COVID-19 Vaccine Concerns and Acceptability by Language in a Marginalized Population in Rhode Island

Strengthening a One Health approach to emerging zoonoses

Given the enormous global impact of the COVID-19 pandemic, outbreaks of highly pathogenic avian influenza in Canada, and manifold other zoonotic pathogen activity, there is a pressing need for a deeper understanding of the human-animal-environment interface and the intersecting biological, ecological, and societal factors contributing to the emergence, spread, and impact of zoonotic diseases. We aim to apply a One Health approach to pressing issues related to emerging zoonoses, and propose a functional framework of interconnected but distinct groups of recommendations around strategy and governance, technical leadership (operations), equity, education and research for a One Health approach and Action Plan for Canada. Change is desperately needed, beginning by reorienting our approach to health and recalibrating our perspectives to restore balance with the natural world in a rapid and sustainable fashion. In Canada, a major paradigm shift in how we think about health is required. All of society must recognize the intrinsic value of all living species and the importance of the health of humans, other animals, and ecosystems to health for all.

Factors Associated With COVID-19 Vaccine Acceptance Among Patients Receiving Care at a Federally Qualified Health Center

BACKGROUND

COVID-19 vaccine hesitancy in the United States is high, with at least 63 million unvaccinated individuals to date. Socioeconomically disadvantaged populations experience lower COVID-19 vaccination rates despite facing a disproportionate COVID-19 burden.

OBJECTIVE

To assess the factors associated with COVID-19 vaccine acceptance among under-resourced, adult patients.

METHODS

Participants were patients receiving care at a Federally Qualified Health Center (FQHC) in St. Paul, Minnesota. Data were collected via multiple modes over 2 phases in 2020 (self-administered electronic survey) and 2021 (study team-administered survey by telephone, self-administered written survey) to promote diversity and inclusion for study participation. The primary outcome was COVID-19 vaccine acceptance. Using logistic regression analysis, associations between vaccine acceptance and factors including risk perception, concerns about the COVID-19 vaccine, social determinants of health (SDOH), co-morbidities, pandemic-induced hardships, and stress were assessed by adjusted odds ratios (AORs) and 95% confidence intervals (CI).

RESULTS

One hundred sixty-eight patients (62.5% female; mean age [SD]: 49.9 [17.4] years; 32% <$20 000 annual household income; 69%

CONCLUSIONS

Our study in a socioeconomically disadvantaged population suggests that risk perception is associated with an increased likelihood of vaccine acceptance, while concerns about the COVID-19 vaccine are associated with a lower likelihood of vaccine acceptance. As these factors could impact vaccine uptake, consistent, innovative, and context-specific risk communication strategies may improve vaccine coverage in this population.

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Key Words

• COVID
• COVID-19 vaccines
• Federally Qualified Health Center
• community health
• health disparities
• health promotion
• prevention
• social determinants of health
• underserved communities
• vaccine hesitancy

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MESH Headings

• Adult
• Humans
• Female
• Adolescent
• Male
• COVID-19 Vaccines/therapeutic use
• COVID-19/prevention & control
• Communication
• Electronics
• Health Facilities
• Vaccination

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Grants

• KL2 TR002379 NCATS NIH HHS
• R21 MD013490 NIMHD NIH HHS
• UL1 TR000135 NCATS NIH HHS
• National Center for Advancing Translational Sciences
• National Institute on Minority Health and Health Disparities
• Centers for Disease Control and Prevention
• American Heart Association

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Affiliation(s)

Mathias Lalika Mayo Clinic, Rochester, MN, USA
Cynthia Woods Open Cities Health Center, St Paul, MN, USA
Aarti Patel Open Cities Health Center, St Paul, MN, USA
Christopher Scott Mayo Clinic, Rochester, MN, USA
Alexander Lee Mayo Clinic, Rochester, MN, USA
Jennifer Weis Mayo Clinic, Rochester, MN, USA
Clarence Jones Hue-Man Partnership, Minneapolis, MN, USA
Adeline Abbenyi Mayo Clinic, Rochester, MN, USA
Tabetha A. Brockman Mayo Clinic, Rochester, MN, USA
Irene G. Sia Mayo Clinic, Rochester, MN, USA
Richard O. White Mayo Clinic, Jacksonville, FL, USA
Chyke A. Doubeni The Ohio State University Wexner Medical Center, Columbus, OH, USA
LaPrincess C. Brewer Mayo Clinic, Rochester, MN, USA

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Parental perceptions of the COVID-19 vaccine for 5- to 11-year-old children: Focus group findings from Worcester Massachusetts

Vaccine hesitancy is a long-standing public health issue. The present work describes parental perceptions of COVID-19 vaccination for 5- to 11-year-old children, to aid in vaccination efforts. Parents of 5- to 11-year-old children residing in Worcester, Massachusetts, were recruited through community partner outreach to participate in semi-structured focus groups. Focus groups were conducted via Zoom in English (n = 4) and Spanish (n = 3) with a total of 67 parents. Rapid qualitative analysis was used. Most participants were female and of Hispanic ethnicity. Themes included: (1) Trusted sources and influential types of information (e.g. personal COVID-19 vaccine stories from peers and healthcare providers), (2) Motivations for vaccination: health (i.e. protecting children, families, and communities from COVID-19), (3) Motivations for vaccination: social, emotional, and educational (i.e. mitigating related negative effects of COVID-19), (4) Drivers of vaccine hesitancy (e.g. frustration, uncertainty, and confusion), (5) Differentiating vaccine acceptance, hesitancy, and resistance, (6) Needed information. Although this context may be unique to parents of 5- to 11-year-old children from Central Massachusetts, especially those who may be Spanish-speaking, or of Hispanic ethnicity, this work reinforces the need for effective and persistent communication to combat vaccine hesitancy. In describing parents' perceptions toward COVID-19 vaccination in their 5- to 11-year-old children, we contextualize vaccine hesitancy and highlight opportunities for existing evidence-based communication strategies to increase vaccine confidence and uptake in pediatric populations.