Health literacy and COVID-19 vaccine acceptance worldwide: A systematic review

Factors influencing parental COVID-19 vaccination willingness for children in Japan

Objectives

This study aims to investigate the factors influencing parental willingness in COVID-19 vaccination for children in Japan in light of the introduction of pediatric vaccines.

Methods

An online survey was conducted in February 2022, coinciding with the imminent start of pediatric COVID-19 vaccinations in Japan. It assessed attitudes toward vaccine uptake and included questions about health-related attributes, psychological considerations, and sources of COVID-19 information. Data from 2,419 respondents who had children under the age of 12 were analyzed using multinomial logistic regression to identify factors associated with parental willingness towards COVID-19 vaccination for children. The outcomes were "agree" (in favor of vaccination), "not sure" (undecided), with "disagree" (against vaccination) as the reference category.

Results

Among participants supportive of vaccination ("agree" compared to the "disagree" reference), salient determinants included: gender (Men in reference to women: odds ratio [OR] 1.54; 95 % confidence interval [CI] 1.11-2.15), highest educational level (Junior College/Vocational in reference to under high school: OR 0.61; 95 % CI 0.40-0.93, Bachelor's /Master's/Doctoral degree in reference to under high school: OR 0.59; 95 % CI 0.42-0.84), perception of benefits of COVID-19 vaccination (Significant in reference to Insignificant: OR 2.04; 95 % CI 1.26-3.28), perception of risks of COVID-19 vaccination (Significant in reference to Insignificant: OR 0.28; 95 % CI 0.19-0.42, Neutral in reference to Insignificant: OR 0.48; 95 % CI 0.33-0.71), the number of referenced information sources utilized for COVID-19 was associated with attitudes towards children's vaccination (OR 1.02; 95 % CI 1.00-1.04).

Conclusion

The study highlights the multifaceted factors influencing parents' COVID-19 vaccination attitudes for their children, encompassing socioeconomic, health, psychological, and informational aspects. Factors like cautious information gathering, vaccine concerns and diverse referenced information sources impact willingness. To facilitate informed decision-making, essential measures include government risk communication, widespread vaccine information dissemination, and enhancing parents' health information accessibility and evaluation skills are important.

Support for Mandatory COVID-19 Vaccines for 5- to 11-Year-Old Children: Cross-sectional study of Omani mothers

Objectives

This study aimed to investigate the variables that influenced a sample of Omani mothers' support for mandatory COVID-19 vaccines for children. The vaccination against COVID-19 averted millions of fatalities during the COVID-19 pandemic. Nevertheless, a considerable number of parents and caregivers opposed mandating COVID-19 vaccines for children.

Methods

This cross-sectional study was conducted at several healthcare facilities in Oman using a structured questionnaire between February and March 2022. Univariable and multivariable logistic regression models were used to analyse the data.

Results

A total of 700 Omani mothers (response rate = 73.4%) who had children aged 5-11 years old were included. The median age of the mothers was 38 ± 5.19 years. The results of multivariable logistic regression were generally consistent with those of the univariable analysis except for age (odds ratio [OR] = 1.06, 95% confidence interval [CI]: 0.58-1.93; P = 0.86) and income (OR = 1.09, 95% CI: 0.58-2.03; P = 0.79). Mothers who were vaccine hesitant (OR = 9.82, 95% CI: 5.27-18.28; P <0.001), tested positive for COVID-19 (OR = 3.25, 95% CI: 1.80-5.86; P <0.001) and had one or two doses of COVID-19 vaccines (OR = 5.41, 95% CI: 2.92-10.03; P <0.001) were more likely to refuse mandating COVID-19 vaccines for children 5-11 years old.

Conclusion

Mothers who were vaccine hesitant, tested positive for COVID-19 and had one or two doses of COVID-19 vaccines were more likely to oppose mandatory COVID-19 vaccines for young children. The findings should aid public health authorities in designing future childhood vaccine literacy programmes with specific attention to some subgroups in Oman to help reduce opposition to vaccines in future pandemics among mothers.

Perspectives in the Development of Tools to Assess Vaccine Literacy

Vaccine literacy (VL) is the ability to find, understand, and evaluate vaccination-related information to make appropriate decisions about immunization. The tools developed so far for its evaluation have produced consistent results. However, some dimensions may be underestimated due to the complexity of factors influencing VL. Moreover, the heterogeneity of methods used in studies employing these tools hinders a comprehensive understanding of its role even more. To overcome these limitations, a path has been sought to propose new instruments. This has necessitated updating earlier literature reviews on VL and related tools, exploring its relationship with vaccine hesitancy (VH), and examining associated variables like beliefs, attitudes, and behaviors towards immunization. Based on the current literature, and supported by the re-analysis of a dataset from an earlier study, we propose a theoretical framework to serve as the foundation for creating future assessment tools. These instruments should not only evaluate the psychological factors underlying the motivational aspect of VL, but also encompass knowledge and competencies. The positioning of VL in the framework at the intersection between sociodemographic antecedents and attitudes, leading to behaviors and outcomes, explains why and how VL can directly or indirectly influence vaccination decisions by countering VH and operating at personal, as well as at organizational and community levels.

The anti-SARS-CoV-2 BNT162b2 vaccine suppresses mithramycin-induced erythroid differentiation and expression of embryo-fetal globin genes in human erythroleukemia K562 cells

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is causative of the ongoing coronavirus disease 2019 (COVID-19) pandemic. The SARS-CoV-2 Spike protein (S-protein) plays an important role in the early phase of SARS-CoV-2 infection through efficient interaction with ACE2. The S-protein is produced by RNA-based COVID-19 vaccines, that were fundamental for the reduction of the viral spread within the population and the clinical severity of COVID-19. However, the S-protein has been hypothesized to be responsible for damaging cells of several tissues and for some important side effects of RNA-based COVID-19 vaccines. Considering the impact of COVID-19 and SARS-CoV-2 infection on the hematopoietic system, the aim of this study was to verify the effect of the BNT162b2 vaccine on erythroid differentiation of the human K562 cell line, that has been in the past intensively studied as a model system mimicking some steps of erythropoiesis. In this context, we focused on hemoglobin production and induced expression of embryo-fetal globin genes, that are among the most important features of K562 erythroid differentiation. We found that the BNT162b2 vaccine suppresses mithramycin-induced erythroid differentiation of K562 cells. Reverse-transcription-qPCR and Western blotting assays demonstrated that suppression of erythroid differentiation was associated with sharp inhibition of the expression of α-globin and γ-globin mRNA accumulation. Inhibition of accumulation of ζ-globin and ε-globin mRNAs was also observed. In addition, we provide in silico studies suggesting a direct interaction between SARS-CoV-2 Spike protein and Hb Portland, that is the major hemoglobin produced by K562 cells. This study thus provides information suggesting the need of great attention on possible alteration of hematopoietic parameters following SARS-CoV-2 infection and/or COVID-19 vaccination.