A scoping review on the decision-making dynamics for accepting or refusing the COVID-19 vaccination among adolescent and youth populations

Factors influencing nurses and nursing students' attitudes towards vaccinations: A cross-sectional study

BACKGROUND

Vaccination hesitancy remains the main obstacle to improving vaccination coverage. Influenza and COVID-19 vaccination coverage among healthcare professionals is essential. It is crucial to study the vaccination attitudes of healthcare professionals as they significantly influence the vaccination attitudes and behaviour of the rest of the population.

OBJECTIVE

The aim of this study was to describe the attitudes of Finnish nurses and nursing students towards COVID-19 and Influenza vaccination and explain what factors influence these attitudes.

DESIGN

A cross-sectional study.

SETTING AND PARTICIPANTS

A total of 1353 nurses from five hospital organisations and 580 nursing students from eight Universities of Applied Sciences participated in the survey. Participants were invited to complete the questionnaire through Webropol between March and September 2023.

METHODS

To collect data anonymously, a self-reported web-based questionnaire combining the Vaccination Attitude Examination (VAX) scale and Bergen's Social Media Addiction (BSMA) scale was used. K-means cluster analysis was performed to describe vaccination attitude profiles.

RESULTS

Four distinct vaccination attitude profiles were identified: Profile A - Confident Pro-Vaccine (n = 605) exhibited low hesitancy, with high confidence in vaccine safety and effectiveness; Profile B - Cautiously Pro-Vaccine (n = 764) showed moderate hesitancy, mainly concerned about unforeseen future effects; Profile C - Hesitant with Mistrust (n = 405) expressed high hesitancy, with significant worries about vaccine safety and mistrust in health authorities; and Profile D - Strongly Vaccine-Hesitant (n = 159) demonstrated very high hesitancy, marked by strong beliefs in potential long-term negative effects of vaccination. Significant differences in VAX-scale mean scores were found between the profiles, ranging from 1.27 for Profile A to 6.65 for Profile D. Overall, nursing students were more hesitant than practising nurses, with students being overrepresented in the more hesitant profiles. Clinical training in a COVID-19 unit was associated with more favourable vaccination attitudes among nursing students. The uptake of the full series of COVID-19 and annual Influenza vaccines was generally high in the sample (90.8 % and 87 %, respectively). However, a clear pattern between specific social media use and vaccination attitudes was not found. Major concerns related to vaccine hesitancy focused on the uncertainty of vaccines' long-term effects.

CONCLUSION

This study provides valuable insights into the complex nature of vaccination hesitancy among nurses and nursing students. These findings underscore the need for targeted interventions to address underlying concerns and promote vaccine acceptance within this demographic. In future research, it would be essential to gather more in-depth knowledge, particularly regarding nursing students' attitudes towards vaccination and the factors influencing them.

Global Systematic Scoping Review of Adolescent Factors Associated With COVID-19 Vaccine Hesitancy

Although COVID-19 vaccination is recommended for adolescents aged 12-17 years, they remain one of the least commonly vaccinated age groups. Therefore, studies investigating the factors associated with vaccine hesitancy among adolescents are needed. We conducted a systematic review of the literature in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses standards from inception to October 23, 2022, for adolescent-reported factors associated with vaccine hesitancy. Titles and abstracts of articles were screened, full-text articles were reviewed for eligibility, and eligible articles were extracted by 2 independent reviewers. Results were summarized using a narrative synthesis. The review protocol was prospectively registered in PROSPERO (CRD42022363411). Of 4,140 articles screened, 302 were selected for full-text review, 27 of which met the eligibility criteria. Most studies evaluated age (n = 20 studies) and sex (n = 21 studies) in relation to COVID-19 vaccine hesitancy, yet these were uncommonly linked with vaccine hesitancy among adolescents. Adolescents consistently reported the impact of the pandemic on social activities, social and parental norms, and a sense of communal responsibility as reasons for vaccinating. Although fewer studies (n = 18 studies) evaluated theoretical-based factors, the studies conducted showed that perceived vaccine safety and efficacy (n = 6 studies), risks from vaccination (n = 5 studies), and social and parental norms (n = 3) were consistently linked with vaccine hesitancy. To address low vaccination rates, adolescent-engaged research remains needed that considers their perspectives on COVID-19 vaccines.

Integrating youth participatory action research and health communication to inform youth and young adult covid-19 vaccine communication research

COVID-19 vaccination rates remain lower among adolescents compared with adults. Youth participatory action research (YPAR) offers opportunities to inform youth vaccine communication at the local and population level. However, few studies have integrated systematic health communication research with YPAR. In the current study, a diverse team of paid high school interns, undergraduate student mentors and communication researchers in West Philadelphia YPAR programs developed a theory-informed communication survey to measure teen COVID-19 vaccine beliefs, information sources and behavior. The survey was distributed locally and informed youth-created vaccine campaign messages. In addition, YPAR-derived survey measures complimented a qualitative online elicitation survey with US young adults. Responses were coded using inductive content analysis, informing measures for a subsequent population-level study of young adults. This research followed protocols approved by an Institutional Review Board. Applying a YPAR framework elevated youth voices in the study development process. Communication theory and methods aided the development of survey studies to advance both local YPAR program objectives and population-level research. Future implications are discussed.

"Why would we?" A qualitative study on COVID-19 vaccination decision making among Ukrainian economic female migrants in Poland

Background

Ukraine has one of the lowest COVID-19 vaccination rates in Europe. This may pose a significant epidemiological risk in the context of the refugee crisis and the fact that, since 2020, SARS-CoV-2 has been spreading and changing globally.

Objective

To evaluate determinants of vaccination decision making among Ukrainian female migrants (UFMs).

Methods

A qualitative study with 45 UFMs was conducted between December 2021 and January 2022. UFMs, from 2 Polish provinces, differing in age, education and length of stay were invited with the use of the snowball technique. Using a semi-structured topic guide, eight focus groups were conducted in person, recorded and transcribed. Thematic, qualitative analysis was made; key themes which emerged from the data (with the help of the Working Group Determinants of Vaccine Hesitancy Matrix), were related to contextual, individual/group and contextual vaccine/vaccination-specific influences.

Results

Mothers were found to be playing a crucial role in children and adolescent COVID-19 vaccine decision-making process. Universal trust in the Polish healthcare system and vaccination procedures, employer requirements and willingness to preserve jobs, desire to get back to normal and social influences were paramount prerequisites to let UFMs make a decision to get vaccinated. However, COVID-19 vaccines also faced backlash among UFMs. Negative experiences with vaccines provided in Ukraine, doubts about the rapid vaccine development, combined with lack of confidence in vaccine safety, specifically regarding child vaccination, might have a bearing on UFMs' decision about declining COVID-19 vaccine while on migration. Discrimination through HCWs during vaccination visits was also reported. Corrupted Ukrainian healthcare system, which facilitates proof forgery regarding vaccination certificates, could act as a negative influencer of UFMs' vaccine decision-making.

Conclusion

The results provide the novel information, expressed in economic UFMs' own words. Findings show that influencers of the decision-making process regarding the COVID-19 vaccination are complex and polarized; elements of hesitancy may persist after migration. Any continuation of UFMs' vaccination with COVID-19 vaccine should be subject to designing accessible information to address modifiable demotivators of the vaccine decision-making process identified in this study.

Government-Nongovernmental Organization (NGO) Collaboration in Macao's COVID-19 Vaccine Promotion: Social Media Case Study

BACKGROUND

The COVID-19 pandemic triggered unprecedented global vaccination efforts, with social media being a popular tool for vaccine promotion.

OBJECTIVE

This study probes into Macao's COVID-19 vaccine communication dynamics, with a focus on the multifaceted impacts of government agendas on social media.

METHODS

We scrutinized 22,986 vaccine-related Facebook posts from January 2020 to August 2022 in Macao. Using automated content analysis and advanced statistical methods, we unveiled intricate agenda dynamics between government and nongovernment entities.

RESULTS

"Vaccine importance" and "COVID-19 risk" were the most prominent topics co-occurring in the overall vaccine communication. The government tended to emphasize "COVID-19 risk" and "vaccine effectiveness," while regular users prioritized vaccine safety and distribution, indicating a discrepancy in these agendas. Nonetheless, the government has limited impact on regular users in the aspects of vaccine importance, accessibility, affordability, and trust in experts. The agendas of government and nongovernment users intertwined, illustrating complex interactions.

CONCLUSIONS

This study reveals the influence of government agendas on public discourse, impacting environmental awareness, public health education, and the social dynamics of inclusive communication during health crises. Inclusive strategies, accommodating public concerns, and involving diverse stakeholders are paramount for effective social media communication during health crises.