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Schwartz AJ, Richman AR, Torres E. Messaging Preferences about the COVID-19 Vaccine among Adults in Eastern North Carolina. J Community Health 2024:10.1007/s10900-024-01396-9. [PMID: 39235541 DOI: 10.1007/s10900-024-01396-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2024] [Indexed: 09/06/2024]
Abstract
Racially and ethnically diverse populations and individuals residing in rural areas were disproportionally impacted by the coronavirus pandemic, and Eastern North Carolina (ENC) is one region where such impacts were apparent. To understand at-risk individuals' perceptions and hesitancy to COVID-19 vaccines and the preferred means of receiving vaccination-related messages, we conducted four qualitative focus groups (N = 40) with diverse rural ENC residents. The analysis of the focus group transcripts revealed five themes: (1) reasons people trusted the COVID-19 vaccines, (2) reasons people mistrusted the COVID-19 vaccines, (3) the best means to deliver messages regarding COVID-19 vaccination, (4) the individuals trusted most to deliver such messages, and (5) the decisions people made regarding whether to get vaccinated and how that was connected to God. By incorporating participant perspectives and preferences in receiving messaging into campaigns, there is a potential for greater vaccine uptake.
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Affiliation(s)
- Abby J Schwartz
- School of Social Work, East Carolina University, Greenville, NC, USA.
| | - Alice R Richman
- Department of Health Education and Promotion, East Carolina University, Greenville, NC, USA
| | - Essie Torres
- Office of the Vice Chancellor for Research, University of North Carolina, Chapel Hill, NC, USA
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Tiruneh YM, Cuccaro PM, Elliott KS, Xie J, Martinez J, Owens M, Alvarado CR, Yamal JM. Vaccine Uptake and Intentions: Insights from a Texas Survey on Factors Influencing COVID-19 Vaccination Decisions. Vaccines (Basel) 2024; 12:601. [PMID: 38932330 PMCID: PMC11209159 DOI: 10.3390/vaccines12060601] [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: 04/19/2024] [Revised: 05/23/2024] [Accepted: 05/27/2024] [Indexed: 06/28/2024] Open
Abstract
The effectiveness of COVID-19 vaccines depends on widespread vaccine uptake. Employing a telephone-administered weighted survey with 19,502 participants, we examined the determinants of COVID-19 vaccine acceptance among adults in Texas. We used multiple regression analysis with LASSO-selected variables to identify factors associated with COVID-19 vaccine uptake and intentions to receive the vaccine among the unvaccinated. The prevalence of unvaccinated individuals (22%) was higher among those aged 18-39, males, White respondents, English speakers, uninsured individuals, those facing financial challenges, and individuals expressing no concern about contracting the illness. In a fully adjusted regression model, higher odds of being unvaccinated were observed among males (aOR 1.11), the uninsured (aOR 1.38), smokers (aOR 1.56), and those facing financial struggles (aOR 1.62). Conversely, Asians, Blacks, and Hispanics were less likely to be unvaccinated compared to Whites. Among the unvaccinated, factors associated with stronger intent to receive the vaccine included age (over 65 years), Black and Hispanic ethnicity, and perceived risk of infection. Hispanic individuals, the uninsured, those covered by public insurance, and those facing financial challenges were more likely to encounter barriers to vaccine receipt. These findings underscore the importance of devising tailored strategies, emphasizing nuanced approaches that account for demographic, socioeconomic, and attitudinal factors in vaccine distribution and public health interventions.
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Affiliation(s)
- Yordanos M. Tiruneh
- Department of Preventive Medicine and Population Health, School of Medicine, University of Texas at Tyler, Tyler, TX 75708, USA
- Department of Internal Medicine, School of Medicine, University of Texas at Tyler, Tyler, TX 75708, USA
- Department of Internal Medicine, Division of Infectious Diseases, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Paula M. Cuccaro
- Center for Health Promotion and Prevention Research, Department of Health Promotion and Behavioral Sciences, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX 78701, USA;
| | - Kimberly S. Elliott
- Department of Health Policy, Economics, and Management, School of Professions, University of Texas at Tyler, Tyler, TX 75708, USA;
| | - Jing Xie
- Coordinating Center for Clinical Trials, Department of Biostatistics and Data Science, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX 77030, USA; (J.X.); (J.M.); (J.-M.Y.)
| | - Journey Martinez
- Coordinating Center for Clinical Trials, Department of Biostatistics and Data Science, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX 77030, USA; (J.X.); (J.M.); (J.-M.Y.)
| | - Mark Owens
- Department of Political Science, School of Humanities and Social Sciences, The Citadel, Charleston, SC 29409, USA;
| | - Christian R. Alvarado
- Department of Epidemiology and Biostatistics, School of Medicine, University of Texas at Tyler, Tyler, TX 75708, USA;
| | - Jose-Miguel Yamal
- Coordinating Center for Clinical Trials, Department of Biostatistics and Data Science, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX 77030, USA; (J.X.); (J.M.); (J.-M.Y.)
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Le AB, Yuan S, Chow A, Mullins-Jaime C, Smith TD. The impact of safety behavior, perceived risk, and workplace resources on COVID outcomes for U.S. Aircraft Rescue and Firefighting personnel. Work 2024:WOR230316. [PMID: 38788107 DOI: 10.3233/wor-230316] [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: 05/26/2024] Open
Abstract
BACKGROUND Aircraft rescue and firefighting (ARFF) personnel are first responders located at airports in the United States who provide emergency response, mitigation, evacuation, and rescue of passengers and crew of aircraft at airports. The nature of their work puts ARFF personnel in close contact with travelers on a regular basis and at elevated risk for COVID-19 exposure. OBJECTIVE In this study, we focused on safety behavior, perceived risk, and workplace resources to understand COVID-19 outcomes in the early pandemic among the overlooked worker population of ARFF personnel. The goal of this study was to examine how a self-reported positive COVID test were associated with safety behavior, perceived risk, and workplace resources. METHODS Cross-sectional survey data were collected among ARFF personnel a year into the COVID-19 pandemic. RESULTS Regression results showed that each additional unit increase in perceived susceptibility to COVID-19 was associated with a 133% increase in the odds of testing positive for COVID-19 (OR = 2.33, p < 0.05), and with each additional unit increase in perceived severity level, the odds of getting COVID-19 decreased by 47% (OR = 0.53, p < 0.05). CONCLUSIONS Infection control among first responders may be improved by providing relevant information physical and emotional resources, and support that help shape perceptions of risk and adoption of prevention behaviors.
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Affiliation(s)
- Aurora B Le
- Department of Health Behavior, School of Public Health, Texas A& M University, College Station, TX, USA
| | - Shuhan Yuan
- Department of Applied Health Science, School of Public Health, Indiana University, Bloomington, IN, USA
| | - Angela Chow
- Department of Applied Health Science, School of Public Health, Indiana University, Bloomington, IN, USA
| | - Charmaine Mullins-Jaime
- Department of the Built Environment, Bailey College of Engineering and Technology, Indiana State University, Terre Haute, IN, USA
| | - Todd D Smith
- Department of Applied Health Science, School of Public Health, Indiana University, Bloomington, IN, USA
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Simsekoglu N, Akyuz E, Guven R, Pasin O. Attitudes toward COVID-19 vaccines during pregnancy and breastfeeding. Front Public Health 2024; 12:1286891. [PMID: 38496391 PMCID: PMC10940332 DOI: 10.3389/fpubh.2024.1286891] [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: 08/31/2023] [Accepted: 02/20/2024] [Indexed: 03/19/2024] Open
Abstract
Background Although vaccination is one of the most effective means of controlling the spread of COVID-19, public concerns and indecision about vaccination still continue. Because pregnant and breastfeeding individuals are at high risk for severe outcomes in case of infections, determining their level of hesitation and attitude toward COVID-19 vaccines will guide the management of the disease. This study aimed to determine pregnant and breastfeeding women's levels of hesitation and attitude toward COVID-19 vaccines as well as their related factors. Methods The sample of this descriptive research consisted of 103 pregnant or breastfeeding individuals who were seen at the obstetrics and gynecology outpatients clinic of a state hospital in Istanbul, Turkey. The data were collected using a 'demographic data form', the 'Vaccine Hesitancy Scale in Pandemic', and the 'Attitudes toward COVID-19 Vaccine Scale'. The research data were analyzed with appropriate statistical methods. Results The mean age of the participants was 29.71 ± 4.75, 51% were pregnant, and 74.8% had received the COVID-19 vaccine. The mean score of the 'Vaccination Hesitancy Scale in Pandemic' was 30.83 ± 6.91, and the mean score for the 'Attitude Scale toward the COVID-19 Vaccine' was 25.50 ± 5.20. A significant difference was found between the total score of the 'Vaccine Hesitation Scale in the Pandemic' and the mean score of the 'Lack of Confidence' sub-dimension between the 'working status' and the 'influenza vaccination' status. In terms of the mean score of the 'Risk' sub-dimension, a significant difference was found between the 'period of vaccination' (p < 0.05). According to the mean total score of the 'Attitude Towards COVID-19 Vaccine Scale', there was a significant difference between the 'smoking' status. There was a significant difference in the 'Positive Attitude' sub-dimension in terms of the 'flu vaccination' status. There was a significant difference in the 'Negative Attitude' sub-dimension in terms of the 'chronic disease' status. A positive correlation was found between the total scores of the scales. Conclusion It was concluded that although the participants had a high level of hesitation toward the COVID-19 vaccine, they had a positive attitude. The results obtained will be guided in determining the strategies to be developed for these specific groups in future pandemics.
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Affiliation(s)
- Nesibe Simsekoglu
- Department of Home Patient Care, Hamidiye Vocational School of Health Services, University of Health Sciences, Istanbul, Turkey
| | - Enes Akyuz
- Department of Biophysics, Faculty of International Medicine, University of Health Sciences, Istanbul, Turkey
| | - Rabia Guven
- Division of Obstetrics and Gynaecology, Beykoz State Hospital, Istanbul, Turkey
| | - Ozge Pasin
- Department of Biostatistics, Faculty of Medicine, Bezmialem University, Istanbul, Turkey
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Al-Saudi G, Thabit AK, Jose J, Badr AF, Jad L, Kaae S, Jacobsen R. Exploring the reasons behind low COVID-19 vaccination coverage in ethnic minorities-A qualitative study among Arabic-speaking public in Denmark. Health Policy 2024; 139:104965. [PMID: 38104373 DOI: 10.1016/j.healthpol.2023.104965] [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: 03/31/2023] [Revised: 12/06/2023] [Accepted: 12/11/2023] [Indexed: 12/19/2023]
Abstract
AIMS In Denmark, COVID-19 infection rates have been higher, and vaccination coverage has been lower in areas with many residents from ethnic minority backgrounds. This study aimed to explore COVID-19 vaccination perceptions among Arabic-speaking minorities in Denmark. MATERIALS AND METHODS A total of 16 individuals, varying in age, gender, education, employment, health, vaccination status, and the Arabic-speaking country of origin, were recruited and interviewed in Arabic. The interviews were transcribed verbatim, translated into English, and analyzed using directed thematic analysis. RESULTS Most interviewees had some knowledge about how vaccines work to prevent infections; however, a wide spectrum of opinions about the effectiveness and safety of COVID-19 vaccines and vaccination policies in Denmark emerged. COVID-19 vaccination issues were extensively discussed in Arabic-speaking communities, but consensus was rarely reached. Many participants felt confused and only took vaccines for practical considerations, such as travel. Due to language barriers, some participants experienced difficulties in understanding vaccination-related information in electronic invitations from the health authorities and at vaccination centers, with family members often stepping in to provide translations. CONCLUSIONS Systematic efforts to actively disseminate translated COVID-19 vaccination information are needed to support ethnic minority individuals in making informed decisions.
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Affiliation(s)
- Ghuna Al-Saudi
- Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Abrar K Thabit
- Pharmacy Practice Department, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Jimmy Jose
- School of Pharmacy, University of Nizwa, Nizwa, Sultanate of Oman
| | - Aisha F Badr
- Pharmacy Practice Department, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Lama Jad
- Pharmacy Practice Department, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Susanne Kaae
- Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ramune Jacobsen
- Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
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Nalubega P, Namugumya R, Zalwango F, Ssali A, Mboizi R, Hookham L, Seeley J, Le Doare K. COVID-19 disease and vaccination in pregnancy: understanding knowledge, perceptions and experiences among pregnant women and community leaders in Uganda. Trans R Soc Trop Med Hyg 2023; 117:697-704. [PMID: 37132467 PMCID: PMC10546905 DOI: 10.1093/trstmh/trad028] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/13/2023] [Accepted: 04/18/2023] [Indexed: 05/04/2023] Open
Abstract
BACKGROUND We investigated pregnant women and community leaders' knowledge, perceptions and experiences of the coronavirus disease 2019 (COVID-19) vaccination program during pregnancy in Uganda and how this changed over the course of the pandemic. METHODS We conducted 20 in-depth interviews (IDIs) and two group discussions (GDs) with pregnant women and four GDs with community leaders in Kawempe division of Kampala, Uganda. The first round of IDIs/GDs were carried out in March 2021. In July 2021, telephone IDIs were conducted with 7 pregnant women and 10 community leaders randomly selected from first-round interview participants. Themes were analysed deductively drawing codes from the topic guides. RESULTS In the first round, the majority of participants thought COVID-19 was not real because of misconceptions around government messaging/motivation and beliefs that Africans would not be affected. In the second round, participants recognised COVID-19 disease, because of rising case numbers and fatalities. There was increased awareness of the benefits of the vaccine. However, pregnant women remained unsure of vaccine safety and quality, citing side effects like fevers and general body weakness. Role models and coherent public health messaging and healthcare workers were key enablers of vaccine uptake. CONCLUSIONS Targeted and sustained COVID-19 communication and engagement strategies are needed, especially for pregnant women and others in their communities, to improve vaccine confidence during outbreaks.
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Affiliation(s)
- Phiona Nalubega
- Medical Research Council/Uganda Virus Research Institute, and London School of Hygiene and Tropical Medicine Uganda Research Unit, P.O. Box 49, Entebbe, Uganda
| | - Ritah Namugumya
- Medical Research Council/Uganda Virus Research Institute, and London School of Hygiene and Tropical Medicine Uganda Research Unit, P.O. Box 49, Entebbe, Uganda
| | - Flavia Zalwango
- Medical Research Council/Uganda Virus Research Institute, and London School of Hygiene and Tropical Medicine Uganda Research Unit, P.O. Box 49, Entebbe, Uganda
| | - Agnes Ssali
- Medical Research Council/Uganda Virus Research Institute, and London School of Hygiene and Tropical Medicine Uganda Research Unit, P.O. Box 49, Entebbe, Uganda
| | - Robert Mboizi
- Makerere University–Johns Hopkins University Research Collaboration, P.O. Box 23491, Kampala, Uganda
| | - Lauren Hookham
- St. George's, University of London, Cranmer Terrace, London SW17 0RE, UK
| | - Janet Seeley
- Medical Research Council/Uganda Virus Research Institute, and London School of Hygiene and Tropical Medicine Uganda Research Unit, P.O. Box 49, Entebbe, Uganda
- London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, UK
| | - Kirsty Le Doare
- Medical Research Council/Uganda Virus Research Institute, and London School of Hygiene and Tropical Medicine Uganda Research Unit, P.O. Box 49, Entebbe, Uganda
- St. George's, University of London, Cranmer Terrace, London SW17 0RE, UK
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Daniore P, Moser A, Höglinger M, Probst Hensch N, Imboden M, Vermes T, Keidel D, Bochud M, Ortega Herrero N, Baggio S, Chocano-Bedoya P, Rodondi N, Tancredi S, Wagner C, Cullati S, Stringhini S, Gonseth Nusslé S, Veys-Takeuchi C, Zuppinger C, Harju E, Michel G, Frank I, Kahlert CR, Albanese E, Crivelli L, Levati S, Amati R, Kaufmann M, Geigges M, Ballouz T, Frei A, Fehr J, von Wyl V. Interplay of Digital Proximity App Use and SARS-CoV-2 Vaccine Uptake in Switzerland: Analysis of Two Population-Based Cohort Studies. Int J Public Health 2023; 68:1605812. [PMID: 37799349 PMCID: PMC10549773 DOI: 10.3389/ijph.2023.1605812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 08/18/2023] [Indexed: 10/07/2023] Open
Abstract
Objectives: Our study aims to evaluate developments in vaccine uptake and digital proximity tracing app use in a localized context of the SARS-CoV-2 pandemic. Methods: We report findings from two population-based longitudinal cohorts in Switzerland from January to December 2021. Failure time analyses and Cox proportional hazards regression models were conducted to assess vaccine uptake and digital proximity tracing app (SwissCovid) uninstalling outcomes. Results: We observed a dichotomy of individuals who did not use the SwissCovid app and did not get vaccinated, and who used the SwissCovid app and got vaccinated during the study period. Increased vaccine uptake was observed with SwissCovid app use (aHR, 1.51; 95% CI: 1.40-1.62 [CI-DFU]; aHR, 1.79; 95% CI: 1.62-1.99 [CSM]) compared to SwissCovid app non-use. Decreased SwissCovid uninstallation risk was observed for participants who got vaccinated (aHR, 0.55; 95% CI: 0.38-0.81 [CI-DFU]; aHR, 0.45; 95% CI: 0.27-0.78 [CSM]) compared to participants who did not get vaccinated. Conclusion: In evolving epidemic contexts, these findings underscore the need for communication strategies as well as flexible digital proximity tracing app adjustments that accommodate different preventive measures and their anticipated interactions.
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Affiliation(s)
- Paola Daniore
- Institute for Implementation Science in Health Care, University of Zurich, Zurich, Switzerland
- Digital Society Initiative, University of Zurich, Zurich, Switzerland
| | - André Moser
- Clinical Trials Unit Bern, University of Bern, Bern, Switzerland
| | - Marc Höglinger
- Winterthur Institute of Health Economics, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Nicole Probst Hensch
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Medea Imboden
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Thomas Vermes
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Dirk Keidel
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Murielle Bochud
- Unisanté, University Center for Primary Care and Public Health, Lausanne, Switzerland
| | - Natalia Ortega Herrero
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
| | - Stéphanie Baggio
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
| | - Patricia Chocano-Bedoya
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
| | - Nicolas Rodondi
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
- Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Stefano Tancredi
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
| | - Cornelia Wagner
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
| | - Stéphane Cullati
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
- Department of Readaptation and Geriatrics, University of Geneva, Geneva, Switzerland
| | - Silvia Stringhini
- Department of Health and Community Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Semira Gonseth Nusslé
- Unisanté, University Center for Primary Care and Public Health, Lausanne, Switzerland
| | | | - Claire Zuppinger
- Unisanté, University Center for Primary Care and Public Health, Lausanne, Switzerland
| | - Erika Harju
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Clinical Trial Unit, Lucerne Cantonal Hospital, Lucerne, Switzerland
- School of Health Sciences, ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Gisela Michel
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Irène Frank
- Clinical Trial Unit, Lucerne Cantonal Hospital, Lucerne, Switzerland
| | - Christian R. Kahlert
- Department of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
- Infectious Diseases and Hospital Epidemiology, Children’s Hospital of Eastern Switzerland, St. Gallen, Switzerland
| | - Emiliano Albanese
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
| | - Luca Crivelli
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
- Department Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland
| | - Sara Levati
- Department Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland
| | - Rebecca Amati
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
| | - Marco Kaufmann
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Marco Geigges
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Tala Ballouz
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Anja Frei
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Jan Fehr
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
- Division of Infectious Disease and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland
| | - Viktor von Wyl
- Institute for Implementation Science in Health Care, University of Zurich, Zurich, Switzerland
- Digital Society Initiative, University of Zurich, Zurich, Switzerland
- Division of Infectious Disease and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland
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Janitz AE, Neil JM, Bray LA, Jervis LL, Ross L, Campbell JE, Doescher MP, Spicer PG, Williams ML, Lopez AK, Uribe-Frias CA, Chen S, James JA, VanWagoner TM. CATCH-UP vaccines: protocol for a randomized controlled trial using the multiphase optimization strategy (MOST) framework to evaluate education interventions to increase COVID-19 vaccine uptake in Oklahoma. BMC Public Health 2023; 23:1146. [PMID: 37316843 PMCID: PMC10265558 DOI: 10.1186/s12889-023-16077-w] [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: 03/03/2023] [Accepted: 06/08/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Oklahoma's cumulative COVID-19 incidence is higher in rural than urban counties and higher than the overall US incidence. Furthermore, fewer Oklahomans have received at least one COVID-19 vaccine compared to the US average. Our goal is to conduct a randomized controlled trial using the multiphase optimization strategy (MOST) to test multiple educational interventions to improve uptake of COVID-19 vaccination among underserved populations in Oklahoma. METHODS Our study uses the preparation and optimization phases of the MOST framework. We conduct focus groups among community partners and community members previously involved in hosting COVID-19 testing events to inform intervention design (preparation). In a randomized clinical trial, we test three interventions to improve vaccination uptake: (1) process improvement (text messages); (2) barrier elicitation and reduction (electronic survey with tailored questions/prompts); and (2) teachable moment messaging (motivational interviewing) in a three-factor fully crossed factorial design (optimization). DISCUSSION Because of Oklahoma's higher COVID-19 impact and lower vaccine uptake, identifying community-driven interventions is critical to address vaccine hesitancy. The MOST framework provides an innovative and timely opportunity to efficiently evaluate multiple educational interventions in a single study. TRIAL REGISTRATION ClinicalTrials.gov: NCT05236270, First Posted: February 11, 2022, Last Update Posted: August 31, 2022.
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Affiliation(s)
- Amanda E Janitz
- University of Oklahoma Health Sciences Center, 801 NE 13th St., CHB 309, Oklahoma City, OK, 73104, USA.
| | - Jordan M Neil
- University of Oklahoma Health Sciences Center, 801 NE 13th St., CHB 309, Oklahoma City, OK, 73104, USA
| | - Laura A Bray
- University of Oklahoma Norman Campus, 5 Partners Place, 201 Stephenson Parkway, Suite 4100, Norman, OK, 73072, USA
| | - Lori L Jervis
- University of Oklahoma Norman Campus, 5 Partners Place, 201 Stephenson Parkway, Suite 4100, Norman, OK, 73072, USA
| | - Laura Ross
- Public Health Institute of Oklahoma, P.O. Box 60926, Oklahoma City, OK, 73146, USA
| | - Janis E Campbell
- University of Oklahoma Health Sciences Center, 801 NE 13th St., CHB 309, Oklahoma City, OK, 73104, USA
| | - Mark P Doescher
- University of Oklahoma Health Sciences Center, 801 NE 13th St., CHB 309, Oklahoma City, OK, 73104, USA
| | - Paul G Spicer
- University of Oklahoma Norman Campus, 5 Partners Place, 201 Stephenson Parkway, Suite 4100, Norman, OK, 73072, USA
| | - Mary L Williams
- University of Oklahoma Health Sciences Center, 801 NE 13th St., CHB 309, Oklahoma City, OK, 73104, USA
| | - April K Lopez
- University of Oklahoma Health Sciences Center, 801 NE 13th St., CHB 309, Oklahoma City, OK, 73104, USA
| | - Conce A Uribe-Frias
- University of Oklahoma Health Sciences Center, 801 NE 13th St., CHB 309, Oklahoma City, OK, 73104, USA
| | - Sixia Chen
- University of Oklahoma Health Sciences Center, 801 NE 13th St., CHB 309, Oklahoma City, OK, 73104, USA
| | - Judith A James
- Oklahoma Medical Research Foundation, 825 NE 13th Street, Oklahoma City, OK, 73104, USA
| | - Timothy M VanWagoner
- University of Oklahoma Health Sciences Center, 801 NE 13th St., CHB 309, Oklahoma City, OK, 73104, USA
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9
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Kimbler KJ, Gromer C, Ayala M, Casey B. Correlates of COVID-19 Preventative Behaviors before and after Vaccination Availability. Behav Sci (Basel) 2023; 13:501. [PMID: 37366753 PMCID: PMC10295163 DOI: 10.3390/bs13060501] [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: 05/23/2023] [Revised: 06/09/2023] [Accepted: 06/09/2023] [Indexed: 06/28/2023] Open
Abstract
As the COVID-19 pandemic progressed, various preventative behaviors and eventually vaccinations became available to decrease the spread of the virus. The current study examined a variety of variables (i.e., age, COVID-19-related economic hardship, interpersonal concern, personality, fear of COVID-19, normative beliefs, political beliefs, and vaccine hesitancy) to better understand predictors of preventative behaviors and vaccination status at different points throughout the pandemic. Online questionnaires, administered through Qualtrics, were used to collect data using two convenience samples. One was a small sample (N = 44) of non-student participants before the vaccine was readily available. The other sample (N = 274) included college student participants and occurred after the vaccine had been available to all participants. Results suggest that several variables (i.e., fear of COVID-19, normative beliefs, interpersonal concern, and openness) were consistent predictors of public health behaviors at both points in time and across differently aged samples. Other variables (i.e., agreeableness, extraversion, conscientiousness, and economic hardship) were less consistent with their relationships with public health behaviors. Implications related to both research and public health are discussed.
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Chen YL, Rahman A. Effects of Target Variables on Interpersonal Distance Perception for Young Taiwanese during the COVID-19 Pandemic. Healthcare (Basel) 2023; 11:1711. [PMID: 37372829 DOI: 10.3390/healthcare11121711] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 05/29/2023] [Accepted: 06/09/2023] [Indexed: 06/29/2023] Open
Abstract
The COVID-19 pandemic has affected not only public health but also people's daily lives. Among various strategies to prevent infection, mask wearing and vaccination are considered to be the most effective methods; however, they may affect the comfortable interpersonal distance (IPD) for social interactions. In 2023, although the COVID-19 epidemic is considered to be similar to influenza, the public health sector of Taiwan still plans to give each person at least one dose per year, and even two does for special cases such as the elderly; and more than 90% of Taiwanese are still accustomed to wearing masks in public areas. Compared with mask wearing, studies examining the effects of vaccination on IPD are lacking. Therefore, an online survey was conducted in this study to collect the IPD data of 50 male and 50 female participants to elucidate the effects of mask wearing, vaccination, and target sex variables on IPD. The results showed that all variables significantly affected IPD (all p < 0.001). The effect of masks on IPD (49.1 cm) was slightly greater than that of vaccination (43.5 cm). The IPDs reported for wearing and not wearing masks were 145.7 and 194.8 cm, respectively, and those for vaccinated and unvaccinated were 148.5 and 192.0 cm, respectively. Regardless of participant sex, the IPDs for the female targets were significantly shorter than those for the male targets, which was consistent with the results of previous studies. Although mask wearing and vaccination are functionally different in nature, the findings indicate that the effects of both on IPD are nearly identical, jointly shortening IPD to approximately 93 cm. This implies that not only masks but also vaccination could lead to the shortening of IPD and may cause challenges in the prevention and control of COVID-19 transmission.
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Affiliation(s)
- Yi-Lang Chen
- Department of Industrial Engineering and Management, Ming Chi University of Technology, New Taipei 24301, Taiwan
| | - Andi Rahman
- Department of Industrial Engineering and Management, Ming Chi University of Technology, New Taipei 24301, Taiwan
- Department of Industrial Engineering, Andalas University, Padang 25175, Indonesia
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11
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Manrique de Lara A, Colmenares-Roa T, Pascual-Ramos V, Moctezuma-Rios JF, Contreras-Yañez I, Guaracha-Basañez GA, Álvarez-Hernández E, Meza-López Y Olguín G, Peláez-Ballestas I. Sociocultural and moral narratives influencing the decision to vaccinate among rheumatic disease patients: a qualitative study. Clin Rheumatol 2023:10.1007/s10067-023-06609-5. [PMID: 37129776 PMCID: PMC10152007 DOI: 10.1007/s10067-023-06609-5] [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: 02/07/2023] [Revised: 04/16/2023] [Accepted: 04/21/2023] [Indexed: 05/03/2023]
Abstract
INTRODUCTION/OBJECTIVES Vaccination is a process that involves individual, social, and ethical aspects, beyond public governance of vaccines or vaccination as a public health concern. The aim of this study is to describe the sociocultural and moral narratives that influence the decision to vaccinate in general and to vaccinate against COVID-19 specifically, among patients at the rheumatology units of two hospitals. METHODS Qualitative study involving individual semi-structured interviews following an interview guide. We conducted a thematic analysis using the ATLAS.ti software, with further triangulation to verify concordance and aid in the interpretation of the data from a medical anthropology framework and using a narrative ethics approach to gain insight into the participants' underlying moral values. RESULTS We interviewed 37 patients in total, along with 3 rheumatologists. Five core themes emerged from the analysis to understand the decision to vaccinate: (1) information about vaccines and disease, (2) perceived risk-benefit of vaccination, (3) the physician-patient relationship, (4) governance of vaccination programs, (5) attitudes towards vaccines. Individual and family experiences with vaccination are diverse depending on the type of vaccine. The COVID-19 vaccine, as a new medical technology, is met with more controversy leading to hesitancy. CONCLUSIONS The decision to vaccinate among Mexican rheumatic disease patients can sometimes involve doubt and distrust, especially for those with a lupus diagnosis, but ultimately there is acceptance in most cases. Though patients make and value autonomous decisions, there is a collective process involving sociocultural and ethical aspects. Key points • The complexity of vaccine decision-making is better identified through a narrative, qualitative approach like the one used in this study, as opposed to solely quantitative approaches • Sociocultural and moral perspectives of vaccination shape decision-making and, therefore, highlight the importance of including patients in the development of effective clinical practice guidelines as well as ethically justified public policy • Sociohistorical context and personal experiences of immunization influence vaccine decision-making much more than access to biomedical information about vaccines, showing that approaches based on the information deficit model are inadequate to fight vaccine hesitancy.
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Affiliation(s)
| | | | - Virgina Pascual-Ramos
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas Y Nutrición Salvador Zubirán, Mexico City, México
| | | | - Irazú Contreras-Yañez
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas Y Nutrición Salvador Zubirán, Mexico City, México
| | | | | | | | - Ingris Peláez-Ballestas
- Hospital General de Mexico "Dr. Eduardo Liceaga", Mexico City, México.
- Rheumatology Unit, Hospital General de Mexico "Dr. Eduardo Liceaga", Mexico City, México.
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12
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Kohut M, Scharnetzki L, Pajka J, Jacobs EA, Fairfield KM. Decisions about adopting novel COVID-19 vaccines among White adults in a rural state, USA: A qualitative study. Health Expect 2023; 26:1052-1064. [PMID: 36864735 PMCID: PMC10154856 DOI: 10.1111/hex.13714] [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: 09/16/2022] [Revised: 01/10/2023] [Accepted: 01/13/2023] [Indexed: 03/04/2023] Open
Abstract
PURPOSE Many people, especially in rural areas of the United States, choose not to receive novel COVID-19 vaccinations despite public health recommendations. Understanding how people describe decisions to get vaccinated or not may help to address hesitancy. METHODS We conducted semistructured interviews with 17 rural inhabitants of Maine, a sparsely populated state in the northeastern US, about COVID-19 vaccine decisions during the early rollout (March-May 2021). We used the framework method to compare responses, including between vaccine Adopters and Non-adopters. FINDINGS Adopters framed COVID-19 as unequivocally dangerous, if not personally, then to other people. Describing their COVID concerns, Adopters emphasized disease morbidities. By contrast, Non-adopters never mentioned morbidities, referencing instead mortality risk, which they perceived as minimal. Instead of risks associated with the disease, Non-adopters emphasized risks associated with vaccination. Uncertainty about the vaccine development process, augmented by social media, bolstered concerns about the long-term unknown risks of vaccines. Vaccine Adopters ultimately described trusting the process, while Non-adopters expressed distrust. CONCLUSION Many respondents framed their COVID vaccination decision by comparing the risks between the disease and the vaccine. Associating morbidity risks with COVID-19 diminishes the relevance of vaccine risks, whereas focusing on low perceived mortality risks heightens their relevance. Results could inform efforts to address COVID-19 vaccine hesitancy in the rural US and elsewhere. PATIENT OR PUBLIC CONTRIBUTION Members of Maine rural communities were involved throughout the study. Leaders of community health groups provided feedback on the study design, were actively involved in recruitment, and reviewed findings after analysis. All data produced and used in this study were co-constructed through the participation of community members with lived experience.
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Affiliation(s)
- Mike Kohut
- Center for Interdisciplinary Population Health Research (CIPHR), Portland, Maine, USA
| | - Liz Scharnetzki
- Center for Interdisciplinary Population Health Research (CIPHR), Portland, Maine, USA
| | - Joseph Pajka
- Center for Interdisciplinary Population Health Research (CIPHR), Portland, Maine, USA
| | - Elizabeth A Jacobs
- Center for Interdisciplinary Population Health Research (CIPHR), Portland, Maine, USA
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13
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Bent RK, Weinbrenner J, Faihs V, Steffens S, Nau T, Vitus M, Mathes S, Darsow U, Biedermann T, Brockow K. Increasing the COVID-19 immunization rate through allergy testing. J Eur Acad Dermatol Venereol 2023; 37:1228-1235. [PMID: 36808753 DOI: 10.1111/jdv.18979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 02/01/2023] [Indexed: 02/20/2023]
Abstract
BACKGROUND Vaccination of the population is required to combat the COVID-19 pandemic. Allergy testing could reduce anxiety towards COVID-19 vaccination and thereby may increase vaccination rate, however, its effectiveness remains unclear. METHODS One hundred and thirty prospective real-life patients in need of but not daring to get vaccinated asked for allergy workup for COVID-19 vaccine hypersensitivity in 2021/2022. Characterization of patients, identification of anxieties, decrease of patient's anxiety levels, overall vaccination rate and adverse reactions after vaccination were assessed. RESULTS Tested patients were characterized by being female (91.5%) and having a high rate of previous allergies (e.g. to food 55.4%, drugs 54.6%, or previous vaccinations 50%) and dermatological disease (29.2%) but not always had medical contraindications for COVID-19 vaccination. Sixty one patients (49.6%) were highly concerned (4-6, Likert scale 0-6) about vaccination and 47 (37.6%) expressed resolving thoughts about vaccinaion anaphylaxis (3-6, Likert scale 0-6). However only 35 patients (28.5%) were scared of getting COVID-19 within 2 months (4-6, Likert scale 0-6) and only 11 (9%) patients had high expectations of getting COVID-19 (4-6, Likert scale 0-6). Allergy testing significantly (p < 0.01 to p < 0.05 respectively) reduced the median anxiety of allergic symptoms following vaccination: dyspnoea (4.2-3.1), to faint (3.7-2.7), long-term consequences (3.6-2.2), pruritus (3.4-2.6), skin rash (3.3-2.6) and death (3.2-2.6). After allergy testing, most patients (108/122, 88.5%) let themselves be vaccinated within 60 days. Revaccinated patients with previous symptoms experienced a reduction of symptoms (p < 0.05) upon revaccination. CONCLUSIONS Patients not daring to get vaccinated have more anxiety towards vaccination than to acquire COVID-19. For those, allergy testing excludes vaccine allergy, and is a tool to increase vaccination willingness and thereby helps to combat vaccination hesitancy.
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Affiliation(s)
- R K Bent
- Department of Dermatology and Allergy Biederstein, Faculty of Medicine, Technical University of Munich, Munich, Germany
| | - J Weinbrenner
- Department of Dermatology and Allergy Biederstein, Faculty of Medicine, Technical University of Munich, Munich, Germany
| | - V Faihs
- Department of Dermatology and Allergy Biederstein, Faculty of Medicine, Technical University of Munich, Munich, Germany
| | - S Steffens
- Department of Dermatology and Allergy Biederstein, Faculty of Medicine, Technical University of Munich, Munich, Germany
| | - T Nau
- Department of Dermatology and Allergy Biederstein, Faculty of Medicine, Technical University of Munich, Munich, Germany
| | - M Vitus
- Department of Dermatology and Allergy Biederstein, Faculty of Medicine, Technical University of Munich, Munich, Germany
| | - S Mathes
- Department of Dermatology and Allergy Biederstein, Faculty of Medicine, Technical University of Munich, Munich, Germany
| | - U Darsow
- Department of Dermatology and Allergy Biederstein, Faculty of Medicine, Technical University of Munich, Munich, Germany
| | - T Biedermann
- Department of Dermatology and Allergy Biederstein, Faculty of Medicine, Technical University of Munich, Munich, Germany
| | - K Brockow
- Department of Dermatology and Allergy Biederstein, Faculty of Medicine, Technical University of Munich, Munich, Germany
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14
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Gentsch AT, Butler J, O'Laughlin K, Eucker SA, Chang A, Duber H, Geyer RE, Guth A, Kanzaria HK, Pauley A, Rising KL, Chavez CL, Tupetz A, Rodriguez RM. Perspectives of COVID-19 vaccine-hesitant emergency department patients to inform messaging platforms to promote vaccine uptake. Acad Emerg Med 2023; 30:32-39. [PMID: 36310395 PMCID: PMC9874774 DOI: 10.1111/acem.14620] [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: 07/19/2022] [Revised: 10/20/2022] [Accepted: 10/27/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Efforts to promote COVID-19 vaccine acceptance must consider the critical role of the emergency department (ED) in providing health care to underserved patients. Focusing on patients who lacked primary care, we sought to elicit the perspectives of unvaccinated ED patients regarding COVID-19 vaccination concerns and potential approaches that might increase their vaccine acceptance. METHODS We conducted this qualitative interview study from August to November 2021 at four urban EDs in San Francisco, California; Seattle, Washington; Durham, North Carolina; and Philadelphia, Pennsylvania. We included ED patients who were ≥18 years old, fluent in English or Spanish, had not received a COVID-19 vaccine, and did not have primary care physicians or clinics. We excluded patients who were unable to complete an interview, in police custody, under suspicion of active COVID-19 illness, or presented with a psychiatric chief complaint. We enrolled until we reached thematic saturation in relevant domains. We analyzed interview transcripts with a content analysis approach focused on identifying concerns about COVID-19 vaccines and ideas regarding the promotion of vaccine acceptance and potential trusted messengers. RESULTS Of 65 patients enrolled, 28 (43%) identified as female, their median age was 36 years (interquartile range 29-49), and 12 (18%) interviews were conducted in Spanish. Primary concerns about COVID-19 vaccines included risk of complications, known and unknown side effects, and fear of contracting COVID-19 from vaccines. Trust played a major role for patients in deciding which sources to use for vaccine information and in engendering vaccine acceptance. Health care providers and family or friends were commonly cited as trusted messengers of information. CONCLUSIONS We characterized concerns about COVID-19 vaccines, uncovered themes that may promote vaccine acceptance, and identified trusted messengers-primarily health care professionals. These data may inform the development of nuanced COVID-19 vaccine messaging platforms to address COVID-19 vaccine hesitancy among underserved ED populations.
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Affiliation(s)
- Alexzandra T Gentsch
- Center for Connected Care, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Jonathan Butler
- Department of Family and Community Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Kelli O'Laughlin
- Department of Emergency Medicine, University of Washington, Seattle, Washington, USA
| | - Stephanie A Eucker
- Department of Emergency Medicine, Duke University, Durham, North Carolina, USA
| | - AnnaMarie Chang
- Center for Connected Care, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Herbie Duber
- Department of Emergency Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Rachel E Geyer
- Department of Family Medicine, University of Washington, Seattle, Washington, USA
| | - Amanda Guth
- Center for Connected Care, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Hemal K Kanzaria
- Department of Emergency Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Alena Pauley
- Department of Emergency Medicine, Duke University, Durham, North Carolina, USA
| | - Kristin L Rising
- Center for Connected Care, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Cecilia Lara Chavez
- Department of Emergency Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Anna Tupetz
- Department of Emergency Medicine, Duke University, Durham, North Carolina, USA
| | - Robert M Rodriguez
- Department of Emergency Medicine, University of California, San Francisco, San Francisco, California, USA
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15
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Capurro G, Tustin J, Jardine CG, Driedger SM. When good messages go wrong: Perspectives on COVID-19 vaccines and vaccine communication from generally vaccine accepting individuals in Canada. Hum Vaccin Immunother 2022; 18:2145822. [PMID: 36452995 PMCID: PMC9762838 DOI: 10.1080/21645515.2022.2145822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Vaccines are one of the most important and successful public health interventions to reduce the spread of infectious diseases. However, unlike childhood diseases and routine vaccines, COVID-19 is a novel threat, and COVID-19 vaccines may elicit specific anxieties. Through focus groups, we examine the concerns and attitudes toward the COVID-19 vaccine expressed by individuals who accept routine vaccinations in Canada. We also conducted a pre-focus group survey to document participant attitudes towards vaccines in general. While most participants had received at least one dose of the COVID-19 vaccine or had the intention to get it, many had concerns. First, participants felt anxious about the quick development and approval of the vaccines, even if they recognized that the vaccines have undergone clinical trials. Second, participants felt confused about shifting public health guidelines regarding vaccine safety, changing the interval between doses, and mixing different vaccine brands. Finally, participants said they felt abandoned when deciding whether to get vaccinated or not. People who generally accept vaccines expressed concerns about COVID-19 vaccines, mostly related to the inevitable uncertainties of a new vaccine (i.e. novelty, safety, mandates, etc.). COVID-19 vaccine hesitancy, understood as concerns about the novelty of a vaccine and the rapid implementation of it, could be useful for understanding questioning attitudes towards COVID-19 vaccines from people who accept routine vaccinations. Understanding COVID-19 vaccine hesitancy can also provide valuable insights as booster doses are periodically needed and people may not be as accepting of these additional doses.
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Affiliation(s)
- Gabriela Capurro
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Jordan Tustin
- School of Occupational and Public Health, Toronto Metropolitan University, Toronto, Canada
| | - Cindy G. Jardine
- Faculty of Health Sciences, University of Fraser Valley, Chilliwack, Canada
| | - S. Michelle Driedger
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada,CONTACT S. Michelle Driedger Department of Community Health Sciences, University of Manitoba, S113-750 Bannatyne Ave, Winnipeg, Manitoba R3E 0W3, Canada
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16
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Longitudinal Serological Surveillance for COVID-19 Antibodies after Infection and Vaccination. Microbiol Spectr 2022; 10:e0202622. [PMID: 36121258 PMCID: PMC9603261 DOI: 10.1128/spectrum.02026-22] [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: 12/31/2022] Open
Abstract
The impact of COVID-19 is still felt around the world, and more information is needed regarding infection risk, vaccination responses, and the timing of booster vaccinations. We aimed to evaluate the association of vaccination with closely followed, longitudinal antibody titers and COVID-19 infection events. We conducted a natural history study in a convenience cohort in an ambulatory research unit. We measured anti-nucleocapsid and anti-spike antibody levels every 3 months for 1 year and captured weekly reports of medically confirmed COVID-19 infections. We analyzed the association of antibody titers with infection events as well as the association of the decision to receive vaccination with social, medical, and behavioral characteristics. 629 subjects were followed for 1 year, and 82.8% of them were vaccinated. 90 cases of medically confirmed COVID-19 infection were reported. Notable findings from our study include: an association of vaccination choice with social distancing, a qualitatively different anti-spike response in participants receiving the Ad26.COV2.S vaccine compared to those receiving mRNA vaccines, a muted anti-nucleocapsid response in breakthrough infections compared to unvaccinated infections, and the identification of a low antibody titer threshold associated with the risk of breakthrough infections. We conclude that, in a real-life setting, vaccination and social distancing behavior are positively correlated. The observed effect of vaccination in preventing COVID-19 may include both vaccine-mediated protection and the associated more cautious behavior exhibited by vaccinated individuals. In addition, we identified an antibody threshold associated with breakthrough infections in mRNA vaccinees, and this threshold may be used in medical decision-making regarding the timing of booster vaccinations. Therefore, our data may aid in the refinement of vaccination strategies during the COVID-19 pandemic. IMPORTANCE The COVID-19 pandemic continues to impact societies and health care systems worldwide and is continuously evolving. Immunity via vaccination or prior infection is the first and most important line of defense against COVID-19. We still do not have complete information on how vaccination-induced or infection-induced antibody titers change with time or on how this information can be used to guide decisions regarding booster vaccination. In a longitudinal observational study of a cohort of 629 subjects, 82% of breakthrough infections in vaccinees occurred when their anti-spike antibody titers were below 3,000 AU/mL. Our findings suggest that there may be an antibody threshold associated with breakthrough infections and that this threshold could possibly be used to aid decision-making regarding booster vaccinations. In addition, the use of anti-nucleocapsid antibody tiers may significantly underestimate the prevalence of breakthrough infections in vaccinated individuals.
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Adzrago D, Sulley S, Ormiston CK, Mamudu L, Williams F. Differences in the Perceived Likelihood of Receiving COVID-19 Vaccine. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192113723. [PMID: 36360602 PMCID: PMC9653770 DOI: 10.3390/ijerph192113723] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/18/2022] [Accepted: 10/19/2022] [Indexed: 05/14/2023]
Abstract
There are limited studies on the perceived likelihood of receiving a COVID-19 vaccine among the general US population and its subpopulations. We examined the association between the perceived likelihood of receiving a COVID-19 vaccine with the self-reported likelihood of contracting COVID-19, social-distancing stress, COVID-19 diagnosis status, mental health disorders, and sociodemographic characteristics. The data were collected using a national cross-sectional survey (N = 5404) between 13 May 2021 and 9 January 2022. A multivariable logistic regression analysis was performed. Setting: United States. Participants: Adults aged ≥ 18 years. The majority of US adults (67.34%) indicated they intended to receive a COVID-19 vaccine. There was a decreased perceived likelihood of getting vaccinated associated with those aged 18-49 years (Adjusted Odds Ratio (AOR) = 0.29-59; 95% Confidence Interval (CI) = 0.20-0.85); with a less than college education (AOR = 0.37-58; 95% CI = 0.28-0.68); with no health insurance (AOR = 0.48; 95% CI = 0.40, 0.58); with no perceived likelihood of contracting COVID-19 (AOR = 0.78; 95% CI = 0.68, 0.89); and with anxiety/depression (AOR = 0.67; 95% CI = 0.59, 0.76). Black/African Americans had a lower perceived likelihood of receiving a COVID-19 vaccine (AOR = 0.84; 95% CI = 0.71, 0.98), while Asians (AOR = 1.92; 95% CI = 1.35, 2.74) and Hispanics/Latinos (AOR = 1.34; 95% CI = 1.03, 1.74) had a higher perceived likelihood compared with Whites. Individuals reporting social distancing as stressful (AOR = 1.21; 95% CI = 1.01, 1.45) were associated with an increased perceive likelihood of receiving a COVID-19 vaccine. Our study showed that younger adults, Black/African Americans, and those with a less than college education, no health insurance, or anxiety/depression may be less likely to receive vaccination. Future research should examine the explanatory mechanisms contributing to the lower perceived likelihood of vaccination among these groups, such as barriers to vaccine education or vaccine access. Public health interventions should prioritize these populations to improve vaccination rates.
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Affiliation(s)
- David Adzrago
- Center for Health Promotion and Prevention Research, The University of Texas School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Saanie Sulley
- National Healthy Start Association, Washington, DC 20005, USA
| | - Cameron K. Ormiston
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD 20892, USA
| | - Lohuwa Mamudu
- Department of Public Health, California State University, Fullerton, CA 92831, USA
| | - Faustine Williams
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD 20892, USA
- Correspondence:
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18
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Hnuploy K, Sornlorm K, Soe TK, Khammaneechan P, Rakchart N, Jongjit W, Supaviboolas S, Chutipattana N. COVID-19 Vaccine Acceptance and Its Determinants among Myanmar Migrant Workers in Southern Thailand. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13420. [PMID: 36294001 PMCID: PMC9602811 DOI: 10.3390/ijerph192013420] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 10/14/2022] [Accepted: 10/16/2022] [Indexed: 06/16/2023]
Abstract
Success in eradicating COVID-19 will rely on the rate of vaccination adoption worldwide. Vaccine acceptance among vulnerable groups is critical for preventing the spread of COVID-19 and decreasing unnecessary deaths. The purpose of this study was to report on the willingness to obtain COVID-19 immunization and the factors related to its acceptance among Myanmar migrant workers in southern Thailand. This cross-sectional study consisted of 301 samples collected between October and November 2021 and analyzed using multiple logistic regression. Thirty-nine percent of workers intended to receive the COVID-19 vaccine within a year. The following factors were associated with obtaining the COVID-19 vaccine: a high level of perception of COVID-19 (AOR = 5.43), income less than or equal to 10,000 baht/month (AOR = 6.98), financial status at a sufficient level (AOR = 7.79), wearing a face mask in the previous month almost all the time (AOR =4.26), maintaining 1-2 m of distance from anyone in the last month (AOR =2.51), and measuring temperature in the previous month (AOR = 5.24). High reluctance to accept the COVID-19 vaccine among Myanmar migrant workers can influence efforts to eliminate COVID-19. Collaboration with all stakeholders is critical to helping Myanmar workers understand COVID-19, social measures, and preventive beliefs to increase vaccine uptake.
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Affiliation(s)
- Kanit Hnuploy
- Faculty of Science and Technology, Suratthani Rajabhat University, Suratthani 84100, Thailand
| | - Kittipong Sornlorm
- Faculty of Public Health, Khon Kaen University, Khon Kean 40002, Thailand
| | | | - Patthanasak Khammaneechan
- Excellent Centre for Dengue and Community Public Health (E.C. for DACH), School of Public Health, Walailak University, Nakhon Si Thammarat 80161, Thailand
| | - Navarat Rakchart
- School of Nursing, Walailak University, Nakhon Si Thammarat 80161, Thailand
| | - Wajinee Jongjit
- Department of Public Health Strategy Development, Nakhon Si Thammarat Provincial Public Health Office, Nakhon Si Thammarat 80000, Thailand
| | - Suttakarn Supaviboolas
- Southern Border Regional Center for Primary Health Care Development, Nakhon Si Thammarat 80000, Thailand
| | - Nirachon Chutipattana
- Excellent Centre for Dengue and Community Public Health (E.C. for DACH), School of Public Health, Walailak University, Nakhon Si Thammarat 80161, Thailand
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19
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Coccia M. Improving preparedness for next pandemics: Max level of COVID-19 vaccinations without social impositions to design effective health policy and avoid flawed democracies. ENVIRONMENTAL RESEARCH 2022; 213:113566. [PMID: 35660409 PMCID: PMC9155186 DOI: 10.1016/j.envres.2022.113566] [Citation(s) in RCA: 47] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 04/26/2022] [Accepted: 05/23/2022] [Indexed: 05/21/2023]
Abstract
In the presence of pandemic threats, such as Coronavirus Disease 2019 (COVID-19) crisis, vaccination is one of the fundamental strategies to cope with negative effects of new viral agents in society. The rollout of vast vaccination campaigns also generates the main issue of hesitancy and resistance to vaccines in a share of people. Many studies have investigated how to reduce the social resistance to vaccinations, however the maximum level of vaccinable people against COVID-19 (and in general against pandemic diseases), without coercion in countries, is unknown. The goal of this study is to solve the problem here by developing an empirical analysis, based on global data, to estimate the max share of people vaccinable in relation to socioeconomic wellbeing of nations. Results, based on 150 countries, reveal that vaccinations increase with the income per capita, achieving the maximum share of about 70% of total population, without coercion. This information can provide new knowledge to establish the appropriate goal of vaccination campaigns and in general of health policies to cope with next pandemic impacts, without restrictions that create socioeconomic problems. Overall, then, nations have a natural level of max vaccinable people (70% of population), but strict policies and mandates to achieve 90% of vaccinated population can reduce the quality of democracy and generate socioeconomic issues higher than (pandemic) crisis.
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Affiliation(s)
- Mario Coccia
- CNR -- National Research Council of Italy, Collegio Carlo Alberto, Via Real Collegio, n. 30, 10024, Moncalieri (TO), Italy.
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20
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Lupton D. Understandings and practices related to risk, immunity and vaccination during the Delta variant COVID-19 outbreak in Australia: An interview study. Vaccine X 2022; 11:100183. [PMID: 35722522 PMCID: PMC9192109 DOI: 10.1016/j.jvacx.2022.100183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 06/02/2022] [Accepted: 06/03/2022] [Indexed: 12/04/2022] Open
Abstract
Background The aim of this study was to use indepth social research to better understand the relationships and intersections between understandings and practices of COVID-19 risk, immunity and vaccination in lay people’s accounts. Methods This article reports findings from a qualitative research project involving semi-structured telephone interviews with a diverse group of 40 adults from around Australia about their experiences of the COVID crisis, conducted in late 2021 during the Delta variant outbreak. The participants’ responses to questions about COVID risk, COVID vaccines and how they thought they could best protect their health were analysed using an inductive thematic approach. Results A notion of ‘communal risk’ was expressed together with ‘individual risk’. Relatedly, people’s understandings of what might be characterised as ‘communal immunity’ as well as individual immunity also dominated in their accounts. Both communal risk and communal immunity are influenced by a range of constantly changing and interrelated factors. Locale was a strong factor in shaping people’s experiences and stances related to COVID risk. The participants referred to aspects such as their community’s geographical location; the number of COVID cases and the level of COVID vaccination by others living in their state or territory; adoption of preventive measures; vaccine availability, scheduling and take-up; viral testing and tracing reporting; and the extent and timing of viral spread in the population. These factors were continually related back to highly specific conditions and practices in their community or state of residence. Conclusions Understandings and practices related to COVID risk, immunity and vaccination were based both on individual experiences and broader ideas about the role of community. Spatial contexts are influential but there is also a strong temporality to these understandings and practices. There is a fine balance to be maintained between individual-level protection from COVID risk and community-level actions.
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Affiliation(s)
- Deborah Lupton
- Vitalities Lab, Centre for Social Research in Health and Social Policy Research Centre, Goodsell Building, University of New South Wales (UNSW), Sydney, Australia
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