [Indexed: 12/23/2023]
Abstract
With COVID-19 no longer categorized as a public health emergency of international concern, vaccination strategies and priority groups for vaccination have evolved. Africa Centres for Diseases Prevention and Control proposed the '100-100-70%' strategy which aims to vaccinate all healthcare workers, all vulnerable groups, and 70% of the general population. Understanding whether healthcare workers were reached during previous vaccination campaigns and what can be done to address concerns, anxieties, and other influences on vaccine uptake, will be important to optimally plan how to achieve these ambitious targets. In this mixed-methods study, between June 2021 and July 2022 a quantitative survey was conducted with healthcare workers accessing a comprehensive health check in Zimbabwe to determine whether and, if so, when they had received a COVID-19 vaccine. Healthcare workers were categorized as those who had received the vaccine 'early' (before 30.06.2021) and those who had received it 'late' (after 30.06.2021). In addition, 17 in-depth interviews were conducted to understand perceptions and beliefs about COVID-19 vaccines. Of the 3,086 healthcare workers employed at 43 facilities who participated in the study, 2,986 (97%, 95% CI [92%-100%]) reported that they had received at least one vaccine dose. Geographical location, older age, higher educational attainment and having a chronic condition was associated with receiving the vaccine early. Qualitatively, (mis)information, infection risk perception, quasi-mandatory vaccination requirements, and legitimate concerns such as safety and efficacy influenced vaccine uptake. Meeting the proposed 100-100-70 target entails continued emphasis on strong communication while engaging meaningfully with healthcare workers' concerns. Mandatory vaccination may undermine trust and should not be a substitute for sustained engagement.
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Affiliation(s)
- Tinotenda Taruvinga
- The Health Research Unit Zimbabwe, Biomedical Research & Training Institute, Harare, Zimbabwe
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Africa Centres for Diseases Prevention and Control (Africa CDC), Addis Ababa, Ethiopia
| | - Rudo S. Chingono
- The Health Research Unit Zimbabwe, Biomedical Research & Training Institute, Harare, Zimbabwe
| | - Edson Marambire
- The Health Research Unit Zimbabwe, Biomedical Research & Training Institute, Harare, Zimbabwe
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, Germany
| | - Leyla Larsson
- The Health Research Unit Zimbabwe, Biomedical Research & Training Institute, Harare, Zimbabwe
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, Germany
| | - Ioana D. Olaru
- The Health Research Unit Zimbabwe, Biomedical Research & Training Institute, Harare, Zimbabwe
- Clinical Research Department, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Sibusisiwe Sibanda
- The Health Research Unit Zimbabwe, Biomedical Research & Training Institute, Harare, Zimbabwe
| | - Farirai Nzvere
- The Health Research Unit Zimbabwe, Biomedical Research & Training Institute, Harare, Zimbabwe
| | - Nicole Redzo
- The Health Research Unit Zimbabwe, Biomedical Research & Training Institute, Harare, Zimbabwe
| | - Chiratidzo E. Ndhlovu
- Internal Medicine Unit, University of Zimbabwe Faculty of Medicine and Health Sciences, Harare, Zimbabwe
| | - Simbarashe Rusakaniko
- Department of Community Medicine, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Hilda Mujuru
- Department of Paediatrics and Child Health, University of Zimbabwe College of Health Sciences, Harare, Zimbabwe
| | - Edwin Sibanda
- Bulawayo City Council Health Department, Bulawayo, Zimbabwe
| | | | - Maphios Siamuchembu
- Ministry of Health and Child Care, Provincial Medical Directorate, Bulawayo, Zimbabwe
| | - Rudo Chikodzore
- Ministry of Health and Child Care, Department of Epidemiology and Diseases Control, Harare, Zimbabwe
| | - Agnes Mahomva
- National Response to the COVID-19 Pandemic, Office of the President, and Cabinet, Harare, Zimbabwe
| | - Rashida A. Ferrand
- The Health Research Unit Zimbabwe, Biomedical Research & Training Institute, Harare, Zimbabwe
- Clinical Research Department, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Justin Dixon
- The Health Research Unit Zimbabwe, Biomedical Research & Training Institute, Harare, Zimbabwe
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Katharina Kranzer
- The Health Research Unit Zimbabwe, Biomedical Research & Training Institute, Harare, Zimbabwe
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, Germany
- Clinical Research Department, London School of Hygiene and Tropical Medicine, London, United Kingdom
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11
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Silva MEP, Skeva R, House T, Jay C. Tracking the structure and sentiment of vaccination discussions on Mumsnet. SOCIAL NETWORK ANALYSIS AND MINING 2023; 13:152. [PMID: 38026264 PMCID: PMC10657328 DOI: 10.1007/s13278-023-01155-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 10/03/2023] [Accepted: 10/10/2023] [Indexed: 12/01/2023]
Abstract
Vaccination is one of the most impactful healthcare interventions in terms of lives saved at a given cost, leading the anti-vaccination movement to be identified as one of the top 10 threats to global health in 2019 by the World Health Organization. This issue increased in importance during the COVID-19 pandemic where, despite good overall adherence to vaccination, specific communities still showed high rates of refusal. Online social media has been identified as a breeding ground for anti-vaccination discussions. In this work, we study how vaccination discussions are conducted in the discussion forum of Mumsnet, a UK-based website aimed at parents. By representing vaccination discussions as networks of social interactions, we can apply techniques from network analysis to characterize these discussions, namely network comparison, a task aimed at quantifying similarities and differences between networks. Using network comparison based on graphlets-small connected network subgraphs-we show how the topological structure of vaccination discussions on Mumsnet differs over time, in particular before and after COVID-19. We also perform sentiment analysis on the content of the discussions and show how the sentiment toward vaccinations changes over time. Our results highlight an association between differences in network structure and changes to sentiment, demonstrating how network comparison can be used as a tool to guide and enhance the conclusions from sentiment analysis.
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Affiliation(s)
- Miguel E. P. Silva
- Department of Computer Science, University of Manchester, Oxford Road, Manchester, M13 9PY England UK
- LIAAD, INESC-TEC, Porto, Portugal
| | - Rigina Skeva
- Department of Computer Science, University of Manchester, Oxford Road, Manchester, M13 9PY England UK
| | - Thomas House
- Department of Mathematics, University of Manchester, Oxford Road, Manchester, M13 9PY England UK
| | - Caroline Jay
- Department of Computer Science, University of Manchester, Oxford Road, Manchester, M13 9PY England UK
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12
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Nasiratu I, Pencille LB, Khuzwayo N, Aboagye RG, Tarkang EE. Predictors of COVID-19 vaccine uptake among persons aged 18 years and above in Ga North Municipality, Ghana using the Health Belief Model: A community-based cross-sectional study. PLoS One 2023; 18:e0293350. [PMID: 37934776 PMCID: PMC10629641 DOI: 10.1371/journal.pone.0293350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 09/23/2023] [Indexed: 11/09/2023] Open
Abstract
BACKGROUND Although the coronavirus disease 2019 (COVID-19) vaccination rollout has been accepted by the population of the Ga North Municipality, a substantial proportion has developed hesitancy to COVID-19 vaccination uptake. This study determined the predictors of COVID-19 vaccine uptake among persons aged 18 years and above in the Ga North Municipality using the Health Belief Model. METHODS The study used a cross-sectional study design. Structured questionnaires were used to collect data from a multistage sample of 388 respondents. Multivariable binary logistic regression was used to determine the predictors of COVID-19 vaccination uptake at the level of 0.05 and 95% confidence interval. RESULTS Vaccination uptake was 72.2%. The odds of COVID-19 vaccination uptake were higher among men than women [AOR = 2.02, 95% Cl: 1.13-3.20] and among singles than the married [AOR = 1.90, 95% Cl: 1.07-3.36], but lower among Muslims than Christians [AOR = 0.33, 95%Cl: 0.18-0.60]. Perceived susceptibility [AOR = 2.43, 95% Cl: 1.36-4.35], perceived barriers [AOR = 0.54, 95%Cl: 0.31-0.95], cues to action [AOR = 2.23, 95% Cl: 1.19-4.21] and self-efficacy [AOR = 3.23 95% Cl: 1.82-5.71] were the significant predictors of COVID-19 vaccination uptake. CONCLUSION The uptake of the COVID-19 vaccine in GA North Municipality is high. Health promotion interventions should focus on increasing perceived susceptibility to COVID-19, minimising barriers to COVID-19 vaccine uptake, and promoting cues and self-confidence for COVID-19 vaccine uptake. It should also target women, the married, and Muslims.
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Affiliation(s)
- Imoro Nasiratu
- Department of Population and Behavioural Sciences, School of Public Health, University of Health and Allied Sciences, Ho, Ghana
| | | | - Nelisiwe Khuzwayo
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | | | - Elvis Enowbeyang Tarkang
- Department of Population and Behavioural Sciences, School of Public Health, University of Health and Allied Sciences, Ho, Ghana
- HIV/AIDS Prevention Research Network Cameroon, Kumba, Cameroon
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
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13
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Hardin B, Graboyes M, Kosty D, Cioffi C. Vaccine decision making among people who inject drugs: Improving on the WHO's 3C model of vaccine hesitancy. Prev Med Rep 2023; 35:102341. [PMID: 37593355 PMCID: PMC10428103 DOI: 10.1016/j.pmedr.2023.102341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 07/19/2023] [Accepted: 07/20/2023] [Indexed: 08/19/2023] Open
Abstract
The objectives of this study were to 1) identify vaccination rates among PWID in Oregon at a time when vaccines were easily accessible, 2) quantitatively identify convergence with demographic correlates of vaccination willingness and uptake to promote generalizability, and 3) explore the factors PWID were considering when deciding whether or not to receive the COVID-19 vaccine. We conducted a mixed-methods study design including 260 quantitative surveys and 41 in-depth qualitative interviews with PWID, conducted July - September 2021 at syringe services programs in Lane County, Oregon. Among the 260 survey respondents, 37.3% indicated that they had received a COVID-19 vaccine by October 1, 2021. In the same period, an estimated 70.1% of the total Lane County population had completed their COVID-19 vaccinations (not including booster rounds). We explored alignment with the WHO's 3C model of vaccine hesitancy and identified, instead, five common factors as key motivators for vaccine decisions: confidence, convenience, concern, communication, and community implications among PWID. Interviews with PWID describe systemic barriers which prevented them from accessing healthcare resources. We highlight that our proposed 5C model may more accurately depict how PWID navigate vaccine decisions by incorporating the ways that social inequities, infrastructural barriers, and community values influence an individual's vaccine deliberation.
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Affiliation(s)
- Blake Hardin
- Department of Global Studies, University of Oregon, United States
| | | | - Derek Kosty
- Prevention Science Institute, University of Oregon, United States
| | - Camille Cioffi
- Prevention Science Institute, University of Oregon, United States
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14
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Anino CO, Wandera I, Masimba ZO, Kirui CK, Makero CS, Omari PK, Sanga P. Determinants of Covid-19 vaccine uptake among the elderly aged 58 years and above in Kericho County, Kenya: Institution based cross sectional survey. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001562. [PMID: 37698989 PMCID: PMC10497123 DOI: 10.1371/journal.pgph.0001562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 08/07/2023] [Indexed: 09/14/2023]
Abstract
Hesitancy to Covid-19 vaccine is a global challenge despite the compelling evidence of the value of vaccine in preventing disease and saving lives. It is suggested that context-specific strategies can enhance acceptability and decrease hesitancy to Covid-19 vaccine. Hence, the study determined uptake and determinants of Covid-19 vaccine following a sustained voluntary vaccination drive by Kenyan government. We conducted institution based cross-sectional survey of 1244 elderly persons aged 58 to 98 years in the months of January, February and March, 2022. A multinomial logistic regression analysis was used to investigate determinants of Covid 19 vaccine uptake. The predictor variables included socioeconomic and demographic characteristics, convenience and ease of access of the vaccine, collective responsibility, complacency and the three dimensions of confidence; trust in safety, trust in decision makers and delivery system. The findings are reported as the adjusted odd ratio (AOR) at 95% confidence interval (CI). Significant level was considered at p <0.05. The results from the multinomial logistic regression analysis indicated that advanced age and presence of chronic disease were associated with increased odds of doubt on Covid 19 vaccine, while long distance from vaccination centers was associated with increased odds of delay in vaccination. Overall, the findings of this study provided valuable insights into the factors influencing vaccine hesitancy among the elderly population in Kenya and will inform the development of targeted interventions to increase vaccine acceptance and uptake in this population.
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15
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Wollburg P, Markhof Y, Kanyanda S, Zezza A. Assessing COVID-19 vaccine hesitancy and barriers to uptake in Sub-Saharan Africa. COMMUNICATIONS MEDICINE 2023; 3:121. [PMID: 37696937 PMCID: PMC10495410 DOI: 10.1038/s43856-023-00330-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 06/29/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND Despite improved availability of COVID-19 vaccines in Sub-Saharan Africa, vaccination campaigns in the region have struggled to pick up pace and trail the rest of the world. Yet, a successful vaccination campaign in Sub-Saharan Africa will be critical to containing COVID-19 globally. METHODS Here, we present new descriptive evidence on vaccine hesitancy, uptake, last-mile delivery barriers, and potential strategies to reach those who remain unvaccinated. Our data comes from national high frequency phone surveys in six countries in East and West Africa with a total population of 415 million people. Samples were drawn from nationally representative samples of households interviewed in recent in-person surveys. Our estimates are based on a survey module harmonized across countries and are re-weighted to mitigate potential sample selection biases. RESULTS We show that vaccine acceptance remains generally high among respondents in Sub-Saharan Africa (between 95.1% and 63.3%) even though hesitancy is non-negligible among those pending vaccination. Many who are willing to get vaccinated are deterred by a lack of easy access to vaccines at the local level. Furthermore, social ties and perceptions as well as intra-household power relations matter for vaccine take-up. Among the unvaccinated population, radio broadcasts have widespread reach and medical professionals are highly trusted. CONCLUSIONS Our findings highlight that creating a positive social norm around COVID-19 vaccination, messaging that leverages trusted and accessible information sources and channels, and more easily accessible vaccination sites at the community level are promising policy options to boost vaccination campaigns in the region and end the pandemic everywhere.
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Affiliation(s)
| | - Yannick Markhof
- Development Data Group, World Bank, Washington, DC, USA
- UNU-MERIT, United Nations University, Maastricht, Netherlands
| | | | - Alberto Zezza
- Development Data Group, World Bank, Washington, DC, USA
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16
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Maureen Ayikoru, Cole J, Dodds K, Atcero M, Bada JK, Petrikova I, Worodria W. Addressing vaccine concerns through the spectrum of vaccine acceptance. Soc Sci Med 2023; 333:116146. [PMID: 37579556 DOI: 10.1016/j.socscimed.2023.116146] [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: 01/03/2023] [Revised: 07/30/2023] [Accepted: 08/03/2023] [Indexed: 08/16/2023]
Abstract
RATIONALE/OBJECTIVE Several studies have examined attitudes towards COVID-19 vaccines, giving prominence to hesitancy and conceptual models that seek to explain its prevalence, mostly in high-income contexts. An alternative conceptual approach that prioritises an understanding of vaccine concerns, the rationality of the questions people have, the political and media ecologies that raise them, will help recommend ways in which such concerns can be addressed. This current study employs the Spectrum of Vaccine Acceptance as a conceptual framework to explain vaccine concerns, in a low-income context. METHODS A cross-sectional survey was designed by drawing on the extant literature on indirect impacts of COVID-19 pandemic. The survey was administered face to face to a stratified random sample of 459 healthcare professionals in Uganda, from 1st to July 31, 2021. Key findings from the survey were explored using focus group interviews. Descriptive analysis was performed to quantify key responses on socio-demographic characteristics, feelings and views about COVID-19 and vaccines. Qualitative themes from the survey and focus groups were explained through the framework of the Spectrum of Vaccine Acceptance. RESULTS Vaccine acceptance was the most dominant attitude among healthcare professionals, with 74.9% of all respondents (N = 224) having been vaccinated. The findings highlight a relationship between vaccine acceptance, vaccine questioning and vaccine hesitancy, in that nearly 60% (N = 127) of those that were already vaccinated had several concerns about the vaccines they had received, suggesting that questions do not necessarily equate to refusal. This led to a partial reframing of the Spectrum of Vaccine Acceptance. CONCLUSION Factors which determine and differentiate vaccine concerns among healthcare professionals in a low-income context show that rational concerns far outweigh non-sensical and conspiratorial views. The findings will act as a useful input into the importance of understanding and addressing vaccine concerns, and the role of managing information voids in pandemic management.
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Affiliation(s)
- Maureen Ayikoru
- Royal Holloway, University of London (RHUL), Egham Hill, Egham, Surrey, TW20 0EX, UK.
| | - Jennifer Cole
- Royal Holloway, University of London (RHUL), Egham Hill, Egham, Surrey, TW20 0EX, UK
| | - Klaus Dodds
- Royal Holloway, University of London (RHUL), Egham Hill, Egham, Surrey, TW20 0EX, UK
| | - Milburga Atcero
- Makerere University Business School (MUBS), Plot 21A, Portbell Road, P.O. Box, 1337, Kampala, Uganda
| | - Joseph K Bada
- Makerere University Business School (MUBS), Plot 21A, Portbell Road, P.O. Box, 1337, Kampala, Uganda
| | - Ivica Petrikova
- Royal Holloway, University of London (RHUL), Egham Hill, Egham, Surrey, TW20 0EX, UK
| | - William Worodria
- Makerere Lung Institute, Makerere University College of Health Sciences, New Mulago Complex, P.O. Box 7749, Kampala, Uganda
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Taruvinga T, Chingono RS, Marambire E, Larsson L, Olaru ID, Sibanda S, Nzvere F, Redzo N, Ndhlovu CE, Rusakaniko S, Mujuru H, Sibanda E, Chonzi P, Siamuchembu M, Chikodzore R, Mahomva A, Ferrand RA, Dixon J, Kranzer K. Exploring COVID-19 vaccine uptake among healthcare workers in Zimbabwe: A mixed methods study. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.07.17.23292791. [PMID: 37503278 PMCID: PMC10371179 DOI: 10.1101/2023.07.17.23292791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
With COVID-19 no longer categorized as a public health emergency of international concern, vaccination strategies and priority groups for vaccination have evolved. Africa Centers for Diseases Prevention and Control proposed the '100-100-70%' strategy which aims to vaccinate all healthcare workers, all vulnerable groups, and 70% of the general population. Understanding whether healthcare workers were reached during previous vaccination campaigns and what can be done to address concerns, anxieties, and other influences on vaccine uptake, will be important to optimally plan how to achieve these ambitious targets. In this mixed-methods study, between June 2021 and July 2022 a quantitative survey was conducted with healthcare workers accessing a comprehensive health check in Zimbabwe to determine whether and, if so, when they had received a COVID-19 vaccine. Healthcare workers were categorized as those who had received the vaccine 'early' (before 30.06.2021) and those who had received it 'late' (after 30.06.2021). In addition, 17 in-depth interviews were conducted to understand perceptions and beliefs about COVID-19 vaccines. Of the 2905 healthcare workers employed at 37 facilities who participated in the study, 2818 (97%, 95% CI [92%-102%]) reported that they had received at least one vaccine dose. Geographical location, older age, higher educational attainment and having a chronic condition was associated with receiving the vaccine early. Qualitatively, (mis)information, infection risk perception, quasi-mandatory vaccination requirements, and legitimate concerns such as safety and efficacy influenced vaccine uptake. Meeting the proposed 100-100-70 target entails continued emphasis on strong communication while engaging meaningfully with healthcare workers' concerns. Mandatory vaccination may undermine trust and should not be a substitute for sustained engagement.
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Affiliation(s)
- Tinotenda Taruvinga
- The Health Research Unit Zimbabwe, Biomedical Research & Training Institute, Harare, Zimbabwe
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
- Africa Centres for Diseases Prevention and Control (Africa CDC), Addis Ababa, Ethiopia
| | - Rudo S. Chingono
- The Health Research Unit Zimbabwe, Biomedical Research & Training Institute, Harare, Zimbabwe
| | - Edson Marambire
- The Health Research Unit Zimbabwe, Biomedical Research & Training Institute, Harare, Zimbabwe
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, Germany
| | - Leyla Larsson
- The Health Research Unit Zimbabwe, Biomedical Research & Training Institute, Harare, Zimbabwe
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, Germany
| | - Ioana D. Olaru
- The Health Research Unit Zimbabwe, Biomedical Research & Training Institute, Harare, Zimbabwe
- Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK
| | - Sibusisiwe Sibanda
- The Health Research Unit Zimbabwe, Biomedical Research & Training Institute, Harare, Zimbabwe
| | - Farirayi Nzvere
- The Health Research Unit Zimbabwe, Biomedical Research & Training Institute, Harare, Zimbabwe
| | - Nicole Redzo
- The Health Research Unit Zimbabwe, Biomedical Research & Training Institute, Harare, Zimbabwe
| | - Chiratidzo E. Ndhlovu
- Internal Medicine Unit, University of Zimbabwe Faculty of Medicine and Health Sciences Harare, Zimbabwe
| | - Simbarashe Rusakaniko
- Department of Community Medicine, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Hilda Mujuru
- . Department of Paediatrics and Child Health, University of Zimbabwe College of Health Sciences, Harare, Zimbabwe
| | - Edwin Sibanda
- Bulawayo City Council Health Department, Bulawayo, Zimbabwe
| | | | - Maphios Siamuchembu
- Ministry of Health and Child Care, Provincial Medical Directorate, Bulawayo, Zimbabwe
| | - Rudo Chikodzore
- Ministry of Health and Child Care, Department of Epidemiology and Diseases Control, Harare, Zimbabwe
| | - Agnes Mahomva
- National Response to the COVID-19 Pandemic, Office of the President, and Cabinet, Harare, Zimbabwe
| | - Rashida A. Ferrand
- The Health Research Unit Zimbabwe, Biomedical Research & Training Institute, Harare, Zimbabwe
- Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK
| | - Justin Dixon
- The Health Research Unit Zimbabwe, Biomedical Research & Training Institute, Harare, Zimbabwe
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | - Katharina Kranzer
- The Health Research Unit Zimbabwe, Biomedical Research & Training Institute, Harare, Zimbabwe
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, Germany
- Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK
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18
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Larsson L, Dziva Chikwari C, Simms V, Tembo M, Mahomva A, Mugurungi O, Hayes RJ, Mackworth-Young CRS, Bernays S, Mavodza C, Taruvinga T, Bandason T, Dauya E, Ferrand RA, Kranzer K. Addressing sociodemographic disparities in COVID-19 vaccine uptake among youth in Zimbabwe. BMJ Glob Health 2023; 8:e012268. [PMID: 37407229 DOI: 10.1136/bmjgh-2023-012268] [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: 03/10/2023] [Accepted: 06/17/2023] [Indexed: 07/07/2023] Open
Abstract
INTRODUCTION COVID-19 vaccine acceptance research has mostly originated from high-income countries and reasons why youth may not get vaccinated may differ in low-income settings. Understanding vaccination coverage across different population groups and the sociocultural influences in healthcare delivery is important to inform targeted vaccination campaigns. METHODS A population-based survey was conducted in 24 communities across three provinces (Harare, Bulawayo and Mashonaland East) in Zimbabwe between October 2021 and June 2022. Youth aged 18-24 years were randomly selected using multistage sampling. Sociodemographic characteristics, COVID-19 vaccination uptake and reasons for non-uptake were collected, and odds of vaccination was investigated using logistic regression. RESULTS 17 682 youth were recruited in the survey (n=10 742, 60.8% female). The median age of participants was 20 (IQR: 19-22) years. Almost two thirds (n=10 652, 60.2%) reported receiving at least one dose of COVID-19 vaccine. A higher proportion of men than women had been vaccinated (68.9% vs 54.7%), and vaccination prevalence increased with age (<19 years: 57.5%, 20-22: 61.5%, >23: 62.2%). Lack of time to get vaccinated, belief that the vaccine was unsafe and anxiety about side effects (particularly infertility) were the main reasons for not getting vaccinated. Factors associated with vaccination were male sex (OR=1.69, 95% CI 1.58 to 1.80), increasing age (>22 years: OR=1.12, 95% CI 1.04 to 1.21), education level (postsecondary: OR=4.34, 95% CI 3.27 to 5.76) and socioeconomic status (least poor: OR=1.32, 95% CI 1.20 to 1.47). CONCLUSION This study found vaccine inequity across age, sex, educational attainment and socioeconomic status among youth. Strategies should address these inequities by understanding concerns and tailoring vaccine campaigns to specific groups.
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Affiliation(s)
- Leyla Larsson
- Biomedical Research and Training Institute, Harare, Zimbabwe
- Division of Infectious Diseases and Tropical Medicine, Ludwig Maximilians University Munich, Munchen, Germany
| | - Chido Dziva Chikwari
- Biomedical Research and Training Institute, Harare, Zimbabwe
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Victoria Simms
- Biomedical Research and Training Institute, Harare, Zimbabwe
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Mandikudza Tembo
- Biomedical Research and Training Institute, Harare, Zimbabwe
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Agnes Mahomva
- National Response to the COVID-19 Pandemic, Zimbabwe Government Office of the President and Cabinet, Harare, Zimbabwe
| | | | - Richard J Hayes
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Constance R S Mackworth-Young
- Biomedical Research and Training Institute, Harare, Zimbabwe
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | - Sarah Bernays
- School of Public Health, University of Sydney-Sydney Medical School Nepean, Sydney, New South Wales, Australia
- Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Constancia Mavodza
- Biomedical Research and Training Institute, Harare, Zimbabwe
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Tinotenda Taruvinga
- Biomedical Research and Training Institute, Harare, Zimbabwe
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
| | - Tsitsi Bandason
- Biomedical Research and Training Institute, Harare, Zimbabwe
| | - Ethel Dauya
- Biomedical Research and Training Institute, Harare, Zimbabwe
| | - Rashida Abbas Ferrand
- Biomedical Research and Training Institute, Harare, Zimbabwe
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Katharina Kranzer
- Division of Infectious Diseases and Tropical Medicine, Ludwig Maximilians University Munich, Munchen, Germany
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
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19
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Sharma E, Mondal S, Das S, Vrana VG. Scale Development for COVID-19 Vaccine Hesitancy by Integration of Socio-Demographic and Psychological Factors. Vaccines (Basel) 2023; 11:1052. [PMID: 37376441 DOI: 10.3390/vaccines11061052] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 05/27/2023] [Accepted: 05/29/2023] [Indexed: 06/29/2023] Open
Abstract
Vaccination is the most cost-effective way to maintain population health. However, it can only be effective if widespread acceptance is held. The efficacy of COVID-19 vaccines depends on their favor. When countries start to vaccinate their citizens, there is a certain level of skepticism about the effectiveness of the vaccines. The hesitancy study on vaccines has gained momentum following the pandemic. However, few studies have examined the link between the psychological and sociodemographic factors influencing the fit. This paper proposes integrating the concepts of the information systems success and stimulus-organism-response into a cognitive fit theory framework to explore the integration of psychological and sociodemographic factors in the receivers' reactions (n = 1510). This study analyses the factors that influence the hesitancy of vaccines and the public's refusal in Asia and Europe. Receivers' reactions were assessed to various stimuli and we explored the link between psychological and sociodemographic elements and the concept of fit. Two surveys were conducted following the scale development of Mackenzie. The first was to develop the fit scale, while the second was to validate the fit scale. The results of the second survey were analyzed using structural equation modelling. The results indicate that the scale's fit development is valid and reliable. The quality of the vaccine information, the psychological characteristics of the vaccine system, and vaccine receivers' satisfaction are also beneficial factors for emotional and cognitive fit. Maintaining the vaccines' quality and efficiency can help improve the fit between sociodemographic and psychological characteristics. It can also enhance receivers' satisfaction and encourage continued vaccine administration. This study is regarded as one of the first to examine and develop an emotional and cognitive fit scale for practitioners and researchers.
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Affiliation(s)
- Eliza Sharma
- Symbiosis Institute of Business Management Bengaluru, Symbiosis International (Deemed University), Karnataka 560100, India
| | - Subhra Mondal
- The Honors Programme, Department of Marketing, South Star Management Institute, Duy Tan University, Da Nang 550000, Vietnam
| | - Subhankar Das
- The Honors Programme, Department of Marketing, South Star Management Institute, Duy Tan University, Da Nang 550000, Vietnam
| | - Vasiliki G Vrana
- Department of Business Administration, School of Economics and Administration, The Campus of Serres, International Hellenic University, 62124 Serres, Greece
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20
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Takagi MA, Hess S, Smith Z, Gawronski K, Kumar A, Horsley J, Haddad N, Noveloso B, Zyzanski S, Ragina N. The impact of educational interventions on COVID-19 and vaccination attitudes among patients in Michigan: A prospective study. Front Public Health 2023; 11:1144659. [PMID: 37077191 PMCID: PMC10106744 DOI: 10.3389/fpubh.2023.1144659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 03/14/2023] [Indexed: 04/05/2023] Open
Abstract
BackgroundMass vaccination serves as an effective strategy to combat the COVID-19 pandemic. Vaccine hesitancy is a recognized impediment to achieving a vaccination rate necessary to protect communities. However, solutions and interventions to address this issue are limited by a lack of prior research.MethodsOver 200 patients from 18 Michigan counties participated in this study. Each participant received an initial survey, including demographical questions and knowledge and opinion questions regarding COVID-19 and vaccines. Participants were randomly assigned an educational intervention in either video or infographic format. Patients received a post-survey to assess changes in knowledge and attitudes. Paired sample t-tests and ANOVA were used to measure the effectiveness of the educational interventions. Participants also elected to complete a 3-month follow-up survey.ResultsPatients showed increased knowledge after the educational intervention in six out of seven COVID-19 topics (p < 0.005). There was increased vaccine acceptance after the intervention but no difference in the effectiveness between the two intervention modalities. Post-intervention, more patients believed in CDC recommendations (p = 0.005), trusted the vaccine (p = 0.001), believed the vaccines had adequate testing (p = 0.019), recognized prior mistreatment in the medical care system (p = 0.005), agreed that a source they trust told them to receive a vaccine (p = 0.015), and were worried about taking time off of work to get a vaccine (p = 0.023). Additionally, post-intervention, patients were less concerned about mild reactions of the virus (p = 0.005), the rapid development of the vaccines (p < 0.001), and vaccine side effects (p = 0.031). Data demonstrated that attitude and knowledge improved when comparing pre-educational intervention to follow-up but decreased from post-intervention to follow-up.ConclusionThe findings illustrate that educational interventions improved COVID-19 and vaccine knowledge among patients and that the knowledge was retained. Educational interventions serve as powerful tools to increase knowledge within communities and address negative views on vaccination. Interventions should be continually utilized to reinforce information within communities to improve vaccination rates.
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Affiliation(s)
- Maya Asami Takagi
- Central Michigan University, College of Medicine, Mt. Pleasant, MI, United States
| | - Samantha Hess
- Central Michigan University, College of Medicine, Mt. Pleasant, MI, United States
| | - Zachary Smith
- Central Michigan University, College of Medicine, Mt. Pleasant, MI, United States
| | - Karissa Gawronski
- Central Michigan University, College of Medicine, Mt. Pleasant, MI, United States
| | - Ayushi Kumar
- Central Michigan University, College of Medicine, Mt. Pleasant, MI, United States
| | - Jacob Horsley
- Central Michigan University, College of Medicine, Mt. Pleasant, MI, United States
| | - Nicholas Haddad
- Central Michigan University Medical Education Partners, Saginaw, MI, United States
| | - Bernard Noveloso
- Central Michigan University Medical Education Partners, Saginaw, MI, United States
| | - Stephen Zyzanski
- Department of Family Medicine and Community Health, School of Medicine, Case Western Reserve University, Saginaw, MI, United States
| | - Neli Ragina
- Central Michigan University, College of Medicine, Mt. Pleasant, MI, United States
- *Correspondence: Neli Ragina,
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21
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Cavanaugh AM, Raparti L, Bhurgri M, Herrington A, Holladay C, Arora V, Spicer KB, Thoroughman DA, Winter K. Characteristics of Decedents With COVID-19-Related Mortality in Kentucky, July 1-August 13, 2021. Public Health Rep 2023:333549231155867. [PMID: 36927290 PMCID: PMC10020852 DOI: 10.1177/00333549231155867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
Abstract
OBJECTIVE Although vaccination reduces the risk of severe COVID-19, fatal COVID-19 cases after vaccination can occur. We examined the characteristics of decedents with COVID-19-related mortality to help inform discussions about vaccination, boosters, and mitigation strategies. METHODS We examined COVID-19-related deaths in Kentucky resulting from infections occurring from July 1 through August 13, 2021. We used records from case investigations, medical records, the Kentucky Health Information Exchange, and the Kentucky Immunization Registry to determine demographic information, vaccination status, and underlying health conditions, including calculation of the Charlson Comorbidity Index (CCI). We calculated mortality incidence rates by vaccination status by using data for unvaccinated and fully vaccinated populations in Kentucky as of July 1, 2021. RESULTS In total, 777 COVID-19-related deaths occurred in Kentucky during the study period; 592 (76.2%) occurred among unvaccinated people. Compared with unvaccinated decedents, fully vaccinated decedents were older (median age, 77 vs 65 years; P < .001), had higher comorbidity levels (median CCI, 3 vs 1; P < .001), and were more likely to have immunocompromised health status (26.4% vs 16.0%; P = .003). Diabetes, hypertension, heart disease, and chronic lung disease were more common among vaccinated decedents than among unvaccinated decedents. Unvaccinated adults had a significantly higher risk of death than fully vaccinated adults (incidence rate ratio for age 20-49 years: 20.5 [95% CI, 6.5-64.8]; 50-64 years: 14.6 [95% CI, 9.4-22.7]; ≥65 years: 10.2 [95% CI, 8.3-12.4]). CONCLUSIONS Immunocompromised health status, older age, and higher comorbidity were prevalent among fully vaccinated decedents, suggesting adults with these characteristics may benefit from additional protection strategies. Further understanding of the protection of additional and booster doses is needed.
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Affiliation(s)
- Alyson M Cavanaugh
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA.,Kentucky Department for Public Health, Frankfort, KY, USA
| | | | | | - Amy Herrington
- Kentucky Department for Public Health, Frankfort, KY, USA
| | | | - Vaneet Arora
- Kentucky Department for Public Health, Frankfort, KY, USA.,University of Kentucky, Lexington, KY, USA
| | - Kevin B Spicer
- Kentucky Department for Public Health, Frankfort, KY, USA.,Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Douglas A Thoroughman
- Kentucky Department for Public Health, Frankfort, KY, USA.,Career Epidemiology Field Officer Program, Division of State and Local Readiness, Center for Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kathleen Winter
- Kentucky Department for Public Health, Frankfort, KY, USA.,University of Kentucky, Lexington, KY, USA
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22
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Hatcher B. Decolonizing health policy and practice: Vaccine hesitancy in the United States. Nurs Philos 2023; 24:e12428. [PMID: 36894517 DOI: 10.1111/nup.12428] [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: 02/16/2023] [Accepted: 02/17/2023] [Indexed: 03/11/2023]
Abstract
Using 2021 data and information related to COVID-19, this paper discusses the contribution of colonization, medical mistrust and racism to vaccine hesitancy. Vaccine hesitancy is defined as 'delay in acceptance or refusal of vaccines despite availability'. Colonization is described as the 'way the extractive economic system of capitalism came to the United States, supported by systems of supremacy and domination, which are a necessary part of keeping the wealth and power accumulated in the hands of the colonizers and ultimately their financiers'. The system of colonization results in policies and practices, including those related to health, that continue to create oppression and support racism. Persons experience trauma as the byproduct of colonization. Chronic stress and trauma create chronic inflammation and all diseases, whether genetic or lifestyle, have a common pathogenesis that is a component of inflammation. Medical mistrust is the absence of trust that healthcare providers and organizations genuinely care for patients' interests, are honest, practice confidentiality and have the competence to produce the best possible results. Finally, racism is described as everyday racism and perceived racism in healthcare.
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Affiliation(s)
- Barbara Hatcher
- Hatcher-DuBois-Odrick Group LLC, Washington, District of Columbia, USA
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23
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Ahmed W, Ali S, Waqas H, Asghar M, Erum N. Identifying and Evaluating the Socioeconomic Factors of COVID Vaccine Hesitancy Through an Integrated Multicriteria Decision Analysis Approach. GLOBAL SOCIAL WELFARE : RESEARCH, POLICY & PRACTICE 2023:1-9. [PMID: 36846516 PMCID: PMC9944403 DOI: 10.1007/s40609-023-00268-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/14/2023] [Indexed: 06/18/2023]
Abstract
The governments have been facing the challenges to develop tailored strategies to decrease COVID vaccine hesitancy (CVH) and refusal and increase the acceptability and uptake to ensure the protection of public health. In Pakistan, it has been a great challenge for the government to increase the acceptability of the COVID vaccine. CVH has been a great hurdle to achieving this objective. The authors found it imperative to identify and evaluate the factors of CVH in Pakistan. For this purpose, the authors used an integrated multicriteria decision analysis method (MCDM) by combining Delphi and DEMATEL methods. The factors of CVH have been identified and finalized using the Delphi method. The experts' opinions were obtained to evaluate the factors. The DEMATEL method was used to find out the most critical factor(s) of CVH. Moreover, the cause/effect relationship was also developed to have a better understating of factors and their relationships. The analysis revealed "ineffective public awareness strategies" as the most critical factor of CVH followed by "misinformation and disinformation, conspiracy theories", and "acquired knowledge". The study also examined the cause-and-effect relationship between the prioritized factors. The government in Pakistan introduced successful efforts to deal with the COVID-19 pandemic, yet the government could do more to increase vaccine acceptance. For this purpose to serve effective scientific and evidence-based public awareness strategies are needed to increase the acquired knowledge and deal with misinformation, disinformation, and conspiracy theories to increase vaccine acceptance. The government could sue the media, especially social media to increase vaccination. The findings of the study provide a detailed understanding of the CVH in Pakistan and develop a comprehensive public health strategy to deal with any health-related potential issues in the future.
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Affiliation(s)
- Waqas Ahmed
- Department of Management and Marketing, Westminster International University in Tashkent, Tashkent, Uzbekistan
| | - Sharafat Ali
- College of Economics and Management, Nanjing University of Aeronautics and Astronautics, Nanjing, 211106 China
- Department of Economics, Government Graduate College Kot Sultan, Kot Sultan, 31650 Layyah Punjab, Pakistan
| | - Hamid Waqas
- Department of Management and Marketing, Westminster International University in Tashkent, Tashkent, Uzbekistan
| | - Muhammad Asghar
- Department of Economics, Ghazi University, Dera Ghazi Khan, Pakistan
| | - Naila Erum
- Department of Political Science, Rawalpindi Women University, Rawalpindi, Pakistan
- Accounting Research Institute, University Technology, MARA, Shah Alam, UiTM Malaysia
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24
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Development and Evaluation of an Index to Measure the Ability to Get Vaccinated for COVID-19. Vaccines (Basel) 2023; 11:vaccines11020342. [PMID: 36851220 PMCID: PMC9966146 DOI: 10.3390/vaccines11020342] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 01/31/2023] [Accepted: 02/01/2023] [Indexed: 02/05/2023] Open
Abstract
The COVID-19 pandemic has been an historic challenge to public health, and to behavior change programs. There have been challenges in promoting vaccination in LMICs, including Nigeria. One important hypothesis deserving consideration is the ability to obtain vaccination as a potential barrier to vaccination uptake. The MOA (motivation, opportunity, and ability) framework, as illustrated by multiple theories such as COM-B, EAST, and the Fogg model, is a primary theoretical basis for the evaluation of this ability as a factor in vaccination uptake. There is little research on measuring the ability to get vaccinated in LMICs, including on the role of all of the MOA framework. The aim of this study was to develop and evaluate an ability factors index measured through social media-based data collected in Nigeria in late 2021 and early 2022. We present findings from an online survey of 8574 Nigerians and highlight new social media-based data collection techniques in this research. This study found that a new ability factors index comprising 12 items was associated with vaccine uptake independent of measures capturing other components of the MOA framework. This index may serve as a valuable research instrument for future studies. We conclude that a person's perceived ability to get vaccinated, measured by a newly validated index, is related to vaccination uptake and hesitancy, and that more research should be conducted in this area.
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25
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AlShurman BA, Butt ZA. Proposing a New Conceptual Syndemic Framework for COVID-19 Vaccine Hesitancy: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1561. [PMID: 36674314 PMCID: PMC9864682 DOI: 10.3390/ijerph20021561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/09/2023] [Accepted: 01/12/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Discussions regarding syndemics have dominated research in recent years. Vaccine hesitancy has also been propelled to the forefront. In this narrative review, we aim to frame a novel syndemic framework to understand the interaction between vaccine hesitancy, COVID-19, and negative health outcomes. METHODS A non-systematic electronic search was conducted in PubMed and Google Scholar. Search criteria were limited to articles published between November 2019 and June 2022. Articles related to the COVID-19 syndemic and vaccine hesitancy were included. RESULTS Our review revealed that the adherence to COVID-19 regulations-although they were effective in preventing COVID-19 transmission, cases, and deaths-created a dynamically unstable 'vicious cycle' between undesirable health, economic, and social outcomes. The "accumulation" of complex stressors decreased individuals' cognitive flexibility and hindered them from making decisions and getting vaccinated. Furthermore, it increased individuals' risk of acquiring COVID-19, losing their employment, increasing poverty, and decreasing healthcare utilization. We illustrated how the amalgamation of sociodemographic and contextual factors associated with COVID-19 might impact people's vaccine decisions, making them more hesitant toward COVID-19 vaccination. Failing to receive vaccinations increases the chances of COVID-19 transmission, hospitalization, and other negative health outcomes. CONCLUSIONS Understanding the interaction between these factors is essential to provide policymakers with inspiration to set appropriate interventions for promoting COVID-19 vaccination acceptance to decrease the overall burden of pandemics.
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Affiliation(s)
| | - Zahid Ahmad Butt
- School of Public Health Sciences, University of Waterloo, Waterloo, ON N2L 3G1, Canada
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26
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Koskan AM, LoCoco IE, Daniel CL, Teeter BS. Rural Americans' COVID-19 Vaccine Perceptions and Willingness to Vaccinate against COVID-19 with Their Community Pharmacists: An Exploratory Study. Vaccines (Basel) 2023; 11:vaccines11010171. [PMID: 36680016 PMCID: PMC9864964 DOI: 10.3390/vaccines11010171] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/06/2023] [Accepted: 01/08/2023] [Indexed: 01/15/2023] Open
Abstract
In early 2022 in the U.S., rural adults were the least likely to vaccinate against COVID-19 due to vaccine hesitancy and reduced healthcare access. This study explored the factors influencing rural adults' COVID-19 vaccine perceptions and their acceptance of pharmacist-administered vaccination. We utilized phone-based semi-structured interviews with 30 adults living in rural regions of one southwestern state and analyzed the data using a team-based thematic analysis approach. Vaccine-willing participants described knowing other people affected by the virus and their desired protection from the virus. They reported trusting scientific institutions and the government to provide safe vaccines. Vaccine-hesitant populations, however, feared that the COVID-19 vaccine development process had been rushed, compromising the safety of these newer vaccines. Although they differed in the news sources they preferred for receiving COVID-19 vaccine information, both vaccine-willing and vaccine-hesitant participants described trusting local authorities, such as healthcare providers and county government officials, to provide accurate COVID-19 vaccine information. Regarding the acceptability of pharmacist-administered COVID-19 vaccinations, all but one participant described their acceptance of this healthcare delivery approach. Future outreach should leverage rural adults' trust in local sources, including community pharmacists, deemed more convenient access points to healthcare, when addressing vaccine hesitancy.
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Affiliation(s)
- Alexis M. Koskan
- College of Health Solutions, Arizona State University, 425 N 5th Street, Phoenix, AZ 85004, USA
- Correspondence:
| | - Iris E. LoCoco
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 550 E Van Buren Street, Phoenix, AZ 85006, USA
| | - Casey L. Daniel
- Department of Family Medicine, Whiddon College of Medicine, University of South Alabama, 5795 USA North Drive, Mobile, AL 36608, USA
| | - Benjamin S. Teeter
- Department of Pharmacy Practice, University of Arkansas for Medical Sciences, 4301 W Markham St., Little Rock, AR 72205, USA
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27
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How Behavioral Economics Can Inform the Next Mass Vaccination Campaign: A Narrative Review. Prev Med Rep 2023; 32:102118. [PMID: 36974280 PMCID: PMC10039374 DOI: 10.1016/j.pmedr.2023.102118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 01/03/2023] [Accepted: 01/22/2023] [Indexed: 01/25/2023] Open
Abstract
Designing the next mass vaccination campaign will require ideas and techniques from behavioral economics. History and current events have shown how failing to consider features of human behavior, from individual biases in information processing to the relationships between people and policymakers, frustrated public health efforts. Behavioral economics can inform how a vaccination campaign needs to deliver processes and information necessary to help people decide to vaccinate, especially when mandates to vaccinate are not possible. Such campaigns need to employ both "nudges" (i.e., promote action) and remove "sludge" (i.e., break down blockers) to influence decisions directly. Strategies must be both acute and systemic to the current approach to public health.
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28
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Nguyen T, Boey L, Van Riet C, Dielen S, Dodion H, Giles-Vernick T, Vandaele N, Larson HJ, Peeters Grietens K, Gryseels C, Heyerdahl LW. Embracing context: Lessons from designing a dialogue-based intervention to address vaccine hesitancy. Front Public Health 2023; 11:1069199. [PMID: 36891336 PMCID: PMC9986323 DOI: 10.3389/fpubh.2023.1069199] [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: 10/13/2022] [Accepted: 02/01/2023] [Indexed: 02/22/2023] Open
Abstract
Dialogue with people who are vaccine hesitant has been recommended as a method to increase vaccination uptake. The process of cultivating dialogue is shaped by the context in which it occurs, yet the development of interventions addressing vaccine hesitancy with dialogue often overlooks the role of context and favors relatively fixed solutions. This reflexive paper shares three key lessons related to context for dialogue-based interventions. These lessons emerged during a participatory research project to develop a pilot intervention to create open dialogue among healthcare workers in Belgium about COVID-19 vaccination concerns. Through a mixed methods study consisting of in-depth interviews, focus group discussions, and surveys, we engaged healthcare workers in the design, testing, and evaluation of a digital platform featuring text-based and video-based (face-to-face) interactions. The lessons are: (1) what dialogue means, entails, and requires can vary for a population and context, (2) inherent tension exists between helping participants voice (and overcome) their concerns and exposing them to others' ideas that may exacerbate those concerns, and (3) interactional exchanges (e.g., with peers or experts) that matter to participants may shape the dialogue in terms of its content and form. We suggest that having a discovery-orientation-meaning to work not only inductively and iteratively but also reflexively-is a necessary part of the development of dialogue-based interventions. Our case also sheds light on the influences between: dialogue topic/content, socio-political landscape, population, intervention aim, dialogue form, ethics, researcher position, and types of interactional exchanges.
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Affiliation(s)
- ToTran Nguyen
- Socio-Ecological Health Research Unit, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.,Department of Work and Organisation Studies, KU Leuven, Leuven, Belgium
| | - Lise Boey
- Access-To-Medicines Research Centre, KU Leuven, Leuven, Belgium
| | - Carla Van Riet
- Access-To-Medicines Research Centre, KU Leuven, Leuven, Belgium
| | - Stef Dielen
- Socio-Ecological Health Research Unit, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Hélène Dodion
- Socio-Ecological Health Research Unit, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Tamara Giles-Vernick
- Anthropology and Ecology of Disease Emergence Unit, Department of Global Health, Institut Pasteur, Paris, France
| | - Nico Vandaele
- Access-To-Medicines Research Centre, KU Leuven, Leuven, Belgium
| | - Heidi J Larson
- Vaccine Confidence Project, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Koen Peeters Grietens
- Socio-Ecological Health Research Unit, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.,School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Charlotte Gryseels
- Socio-Ecological Health Research Unit, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Leonardo W Heyerdahl
- Anthropology and Ecology of Disease Emergence Unit, Department of Global Health, Institut Pasteur, Paris, France
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29
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Williams SN, Armitage CJ, Dienes K, Drury J, Tampe T. Public decisions about COVID-19 vaccines: A UK-based qualitative study. PLoS One 2023; 18:e0277360. [PMID: 36877671 PMCID: PMC9987765 DOI: 10.1371/journal.pone.0277360] [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: 03/22/2022] [Accepted: 10/26/2022] [Indexed: 03/07/2023] Open
Abstract
OBJECTIVE To explore UK public decisions around whether or not to get COVID-19 vaccines, and the facilitators and barriers behind participants' decisions. DESIGN This qualitative study consisted of six online focus groups conducted between 15th March and 22nd April 2021. Data were analysed using a framework approach. SETTING Focus groups took place via online videoconferencing (Zoom). PARTICIPANTS Participants (n = 29) were a diverse group (by ethnicity, age and gender) UK residents aged 18 years and older. RESULTS We used the World Health Organization's vaccine hesitancy continuum model to look for, and explore, three main types of decisions related to COVID-19 vaccines: vaccine acceptance, vaccine refusal and vaccine hesitancy (or vaccine delay). Two reasons for vaccine delay were identified: delay due to a perceived need for more information and delay until vaccine was "required" in the future. Nine themes were identified: three main facilitators (Vaccination as a social norm; Vaccination as a necessity; Trust in science) and six main barriers (Preference for "natural immunity"; Concerns over possible side effects; Perceived lack of information; Distrust in government;; Conspiracy theories; "Covid echo chambers") to vaccine uptake. CONCLUSION In order to address vaccine uptake and vaccine hesitancy, it is useful to understand the reasons behind people's decisions to accept or refuse an offer of a vaccine, and to listen to them and engage with, rather than dismiss, these reasons. Those working in public health or health communication around vaccines, including COVID-19 vaccines, in and beyond the UK, might benefit from incorporating the facilitators and barriers found in this study.
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Affiliation(s)
- Simon N. Williams
- School of Psychology, Swansea University, Swansea, Wales, United Kingdom
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America
- * E-mail:
| | - Christopher J. Armitage
- Manchester Centre for Health Psychology, University of Manchester, Manchester, United Kingdom
- Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
- NIHR Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester, United Kingdom
| | - Kimberly Dienes
- School of Psychology, Swansea University, Swansea, Wales, United Kingdom
- Manchester Centre for Health Psychology, University of Manchester, Manchester, United Kingdom
| | - John Drury
- University of Sussex, School of Psychology, Falmer, United Kingdom
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30
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Kosiyaporn H, Netrpukdee C, Pangkariya N, Chandrasiri O, Tangcharoensathien V. The impact of vaccine information and other factors on COVID-19 vaccine acceptance in the Thai population. PLoS One 2023; 18:e0276238. [PMID: 36881578 PMCID: PMC9990931 DOI: 10.1371/journal.pone.0276238] [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: 10/30/2021] [Accepted: 10/02/2022] [Indexed: 03/08/2023] Open
Abstract
Increased misinformation circulating among the population during the COVID-10 pandemic can trigger rejection to take up vaccines. This study assesses the influence of vaccine information and other factors on vaccine acceptance in the Thai population. Between March and August 2021, six rounds of cross-sectional surveys through village health volunteer networks and online channels were conducted; as well as qualitative interviews with frontline health workers, patients with chronic diseases, and religious believers and leaders. Descriptive and multiple logistic regression with 95% level of confidence were used for survey findings while deductive thematic analysis was used for in-depth interview findings. Among the total 193,744 respondents, the initial COVID-19 vaccine acceptance rate decreased from 60.3% in March 2021 to 44.0% in April 2021, then increased to 88.8% in August 2021. Participants who were able to differentiate true and false statements were 1.2 to 2.4 times more likely to accept vaccine than those who were not. Those who perceived a high risk of infection (Adjusted odds ratio; AOR = 2.6-4.7), perceived vaccine safety (AOR = 1.4-2.4), judged the importance of vaccination (AOR = 2.3-5.1), and had trust in vaccine manufacture (AOR = 1.9-3.2) were also more likely to accept the vaccine. Moreover, higher education (AOR = 1.6-4.1) and living in outbreak areas (AOR = 1.4-3.0) were significantly related to vaccine uptake, except in people with chronic diseases who tended not to accept the vaccine (AOR = 0.7-0.9). This study recommends effective infodemic management and comprehensive public communication, prioritising vulnerable groups such as those with a low level of education and people with chronic conditions. Communication through reliable channels can support higher vaccine acceptance and rapid vaccine rollout. Finally, regular monitoring of misinformation is important such as fact checking support, timely legal actions and specific debunking communication.
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Affiliation(s)
- Hathairat Kosiyaporn
- International Health Policy Program, Ministry of Public Health, Nonthaburi, Thailand
- * E-mail:
| | - Chanikarn Netrpukdee
- International Health Policy Program, Ministry of Public Health, Nonthaburi, Thailand
| | - Nattanicha Pangkariya
- International Health Policy Program, Ministry of Public Health, Nonthaburi, Thailand
| | - Orana Chandrasiri
- International Health Policy Program, Ministry of Public Health, Nonthaburi, Thailand
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31
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Muacevic A, Adler JR, Fernandez-Pacheco A, Taylor L, Kahar P, Khanna D. A Survey of Public Health Failures During COVID-19. Cureus 2022; 14:e32437. [PMID: 36644033 PMCID: PMC9833812 DOI: 10.7759/cureus.32437] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 12/12/2022] [Indexed: 12/15/2022] Open
Abstract
The prolonged coronavirus disease 2019 (COVID-19) pandemic has raised concerns about the failures in the public health measures used to manage the spread of this deadly virus. This review focuses its attention on research papers that at their core highlight the individual public health measures instituted by organizations, institutions, and the government of the United States (US) since the start of the COVID-19 pandemic and that were published in 2019 to 2022. Together, these sources help paint a well-rounded view of the US management of this pandemic so that conclusions may be drawn from mistakes that were made and this country may respond better in the future to such situations. This paper is unique because it highlights the areas where improvement is needed, whereas other published work describes the measures taken and how they were carried out, not the failures, which leaves a gap in the literature that this paper hopes to fill. Through a deep dive into public health measures, seven areas in which improvements could be made were pinpointed by the authors. Such measures included mask mandates, social distancing, lockdown/quarantine, hand hygiene, COVID-19 testing, travel screening, and vaccine hesitancy. In exploring each measure, a discussion was carried out about its benefits and shortcomings in alleviating the ramifications of a global pandemic. In addition to the poor supply chain for critical products like personal protective equipment (PPE), the miscommunication between states and federal policies did not allow for the entirety of the US to respond cohesively in the face of the COVID-19 pandemic. This general review is crucial to know what is working and what needs to be changed to increase the benefits provided to the population.
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Jiang X, Lin J, Wang W, Zhao Y, Qiu Y. Theories-based determinants analysis of Hib-combined vaccine hesitancy in China: A multi-group structural equation modeling. Hum Vaccin Immunother 2022; 18:2104057. [PMID: 36286387 PMCID: PMC9746522 DOI: 10.1080/21645515.2022.2104057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVES To explore determinants of Hib-combined vaccine hesitancy in Chinese parents, and to provide scientific intervention measures to tackle vaccine hesitancy. METHODS 2,531 parents were recruited from local healthcare centers in Zhejiang Province by accidental sampling, and completed the self-developed online questionnaire with voluntary participation. Health Belief Model and Model of Determinants of Vaccine Hesitancy were applied to construct the framework of research. Multi-group Structural Equation Modeling was performed to explore the effects of determinants of vaccine hesitancy across various socio-economic status (SES). RESULTS Hib-combined vaccine hesitancy for total sample was 2.184 ± 0.777 (95%CI: 2.153-2.214), and most of them were in low (n = 1436, 56.7%) level. Low SES group (2.335 ± 0.763, 95%CI: 2.271-2.400) had significantly highest vaccine hesitancy. For total sample, Self-Efficacy and Cues to Action presented -0.517 and -0.437 of standard total effect on Vaccine Hesitancy, respectively. The Multi-group Structural Equation Model with satisfying goodness of fit in SES groups (χ2 = 1616.074, df = 314, χ2/df = 5.147, CFI = 0.973, TLI = 0.966, SRMR = 0.027, RMSEA = 0.041) showed that Cues to Action imposed -0.621 (95%CI: -0.867-0.389, p < .001) of major standard total effect on Vaccine Hesitancy in low SES group, while Self-Efficacy imposed -0.560 (95%CI: -0.668-0.444, p < .001) and -0.685 (95%CI: -0.841-0.454, p < .001) of principal standard total effect on Vaccine Hesitancy in middle and high SES groups, respectively. CONCLUSIONS Hib-combined vaccine hesitancy in Chinese parents was low, and the lower the SES, the higher the vaccine hesitancy. Cues to Action and Self-Efficacy played primary role in declining vaccine hesitancy for parents at low SES, and at middle and high SES, respectively.
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Affiliation(s)
- Xuewen Jiang
- Department of Public Health Surveillance & Advisory, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Junfen Lin
- Department of Public Health Surveillance & Advisory, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Wei Wang
- Department of Public Health Surveillance & Advisory, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Yanrong Zhao
- Department of Public Health Surveillance & Advisory, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Yinwei Qiu
- Department of Public Health Surveillance & Advisory, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China,CONTACT Yinwei Qiu Zhejiang Provincial Center for Disease Control and Prevention3399 Binsheng Road, Binjiang District, Hangzhou, Zhejiang, China
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Estrela M, Leitão C, Silva TM, Figueiras A, Roque F, Herdeiro MT. Insights on COVID-19 Vaccination in Portugal: A Qualitative Study among Health Professionals and Teachers. Vaccines (Basel) 2022; 10:vaccines10121984. [PMID: 36560394 PMCID: PMC9781933 DOI: 10.3390/vaccines10121984] [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: 11/03/2022] [Revised: 11/18/2022] [Accepted: 11/20/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Vaccination against COVID-19 has had a major impact over the course of the pandemic, leading to a reduced number of hospitalizations and deaths. However, the mass vaccination process has been accompanied by skepticism and hesitancy since its beginning. As health professionals and teachers are important public health actors who can strongly intervene to reduce vaccination hesitancy among their patients and students, respectively, this study aimed to assess their main perceptions towards COVID-19 vaccination. METHODS Two focus group sessions, one with health professionals and the other with teachers, were conducted according to the COREQ checklist. Qualitative data were analyzed through theoretical thematic analysis. RESULTS In general, none of the groups showed vaccine hesitancy, although both groups had concerns regarding the safety and efficacy of the vaccines. The main concerns of health professionals were mostly related to the long-term impact of the COVID-19 pandemic, while teachers were more worried about the lack of access to reliable information about the COVID-19 vaccination. CONCLUSIONS It is plausible to conclude that it is imperative to provide clear and accurate information for the population in order to avoid vaccination hesitancy.
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Affiliation(s)
- Marta Estrela
- Department of Medical Sciences, iBiMED—Institute of Biomedicine, University of Aveiro, 3810 Aveiro, Portugal
- Faculty of Economics, University of Coimbra, 3000 Coimbra, Portugal
- Health Sciences Research Center, University of Beira Interior (CICS-UBI), 6201 Covilha, Portugal
- Correspondence: (M.E.); (F.R.); (M.T.H.)
| | - Catarina Leitão
- Department of Medical Sciences, iBiMED—Institute of Biomedicine, University of Aveiro, 3810 Aveiro, Portugal
| | - Tânia Magalhães Silva
- Department of Medical Sciences, iBiMED—Institute of Biomedicine, University of Aveiro, 3810 Aveiro, Portugal
| | - Adolfo Figueiras
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15705 Santiago de Compostela, Spain
- Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela, 15705 Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiology and Public Health—CIBERESP), 15706 Santiago de Compostela, Spain
| | - Fátima Roque
- Health Sciences Research Center, University of Beira Interior (CICS-UBI), 6201 Covilha, Portugal
- Research Unit for Inland Development, Guarda Polytechnic Institute (UDI-IPG), 6300 Guarda, Portugal
- Correspondence: (M.E.); (F.R.); (M.T.H.)
| | - Maria Teresa Herdeiro
- Department of Medical Sciences, iBiMED—Institute of Biomedicine, University of Aveiro, 3810 Aveiro, Portugal
- Correspondence: (M.E.); (F.R.); (M.T.H.)
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Njoga EO, Awoyomi OJ, Onwumere-Idolor OS, Awoyomi PO, Ugochukwu ICI, Ozioko SN. Persisting Vaccine Hesitancy in Africa: The Whys, Global Public Health Consequences and Ways-Out-COVID-19 Vaccination Acceptance Rates as Case-in-Point. Vaccines (Basel) 2022; 10:1934. [PMID: 36423029 PMCID: PMC9697713 DOI: 10.3390/vaccines10111934] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/02/2022] [Accepted: 11/11/2022] [Indexed: 08/29/2023] Open
Abstract
Vaccine hesitancy (VH) is the seventh among the WHO's top 10 threats to global public health, which has continued to perpetuate the transmission of vaccine preventable diseases (VPDs) in Africa. Consequently, this paper systematically reviewed COVID-19 vaccine acceptance rates (VARs)-including the vaccine uptake and vaccination intention-in Africa from 2020 to 2022, compared the rates within the five African regions and determined the context-specific causes of VH in Africa. Generally, COVID-19 VARs ranged from 21.0% to 97.9% and 8.2% to 92.0% with mean rates of 59.8 ± 3.8% and 58.0 ± 2.4% in 2021 and 2022, respectively. Southern and eastern African regions had the top two VARs of 83.5 ± 6.3% and 68.9 ± 6.6% in 2021, and 64.2 ± 4.6% and 61.2 ± 5.1% in 2022, respectively. Based on population types, healthcare workers had a marginal increase in their mean COVID-19 VARs from 55.5 ± 5.6% in 2021 to 60.8 ± 5.3% in 2022. In other populations, the mean VARs decreased from 62.7 ± 5.2% in 2021 to 54.5 ± 4% in 2022. As of 25 October 2022, Africa lags behind the world with only 24% full COVID-19 vaccinations compared to 84%, 79% and 63% reported, respectively, in the Australian continent, upper-middle-income countries and globally. Apart from the problems of confidence, complacency, convenience, communications and context, the context-specific factors driving COVID-19 VH in Africa are global COVID-19 vaccine inequality, lack of vaccine production/maintenance facilities, insecurity, high illiteracy level, endemic corruption, mistrust in some political leaders, the spreading of unconfirmed anti-vaccination rumors and political instability. With an overall mean COVID-19 acceptance rate of 58%, VH still subsists in Africa. The low VARs in Africa have detrimental global public health implications, as it could facilitate the emergence of immune invading SARS-CoV-2 variants of concern, which may spread globally. Consequently, there is a need to confront these challenges frontally and engage traditional and religious leaders in the fight against VH in Africa, to restore public trust in the safety and efficacy of vaccines generally. As the availability of COVID-19 vaccines improves, the vaccination of pets and zoo-animals from which reverse zoonotic transmission of SARS-CoV-2 have been reported is recommended, to limit the evolution and spread of new variants of concern and avert possible SARS-CoV-2 epizootic or panzootic diseases in susceptible animal species.
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Affiliation(s)
- Emmanuel O. Njoga
- Department of Veterinary Public Health and Preventive Medicine, Faculty of Veterinary Medicine, University of Nigeria, Nsukka 410001, Nigeria
| | - Olajoju J. Awoyomi
- Department of Veterinary Public Health and Preventive Medicine, College of Veterinary Medicine, Federal University of Agriculture, Abeokuta PMB 2240, Nigeria
| | - Onyinye S. Onwumere-Idolor
- Department of Animal Production, Faculty of Agriculture, Delta State University of Science and Technology, Ozoro PMB 005, Nigeria
| | - Priscilla O. Awoyomi
- Department of Medicine and Surgery, College of Medicine, University of Ibadan, Ibadan 200005, Nigeria
| | - Iniobong C. I. Ugochukwu
- Department of Veterinary Pathology and Microbiology, Faculty of Veterinary Medicine, University of Nigeria, Nsukka 410001, Nigeria
- Department of Veterinary Medicine, Faculty of Veterinary Medicine, Universita degli Studi di Bari, 70010 Valenzano, Italy
| | - Stella N. Ozioko
- Institute of Aquaculture, Faculty of Natural Sciences, University of Stirling, Stirling FK9 4LA, UK
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Fingesi T, Chung Yon L, Soto S, Rosales C. Health knowledge and livelihood experiences with COVID-19 amongst Arizona residents. Front Public Health 2022; 10:939154. [PMID: 36324464 PMCID: PMC9618962 DOI: 10.3389/fpubh.2022.939154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 09/28/2022] [Indexed: 01/25/2023] Open
Abstract
The Coronavirus disease 2019 (COVID-19) pandemic is an ongoing public health concern that is rapidly evolving and has impacted individuals and communities differently. We analyzed deidentified survey datasets to evaluate the perceptions, experiences, and impacts of COVID-19 among Arizona residents. The survey included 1,472 eligible Spanish-speaking participants in Southern (Pima, Santa Cruz, Cochise, Yuma County) and Central Arizona (Maricopa County). Eighteen questions which included participants' health and socio-economic status, source of information on COVID-19, preventive measures, the impact of COVID-19 on household income, and vaccination status were administered to the survey respondents. The analyzed data showed an unequal proportion of the reported source of COVID-19 information between Southern and Central Arizona participants. More male respondents (n = 833, 57%) participated in the study than did the female respondents (n = 638, 43%). Of the 1,472 total participants in both regions, 1,011 (68.7%) participants represented Southern Arizona while 461 (31.3%) participants represented Central Arizona. Of the 461 participants in Central Arizona, the majority reported television (56%) and social media (20%) as their primary source of information. Whereas, of the 1,011 participants in Southern Arizona, the majority reported social media (37%) and television (32%) as their major source of information on COVID-19. Overall, 82% of the participants were vaccinated, with a statistically significant difference between the proportion of vaccinated individuals in the Southern and Central Arizona (chi-square p-value of 0.00139). More individuals in Southern Arizona participated in the survey than in Central Arizona across both genders, with 58% of women reporting loss of jobs due to COVID-19. This study demonstrated that the COVID-19 pandemic profoundly had a more socio-economic impact on women than men, particularly Hispanic women in this subset.
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Affiliation(s)
- Tina Fingesi
- Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States
| | - Lin Chung Yon
- College of Medicine, University of Arizona, Phoenix, AZ, United States
| | - Sheila Soto
- Public Health Practice and Translational Research, Mel and Enid Zuckerman College of Public Health, University of Arizona, Phoenix, AZ, United States
| | - Cecilia Rosales
- Public Health Practice and Translational Research, Mel and Enid Zuckerman College of Public Health, University of Arizona, Phoenix, AZ, United States,*Correspondence: Cecilia Rosales
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Galkin SA, Naidenko DG, Kornetov AN, Goiko VL, Myagkov MG. Features of the attitude to vaccination against COVID-19 in Russia. BULLETIN OF SIBERIAN MEDICINE 2022. [DOI: 10.20538/1682-0363-2022-3-34-40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Background. 1.5 years after the registration of the first vaccine against COVID-19 in Russia, national herd immunity reached only 49.7%. It is obvious that the success of vaccination measures depends on the readiness of the population for immunization and their attitude to the vaccine.The aim of the study was to research the attitude to vaccination against a new coronavirus infection among various socio-demographic population groups in Russia.Materials and methods. The study was conducted online by distributing via social networks a direct link to an electronic form with questions about the attitude to the COVID-19 pandemic and vaccination. A total of 2,786 people (of whom 66.9% were women) aged 16 to 77 years took part in the online survey.Results. It was shown that distrust of vaccination was more often expressed by women and younger people. A targeted approach to these population groups can improve the results of awareness-raising and preventive measures in the context of an ongoing pandemic.
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Affiliation(s)
- S. A. Galkin
- National Research Tomsk State University (NR TSU); Mental Health Research Institute, Tomsk National Research Medical Center (NRMC), Russian Academy of Sciences
| | | | | | - V. L. Goiko
- Mental Health Research Institute, Tomsk National Research Medical Center (NRMC), Russian Academy of Sciences
| | - M. G. Myagkov
- National Research Tomsk State University (NR TSU); University of Oregon Eugene
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Abstract
Purpose of Review In 2019, vaccine hesitancy (VH) was named as one of the top 10 threats to global health by the World Health Organization (WHO). We highlight the factors affecting VH, the role of VH in limiting vaccine uptake and inability to achieve collective immunity, and possible solutions. Recent Findings There are still uncertainties and concerns about the safety and efficacy of vaccines, which promote VH and undermine public confidence in immunization. WHO has designed the behavioral and social drivers (BeSD) tools and survey instruments that can be used by countries to assess reasons for poor vaccine uptake in childhood for COVID-19 and plan national vaccination programs to counter these misconceptions. Summary Vaccines are one of the best preventative measures that public health care has to offer. Evidence from across the world both in high-income countries (HICs) and low/middle-income countries (LMICs) show that VH is a significant phenomenon which is translating into geographical clustering of epidemics. A reasonably high acceptance and coverage rates are necessary for an immunization program to be successful. A context-specific and multifactorial intervention with more high-quality research is needed globally.
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Chandok RS, Madar P, Majeed A. A qualitative study of factors influencing COVID-19 vaccine hesitancy among South Asians in London. JRSM Open 2022; 13:20542704221123430. [PMID: 36213844 PMCID: PMC9536136 DOI: 10.1177/20542704221123430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objectives This qualitative study sought to elicit the views and experiences of patients and health-care professionals to identify the factors associated with COVID-19 vaccine hesitancy among South Asians in London. Design In-depth semi-structured telephone and virtual interviews. Setting UK. Participants Convenience and purposive sample of 12 individuals including patients, clinicians, and a medical receptionist. Main Outcome Measures Our dataset identifies and explains the reasons for distinguishing between those individuals who are COVID-19 vaccine-hesitant, and those who are COVID-19 vaccine-anxious. Results COVID-19 vaccine hesitancy and the decision on whether to - or not to - vaccinate against COVID-19 involves ongoing and unresolved inner conflict about COVID-19 vaccines. Our findings therefore suggest that some individuals may be existing in a state of inbetweeness; where they are neither pro nor anti vaccination, while simultaneously questioning the many 'truths' surrounding COVID-19 and not just one truth such as the safety of COVID-19 vaccines. We argue that this in-between state is intensified by technology and social media; culminating in the Rashomon Effect, whereby a combination of truths, fractured truths, subjective realities, and unreliable or contradictory sources impact on our perceptions of COVID-19. Conclusions Given the complexities arising from the multiple factors influencing vaccine hesitancy and scepticism, 'quick fixes' and 'one size fits all' solutions to address COVID-19 vaccine hesitancy will be ineffective. Therefore, promoting trust and prioritising good after-care as well as on-going care as a response to the effects of the pandemic is vital.
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Affiliation(s)
- Raj S. Chandok
- Department of Primary Care & Public Health, Imperial College London, London, UK,Raj S. Chandok.
| | - Poonam Madar
- Department of International Politics, City, University of London, London, UK
| | - Azeem Majeed
- Department of Primary Care & Public Health, Imperial College London, London, UK
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Khan YH, MacNeil D, Bigelow J, Corvalan Cifuentes MZ, Rottar C. Understanding COVID-19 Vaccine Hesitancy Through an Organizational Behaviour Lens. Cureus 2022; 14:e29459. [PMID: 36168652 PMCID: PMC9506358 DOI: 10.7759/cureus.29459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2022] [Indexed: 11/11/2022] Open
Abstract
Vaccine hesitancy during the COVID-19 pandemic has been a worldwide public health challenge. Organizational behaviour, the study of people’s behaviours in organizational settings, can be used to identify the behavioural drivers contributing to vaccine hesitancy and to develop targeted strategies to combat those drivers and improve vaccine uptake. Some common behaviours driving vaccine hesitancy arise from individualism, motivation, attitude, perception, groupthink, heuristics and cognitive bias. Organizational behaviour strategies to combat vaccine hesitancy include fostering a collectivist attitude, overcoming personal barriers to communication such as individual beliefs and values, utilizing motivation theories to target the individualistic mindset, and overcoming attitudes and perceptions by addressing heuristics and cognitive biases.
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Ogunleye OO, Godman B, Fadare JO, Mudenda S, Adeoti AO, Yinka-Ogunleye AF, Ogundele SO, Oyawole MR, Schönfeldt M, Rashed WM, Galal AM, Masuka N, Zaranyika T, Kalungia AC, Malande OO, Kibuule D, Massele A, Chikowe I, Khuluza F, Taruvinga T, Alfadl A, Malik E, Oluka M, Opanga S, Ankrah DNA, Sefah IA, Afriyie D, Tagoe ET, Amu AA, Msibi MP, Etando A, Alabi ME, Okwen P, Niba LL, Mwita JC, Rwegerera GM, Kgatlwane J, Jairoun AA, Ejekam C, Mavenyengwa RT, Murimi-Worstell I, Campbell SM, Meyer JC. Coronavirus Disease 2019 (COVID-19) Pandemic across Africa: Current Status of Vaccinations and Implications for the Future. Vaccines (Basel) 2022; 10:vaccines10091553. [PMID: 36146631 PMCID: PMC9504201 DOI: 10.3390/vaccines10091553] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 09/06/2022] [Accepted: 09/10/2022] [Indexed: 12/15/2022] Open
Abstract
The introduction of effective vaccines in December 2020 marked a significant step forward in the global response to COVID-19. Given concerns with access, acceptability, and hesitancy across Africa, there is a need to describe the current status of vaccine uptake in the continent. An exploratory study was undertaken to investigate these aspects, current challenges, and lessons learnt across Africa to provide future direction. Senior personnel across 14 African countries completed a self-administered questionnaire, with a descriptive analysis of the data. Vaccine roll-out commenced in March 2021 in most countries. COVID-19 vaccination coverage varied from low in Cameroon and Tanzania and up to 39.85% full coverage in Botswana at the end of 2021; that is, all doses advocated by initial protocols versus the total population, with rates increasing to 58.4% in Botswana by the end of June 2022. The greatest increase in people being fully vaccinated was observed in Uganda (20.4% increase), Botswana (18.5% increase), and Zambia (17.9% increase). Most vaccines were obtained through WHO-COVAX agreements. Initially, vaccination was prioritised for healthcare workers (HCWs), the elderly, adults with co-morbidities, and other at-risk groups, with countries now commencing vaccination among children and administering booster doses. Challenges included irregular supply and considerable hesitancy arising from misinformation fuelled by social media activities. Overall, there was fair to reasonable access to vaccination across countries, enhanced by government initiatives. Vaccine hesitancy must be addressed with context-specific interventions, including proactive programmes among HCWs, medical journalists, and the public.
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Affiliation(s)
- Olayinka O. Ogunleye
- Department of Pharmacology, Therapeutics and Toxicology, Lagos State University College of Medicine, Lagos 100271, Nigeria
- Department of Medicine, Lagos State University Teaching Hospital, Lagos 100271, Nigeria
| | - Brian Godman
- Department of Pharmacoepidemiology, Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow G4 0RE, UK
- Centre of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman 346, United Arab Emirates
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria 02084, South Africa
- Correspondence:
| | - Joseph O. Fadare
- Department of Pharmacology and Therapeutics, Ekiti State University, Ado Ekiti 362103, Nigeria
- Department of Medicine, Ekiti State University Teaching Hospital, Ado Ekiti 360211, Nigeria
| | - Steward Mudenda
- Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka P.O. Box 50110, Zambia
- Department of Disease Control, School of Veterinary Medicine, University of Zambia, Lusaka P.O. Box 32379, Zambia
| | - Adekunle O. Adeoti
- Department of Medicine, Ekiti State University Teaching Hospital, Ado Ekiti 360211, Nigeria
| | | | - Sunday O. Ogundele
- Department of Pharmacology, Therapeutics and Toxicology, Lagos State University College of Medicine, Lagos 100271, Nigeria
- Department of Medicine, Lagos State University Teaching Hospital, Lagos 100271, Nigeria
| | - Modupe R. Oyawole
- Department of Pharmacy, Lagos State University Teaching Hospital, Lagos 100271, Nigeria
| | - Marione Schönfeldt
- Child, Youth and School Health Directorate, National Department of Health, Pretoria 0083, South Africa
| | - Wafaa M. Rashed
- Children’s Cancer Hospital, Egypt-57357 (CCHE-57357), Cairo 11441, Egypt
| | - Ahmad M. Galal
- Biomedical Research Department, Armed Forces College of Medicine, Cairo 11774, Egypt
| | - Nyasha Masuka
- CIMAS, Cimas House, Borrowdale Office Park, Borrowdale Road, Harare P.O. Box 1243, Zimbabwe
| | - Trust Zaranyika
- Department of Medicine, University of Zimbabwe College of Health Sciences, Harare P.O. Box MP167, Zimbabwe
| | - Aubrey C. Kalungia
- Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka P.O. Box 50110, Zambia
| | - Oliver O. Malande
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria 02084, South Africa
- Department of Child Health and Paediatrics, Egerton University, Nakuru P.O.Box 536, Kenya
- East Africa Centre for Vaccines and Immunization (ECAVI), Namela House, Naguru, Kampala P.O. Box 3040, Uganda
| | - Dan Kibuule
- Department of Pharmacology & Therapeutics, Busitema University, Mbale P.O. Box 236, Uganda
| | - Amos Massele
- Department of Clinical Pharmacology and Therapeutics, Hurbert Kairuki Memorial University, 70 Chwaku Road Mikocheni, Dar Es Salaam P.O. Box 65300, Tanzania
| | - Ibrahim Chikowe
- Pharmacy Department, Formerly College of Medicine, Kamuzu University of Health Sciences (KUHeS), Blantyre P.O. Box 278, Malawi
| | - Felix Khuluza
- Pharmacy Department, Formerly College of Medicine, Kamuzu University of Health Sciences (KUHeS), Blantyre P.O. Box 278, Malawi
| | - Tinotenda Taruvinga
- Department of Global Health and Development (GHD), London School of Hygiene and Tropical Medicine (LSHTM), London WC1E 7TH, UK
| | - Abubakr Alfadl
- National Medicines and Poisons Board, Federal Ministry of Health, Khartoum P.O. Box 303, Sudan
- Department of Pharmacy Practice, Unaizah College of Pharmacy, Qassim University, Unaizah 51911, Saudi Arabia
| | - Elfatih Malik
- Department of Community Medicine, Faculty of Medicine, University of Khartoum, Khartoum 11111, Sudan
| | - Margaret Oluka
- Department of Pharmacology & Pharmacognosy, School of Pharmacy, University of Nairobi, Nairobi P.O. Box 19676-00202, Kenya
| | - Sylvia Opanga
- Department of Pharmaceutics and Pharmacy Practice, School of Pharmacy, University of Nairobi, Nairobi P.O. Box 19676-00202, Kenya
| | - Daniel N. A. Ankrah
- Department of Pharmacy, Korle Bu Teaching Hospital, Accra P.O. Box 77, Ghana
| | - Israel A. Sefah
- Pharmacy Practice Department, School of Pharmacy, University of Health and Allied Sciences, Hohoe PMB 31, Ghana
| | - Daniel Afriyie
- Pharmacy Department, Ghana Police Hospital, Accra P.O. Box CT104, Ghana
| | - Eunice T. Tagoe
- Department of Management Science, University of Strathclyde, Glasgow G4 0QU, UK
| | - Adefolarin A. Amu
- Pharmacy Department, Eswatini Medical Christian University, P.O. Box A624, Swazi Plaza, Mbabane H100, Eswatini
| | - Mlungisi P. Msibi
- Faculty of Health Sciences, Department of Medical Laboratory Sciences, Eswatini Medical Christian University, Swazi Plaza P.O. Box A624, Mbabane H100, Eswatini
| | - Ayukafangha Etando
- Department of Medical Laboratory Sciences, Faculty of Health Sciences, Eswatini Medical Christian University, Swazi Plaza P.O. Box A624, Mbabane H100, Eswatini
| | - Mobolaji E. Alabi
- School of Pharmaceutical Sciences, College of Health Sciences, University of Kwazulu-natal (UKZN), Durban 4001, South Africa
| | - Patrick Okwen
- Effective Basic Services (eBASE) Africa, Ndamukong Street, Bamenda 5175, Cameroon
- Faculty of Health and Medical Sciences, Adelaide University, Adelaide 5005, Australia
| | - Loveline Lum Niba
- Effective Basic Services (eBASE) Africa, Ndamukong Street, Bamenda 5175, Cameroon
- Department of Public Health, University of Bamenda, Bambili P.O. Box 39, Cameroon
| | - Julius C. Mwita
- Department of Internal Medicine, Faculty of Medicine, University of Botswana, Gaborone P.O. Box 70480, Botswana
| | - Godfrey M. Rwegerera
- Department of Medicine, Sir Ketumile Masire Teaching Hospital, Gaborone P.O. Box 70480, Botswana
| | - Joyce Kgatlwane
- Department of Pharmacy, University of Botswana, Gaborone P.O. Box 70480, Botswana
| | - Ammar A. Jairoun
- Health and Safety Department, Dubai Municipality, Dubai P.O. Box 67, United Arab Emirates
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang 11800, Malaysia
| | - Chioma Ejekam
- Department of Community Health, Lagos University Teaching Hospital, Idi-Araba, Lagos PMB 21266, Nigeria
| | - Rooyen T. Mavenyengwa
- Medical Microbiology Unit, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare P.O. Box MP167, Zimbabwe
| | - Irene Murimi-Worstell
- School of Pharmacy, Massachusetts College of Pharmacy and Health Sciences, Boston, MA 02115, USA
| | - Stephen M. Campbell
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria 02084, South Africa
- Centre for Epidemiology and Public Health, School of Health Sciences, University of Manchester, Manchester M13 9PL, UK
- NIHR Greater Manchester Patient Safety Translational Research Centre, School of Health Sciences, University of Manchester, Manchester M13 9PL, UK
| | - Johanna C. Meyer
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria 02084, South Africa
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Unravelling the drivers behind COVID-19 vaccination hesitancy and refusal among teachers: A nationwide study. Vaccine 2022; 40:5464-5470. [PMID: 35945046 PMCID: PMC9353686 DOI: 10.1016/j.vaccine.2022.07.059] [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: 12/03/2021] [Revised: 05/17/2022] [Accepted: 07/31/2022] [Indexed: 11/23/2022]
Abstract
This study aims to assess the determinants of the coronavirus disease 2019 (COVID-19) vaccination hesitancy and refusal (VHR) among teachers, from pre-school to higher education, through an online survey. A logistic regression analysis was used to determine the adjusted odds ratio (OR) of the independent variables (perceptions, knowledge, and attitudes) per 1-point increase in the Likert scale, and VHR. Concerns about the vaccines’ efficacy and safety increase the risk of VHR (OR = 6.97, 95 %CI: 4.82–10.09 and OR = 8.71, 95 %CI: 5.52–13.73, respectively). Higher risk perceptions of getting infected (1/OR = 3.94, 95 %CI: 2.93–5.29), trust in the effectiveness of vaccines in reducing this risk or protecting against suffering complications (OR = 3.52, 95 %CI: 2.72–4.55 and OR = 10.94, 95 %CI: 7.16–16.68, respectively), and higher trust levels on the information transmitted regarding COVID-19 vaccination, are associated to lower VHR. As VHR appears to be highly influenced by perceptions, knowledge, and attitudes, it is crucial to promote and design interventions targeted to transforming these determinants.
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Overview of Tools and Measures Investigating Vaccine Hesitancy in a Ten Year Period: A Scoping Review. Vaccines (Basel) 2022; 10:vaccines10081198. [PMID: 36016086 PMCID: PMC9412526 DOI: 10.3390/vaccines10081198] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 07/20/2022] [Accepted: 07/21/2022] [Indexed: 12/23/2022] Open
Abstract
The challenge of vaccine hesitancy, a growing global concern in the last decade, has been aggravated by the COVID-19 pandemic. The need for monitoring vaccine sentiments and early detection of vaccine hesitancy in a population recommended by the WHO calls for the availability of contextually relevant tools and measures. This scoping review covers a ten year-period from 2010–2019 which included the first nine years of the decade of vaccines and aims to give a broad overview of tools and measures, and present a summary of their nature, similarities, and differences. We conducted the review using the framework for scoping reviews by Arksey and O’Malley (2005) and reported it following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews’ guidelines. Of the 26 studies included, only one was conducted in the WHO African Region. Measures for routine childhood vaccines were found to be the most preponderant in the reviewed literature. The need for validated, contextually relevant tools in the WHO Africa Region is essential, and made more so by the scourge of the ongoing pandemic in which vaccination is critical for curtailment.
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Ichino A. Vaccine hesitancy and the reluctance to “tempt fate”. PHILOSOPHICAL PSYCHOLOGY 2022. [DOI: 10.1080/09515089.2022.2096432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Anna Ichino
- Department of Philosophy, Università degli Studi di Milano, Milan, Italy
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Lohiniva AL, Nurzhynska A, Hudi AH, Anim B, Aboagye DC. Infodemic Management Using Digital Information and Knowledge Cocreation to Address COVID-19 Vaccine Hesitancy: Case Study From Ghana. JMIR INFODEMIOLOGY 2022; 2:e37134. [PMID: 35854815 PMCID: PMC9281514 DOI: 10.2196/37134] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 05/24/2022] [Accepted: 06/10/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Infodemic management is an integral part of pandemic management. Ghana Health Services (GHS) together with the UNICEF (United Nations International Children's Emergency Fund) Country Office have developed a systematic process that effectively identifies, analyzes, and responds to COVID-19 and vaccine-related misinformation in Ghana. OBJECTIVE This paper describes an infodemic management system workflow based on digital data collection, qualitative methodology, and human-centered systems to support the COVID-19 vaccine rollout in Ghana with examples of system implementation. METHODS The infodemic management system was developed by the Health Promotion Division of the GHS and the UNICEF Country Office. It uses Talkwalker, a social listening software platform, to collect misinformation on the web. The methodology relies on qualitative data analysis and interpretation as well as knowledge cocreation to verify the findings. RESULTS A multi-sectoral National Misinformation Task Force was established to implement and oversee the misinformation management system. Two members of the task force were responsible for carrying out the analysis. They used Talkwalker to find posts that include the keywords related to COVID-19 vaccine-related discussions. They then assessed the significance of the posts on the basis of the engagement rate and potential reach of the posts, negative sentiments, and contextual factors. The process continues by identifying misinformation within the posts, rating the risk of identified misinformation posts, and developing proposed responses to address them. The results of the analysis are shared weekly with the Misinformation Task Force for their review and verification to ensure that the risk assessment and responses are feasible, practical, and acceptable in the context of Ghana. CONCLUSIONS The paper describes an infodemic management system workflow in Ghana based on qualitative data synthesis that can be used to manage real-time infodemic responses.
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Affiliation(s)
| | | | | | - Bridget Anim
- Health Promotion Division Ghana Health Services Accra Ghana
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Estrela M, Magalhães Silva T, Roque V, Rebelo Gomes E, Roque F, Herdeiro MT, Figueiras A. What determines health professionals' COVID-19 vaccine hesitancy? A nationwide study. Eur J Clin Invest 2022; 52:e13785. [PMID: 35363886 PMCID: PMC9111547 DOI: 10.1111/eci.13785] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 03/09/2022] [Accepted: 03/28/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION To contain the COVID-19 pandemic, higher vaccination rates are essential. However, as vaccine hesitancy is a reality, it is important to understand what drives health professionals to refuse getting vaccinated against COVID-19, who have been in the frontline of this pandemic since its beginning and may be key actors to improve vaccine coverage among their patients. PURPOSE This study aims to assess the factors associated with vaccine hesitancy (VH) among health professionals (physicians, nurses, pharmacists and dentists). METHODS A nationwide cross-sectional study was conducted through an online survey, with 890 Portuguese health professionals. A logistic regression analysis was used to determine the adjusted odds ratio (OR) of the independent variables (perceptions, knowledge and attitudes) per 1-point increase in the Likert scale and VH. RESULTS Complacency, communications, confidence and convenience were strongly associated with VH probability. Concerns about vaccines' efficacy (ORPhysicians = 8.33, 95% CI: 4.51-15.36) and safety (ORNurses = 11.07, 95% CI: 4.12-29.77) increase the risk of VH on all health professional groups. A reduction of VH probability is associated with higher risk perceptions of getting infected (1/ORNurses = 2.76, 95% CI: 1.52-5.02) and suffering complications (1/ORNurses = 33.72, 95% CI: 8.48-134.13), higher confidence in the effectiveness of COVID-19 vaccines (1/ORDentists = 12.29, 95% CI: 2.91-51.89), risk perception of getting infected if vaccinated (1/ORPhysicians = 14.92, 95% CI: 6.85-32.50), risk of suffering from complications after getting vaccinated, and higher trust levels on the information transmitted by competent authorities (1/ORDentists = 17.76, 95% CI: 3.83-82.22). CONCLUSIONS To reduce COVID-19 VH, which appears to be highly influenced by perceptions, knowledge and attitudes, it is essential to promote interventions directed to transforming these potentially modifiable determinants.
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Affiliation(s)
- Marta Estrela
- Department of Medical Sciences, iBiMED-Institute of Biomedicine, University of Aveiro, Aveiro, Portugal
| | - Tânia Magalhães Silva
- Department of Medical Sciences, iBiMED-Institute of Biomedicine, University of Aveiro, Aveiro, Portugal
| | - Vítor Roque
- Research Unit for Inland Development, Guarda Polytechnic Institute (UDI-IPG), Guarda, Portugal
| | - Eva Rebelo Gomes
- Allergy and Clinical Immunology Service, University Hospital Center of Porto, Porto, Portugal
| | - Fátima Roque
- Research Unit for Inland Development, Guarda Polytechnic Institute (UDI-IPG), Guarda, Portugal.,Health Sciences Research Center, University of Beira Interior (CICS-UBI), Covilhã, Portugal
| | - Maria Teresa Herdeiro
- Department of Medical Sciences, iBiMED-Institute of Biomedicine, University of Aveiro, Aveiro, Portugal
| | - Adolfo Figueiras
- Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela, Santiago de Compostela, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiology and Public Health - CIBERESP), Santiago de Compostela, Spain
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Eshel Y, Kimhi S, Marciano H, Adini B. Conspiracy claims and secret intentions as predictors of psychological coping and vaccine uptake during the COVID-19 pandemic. J Psychiatr Res 2022; 151:311-318. [PMID: 35526447 PMCID: PMC9057981 DOI: 10.1016/j.jpsychires.2022.04.042] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 04/19/2022] [Accepted: 04/28/2022] [Indexed: 01/25/2023]
Abstract
The COVID-19 vaccination campaign led to hesitancy, deferment and un-resolving resistance of certain groups or individuals worldwide. Reasons for these reactions include distrust in the COVID-19 vaccine that was developed rapidly, lack of trust in governing entities and unrealistic optimism (UO). Each of these reasons may involve claims of secret intentions or conspiracy theories. The present study examined the role of three different explanations for vaccine hesitancy and rejection, in predicting psychological coping, distress, and level of vaccine uptake, throughout the COVID-19 pandemic. Blaming the vaccine and its producers, blaming the state's authorities, and expressing criticism in UO terms, which may hint of some secret intention that underlies the vaccination request. The research was conducted on a sample of 2002 Israeli adults who responded to an anonymous questionnaire about vaccine hesitancy and psychological coping. We assumed that conspiracy theories aimed at the medical and the governing authorities, and the UO insinuations of covert intentions of these authorities, represent two different psychological processes. UO responses to adversity are aimed at reducing anxiety attributing covert intentions to the authorities and the pharmaceutical companies is an expression of anxiety. Three major hypotheses are examined. First, stronger criticism of the vaccine will be associated with a lower level of vaccination. Second, more extreme criticism of the political and the medical authorities for requesting vaccination, raised as a reason for vaccine hesitation will positively predict a higher level of anxiety and negatively predict the extent of good psychological coping. A stronger opposition to the vaccine in terms of UO will be positively associated with a greater scope of resilience and coping and will be negatively linked to indicators of distress. Results supported these hypotheses and enhanced the ongoing discussion on the contribution of UO to psychological adjustment, by illustrating its beneficial effects on this adjustment. Conspiracy Theories and Secret Intentions as Predictors of Psychological Coping and Vaccine Uptake throughout the COVID-19 Pandemic in Israel.
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Affiliation(s)
- Yohanan Eshel
- Stress and Resilience Research Center, Tel Hai and University of Haifa, Israel.
| | - Shaul Kimhi
- ResWell - Multinational Resilience & Well-being Research Collaboration, Tel Aviv University, Israel.
| | - Hadas Marciano
- Stress and Resilience Research Center, Tel-Hai College, The Institute of Information Processing and Decision Making (IIPDM), University of Haifa, Israel. https://
| | - Bruria Adini
- Head of the Department of Emergency and Disaster Management, ResWell -Multinational Resilience & Well-being Research Collaboration, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Israel.
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Dropkin G. Variation in COVID-19 booster uptake in England: An ecological study. PLoS One 2022; 17:e0270624. [PMID: 35767526 PMCID: PMC9242486 DOI: 10.1371/journal.pone.0270624] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 06/14/2022] [Indexed: 11/19/2022] Open
Abstract
Introduction Variable and low uptake of the COVID-19 booster is a recognised problem, associated with individual characteristics including age, gender, ethnicity, and deprivation. Are there other relevant predictors at area level? Methods Anonymous grouped data was downloaded from the UK Government Coronavirus Dashboard for Middle Super Output Areas (MSOA) in England, along with demographic, employment, and health data from public sources. Mixed models with a random intercept for Upper Tier Local Authority were analysed as quasibinomial Generalized Additive Models. The estimated random effects were then fitted with Bayesian linear mixed models using flu vaccination uptake, change in public health budgets, population proportion of vaccination sites at pharmacies, GP-led, vaccination centres, and hospital hubs, and Region. Results Models for the MSOA-level COVID-19 first and second vaccinations and the Third Injection (including the booster), fit well. Index of Multiple Deprivation, proportion Aged 15-24 and 25-44, and ethnicity groupings Other White, Indian-Pakistani-Bangladeshi, and African-Caribbean-Other Black-Other, are highly significant predictors of lower uptake. The estimated random effects vary widely amongst local authorities, with positive impact of flu vaccine uptake and change in public health budgets, and regional impacts which are positive for London and South East (first and second doses only), and negative for North West and North East. The impact of vaccination sites did not reach 90% credibility, in general. Conclusion COVID-19 vaccination rates at each stage are very well modelled if local authority random effects are included along with non-linear terms for demographic, employment and health data. Deprivation, younger age, and Other White, South Asian, and African-Caribbean-Other ethnicities are associated with lower uptake. The estimated local effects show strong regional variation and are positively associated with flu vaccination and increasing public health budgets. One simple way to improve COVID-19 vaccine uptake in England would be to increase local public health allocations.
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Affiliation(s)
- Greg Dropkin
- Independent Researcher, Liverpool, England
- * E-mail:
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Ten Actions to Counteract Vaccine Hesitancy Suggested by the Italian Society of Hygiene, Preventive Medicine, and Public Health. Vaccines (Basel) 2022; 10:vaccines10071030. [PMID: 35891193 PMCID: PMC9320096 DOI: 10.3390/vaccines10071030] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 06/24/2022] [Accepted: 06/25/2022] [Indexed: 02/01/2023] Open
Abstract
Vaccine hesitancy (VH) is one of the main causes of the widespread decline in vaccination coverage and has become the subject of ongoing debate among public health professionals. The present commentary is a “decalogue” of strategic actions to counteract vaccine hesitancy for public health professionals that comes from the cognitive and formative path put in place by the “Communication in Public Health” working group (WG) of the Italian Society of Hygiene, Preventive Medicine, and Public Health. From the establishment of a national, multidisciplinary WG on VH to the activation of a national monitoring/surveillance system on vaccine hesitancy, several proposals are discussed. The identification and dissemination of good practices and tools to counteract and understand vaccine hesitancy, interdisciplinary training on vaccine hesitancy and on risk communication, community engagement and infodemiology, the inclusion of effective interventions to counteract vaccine hesitancy within the National Immunization Plan (NIP), the promotion and growth of a community of practice and research in the field of vaccine hesitancy, collaborations between scientific societies, and knowledge from the behavioral sciences represent other actions recommended in the present commentary. The present document suggests ten undeferrable strategies that could be implemented at the national and local levels in Italy, and that could be borrowed by other European countries in order to counteract vaccines hesitancy with a systematic and organic approach.
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Fendler A, de Vries EGE, GeurtsvanKessel CH, Haanen JB, Wörmann B, Turajlic S, von Lilienfeld-Toal M. COVID-19 vaccines in patients with cancer: immunogenicity, efficacy and safety. Nat Rev Clin Oncol 2022; 19:385-401. [PMID: 35277694 PMCID: PMC8916486 DOI: 10.1038/s41571-022-00610-8] [Citation(s) in RCA: 111] [Impact Index Per Article: 55.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2022] [Indexed: 12/11/2022]
Abstract
Patients with cancer have a higher risk of severe coronavirus disease (COVID-19) and associated mortality than the general population. Owing to this increased risk, patients with cancer have been prioritized for COVID-19 vaccination globally, for both primary and booster vaccinations. However, given that these patients were not included in the pivotal clinical trials, considerable uncertainty remains regarding vaccine efficacy, and the extent of humoral and cellular immune responses in these patients, as well as the risks of vaccine-related adverse events. In this Review, we summarize the current knowledge generated in studies conducted since COVID-19 vaccines first became available. We also highlight critical points that might affect vaccine efficacy in patients with cancer in the future.
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Affiliation(s)
- Annika Fendler
- Cancer Dynamics Laboratory, The Francis Crick Institute, London, UK
| | - Elisabeth G E de Vries
- Department of Medical Oncology, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands
| | | | - John B Haanen
- Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Bernhard Wörmann
- Division of Hematology, Oncology and Tumour Immunology, Department of Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Samra Turajlic
- Cancer Dynamics Laboratory, The Francis Crick Institute, London, UK
- Skin and Renal Units, The Royal Marsden NHS Foundation Trust, London, UK
| | - Marie von Lilienfeld-Toal
- Department of Haematology and Medical Oncology, University Hospital Jena, Jena, Germany.
- Research Group Infections in Haematology/Oncology, Leibniz Institute for Natural Product Research and Infection Biology, Hans Knöll Institute, Jena, Germany.
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Heyne S, Esser P, Werner A, Lehmann-Laue A, Mehnert-Theuerkauf A. Attitudes toward a COVID-19 vaccine and vaccination status in cancer patients: a cross-sectional survey. J Cancer Res Clin Oncol 2022; 148:1363-1374. [PMID: 35218401 PMCID: PMC8881553 DOI: 10.1007/s00432-022-03961-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 02/16/2022] [Indexed: 02/05/2023]
Abstract
PURPOSE We aim to assess attitudes toward a COVID-19 vaccine and vaccination status in cancer patients and to explore additional factors such as the level of information and comprehensibility and accessibility of this information, anxiety symptoms in general and toward COVID-19, and general health literacy. METHODS We included 425 outpatients (mean age 61.4, age range 30-88 years, 60.5% women) of the Psychosocial Counseling Center for Cancer patients of the Department of Medical Psychology and Medical Sociology, Leipzig. We recorded attitudes toward a COVID-19 vaccine and vaccination status via self-report. The impact of psychosocial factors, including anxiety (GAD-7), COVID-19-specific anxiety (OCS; FCV-19S) and health literacy (HLS-EU-Q16) were analyzed with point-biserial correlations using Pearson's r. RESULTS We found that the vast majority (95.5%) reported being vaccinated against COVID-19 and that overall trust in safety and protective effects of a COVID-19 vaccine was high (90.9%). The vaccination readiness among nonvaccinated cancer survivors was low to very low with "fear of side effects" the most mentioned (72.2%) reason against a COVID-19 vaccine. There was no significant correlation between vaccination status and fear or anxiety symptomatology, and health literacy. Obsessive thoughts about COVID-19 was significantly higher in nonvaccinated cancer patients. CONCLUSIONS Majority of respondents are positive about COVID-19 vaccine, accompanied by a very high rate of COVID-19 immunization in our sample. Further studies with a larger sample of nonvaccinated cancer patients should further investigate the relationship on fear and vaccination hesitancy and align communication strategies accordingly.
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Affiliation(s)
- Svenja Heyne
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany.
| | - Peter Esser
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Anne Werner
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Antje Lehmann-Laue
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Anja Mehnert-Theuerkauf
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
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