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Liu CW, Jeyakumar N, McArthur E, Sontrop JM, Myran DT, Schwartz KL, Sood MM, Tanuseputro P, Garg AX. COVID-19 vaccine uptake among Ontario physicians: a descriptive population-based retrospective cohort study. BMJ Open 2024; 14:e080461. [PMID: 38858148 PMCID: PMC11168153 DOI: 10.1136/bmjopen-2023-080461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 05/13/2024] [Indexed: 06/12/2024] Open
Abstract
OBJECTIVES To determine COVID-19 vaccine uptake among physicians in Ontario, Canada from 14 December 2020 to 13 February 2022. DESIGN Population-based retrospective cohort study. SETTING All registered physicians in Ontario, Canada using data from linked provincial administrative healthcare databases. PARTICIPANTS 41 267 physicians (including postgraduate trainees) who were Ontario residents and registered with the College of Physicians and Surgeons of Ontario were included. Physicians who were out of province, had not accessed Ontario Health Insurance Plan-insured services for their own care for ≥5 years and those with missing identifiers were excluded. PRIMARY AND SECONDARY OUTCOME MEASURES Primary outcomes were the proportions of physicians who were recorded to have received at least one, at least two and three doses of a Health Canada-approved COVID-19 vaccine by study end date. Secondary outcomes were how uptake varied by physician characteristics (including age, sex, specialty and residential location) and time elapsed between doses. RESULTS Of 41 267 physicians, (56% male, mean age 47 years), 39 359 (95.4%) received at least one dose, 39 148 (94.9%) received at least two doses and 35 834 (86.8%) received three doses of a COVID-19 vaccine. Of those who received three doses, the proportions were 90.4% among those aged ≥60 years and 81.2-89.5% among other age groups; 88.7% among family physicians and 89% among specialists. 1908 physicians (4.6%) had no record of vaccination, and this included 3.4% of family physicians and 4.1% of specialists; however, 28% of this group had missing specialty information. CONCLUSIONS In Ontario, within 14 months of COVID-19 vaccine availability, 86.8% of physicians had three doses of a COVID-19 vaccine, compared with 45.6% of the general population. Findings may signify physicians' confidence in the safety and effectiveness of COVID-19 vaccines.
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Affiliation(s)
- Cheng-Wei Liu
- Department of Medicine, Western University, London, Ontario, Canada
| | - Nivethika Jeyakumar
- Institute for Clinical Evaluative Sciences, Ontario, Canada
- Lawson Health Research Institute, London, Ontario, Canada
| | - Eric McArthur
- Institute for Clinical Evaluative Sciences, Ontario, Canada
- Lawson Health Research Institute, London, Ontario, Canada
| | - Jessica M Sontrop
- Lawson Health Research Institute, London, Ontario, Canada
- Department of Epidemiology & Biostatistics, Western University, London, Ontario, Canada
| | - Daniel T Myran
- Institute for Clinical Evaluative Sciences, Ontario, Canada
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Kevin L Schwartz
- Institute for Clinical Evaluative Sciences, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Public Health Ontario, Toronto, Ontario, Canada
| | - Manish M Sood
- Institute for Clinical Evaluative Sciences, Ontario, Canada
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Peter Tanuseputro
- Institute for Clinical Evaluative Sciences, Ontario, Canada
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Amit X Garg
- Department of Medicine, Western University, London, Ontario, Canada
- Institute for Clinical Evaluative Sciences, Ontario, Canada
- Lawson Health Research Institute, London, Ontario, Canada
- Department of Epidemiology & Biostatistics, Western University, London, Ontario, Canada
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Gonzalez-Jaramillo N, Abbühl D, Roa-Díaz ZM, Kobler-Betancourt C, Frahsa A. COVID-19 vaccine acceptance in the general population and under-resourced communities from high-income countries: realist review. BMJ Open 2024; 14:e084560. [PMID: 38631831 PMCID: PMC11029206 DOI: 10.1136/bmjopen-2024-084560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 03/28/2024] [Indexed: 04/19/2024] Open
Abstract
OBJECTIVE To compare vaccination willingness before rollout and 1 year post-rollout uptake among the general population and under-resourced communities in high-income countries. DESIGN A realist review. DATA SOURCES Embase, PubMed, Dimensions ai and Google Scholar. SETTING High-income countries. DEFINITIONS We defined vaccination willingness as the proportion of participants willing or intending to receive vaccines prior to availability. We defined vaccine uptake as the real proportion of the population with complete vaccination as reported by each country until November 2021. RESULTS We included data from 62 studies and 18 high-income countries. For studies conducted among general populations, the proportion of vaccination willingness was 67% (95% CI 62% to 72%). In real-world settings, the overall proportion of vaccine uptake among those countries was 73% (95% CI 69% to 76%). 17 studies reported pre-rollout willingness for under-resourced communities. The summary proportion of vaccination willingness from studies reporting results among people from under-resourced communities was 52% (95% CI 0.46% to 0.57%). Real-world evidence about vaccine uptake after rollout among under-resourced communities was limited. CONCLUSION Our review emphasises the importance of realist reviews for assessing vaccine acceptance. Limited real-world evidence about vaccine uptake among under-resourced communities in high-income countries is a call to context-specific actions and reporting.
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Affiliation(s)
| | - Dominik Abbühl
- ISPM, University of Bern, Bern, Switzerland
- Faculty of Medicine, University of Bern, Bern, Switzerland
| | - Zayne Milena Roa-Díaz
- ISPM, University of Bern, Bern, Switzerland
- Faculty of Medicine, University of Bern, Bern, Switzerland
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Campman SL, Boyd A, Coyer L, Schinkel J, Agyemang C, Galenkamp H, Koopman ADM, Chilunga FP, Schim van der Loeff MF, van Houtum L, Leenstra T, Stronks K, Prins M. SARS-CoV-2 vaccination uptake in six ethnic groups living in Amsterdam, the Netherlands: A registry-based study within the HELIUS cohort. Prev Med 2024; 178:107822. [PMID: 38103796 DOI: 10.1016/j.ypmed.2023.107822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 12/01/2023] [Accepted: 12/11/2023] [Indexed: 12/19/2023]
Abstract
OBJECTIVE Ethnic minority groups have experienced a disproportionate burden of COVID-19, and should therefore be especially encouraged to receive SARS-CoV-2 vaccination. This study compared first-dose uptake of the primary SARS-CoV-2 vaccination series across six ethnic groups in Amsterdam, the Netherlands in 2021. METHODS We analyzed data from participants of the population-based HELIUS cohort. We linked their data to the SARS-CoV-2 vaccination registry data of the Public Health Service of Amsterdam. We included registry data from January 6, 2021 (the start of the Dutch vaccination campaign) until September 6, 2021 (a date by which all adults in the Netherlands could have received one or two vaccine doses). SARS-CoV-2 vaccination uptake was defined as having received at least one vaccine dose of the primary vaccination series. We examined the association between ethnicity and vaccination uptake using multivariable logistic regression, while accounting for the age and sex distribution of ethnic groups in Amsterdam. RESULTS We included 19,006 participants (median age 53 years [interquartile range 41-62], 57% female). SARS-CoV-2 vaccination uptake was highest in the South-Asian Surinamese group (60.3%, 95%CI = 58.2-62.3%), followed by the Dutch (59.6%, 95%CI = 58.0-61.1%), Ghanaian (54.1%, 95%CI = 51.7-56.5%), Turkish (47.7%, 95%CI = 45.9-49.6%), African Surinamese (43.0%, 95%CI = 41.2-44.7%), and Moroccan (35.8%, 95%CI = 34.1-37.5%) groups. After adjusting for age, sex, perceived social support, and presence of relevant comorbidities, participants of African Surinamese, Ghanaian, Turkish and Moroccan origin were significantly less likely to be vaccinated than those of Dutch origin. CONCLUSIONS Prevention strategies should continue tailoring to specific ethnic groups to encourage vaccination uptake and reduce barriers to vaccination.
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Affiliation(s)
- Sophie L Campman
- Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands; Amsterdam UMC location University of Amsterdam, Infectious Diseases, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam Institute for Infection and Immunity, Infectious Diseases, Amsterdam, the Netherlands.
| | - Anders Boyd
- Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands; Amsterdam UMC location University of Amsterdam, Infectious Diseases, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam Institute for Infection and Immunity, Infectious Diseases, Amsterdam, the Netherlands; Stichting hiv monitoring, Amsterdam, the Netherlands
| | - Liza Coyer
- Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands; Amsterdam UMC location University of Amsterdam, Infectious Diseases, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam Institute for Infection and Immunity, Infectious Diseases, Amsterdam, the Netherlands
| | - Janke Schinkel
- Amsterdam UMC location University of Amsterdam, Department of Medical Microbiology and Infection Prevention, Meibergdreef 15, Amsterdam, the Netherlands
| | - Charles Agyemang
- Amsterdam UMC location University of Amsterdam, Department of Public and Occupational Health, Amsterdam, the Netherlands; Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Henrike Galenkamp
- Amsterdam UMC location University of Amsterdam, Department of Public and Occupational Health, Amsterdam, the Netherlands; Amsterdam Public Health, Health Behaviors and Chronic Diseases, Amsterdam, the Netherlands
| | - Anitra D M Koopman
- Amsterdam UMC location University of Amsterdam, Department of Public and Occupational Health, Amsterdam, the Netherlands; Amsterdam Public Health, Health Behaviors and Chronic Diseases, Amsterdam, the Netherlands
| | - Felix P Chilunga
- Amsterdam UMC location University of Amsterdam, Department of Public and Occupational Health, Amsterdam, the Netherlands; Amsterdam Public Health, Health Behaviors and Chronic Diseases, Amsterdam, the Netherlands
| | - Maarten F Schim van der Loeff
- Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands; Amsterdam UMC location University of Amsterdam, Infectious Diseases, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam Institute for Infection and Immunity, Infectious Diseases, Amsterdam, the Netherlands
| | - Lieke van Houtum
- Department of Healthy Living, Public Health Service of Amsterdam, Amsterdam, the Netherlands
| | - Tjalling Leenstra
- Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands; Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Karien Stronks
- Amsterdam UMC location University of Amsterdam, Department of Public and Occupational Health, Amsterdam, the Netherlands; Amsterdam Public Health, Health Behaviors and Chronic Diseases, Amsterdam, the Netherlands
| | - Maria Prins
- Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands; Amsterdam UMC location University of Amsterdam, Infectious Diseases, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam Institute for Infection and Immunity, Infectious Diseases, Amsterdam, the Netherlands
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Vardavas C, Nikitara K, Aslanoglou K, Lagou I, Marou V, Phalkey R, Leonardi-Bee J, Fernandez E, Vivilaki V, Kamekis A, Symvoulakis E, Noori T, Wuerz A, Suk JE, Deogan C. Social determinants of health and vaccine uptake during the first wave of the COVID-19 pandemic: A systematic review. Prev Med Rep 2023; 35:102319. [PMID: 37564118 PMCID: PMC10410576 DOI: 10.1016/j.pmedr.2023.102319] [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] [Received: 11/29/2022] [Revised: 07/07/2023] [Accepted: 07/10/2023] [Indexed: 08/12/2023] Open
Abstract
Social determinants of health significantly impact population health status. The aim of this systematic review was to examine which social vulnerability factors or determinants of health at the individual or county level affected vaccine uptake within the first phase of the vaccination program. We performed a systematic review of peer-reviewed literature published from January 2020 until September 2021 in Medline and Embase (Bagaria et al., 2022) and complemented the review with an assessment of pre-print literature within the same period. We restricted our criteria to studies performed in the EU/UK/EEA/US that report vaccine uptake in the general population as the primary outcome and included various social determinants of health as explanatory variables. This review provides evidence of significant associations between the early phases of vaccination uptake for SARS-CoV-2 and multiple socioeconomic factors including income, poverty, deprivation, race/ethnicity, education and health insurance. The identified associations should be taken into account to increase vaccine uptake in socially vulnerable groups, and to reduce disparities in uptake, in particular within the context of public health preparedness for future pandemics. While further corroboration is needed to explore the generalizability of these findings across the European setting, these results confirm the need to consider vulnerable groups and social determinants of health in the planning and roll-out of SARS-CoV-2 vaccination programs and within the context of future respiratory pandemics.
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Affiliation(s)
- Constantine Vardavas
- School of Medicine, University of Crete, Heraklion, Crete, Greece
- Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Harvard University, Boston, MA, USA
| | | | | | - Ioanna Lagou
- School of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Valia Marou
- School of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Revati Phalkey
- Health Centre for Evidence Based Healthcare, School of Medicine, University of Nottingham, Nottingham, UK
| | - Jo Leonardi-Bee
- Health Centre for Evidence Based Healthcare, School of Medicine, University of Nottingham, Nottingham, UK
| | - Esteve Fernandez
- Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Institut Català d'Oncologia-ICO, L’Hospitalet de Llobregat (Barcelona), Spain
- Tobacco Control Research Group, Institut d’Investigació Biomèdica de. Ellvitge-IDIBELL, L’Hospitalet de Llobregat (Barcelona), Spain
- School of Medicine and Health Sciences, Campus of Bellvitge, Universitat de Barcelona, Spain
- Centre of Biomedical Research Network on Respiratory Diseases (CIBERES de Enfermedaes Respiratorias), Insituto de Salud Carlos III, Madrid, Spain
| | | | | | | | - Teymur Noori
- Emergency Preparedness and Response Support, European Centre for Disease Prevention and Control, Solna, Sweden
| | - Andrea Wuerz
- Emergency Preparedness and Response Support, European Centre for Disease Prevention and Control, Solna, Sweden
| | - Jonathan E. Suk
- Emergency Preparedness and Response Support, European Centre for Disease Prevention and Control, Solna, Sweden
| | - Charlotte Deogan
- Emergency Preparedness and Response Support, European Centre for Disease Prevention and Control, Solna, Sweden
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Campbell J, Kaur A, Gamino D, Benoit E, Amos B, Windsor L. Individual and structural determinants of COVID-19 vaccine uptake in a marginalized community in the United States. Vaccine 2023; 41:5706-5714. [PMID: 37550145 PMCID: PMC10560547 DOI: 10.1016/j.vaccine.2023.07.077] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 07/29/2023] [Accepted: 07/30/2023] [Indexed: 08/09/2023]
Abstract
Socially and medically vulnerable groups (e.g., people 65 years or older, minoritized racial groups, non-telework essential workers, and people with comorbid conditions) experience barriers to COVID-19 prevention and treatment, increased burden of disease, and increased risk of death from COVID-19. Researchers are paying increased attention to social determinants of health (SDH) in explaining inequities in COVID-19-related health outcomes and rates of vaccine uptake. The purpose of the present manuscript is to identify clinically significant predictors of COVID-19 vaccine uptake among people who were socially and medically vulnerable to SARs-CoV-2 infection. Analysis was informed by the SDH framework and included a sample of 641 baseline surveys from participants in a clinical trial designed to increase COVID-19 testing. All participants were at high risk of developing COVID-19-related complications or dying from COVID-19. Following community-based participatory research principles, a well-established community collaborative board conducted every aspect of the study. Multiple logistic regressions were conducted to examine the relationships between individual and structural factors and COVID-19 vaccine uptake. In the final time adjusted model, we found that vaccine uptake was only predicted by specific individual-level factors: being 65 years and older, living with HIV/AIDS, and having previously received a flu vaccine or a COVID-19 test. Those reporting to believe in COVID-19-conspiracy theories were less likely to get the COVID-19 vaccine. More research is needed to identify predictors of vaccine uptake among people with comorbidities that make them more vulnerable to COVID-19 complications or death.
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Affiliation(s)
- Jeanna Campbell
- School of Social Work, University of Illinois Urbana-Champaign, 1010 W Nevada St, Urbana, IL 61801, United States.
| | - Amandeep Kaur
- Interdisciplinary Health Sciences Institute, University of Illinois Urbana-Champaign, 901 W University Ave Ste 201 C-261, Urbana, IL 61801, United States
| | - Danilo Gamino
- North Jersey Community Research Initiative, 393 Central Ave, Newark, NJ 07103, United States
| | - Ellen Benoit
- North Jersey Community Research Initiative, 393 Central Ave, Newark, NJ 07103, United States
| | - Brianna Amos
- Silver School of Social Work, New York University, 1 Washington Square N, New York, NY 10003, United States
| | - Liliane Windsor
- School of Social Work, University of Illinois Urbana-Champaign, 1010 W Nevada St, Urbana, IL 61801, United States; North Jersey Community Research Initiative, 393 Central Ave, Newark, NJ 07103, United States
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Andreeva D, Gill C, Brockbank A, Hejmej J, Conti‐Ramsden F, Doores KJ, Seed PT, Poston L. Trends in Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection and vaccine antibody prevalence in a multi-ethnic inner-city antenatal population: A cross-sectional surveillance study. BJOG 2023; 130:1135-1144. [PMID: 37113111 PMCID: PMC10718194 DOI: 10.1111/1471-0528.17508] [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: 10/11/2022] [Revised: 01/14/2023] [Accepted: 01/24/2023] [Indexed: 04/29/2023]
Abstract
OBJECTIVE To determine severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seroprevalence in pregnancy in an inner-city setting and assess associations with demographic factors and vaccination timing. DESIGN Repeated cross-sectional surveillance study. SETTING London maternity centre. SAMPLE A total of 906 pregnant women attending nuchal scans, July 2020-January 2022. METHODS Blood samples were tested for IgG antibodies against SARS-CoV-2 nucleocapsid (N) and spike (S) proteins. Self-reported vaccination status and coronavirus disease 2019 (COVID-19) infection were recorded. Multivariable regression models determined demographic factors associated with seroprevalence and antibody titres. MAIN OUTCOME MEASURES Immunoglobulin G N- and S-protein antibody titres. RESULTS Of the 960 women, 196 (20.4%) were SARS-CoV-2 seropositive from previous infection. Of these, 70 (35.7%) self-reported previous infection. Among unvaccinated women, women of black ethnic backgrounds were most likely to be SARS-CoV-2 seropositive (versus white adjusted risk ratio [aRR] 1.88, 95% CI 1.35-2.61, p < 0.001). Women from black and mixed ethnic backgrounds were least likely to have a history of vaccination with seropositivity to S-protein (versus white aRR 0.58, 95% CI 0.40-0.84, p = 0.004; aRR 0.56, 95% CI 0.34-0.92, p = 0.021, respectively). Double vaccinated, previously infected women had higher IgG S-protein antibody titres than unvaccinated, previously infected women (mean difference 4.76 fold-change, 95% CI 2.65-6.86, p < 0.001). Vaccination timing before versus during pregnancy did not affect IgG S-antibody titres (mean difference -0.28 fold-change, 95% CI -2.61 to 2.04, p = 0.785). CONCLUSIONS This cross-sectional study demonstrates high rates of asymptomatic SARS-CoV-2 infection with women of black ethnic backgrounds having higher infection risk and lower vaccine uptake. SARS-CoV-2 antibody titres were highest among double-vaccinated, infected women.
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Affiliation(s)
- Daria Andreeva
- Department of Women and Children's Health, School of Life Course and Population SciencesKing's College LondonLondonUK
| | - Carolyn Gill
- Department of Women and Children's Health, School of Life Course and Population SciencesKing's College LondonLondonUK
| | - Anna Brockbank
- Department of Women and Children's Health, School of Life Course and Population SciencesKing's College LondonLondonUK
| | - Joanna Hejmej
- Department of Women and Children's Health, School of Life Course and Population SciencesKing's College LondonLondonUK
| | - Fran Conti‐Ramsden
- Department of Women and Children's Health, School of Life Course and Population SciencesKing's College LondonLondonUK
| | - Katie J. Doores
- Department of Infectious Diseases, School of Immunology and Microbial SciencesKing's College LondonLondonUK
| | - Paul T. Seed
- Department of Women and Children's Health, School of Life Course and Population SciencesKing's College LondonLondonUK
| | - Lucilla Poston
- Department of Women and Children's Health, School of Life Course and Population SciencesKing's College LondonLondonUK
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Martin CA, Woolf K, Bryant L, Goss C, Gogoi M, Lagrata S, Papineni P, Qureshi I, Wobi F, Nellums L, Khunti K, Pareek M. Coverage, completion and outcomes of COVID-19 risk assessments in a multi-ethnic nationwide cohort of UK healthcare workers: a cross-sectional analysis from the UK-REACH Study. Occup Environ Med 2023; 80:399-406. [PMID: 37221040 PMCID: PMC10314065 DOI: 10.1136/oemed-2022-108700] [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: 10/13/2022] [Accepted: 03/31/2023] [Indexed: 05/25/2023]
Abstract
INTRODUCTION There are limited data on the outcomes of COVID-19 risk assessment in healthcare workers (HCWs) or the association of ethnicity, other sociodemographic and occupational factors with risk assessment outcomes. METHODS We used questionnaire data from UK-REACH (UK Research study into Ethnicity And COVID-19 outcomes in Healthcare workers), an ethnically diverse, nationwide cohort of UK HCWs. We derived four binary outcomes: (1) offered a risk assessment; (2) completed a risk assessment; (3) working practices changed as a result of the risk assessment; (4) wanted changes to working practices after risk assessment but working practices did not change.We examined the association of ethnicity, other sociodemographic/occupational factors and actual/perceived COVID-19 risk variables on our outcomes using multivariable logistic regression. RESULTS 8649 HCWs were included in total. HCWs from ethnic minority groups were more likely to report being offered a risk assessment than white HCWs, and those from Asian and black ethnic groups were more likely to report having completed an assessment if offered. Ethnic minority HCWs had lower odds of reporting having their work change as a result of risk assessment. Those from Asian and black ethnic groups were more likely to report no changes to their working practices despite wanting them.Previous SARS-CoV-2 infection was associated with lower odds of being offered a risk assessment and having adjustments made to working practices. DISCUSSION We found differences in risk assessment outcomes by ethnicity, other sociodemographic/occupational factors and actual/perceived COVID-19 risk factors. These findings are concerning and warrant further research using actual (rather than reported) risk assessment outcomes in an unselected cohort.
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Affiliation(s)
- Christopher A Martin
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
- Department of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Katherine Woolf
- Research Department of Medical Education, University College London Medical School, London, UK
| | - Luke Bryant
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Charles Goss
- Department of Occupational Health, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Mayuri Gogoi
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Susie Lagrata
- Queen Square Insitute of Neurology and National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
| | - Padmasayee Papineni
- Department of Infectious Diseases, London North West University Healthcare NHS Trust, Harrow, UK
| | - Irtiza Qureshi
- Population and Lifespan Sciences, University of Nottingham, Nottingham, UK
| | - Fatimah Wobi
- Public Health Institute, Liverpool John Moores University, Liverpool, UK
- School of Law, University of Leicester, Leicester, UK
| | - Laura Nellums
- Population and Lifespan Sciences, University of Nottingham, Nottingham, UK
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Manish Pareek
- Department of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK
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Forbes L, Armes J, Shafi S, Mohamed A, Mustafa R, Dar O, Vandrevala T, Amlôt R, Hayward A, Asaria M, Pirani T, Weston D, Shah S, Zumla A, Ala A. Novel intervention to promote COVID-19 protective behaviours among Black and South Asian communities in the UK: protocol for a mixed-methods pilot evaluation. BMJ Open 2023; 13:e061207. [PMID: 37041047 PMCID: PMC10105914 DOI: 10.1136/bmjopen-2022-061207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/13/2023] Open
Abstract
INTRODUCTION Culturally appropriate interventions to promote COVID-19 health protective measures among Black and South Asian communities in the UK are needed. We aim to carry out a preliminary evaluation of an intervention to reduce risk of COVID-19 comprising a short film and electronic leaflet. METHODS AND ANALYSIS This mixed methods study comprises (1) a focus group to understand how people from the relevant communities interpret and understand the intervention's messages, (2) a before-and-after questionnaire study examining the extent to which the intervention changes intentions and confidence to carry out COVID-19 protective behaviours and (3) a further qualitative study exploring the views of Black and South Asian people of the intervention and the experiences of health professionals offering the intervention. Participants will be recruited through general practices. Data collection will be carried out in the community. ETHICS AND DISSEMINATION The study received Health Research Authority approval in June 2021 (Research Ethics Committee Reference 21/LO/0452). All participants provided informed consent. As well as publishing the findings in peer-reviewed journals, we will disseminate the findings through the UK Health Security Agency, NHS England and the Office for Health Improvement and Disparities and ensure culturally appropriate messaging for participants and other members of the target groups.
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Affiliation(s)
- Lindsay Forbes
- Centre for Health Services Studies, University of Kent, Canterbury, UK
| | - Jo Armes
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Shuja Shafi
- Mass Gatherings and Global Health Network, Harrow, UK
| | - Amran Mohamed
- Department of Access and Medicine, Royal Surrey NHS Foundation Trust, Guildford, UK
| | - Reham Mustafa
- Department of Access and Medicine, Royal Surrey NHS Foundation Trust, Guildford, UK
| | - Osman Dar
- Global Public Health Directorate, UK Health Security Agency, London, UK
| | - Tushna Vandrevala
- Centre for Applied Health and Social Care Research, Faculty of Health, Social Care and Education, Kingston University, London, UK
| | - Richard Amlôt
- Epidemiological and Behavioural Sciences Directorate, UK Health Security Agency, London, UK
| | - Andrew Hayward
- Epidemiology and Public Health, University College London, London, UK
| | - Miqdad Asaria
- Department of Health Policy, London School of Economics, London, UK
| | - Tasneem Pirani
- Department of Critical Care Medicine, King's College Hospital NHS Foundation Trust, London, UK
- School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Dale Weston
- Epidemiological and Behavioural Sciences Directorate, UK Health Security Agency, London, UK
| | | | - Alimuddin Zumla
- Infection and Immunity, University College London, London, UK
| | - Aftab Ala
- Gastroenterology and Hepatology, Royal Surrey County Hospital NHS Foundation Trust, Guildford, UK
- Department of Clinical and Experimental Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
- Institute of Liver Studies, King's College Hospital, London, UK
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Smith LE, Sim J, Cutts M, Dasch H, Amlôt R, Sevdalis N, Rubin GJ, Sherman SM. Psychosocial factors affecting COVID-19 vaccine uptake in the UK: A prospective cohort study (CoVAccS - Wave 3). Vaccine X 2023; 13:100276. [PMID: 36819214 PMCID: PMC9924044 DOI: 10.1016/j.jvacx.2023.100276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 02/09/2023] [Accepted: 02/10/2023] [Indexed: 02/16/2023] Open
Abstract
Background We investigated factors associated with COVID-19 vaccine uptake, future vaccination intentions, and changes in beliefs and attitudes over time. Methods Prospective cohort study. 1500 participants completed an online survey in January 2021 (T1, start of vaccine rollout in the UK), of whom 1148 (response rate 76.5 %) completed another survey in October 2021 (T2, all UK adults offered two vaccine doses). Binary logistic regression analysis was used to investigate factors associated with subsequent vaccine uptake. Content analysis was used to investigate the main reasons behind future vaccine intentions (T2). Changes in beliefs and attitudes were investigated using analysis of variance. Findings At T2, 90.0 % (95 % CI 88.2-91.7 %) of participants had received two doses of a COVID-19 vaccine, 2.2 % (95 % CI 1.3-3.0 %) had received one dose, and 7.4 % (95 % CI 5.9-8.9 %) had not been vaccinated. Uptake was associated with higher intention to be vaccinated at T1, greater perceived vaccination social norms, necessity of vaccination, and perceived safety of the vaccine. People who had initiated vaccination reported being likely to complete it, while those who had not yet received a vaccine reported being unlikely to be vaccinated in the future. At T2, participants perceived greater susceptibility to, but lower severity of, COVID-19 (p < 0.001) than at T1. Perceived safety and adequacy of vaccine information were higher (p < 0.001). Interpretation Targeting modifiable beliefs about the safety and effectiveness of vaccination may increase uptake.
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Affiliation(s)
- Louise E. Smith
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK,NIHR Health Protection Research Unit in Emergency Preparedness and Response, UK,Corresponding author at: Department of Psychological Medicine, King’s College London, Weston Education Centre, Cutcombe Road, London SE5 9RJ, UK
| | - Julius Sim
- School of Medicine, Keele University, UK
| | | | - Hannah Dasch
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK,Centre for Implementation Science, King’s College London, UK
| | - Richard Amlôt
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, UK,Behavioural Science and Insights Unit, UK Health Security Agency, UK
| | - Nick Sevdalis
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK,Centre for Implementation Science, King’s College London, UK
| | - G. James Rubin
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK,NIHR Health Protection Research Unit in Emergency Preparedness and Response, UK
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10
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Collett G, Godec T, Gupta AK. Factors influencing attitudes toward vaccine safety and vaccine effectiveness amongst UK healthcare professionals prior to and at the time of COVID-19 vaccine rollout: Insights from the CoPE-HCP cohort study. Hum Vaccin Immunother 2023; 19:2188823. [PMID: 36977613 PMCID: PMC10078128 DOI: 10.1080/21645515.2023.2188823] [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] [Indexed: 03/30/2023] Open
Abstract
Given the potential for nosocomial outbreaks, we must understand factors associated with negative vaccine attitudes amongst healthcare professionals (HCPs) before the rollout of a newly developed vaccine in a pandemic setting. The aim of this prospective cohort study was to study the impact of preexisting and prevailing mental health on United Kingdom HCPs' attitudes towards a newly developed COVID-19 vaccine. Two online surveys were distributed: first during vaccine development (July-September, 2020) and second during nationwide vaccine rollout (December 2020-March 2021). Mental health (PHQ-9 for depression; GAD-7 for anxiety) was assessed in both surveys. Negative attitude regarding vaccine safety and vaccine effectiveness was assessed at vaccine rollout. A series of logistic regression models were developed relating mental health (preexisting during vaccine development, ongoing and new-onset during rollout, and changes in symptom severity) to negative vaccine attitudes. In 634 HCPs, the presence of depression and/or anxiety during vaccine development was associated with elevated negative attitude towards vaccine safety (adj. OR 1.74 [95% CI 1.10-2.75], p = .02), but not vaccine effectiveness (1.13 [0.77-1.66], p = .53) at rollout. This was independent of other characteristics: age, ethnicity, professional role, and history of contracting COVID-19. Ongoing depression and/or anxiety (1.72 [1.10-2.69], p = .02) was associated with elevated negative attitude regarding vaccine effectiveness, but not vaccine safety. Worsened combined symptom scores over time were associated with elevated negative vaccine effectiveness attitudes (1.03 [1.00-1.05], p < .05), but not vaccine safety. Overall, adverse mental health can impact on HCPs' attitudes towards a newly developed vaccine. Further work is required to understand how this translates to vaccine uptake.
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Affiliation(s)
- George Collett
- William Harvey Research Institute, Queen Mary University of London, London, UK
| | - Thomas Godec
- William Harvey Research Institute, Queen Mary University of London, London, UK
| | - Ajay K Gupta
- William Harvey Research Institute, Queen Mary University of London, London, UK
- Barts Heart Centre, St. Bartholomew's Hospital, Barts Health NHS Trust, London, UK
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11
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Nasa P, Modi P, Setubal G, Puspha A, Upadhyay S, Talal SH. Demographic and risk characteristics of healthcare workers infected with SARS-CoV-2 from two tertiary care hospitals in the United Arab Emirates. World J Virol 2023; 12:122-131. [PMID: 37033144 PMCID: PMC10075053 DOI: 10.5501/wjv.v12.i2.122] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 01/23/2023] [Accepted: 02/22/2023] [Indexed: 03/21/2023] Open
Abstract
BACKGROUND Understanding the transmission dynamics of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among healthcare workers (HCWs) and their social contacts is crucial to plan appropriate risk-reduction measures.
AIM To analyze the socio-demographic risk factors and transmission of SARS-CoV-2 infection among HCWs in two tertiary care hospitals in Dubai, United Arab Emirates.
METHODS The demographic and clinical characteristics were available for all HCWs in both facilities from the human resources department. A cross-sectional survey was conducted from January-April 2022 among HCWs who tested positive through Reverse Transcriptase Polymerase Chain Reaction of the nasopharyngeal swab for SARS-CoV-2 between March 2020 and August 2021 in two tertiary-level hospitals. The survey included questions on demographics, work profile, characteristics of coronavirus disease 2019 (COVID-19), and infection among their household or co-workers. The survey also checked the knowledge and perception of participants on the infection prevention measures related to SARS-CoV-2.
RESULTS Out of a total of 346 HCWs infected with SARS-CoV-2, 286 (82.7%) HCWs consented to participate in this study. From the sample population, 150 (52.5%) of participants were female, and a majority (230, 80.4%) were frontline HCWs, including 121 nurses (121, 42.4%). Only 48 (16.8%) participants were fully vaccinated at the time of infection. Most infected HCWs (85%) were unaware of any unprotected exposure and were symptomatic at the time of testing (225, 78.7%). Nearly half of the participants (140, 49%) had co-infection among household, and nearly one-third (29.5%) had co-infection among three or more household. Another 108 (37.8%) participants reported cross-infection among co-workers. The frontline HCWs were significantly more infected (25.1% vs 8.6%, P < 0.001) compared to non-frontline HCWs. Another significant risk factor for a high infection rate was male sex (P < 0.001). Among the infected frontline HCWs, a significantly higher proportion were male and shared accommodation with family (P < 0.001). COVID-19 vaccination significantly reduced the infection rate (83.2% vs 16.8, P < 0.001) among HCWs. Most participants (99.3%) were aware about importance of appropriate use of personal protective equipment. However, only 70% agreed with the efficacy of the COVID-19 vaccination in preventing an infection and severe disease.
CONCLUSION The risk profiling of the HCWs infected with SARS-CoV-2 found that working at frontline and being male increase the rate of infection. COVID-19 vaccination can effectively reduce the rate of transmission of SARS-CoV-2 among HCWs.
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Affiliation(s)
- Prashant Nasa
- Critical Care Medicine, NMC Specialty Hospital, Dubai 7832, United Arab Emirates
- Department of Internal Medicine, College of Medicine and Health Sciences, Al Ain 15551, United Arab Emirates
| | - Payal Modi
- Department of Microbiology, NMC Royal Hospital, Dubai Investment Park, Dubai 7832, United Arab Emirates
| | - Gladys Setubal
- Prevention and Control of Infection, NMC Specialty Hospital, Dubai 7832, Dubai, United Arab Emirates
| | - Aswini Puspha
- Prevention and Control of Infection, NMC Royal Hospital, Dubai Investment Park, Dubai 7832, United Arab Emirates
| | - Surjya Upadhyay
- Department of Anaesthesiology, NMC Royal Hospital, Dubai Investment Park, Dubai 7832, United Arab Emirates
| | - Syed Habib Talal
- Critical Care Medicine, NMC Specialty Hospital, Dubai 7832, United Arab Emirates
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12
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Nazareth J, Fahad M, Pareek M. Mitigating the return of acute respiratory virus infections. BMJ 2023; 380:352. [PMID: 36787911 DOI: 10.1136/bmj.p352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Affiliation(s)
- Joshua Nazareth
- Department of Respiratory Sciences, University of Leicester, UK
| | - Muhammad Fahad
- Department of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Manish Pareek
- Department of Respiratory Sciences, University of Leicester, UK
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13
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Bedston S, Lowthian E, Jarvis CI, Akbari A, Beggs J, Bradley D, de Lusignan S, Griffiths R, Herbert L, Hobbs R, Kerr S, Lyons J, Midgley W, Owen RK, Quint JK, Tsang R, Torabi F, Sheikh A, Lyons RA. COVID-19 booster vaccination uptake and infection breakthrough amongst health care workers in Wales: A national prospective cohort study. Vaccine 2023; 41:1378-1389. [PMID: 36669966 PMCID: PMC9837216 DOI: 10.1016/j.vaccine.2023.01.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/10/2023] [Accepted: 01/11/2023] [Indexed: 01/15/2023]
Abstract
BACKGROUND From September 2021, Health Care Workers (HCWs) in Wales began receiving a COVID-19 booster vaccination. This is the first dose beyond the primary vaccination schedule. Given the emergence of new variants, vaccine waning vaccine, and increasing vaccination hesitancy, there is a need to understand booster vaccine uptake and subsequent breakthrough in this high-risk population. METHODS We conducted a prospective, national-scale, observational cohort study of HCWs in Wales using anonymised, linked data from the SAIL Databank. We analysed uptake of COVID-19 booster vaccinations from September 2021 to February 2022, with comparisons against uptake of the initial primary vaccination schedule. We also analysed booster breakthrough, in the form of PCR-confirmed SARS-Cov-2 infection, comparing to the second primary dose. Cox proportional hazard models were used to estimate associations for vaccination uptake and breakthrough regarding staff roles, socio-demographics, household composition, and other factors. RESULTS We derived a cohort of 73,030 HCWs living in Wales (78% female, 60% 18-49 years old). Uptake was quickest amongst HCWs aged 60 + years old (aHR 2.54, 95%CI 2.45-2.63), compared with those aged 18-29. Asian HCWs had quicker uptake (aHR 1.18, 95%CI 1.14-1.22), whilst Black HCWs had slower uptake (aHR 0.67, 95%CI 0.61-0.74), compared to white HCWs. HCWs residing in the least deprived areas were slightly quicker to have received a booster dose (aHR 1.12, 95%CI 1.09-1.16), compared with those in the most deprived areas. Strongest associations with breakthrough infections were found for those living with children (aHR 1.52, 95%CI 1.41-1.63), compared to two-adult only households. HCWs aged 60 + years old were less likely to get breakthrough infections, compared to those aged 18-29 (aHR 0.42, 95%CI 0.38-0.47). CONCLUSION Vaccination uptake was consistently lower among black HCWs, as well as those from deprived areas. Whilst breakthrough infections were highest in households with children.
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Affiliation(s)
- Stuart Bedston
- Population Data Science, Swansea University Medical School, Faculty of Medicine, Health & Life Science, Swansea University, UK.
| | - Emily Lowthian
- Department of Education and Childhood Studies, School of Social Sciences, Swansea University, UK.
| | | | - Ashley Akbari
- Population Data Science, Swansea University Medical School, Faculty of Medicine, Health & Life Science, Swansea University, UK.
| | | | - Declan Bradley
- Centre for Public Health, Queen's University Belfast, Belfast, UK. And Public Health Agency, Belfast, UK.
| | - Simon de Lusignan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
| | - Rowena Griffiths
- Population Data Science, Swansea University Medical School, Faculty of Medicine, Health & Life Science, Swansea University, UK.
| | - Laura Herbert
- Population Data Science, Swansea University Medical School, Faculty of Medicine, Health & Life Science, Swansea University, UK.
| | - Richard Hobbs
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
| | - Steven Kerr
- Usher Institute, The University of Edinburgh, Edinburgh, UK.
| | - Jane Lyons
- Population Data Science, Swansea University Medical School, Faculty of Medicine, Health & Life Science, Swansea University, UK.
| | - William Midgley
- Population Data Science, Swansea University Medical School, Faculty of Medicine, Health & Life Science, Swansea University, UK.
| | - Rhiannon K Owen
- Population Data Science, Swansea University Medical School, Faculty of Medicine, Health & Life Science, Swansea University, UK.
| | - Jennifer K Quint
- National Heart & Lung Institute, Faculty of Medicine, Imperial College London, UK.
| | - Ruby Tsang
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
| | - Fatemeh Torabi
- Population Data Science, Swansea University Medical School, Faculty of Medicine, Health & Life Science, Swansea University, UK.
| | - Aziz Sheikh
- Usher Institute and HDR UK BREATHE Hub, University of Edinburgh, UK.
| | - Ronan A Lyons
- Population Data Science, Swansea University Medical School, Faculty of Medicine, Health & Life Science, Swansea University, UK.
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14
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Paul E, Fancourt D, Razai M. Racial discrimination, low trust in the health system and COVID-19 vaccine uptake: a longitudinal observational study of 633 UK adults from ethnic minority groups. J R Soc Med 2022; 115:439-447. [PMID: 35512716 PMCID: PMC9723809 DOI: 10.1177/01410768221095241] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES To examine whether racial/ethnic discrimination predicts future COVID-19 vaccine refusal, and whether this association is explained by trust in government and the health system. DESIGN Longitudinal observational study of racial/ethnic discrimination occurring since the start of the first lockdown (measured in July 2020) and later COVID-19 vaccine status. SETTING UK (England, Scotland, Wales and Northern Ireland). PARTICIPANTS A total of 633 adults belonging to ethnic minority groups who took part in the UCL COVID-19 Social Study. MAIN OUTCOME MEASURES COVID-19 vaccine refusal (vs. accepted/waiting/had at least one dose) between 23 December 2020 and 14 June 2021. RESULTS Nearly 1 in 10 (6.69%) who had refused a COVID-19 vaccine had experienced racial/ethnic discrimination in a medical setting since the start of the pandemic and had experienced twice as many incidents of racial/ethnic discrimination than those who had accepted the vaccine. Structural equation modelling results indicated a nearly four fold (odds ratio = 3.91, 95% confidence interval = 1.40 to 10.92) total effect of racial/ethnic discrimination on refusing the vaccine which was mediated by low trust in the health system to handle the pandemic (odds ratio = 2.49, 95% confidence interval = 1.12 to 5.39). Analyses adjusted for a range of demographic and COVID-19 related factors. CONCLUSIONS Findings underscore the importance of addressing racial/ethnic discrimination and the role the National Health Service in regaining trust from ethnic minority groups to increase COVID-19 vaccine uptake among ethnic minority adults.
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Affiliation(s)
- Elise Paul
- Research Department of Behavioural Science and Health, Institute of Epidemiology & Health, University College London, London, WC1E 7HB, UK
| | - Daisy Fancourt
- Population Health Research Institute, St George's University of London, London, SW17 0RE, UK
| | - Mohammad Razai
- Population Health Research Institute, St George's University of London, London, SW17 0RE, UK
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15
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Veli N, Martin CA, Woolf K, Nazareth J, Pan D, Al-Oraibi A, Baggaley RF, Bryant L, Nellums LB, Gray LJ, Khunti K, Pareek M. Hesitancy for receiving regular SARS-CoV-2 vaccination in UK healthcare workers: a cross-sectional analysis from the UK-REACH study. BMC Med 2022; 20:386. [PMID: 36210437 PMCID: PMC9548389 DOI: 10.1186/s12916-022-02588-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 09/28/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Regular vaccination against SARS-CoV-2 may be needed to maintain immunity in 'at-risk' populations, which include healthcare workers (HCWs). However, little is known about the proportion of HCWs who might be hesitant about receiving a hypothetical regular SARS-CoV-2 vaccination or the factors associated with this hesitancy. METHODS Cross-sectional analysis of questionnaire data collected as part of UK-REACH, a nationwide, longitudinal cohort study of HCWs. The outcome measure was binary, either a participant indicated they would definitely accept regular SARS-CoV-2 vaccination if recommended or they indicated some degree of hesitancy regarding acceptance (probably accept or less likely). We used logistic regression to identify factors associated with hesitancy for receiving regular vaccination. RESULTS A total of 5454 HCWs were included in the analysed cohort, 23.5% of whom were hesitant about regular SARS-CoV-2 vaccination. Black HCWs were more likely to be hesitant than White HCWs (aOR 2.60, 95%CI 1.80-3.72) as were those who reported a previous episode of COVID-19 (1.33, 1.13-1.57 [vs those who tested negative]). Those who received influenza vaccination in the previous two seasons were over five times less likely to report hesitancy for regular SARS-CoV-2 vaccination than those not vaccinated against influenza in either season (0.18, 0.14-0.21). HCWs who trusted official sources of vaccine information (such as NHS or government adverts or websites) were less likely to report hesitancy for a regular vaccination programme. Those who had been exposed to information advocating against vaccination from friends and family were more likely to be hesitant. CONCLUSIONS In this study, nearly a quarter of UK HCWs were hesitant about receiving a regular SARS-CoV-2 vaccination. We have identified key factors associated with hesitancy for regular SARS-CoV-2 vaccination, which can be used to identify groups of HCWs at the highest risk of vaccine hesitancy and tailor interventions accordingly. Family and friends of HCWs may influence decisions about regular vaccination. This implies that working with HCWs and their social networks to allay concerns about SARS-CoV-2 vaccination could improve uptake in a regular vaccination programme. TRIAL REGISTRATION ISRCTN Registry, ISRCTN11811602.
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Affiliation(s)
- Neyme Veli
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
- Department of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Christopher A Martin
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
- Department of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK
| | | | - Joshua Nazareth
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
- Department of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Daniel Pan
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
- Department of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Amani Al-Oraibi
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Rebecca F Baggaley
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Luke Bryant
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Laura B Nellums
- Population and Lifespan Sciences, School of Medicine, University of Nottingham, Nottingham, UK
| | - Laura J Gray
- Biostatistics Research Group, Department of Health Sciences, University of Leicester, Leicester, UK
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Manish Pareek
- Department of Respiratory Sciences, University of Leicester, Leicester, UK.
- Department of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK.
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16
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Galanis P, Vraka I, Katsiroumpa A, Siskou O, Konstantakopoulou O, Katsoulas T, Mariolis-Sapsakos T, Kaitelidou D. COVID-19 Vaccine Uptake among Healthcare Workers: A Systematic Review and Meta-Analysis. Vaccines (Basel) 2022; 10:1637. [PMID: 36298502 PMCID: PMC9610263 DOI: 10.3390/vaccines10101637] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 09/24/2022] [Accepted: 09/26/2022] [Indexed: 11/17/2022] Open
Abstract
The vaccine-induced immunity of healthcare workers (HCWs) is crucial to controlling the COVID-19 pandemic. Therefore, we conducted a systematic review and meta-analysis to assess the COVID-19 vaccine uptake among HCWs worldwide and to identify predictors of vaccination. We searched Scopus, Web of Science, Medline, PubMed, ProQuest, CINAHL, and medRxiv up to 25 August 2022. We applied the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. We found 25 studies including 491,624 vaccinated HCWs, while the full sample included 555,561 HCWs. The overall proportion of vaccinated HCWs was 77.3%. Vaccine uptake for studies that were conducted in North America (85.6%) was higher than the proportion for studies that were conducted in Asia (79.5%), Europe (72.8%), and Africa (65.6%). The overall prevalence of COVID-19 vaccine uptake was 83.6% and 77.4% for physicians and nurses, respectively. Older age, white race, physicians' profession, seasonal influenza vaccine, direct COVID-19 patient care, and confidence in COVID-19 vaccine safety and effectiveness were positive predictors of vaccine uptake, while history of SARS-CoV-2 infection was a negative predictor. Deep understanding of the factors that influence HCWs' decisions to receive a COVID-19 vaccine is critical to implementing tailored communication strategies for HCWs who are at risk for not getting vaccinated.
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Affiliation(s)
- Petros Galanis
- Clinical Epidemiology Laboratory, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Irene Vraka
- Department of Radiology, P. & A. Kyriakou Children’s Hospital, 11527 Athens, Greece
| | - Aglaia Katsiroumpa
- Clinical Epidemiology Laboratory, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Olga Siskou
- Department of Tourism Studies, University of Piraeus, 18534 Piraeus, Greece
| | - Olympia Konstantakopoulou
- Center for Health Services Management and Evaluation, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Theodoros Katsoulas
- Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | | | - Daphne Kaitelidou
- Center for Health Services Management and Evaluation, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece
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17
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Gogoi M, Wobi F, Qureshi I, Al-Oraibi A, Hassan O, Chaloner J, Nellums LB, Pareek M. "The vaccination is positive; I don't think it's the panacea": A qualitative study on COVID-19 vaccine attitudes among ethnically diverse healthcare workers in the United Kingdom. PLoS One 2022; 17:e0273687. [PMID: 36084076 PMCID: PMC9462779 DOI: 10.1371/journal.pone.0273687] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 08/12/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Globally, healthcare workers (HCWs) were prioritised for receiving vaccinations against the coronavirus disease-2019 (COVID-19). Previous research has shown disparities in COVID-19 vaccination uptake among HCWs based on ethnicity, job role, sex, age, and deprivation. However, vaccine attitudes underpinning these variations and factors influencing these attitudes are yet to be fully explored. METHODS We conducted a qualitative study with 164 HCWs from different ethnicities, sexes, job roles, migration statuses, and regions in the United Kingdom (UK). Interviews and focus groups were conducted online or telephonically, and recorded with participants' permission. Recordings were transcribed and a two-pronged analytical approach was adopted: content analysis for categorising vaccine attitudes and thematic analysis for identifying factors influencing vaccine attitudes. FINDINGS We identified four different COVID-19 vaccine attitudes among HCWs: Active Acceptance, Passive Acceptance, Passive Decline, and Active Decline. Content analysis of the transcripts showed that HCWs from ethnic minority communities and female HCWs were more likely to either decline (actively/passively) or passively accept vaccination-reflecting hesitancy. Factors influencing these attitudes included: trust; risk perception; social influences; access and equity; considerations about the future. INTERPRETATION Our data show that attitudes towards COVID-19 vaccine are diverse, and elements of hesitancy may persist even after uptake. This has implications for the sustainability of the COVID-19 vaccine programme, particularly as new components (for example boosters) are being offered. We also found that vaccine attitudes differed by ethnicity, sex and job role, which calls for an intersectional and dynamic approach for improving vaccine uptake among HCWs. Trust, risk perception, social influences, access and equity and future considerations all influence vaccine attitudes and have a bearing on HCWs' decision about accepting or declining the COVID-19 vaccine. Based on our findings, we recommend building trust, addressing structural inequities and, designing inclusive and accessible information to address hesitancy.
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Affiliation(s)
- Mayuri Gogoi
- Department of Respiratory Sciences, University of Leicester, Leicester, United Kingdom
| | - Fatimah Wobi
- Department of Respiratory Sciences, University of Leicester, Leicester, United Kingdom
| | - Irtiza Qureshi
- Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Amani Al-Oraibi
- Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Osama Hassan
- Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Jonathan Chaloner
- Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Laura B. Nellums
- Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Manish Pareek
- Department of Respiratory Sciences, University of Leicester, Leicester, United Kingdom
- Department of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
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18
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Inghels M, Kane R, Lall P, Nelson D, Nanyonjo A, Asghar Z, Ward D, McCranor T, Kavanagh T, Hogue T, Phull J, Tanser F. Ethnicity and risk for SARS-CoV-2 infection among the healthcare workforce: Results of a retrospective cohort study in rural United Kingdom. Int J Infect Dis 2022; 122:115-122. [PMID: 35569751 PMCID: PMC9098657 DOI: 10.1016/j.ijid.2022.05.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 05/06/2022] [Accepted: 05/06/2022] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND The reason why Black and South Asian healthcare workers are at a higher risk for SARS-CoV-2 infection remain unclear. We aimed to quantify the risk for SARS-CoV-2 infection among healthcare staff who belong to the ethnic minority and elucidate pathways of infection. METHODS A one-year follow-up retrospective cohort study has been conducted among National Health Service employees who were working at 123 facilities in Lincolnshire, UK. RESULTS Overall, 13,366 professionals were included. SARS-CoV-2 incidence per person-year was 5.2% (95% CI: 3.6-7.6%) during the first COVID-19 wave (January-August 2020) and 17.2% (13.5-22.0%) during the second wave (September 2020-February 2021). Compared with White staff, Black and South Asian employees were at higher risk for SARS-CoV-2 infection during both the first wave (hazard ratio, HR 1.58 [0.91-2.75] and 1.69 [1.07-2.66], respectively) and the second wave (HR 2.09 [1.57-2.76] and 1.46 [1.24-1.71]). Higher risk for SARS-CoV-2 infection persisted even after controlling for age, sex, pay grade, residence environment, type of work, and time exposure at work. Higher adjusted risk for SARS-CoV-2 infection were also found among lower-paid health professionals. CONCLUSION Black and South Asian health workers continue to be at higher risk for SARS-CoV-2 infection than their White counterparts. Urgent interventions are required to reduce SARS-CoV-2 infection in these ethnic groups.
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Affiliation(s)
- Maxime Inghels
- Lincoln International Institute for Rural Health, University of Lincoln, Lincoln, UK; Centre Population et Développement (UMR 196 Paris Descartes - IRD), SageSud (ERL INSERM 1244), Institut de Recherche pour le Développement, Paris, France.
| | - Ros Kane
- School of Health and Social Care, University of Lincoln, UK
| | - Priya Lall
- Lincoln International Institute for Rural Health, University of Lincoln, Lincoln, UK; London Interdisciplinary School, London, UK
| | - David Nelson
- Lincoln International Institute for Rural Health, University of Lincoln, Lincoln, UK
| | - Agnes Nanyonjo
- Lincoln International Institute for Rural Health, University of Lincoln, Lincoln, UK
| | - Zahid Asghar
- School of Health and Social Care, University of Lincoln, UK
| | | | - Tracy McCranor
- Lincolnshire Partnership NHS Foundation Trust, Lincolnshire, UK
| | - Tony Kavanagh
- Lincolnshire Partnership NHS Foundation Trust, Lincolnshire, UK
| | - Todd Hogue
- School of Psychology, University of Lincoln, UK
| | - Jaspreet Phull
- Lincolnshire Partnership NHS Foundation Trust, Lincolnshire, UK
| | - Frank Tanser
- Lincoln International Institute for Rural Health, University of Lincoln, Lincoln, UK; School of Nursing and Public Health, University of KwaZulu-Natal, Durban South Africa
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19
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Kamali K, Hoseinzade Z, Hajimiri K, Hoveidamanesh S, Zahraei SM, Gouya MM, Bavandpouri SM, Mohamadi T, Mohamadi S, Bigdeli Z, Maleki A, Shirzad M, Heidari Z, Farsadegi M, Shoghli A. Determinants of COVID-19 vaccine acceptance in healthcare workers in Iran: National Survey. BMC Infect Dis 2022; 22:703. [PMID: 35996088 PMCID: PMC9395894 DOI: 10.1186/s12879-022-07675-x] [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] [Received: 09/20/2021] [Accepted: 08/09/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND AND AIM It seems that acceptance of COVID-19 vaccination is the most effective way to tackle the COVID-19 pandemic now. Health care workers (HCWs) are one of the most important groups who are at risk for COVID-19 infection. This study aimed to assess the COVID-19 vaccine acceptance among HCWs in Iran and its determinants. METHODS A cross-sectional survey was carried out among 3600 HCWs in Iran. Data were collected through a self-administered questionnaire by a trained team from February to March 2021. Multi-stage cluster sampling method was used for selecting respondents of the study. Multivariate logistic regression analysis was used to determine the key factors of COVID-19 vaccine acceptance among participants. P-value < 0.05 was considered statistically significant. RESULTS Out of the 3536 respondents, 2191 (62.1%) intended to uptake the COVID-19 vaccine. Only about 10 percent of respondents said they did not trust any vaccine (domestic or foreign). Willing to accept a COVID-19 vaccine was relatively high among males, doctors, and those who had a history of hospitalization due to COVID-19 infection. The multivariate regression analysis showed respondents who were 40-50 years (aOR: 1.56; 95% CI: 1.47-1.66), had a history of COVID-19 infection (aOR: 0.85; 95% CI: 0.83-0.88), and hospitalized due to COVID-19 infection (aOR: 2.18; 95% CI: 1.97-2.39), were significantly associated with vaccine acceptance (p < 0.05). CONCLUSION Our study showed moderate acceptance of COVID-19 vaccination in the HCWs in the Islamic Republic of Iran. The most important factor in the acceptance of the COVID-19 vaccine by the health staff is having a history of hospitalization. Further training and justification of health personnel is needed to increase the acceptance of COVID 19 vaccine.
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Affiliation(s)
- Koorosh Kamali
- School of Public Health, Social Determinants of Health Research Center, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Zarrintaj Hoseinzade
- Social Medicine, School of Medicine, Social Determinants of Health Research Center, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Khadijeh Hajimiri
- Health Education and Promotion, School of Public Health, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Soodabeh Hoveidamanesh
- Community Medicine, Burn Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Mohsen Zahraei
- Center for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran, Iran
| | - Mohammad Mehdi Gouya
- Infectious Disease, School of Medicine, Iran University of Medical Sciences, Teheran, Iran
| | | | - Tahereh Mohamadi
- Business Administration, Health Insurance Organization, Zanjan, Iran
| | - Soraya Mohamadi
- Biostatistics, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Zohre Bigdeli
- Biostatistics, Social Determinant of Health Research Center, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Azam Maleki
- Reproductive Health, Social Determinants of Health Research Center, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Mahboubeh Shirzad
- Health Education and Promotion, School of Public Health, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Zahra Heidari
- Social Determinant of Health Research Center, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Mahya Farsadegi
- School of Dentistry, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Alireza Shoghli
- Social Medicine, School of Medicine, Social Determinants of Health Research Center, Zanjan University of Medical Sciences, Zanjan, Iran.
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20
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Ekezie W, Awwad S, Krauchenberg A, Karara N, Dembiński Ł, Grossman Z, del Torso S, Dornbusch HJ, Neves A, Copley S, Mazur A, Hadjipanayis A, Grechukha Y, Nohynek H, Damnjanović K, Lazić M, Papaevangelou V, Lapii F, Stein-Zamir C, Rath B. Access to Vaccination among Disadvantaged, Isolated and Difficult-to-Reach Communities in the WHO European Region: A Systematic Review. Vaccines (Basel) 2022; 10:vaccines10071038. [PMID: 35891201 PMCID: PMC9324407 DOI: 10.3390/vaccines10071038] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 05/30/2022] [Accepted: 06/14/2022] [Indexed: 01/27/2023] Open
Abstract
Vaccination has a significant impact on morbidity and mortality. High vaccination coverage rates are required to achieve herd protection against vaccine-preventable diseases. However, limited vaccine access and hesitancy among specific communities represent significant obstacles to this goal. This review provides an overview of critical factors associated with vaccination among disadvantaged groups in World Health Organisation European countries. Initial searches yielded 18,109 publications from four databases, and 104 studies from 19 out of 53 countries reporting 22 vaccine-preventable diseases were included. Nine groups representing the populations of interest were identified, and most of the studies focused on asylum seekers, refugees, migrants and deprived communities. Recall of previous vaccinations received was poor, and serology was conducted in some cases to confirm protection for those who received prior vaccinations. Vaccination coverage was lower among study populations compared to the general population or national average. Factors that influenced uptake, which presented differently at different population levels, included health service accessibility, language and vaccine literacy, including risk perception, disease severity and vaccination benefits. Strategies that could be implemented in vaccination policy and programs were also identified. Overall, interventions specific to target communities are vital to improving uptake. More innovative strategies need to be deployed to improve vaccination coverage among disadvantaged groups.
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Affiliation(s)
- Winifred Ekezie
- Vienna Vaccine Safety Initiative e.V., 10437 Berlin, Germany; (W.E.); (S.A.)
- Department of Epidemiology and Public Health, University of Nottingham, Nottingham NG5 1PB, UK
- College of Life Sciences, University of Leicester, Leicester LE5 4PW, UK
- ImmuHubs Consortium, Coordinating Entity: Vienna Vaccine Safety Initiative e.V., 10437 Berlin, Germany;
| | - Samy Awwad
- Vienna Vaccine Safety Initiative e.V., 10437 Berlin, Germany; (W.E.); (S.A.)
- ImmuHubs Consortium, Coordinating Entity: Vienna Vaccine Safety Initiative e.V., 10437 Berlin, Germany;
- Stanford University, Palo Alto, CA 94305, USA
| | - Arja Krauchenberg
- ImmuHubs Consortium, Coordinating Entity: Vienna Vaccine Safety Initiative e.V., 10437 Berlin, Germany;
- European Parents Association, 1000 Brussels, Belgium
| | - Nora Karara
- Young European Academy of Paediatrics, 1000 Brussels, Belgium;
- Evangelical Hospital Queen Elisabeth Herzberge, 10365 Berlin, Germany
| | - Łukasz Dembiński
- European Academy of Paediatrics, 1000 Brussels, Belgium; (Ł.D.); (Z.G.); (S.d.T.); (H.J.D.); (A.N.); (S.C.); (A.M.); (A.H.); (Y.G.); (V.P.); (F.L.)
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Zachi Grossman
- European Academy of Paediatrics, 1000 Brussels, Belgium; (Ł.D.); (Z.G.); (S.d.T.); (H.J.D.); (A.N.); (S.C.); (A.M.); (A.H.); (Y.G.); (V.P.); (F.L.)
- Adelson School of Medicine, Ariel University, Ariel 40700, Israel
| | - Stefano del Torso
- European Academy of Paediatrics, 1000 Brussels, Belgium; (Ł.D.); (Z.G.); (S.d.T.); (H.J.D.); (A.N.); (S.C.); (A.M.); (A.H.); (Y.G.); (V.P.); (F.L.)
| | - Hans Juergen Dornbusch
- European Academy of Paediatrics, 1000 Brussels, Belgium; (Ł.D.); (Z.G.); (S.d.T.); (H.J.D.); (A.N.); (S.C.); (A.M.); (A.H.); (Y.G.); (V.P.); (F.L.)
| | - Ana Neves
- European Academy of Paediatrics, 1000 Brussels, Belgium; (Ł.D.); (Z.G.); (S.d.T.); (H.J.D.); (A.N.); (S.C.); (A.M.); (A.H.); (Y.G.); (V.P.); (F.L.)
| | - Sian Copley
- European Academy of Paediatrics, 1000 Brussels, Belgium; (Ł.D.); (Z.G.); (S.d.T.); (H.J.D.); (A.N.); (S.C.); (A.M.); (A.H.); (Y.G.); (V.P.); (F.L.)
| | - Artur Mazur
- European Academy of Paediatrics, 1000 Brussels, Belgium; (Ł.D.); (Z.G.); (S.d.T.); (H.J.D.); (A.N.); (S.C.); (A.M.); (A.H.); (Y.G.); (V.P.); (F.L.)
| | - Adamos Hadjipanayis
- European Academy of Paediatrics, 1000 Brussels, Belgium; (Ł.D.); (Z.G.); (S.d.T.); (H.J.D.); (A.N.); (S.C.); (A.M.); (A.H.); (Y.G.); (V.P.); (F.L.)
| | - Yevgenii Grechukha
- European Academy of Paediatrics, 1000 Brussels, Belgium; (Ł.D.); (Z.G.); (S.d.T.); (H.J.D.); (A.N.); (S.C.); (A.M.); (A.H.); (Y.G.); (V.P.); (F.L.)
| | - Hanna Nohynek
- Finnish Institute for Health and Welfare, FI-00271 Helsinki, Finland;
| | - Kaja Damnjanović
- Faculty of Philosophy, University of Belgrade, 11000 Beograd, Serbia;
| | - Milica Lazić
- Faculty of Philosophy, University of Novi Sad, 21000 Novi Sad, Serbia;
| | - Vana Papaevangelou
- European Academy of Paediatrics, 1000 Brussels, Belgium; (Ł.D.); (Z.G.); (S.d.T.); (H.J.D.); (A.N.); (S.C.); (A.M.); (A.H.); (Y.G.); (V.P.); (F.L.)
| | - Fedir Lapii
- European Academy of Paediatrics, 1000 Brussels, Belgium; (Ł.D.); (Z.G.); (S.d.T.); (H.J.D.); (A.N.); (S.C.); (A.M.); (A.H.); (Y.G.); (V.P.); (F.L.)
| | | | - Barbara Rath
- Vienna Vaccine Safety Initiative e.V., 10437 Berlin, Germany; (W.E.); (S.A.)
- Department of Epidemiology and Public Health, University of Nottingham, Nottingham NG5 1PB, UK
- ImmuHubs Consortium, Coordinating Entity: Vienna Vaccine Safety Initiative e.V., 10437 Berlin, Germany;
- Correspondence:
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21
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Susło R, Pobrotyn P, Mierzecki A, Drobnik J. Fear of Illness and Convenient Access to Vaccines Appear to Be the Missing Keys to Successful Vaccination Campaigns: Analysis of the Factors Influencing the Decisions of Hospital Staff in Poland concerning Vaccination against Influenza and COVID-19. Vaccines (Basel) 2022; 10:vaccines10071026. [PMID: 35891190 PMCID: PMC9318872 DOI: 10.3390/vaccines10071026] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 06/23/2022] [Accepted: 06/24/2022] [Indexed: 12/10/2022] Open
Abstract
The COVID-19 pandemic has lasted for two years as of 2022, and it is common knowledge that vaccines are an essential tool to mitigate the health, economic, and social fallout. Unfortunately, vaccine hesitancy is still a serious global problem, both in the general population and among healthcare workers. The authors used an original questionnaire to conduct an anonymous survey study in the University Clinical Hospital in Wrocław, Poland, in April and May of 2021 after acquiring consent from the Medical University of Wrocław, Poland Bioethical Committee. The study results demonstrate that, to a significant extent, the decisions concerning vaccinations are based on factors that are difficult to change with rational argumentation, including people’s personal opinions or beliefs concerning vaccinations and their earlier experiences with vaccinations. The study results suggest that the impregnating effect of one’s own opinions, beliefs, and experiences can be surmounted if vaccines are dispensed free and conveniently while the pathogen is irrationally and emotionally perceived as untamed and possibly severe and life threatening. It makes a significant difference as in such cases that the percentage of participants whose decisions concerning vaccination are influenced by the risks to life or health of one’s own or others rises by about 27 and 36 percent points, respectively. Therefore, in order to succeed, campaigns for vaccinations need to include strong subjective and emotional communication, appealing to negative emotions and exploiting the public’s fear of the unknown while stressing tangible and personal threats possibly resulting from acquiring a vaccine-preventable infectious disease.
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Affiliation(s)
- Robert Susło
- Epidemiology and Medical Education Unit, Population Health Department, Health Sciences Faculty, Wrocław Medical University, 50-556 Wrocław, Poland;
- Correspondence:
| | | | - Artur Mierzecki
- Family Medicine Department, General Medicine and Dentistry Faculty, Medical University in Szczecin, 70-203 Szczecin, Poland;
| | - Jarosław Drobnik
- Epidemiology and Medical Education Unit, Population Health Department, Health Sciences Faculty, Wrocław Medical University, 50-556 Wrocław, Poland;
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22
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Elliott TR, Perrin PB, Powers MB, Jacobi KS, Warren AM. Predictors of Vaccine Hesitancy among Health Care Workers during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127123. [PMID: 35742372 PMCID: PMC9222587 DOI: 10.3390/ijerph19127123] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 06/01/2022] [Accepted: 06/08/2022] [Indexed: 02/04/2023]
Abstract
Most studies of COVID-19 vaccine hesitancy among health care workers (HCWs) have been descriptive, few have tested models to predict hesitancy, and none have examined the possible relationship between HCWs’ distress and vaccine hesitancy. This study examined predictors of COVID-19 vaccine hesitancy, including HCWs’ distress after taking into account HCW sex, doctoral-level status, race, age, and exposure to COVID-19. Further, it examined specific reasons HCWs endorsed for their hesitancy. 266 HCWs in the United States (U.S.). completed an online survey administered in January 2021, following the availability of the vaccine for HCWs in the U.S. The survey assessed demographics, depression, anxiety, COVID-19 vaccine hesitancy, and reasons for hesitancy. A comprehensive linear regression model explained 72.2% of the variance in COVID-19 vaccine hesitancy. HCWs were more hesitant if they did not know someone personally who had tested positive. Distress had no effect. The reasons most predicting vaccine hesitancy included safety, potential side effects, believing the risks from COVID-19 were lower than from the vaccine, not feeling at risk for getting COVID-19, and current pregnancy. Rather than rely on providing information about the COVID-19 vaccines to HCWs, strategies that address their concerns are required to promote vaccine acceptance. Contemporary issues of political polarization, misinformation and mistrust are likely to contribute to the concerns HCWs have about the COVID-19 vaccines.
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Affiliation(s)
- Timothy R. Elliott
- Department of Educational Psychology, Texas A&M University, College Station, TX 77843, USA;
- Correspondence:
| | - Paul B. Perrin
- Department of Psychology, Virginia Commonwealth University, Richmond, VA 23284, USA;
| | - Mark B. Powers
- Trauma Research Consortium, Baylor Scott & White Research Institute, Department of Trauma, Critical Care and Acute Care Surgery, Baylor University Medical Center, Dallas, TX 75246, USA; (M.B.P.); (A.M.W.)
| | - Katelin S. Jacobi
- Department of Educational Psychology, Texas A&M University, College Station, TX 77843, USA;
| | - Ann Marie Warren
- Trauma Research Consortium, Baylor Scott & White Research Institute, Department of Trauma, Critical Care and Acute Care Surgery, Baylor University Medical Center, Dallas, TX 75246, USA; (M.B.P.); (A.M.W.)
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23
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Martin CA, Pan D, Melbourne C, Teece L, Aujayeb A, Baggaley RF, Bryant L, Carr S, Gregary B, Gupta A, Guyatt AL, John C, McManus IC, Nazareth J, Nellums LB, Reza R, Simpson S, Tobin MD, Woolf K, Zingwe S, Khunti K, Abrams KR, Gray LJ, Pareek M. Risk factors associated with SARS-CoV-2 infection in a multiethnic cohort of United Kingdom healthcare workers (UK-REACH): A cross-sectional analysis. PLoS Med 2022; 19:e1004015. [PMID: 35617423 PMCID: PMC9187071 DOI: 10.1371/journal.pmed.1004015] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 06/10/2022] [Accepted: 05/09/2022] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Healthcare workers (HCWs), particularly those from ethnic minority groups, have been shown to be at disproportionately higher risk of infection with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) compared to the general population. However, there is insufficient evidence on how demographic and occupational factors influence infection risk among ethnic minority HCWs. METHODS AND FINDINGS We conducted a cross-sectional analysis using data from the baseline questionnaire of the United Kingdom Research study into Ethnicity and Coronavirus Disease 2019 (COVID-19) Outcomes in Healthcare workers (UK-REACH) cohort study, administered between December 2020 and March 2021. We used logistic regression to examine associations of demographic, household, and occupational risk factors with SARS-CoV-2 infection (defined by polymerase chain reaction (PCR), serology, or suspected COVID-19) in a diverse group of HCWs. The primary exposure of interest was self-reported ethnicity. Among 10,772 HCWs who worked during the first UK national lockdown in March 2020, the median age was 45 (interquartile range [IQR] 35 to 54), 75.1% were female and 29.6% were from ethnic minority groups. A total of 2,496 (23.2%) reported previous SARS-CoV-2 infection. The fully adjusted model contained the following dependent variables: demographic factors (age, sex, ethnicity, migration status, deprivation, religiosity), household factors (living with key workers, shared spaces in accommodation, number of people in household), health factors (presence/absence of diabetes or immunosuppression, smoking history, shielding status, SARS-CoV-2 vaccination status), the extent of social mixing outside of the household, and occupational factors (job role, the area in which a participant worked, use of public transport to work, exposure to confirmed suspected COVID-19 patients, personal protective equipment [PPE] access, aerosol generating procedure exposure, night shift pattern, and the UK region of workplace). After adjustment, demographic and household factors associated with increased odds of infection included younger age, living with other key workers, and higher religiosity. Important occupational risk factors associated with increased odds of infection included attending to a higher number of COVID-19 positive patients (aOR 2.59, 95% CI 2.11 to 3.18 for ≥21 patients per week versus none), working in a nursing or midwifery role (1.30, 1.11 to 1.53, compared to doctors), reporting a lack of access to PPE (1.29, 1.17 to 1.43), and working in an ambulance (2.00, 1.56 to 2.58) or hospital inpatient setting (1.55, 1.38 to 1.75). Those who worked in intensive care units were less likely to have been infected (0.76, 0.64 to 0.92) than those who did not. Black HCWs were more likely to have been infected than their White colleagues, an effect which attenuated after adjustment for other known risk factors. This study is limited by self-selection bias and the cross sectional nature of the study means we cannot infer the direction of causality. CONCLUSIONS We identified key sociodemographic and occupational risk factors associated with SARS-CoV-2 infection among UK HCWs, and have determined factors that might contribute to a disproportionate odds of infection in HCWs from Black ethnic groups. These findings demonstrate the importance of social and occupational factors in driving ethnic disparities in COVID-19 outcomes, and should inform policies, including targeted vaccination strategies and risk assessments aimed at protecting HCWs in future waves of the COVID-19 pandemic. TRIAL REGISTRATION The study was prospectively registered at ISRCTN (reference number: ISRCTN11811602).
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Affiliation(s)
- Christopher A. Martin
- Department of Respiratory Sciences, University of Leicester, Leicester, United Kingdom
- Department of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - Daniel Pan
- Department of Respiratory Sciences, University of Leicester, Leicester, United Kingdom
- Department of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - Carl Melbourne
- Genetic Epidemiology Research Group, Department of Health Sciences, University of Leicester, Leicester, United Kingdom
| | - Lucy Teece
- Biostatistics Research Group, Department of Health Sciences, University of Leicester, Leicester, United Kingdom
| | - Avinash Aujayeb
- Respiratory Department, Northumbria Specialist Emergency Care Hospital, United Kingdom
| | - Rebecca F. Baggaley
- Department of Respiratory Sciences, University of Leicester, Leicester, United Kingdom
| | - Luke Bryant
- Department of Respiratory Sciences, University of Leicester, Leicester, United Kingdom
| | - Sue Carr
- Department of Nephrology, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
- General Medical Council, London, United Kingdom
| | - Bindu Gregary
- Lancashire Clinical Research Facility, Royal Preston Hospital, United Kingdom
| | - Amit Gupta
- Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Anna L. Guyatt
- Department of Health Sciences, University of Leicester, Leicester, United Kingdom
| | - Catherine John
- Department of Health Sciences, University of Leicester, Leicester, United Kingdom
| | - I Chris McManus
- University College London Medical School, London, United Kingdom
| | - Joshua Nazareth
- Department of Respiratory Sciences, University of Leicester, Leicester, United Kingdom
- Department of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - Laura B. Nellums
- Population and Lifespan Sciences, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Rubina Reza
- Centre for Research & Development, Derbyshire Healthcare NHS Foundation Trust, Derby, United Kingdom
| | - Sandra Simpson
- Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, United Kingdom
| | - Martin D. Tobin
- Department of Health Sciences, University of Leicester, Leicester, United Kingdom
| | - Katherine Woolf
- University College London Medical School, London, United Kingdom
| | - Stephen Zingwe
- Research and Development Department, Berkshire Healthcare NHS Foundation Trust, Bracknell, United Kingdom
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester, United Kingdom
| | - Keith R. Abrams
- Department of Statistics, University of Warwick, United Kingdom
| | - Laura J. Gray
- Biostatistics Research Group, Department of Health Sciences, University of Leicester, Leicester, United Kingdom
| | - Manish Pareek
- Department of Respiratory Sciences, University of Leicester, Leicester, United Kingdom
- Department of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
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24
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Hussain B, Latif A, Timmons S, Nkhoma K, Nellums LB. Overcoming COVID-19 vaccine hesitancy among ethnic minorities: A systematic review of UK studies. Vaccine 2022; 40:3413-3432. [PMID: 35534309 PMCID: PMC9046074 DOI: 10.1016/j.vaccine.2022.04.030] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 03/09/2022] [Accepted: 04/06/2022] [Indexed: 12/31/2022]
Abstract
Ethnic minority communities in the UK have been disproportionately affected by the pandemic, with increased risks of infection, severe disease, and death. Hesitancy around the COVID-19 vaccine may be contributing to disparities in vaccine delivery to ethnic minority communities. This systematic review aims to strengthen understanding of COVID-19 vaccine concerns among ethnic minorities in the UK. Five databases were searched in February 2022, yielding 24 peer-reviewed studies reporting on vaccine hesitancy or acceptance in ethnic minority groups. Data were extracted using a standardised form, and quality assessment was carried out using the Standard Quality Criteria. There were three key themes: (1). Prevalence of vaccine hesitancy; (2). Reasons for vaccine hesitancy and acceptance; and (3). Recommendations to address vaccine concerns. Vaccine hesitancy, which was more common among some ethnic minority groups, is a complex phenomenon, driven by misinformation, mistrust, concerns about safety and efficacy, and structural and systemic inequities. Community engagement and tailored communication may help to address vaccine concerns. Robust data disaggregated by ethnicities are needed to better understand barriers and facilitators for COVID-19 vaccine delivery in ethnic minority communities. Strategies to address structural disadvantage need to be inclusive, comprehensive, and behaviorally informed and foster confidence in healthcare systems and governments. Community leaders and health care practitioners may prove to be the most important agents in creating an environment of trust within ethnic minority groups.
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25
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Galanis P, Moisoglou I, Vraka I, Siskou O, Konstantakopoulou O, Katsiroumpa A, Kaitelidou D. Predictors of COVID-19 Vaccine Uptake in Healthcare Workers: A Cross-Sectional Study in Greece. J Occup Environ Med 2022; 64:e191-e196. [PMID: 35467601 PMCID: PMC9083308 DOI: 10.1097/jom.0000000000002463] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE We assessed the uptake of a COVID-19 vaccine and associated factors in a sample of healthcare workers (HCWs). METHODS An on-line cross-sectional study with 885 HCWs was conducted in Greece during August 2021. We measured socio-demographic data of HCWs and attitudes towards vaccination and the COVID-19 pandemic. A convenience sample was used since the questionnaire was distributed through social media and emails. RESULTS The majority of HCWs were vaccinated against the COVID-19 (91.5%). Females and HCWs with a history of seasonal influenza vaccination had a greater probability to get a COVID-19 vaccine. Also, increased self-perceived knowledge regarding the COVID-19 pandemic and increased trust in COVID-19 vaccines were associated with COVID-19 vaccine uptake. CONCLUSIONS Policymakers and scientists should develop novel strategies to improve COVID-19 vaccine uptake among HCWs.
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Affiliation(s)
- Petros Galanis
- Clinical Epidemiology Laboratory, Faculty of Nursing, National and Kapodistrian University of Athens, Athens, Greece (Dr Galanis and Ms Katsiroumpa); Pulmonary Clinic, General Hospital of Lamia, Lamia, Greece (Dr Moisoglou); Department of Radiology, P & A Kyriakou Children's Hospital, Athens, Greece (Dr Vraka); Center for Health Services Management and Evaluation, Faculty of Nursing, National and Kapodistrian University of Athens, Athens, Greece (Dr Siskou, Dr Konstantakopoulou, and Dr Kaitelidou)
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Briko NI, Korshunov VA, Mindlina AY, Polibin RV, Antipov MO, Brazhnikov AI, Vyazovichenko YE, Glushkova EV, Lomonosov KS, Lomonosova AV, Lopukhov PD, Pozdnyakov AA, Saltykova TS, Torchinsky NV, Tsapkova NN, Chernyavskaya OP, Shamis AV. Healthcare Workers' Acceptance of COVID-19 Vaccination in Russia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074136. [PMID: 35409818 PMCID: PMC8998926 DOI: 10.3390/ijerph19074136] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/26/2022] [Accepted: 03/29/2022] [Indexed: 02/04/2023]
Abstract
During the COVID-19 pandemic, the problem of the population’s adherence to vaccination has become significantly aggravated around the world. This study is aimed at evaluating healthcare workers’ (HCWs) acceptance of COVID-19 vaccination in Russia. A cross-sectional multicenter study was carried out by interviewing HCWs in Russia using an electronic questionnaire and snowball sampling. The analysis included 85,216 questionnaires from 81 out of 85 regions of Russia. Statistical analysis was performed using SPSS v.22. The results indicated that 35.0% (CI 95%, 34.7–35.3) of HCWs were ready to get COVID-19 vaccination. The acceptance level was 42.4% (41.8–42.9) for all physicians and 31.3% (30.9–31.6) for nursing staff. A total of 29.4% (29.1–29.7) of HCWs were willing to recommend COVID-19 vaccination to patients: 38.5% (38.0–39.1) of physicians, and 24.7% (24.4–25.1) of nursing staff. Acceptance of COVID-19 vaccination is higher among HCWs dealing with infectious diseases and involved in vaccination. The low acceptance of HCWs toward vaccination against COVID-19 can be explained by the low level of awareness of HCWs in these issues. Additional educational programs are needed for HCWs, both for physicians and nurses, using all possible forms and methods of education.
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27
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Kumar N, Corpus I, Hans M, Harle N, Yang N, McDonald C, Sakai SN, Janmohamed K, Chen K, Altice FL, Tang W, Schwartz JL, Jones-Jang SM, Saha K, Memon SA, Bauch CT, Choudhury MD, Papakyriakopoulos O, Tucker JD, Goyal A, Tyagi A, Khoshnood K, Omer S. COVID-19 vaccine perceptions in the initial phases of US vaccine roll-out: an observational study on reddit. BMC Public Health 2022; 22:446. [PMID: 35255881 PMCID: PMC8899002 DOI: 10.1186/s12889-022-12824-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 02/21/2022] [Indexed: 11/11/2022] Open
Abstract
Background Open online forums like Reddit provide an opportunity to quantitatively examine COVID-19 vaccine perceptions early in the vaccine timeline. We examine COVID-19 misinformation on Reddit following vaccine scientific announcements, in the initial phases of the vaccine timeline. Methods We collected all posts on Reddit (reddit.com) from January 1 2020 - December 14 2020 (n=266,840) that contained both COVID-19 and vaccine-related keywords. We used topic modeling to understand changes in word prevalence within topics after the release of vaccine trial data. Social network analysis was also conducted to determine the relationship between Reddit communities (subreddits) that shared COVID-19 vaccine posts, and the movement of posts between subreddits. Results There was an association between a Pfizer press release reporting 90% efficacy and increased discussion on vaccine misinformation. We observed an association between Johnson and Johnson temporarily halting its vaccine trials and reduced misinformation. We found that information skeptical of vaccination was first posted in a subreddit (r/Coronavirus) which favored accurate information and then reposted in subreddits associated with antivaccine beliefs and conspiracy theories (e.g. conspiracy, NoNewNormal). Conclusions Our findings can inform the development of interventions where individuals determine the accuracy of vaccine information, and communications campaigns to improve COVID-19 vaccine perceptions, early in the vaccine timeline. Such efforts can increase individual- and population-level awareness of accurate and scientifically sound information regarding vaccines and thereby improve attitudes about vaccines, especially in the early phases of vaccine roll-out. Further research is needed to understand how social media can contribute to COVID-19 vaccination services.
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Affiliation(s)
- Navin Kumar
- Section of Infectious Diseases, Yale School of Medicine, New Haven, CT, USA.
| | | | | | | | - Nan Yang
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA
| | - Curtis McDonald
- Department of Statistics, Yale University, New Haven, CT, USA
| | | | | | - Keyu Chen
- Section of Infectious Diseases, Yale School of Medicine, New Haven, CT, USA
| | - Frederick L Altice
- Section of Infectious Diseases, Yale School of Medicine, New Haven, CT, USA.,Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
| | - Weiming Tang
- University of North Carolina Project-China, Guangzhou, China.,Social Entrepreneurship to Spur Health (SESH) Global, Guangzhou, China.,University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jason L Schwartz
- Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, USA
| | - S Mo Jones-Jang
- Department of Communications, Boston College, Boston, MA, USA
| | - Koustuv Saha
- Microsoft Research Lab, Montreal, Québec, Canada
| | | | - Chris T Bauch
- Department of Applied Mathematics, University of Waterloo, Waterloo, Ontario, Canada
| | | | | | - Joseph D Tucker
- University of North Carolina Project-China, Guangzhou, China.,School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, USA
| | - Abhay Goyal
- Department of Computer Science, Stony Brook University, New York, NY, USA
| | - Aman Tyagi
- Engineering and Public Policy, Carnegie Mellon University, Pittsburgh, PA, USA
| | - Kaveh Khoshnood
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
| | - Saad Omer
- Yale Institute for Global Health, New Haven, CT, USA
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28
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Bedston S, Akbari A, Jarvis CI, Lowthian E, Torabi F, North L, Lyons J, Perry M, Griffiths LJ, Owen RK, Beggs J, Chuter A, Bradley DT, de Lusignan S, Fry R, Richard Hobbs FD, Hollinghurst J, Katikireddi SV, Murphy S, O'Reily D, Robertson C, Shi T, Tsang RSM, Sheikh A, Lyons RA. COVID-19 vaccine uptake, effectiveness, and waning in 82,959 health care workers: A national prospective cohort study in Wales. Vaccine 2022; 40:1180-1189. [PMID: 35042645 PMCID: PMC8760602 DOI: 10.1016/j.vaccine.2021.11.061] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 11/05/2021] [Accepted: 11/22/2021] [Indexed: 12/02/2022]
Abstract
BACKGROUND While population estimates suggest high vaccine effectiveness against SARS-CoV-2 infection, the protection for health care workers, who are at higher risk of SARS-CoV-2 exposure, is less understood. METHODS We conducted a national cohort study of health care workers in Wales (UK) from 7 December 2020 to 30 September 2021. We examined uptake of any COVID-19 vaccine, and the effectiveness of BNT162b2 mRNA (Pfizer-BioNTech) against polymerase chain reaction (PCR) confirmed SARS-CoV-2 infection. We used linked and routinely collected national-scale data within the SAIL Databank. Data were available on 82,959 health care workers in Wales, with exposure extending to 26 weeks after second doses. RESULTS Overall vaccine uptake was high (90%), with most health care workers receiving theBNT162b2 vaccine (79%). Vaccine uptake differed by age, staff role, socioeconomic status; those aged 50-59 and 60+ years old were 1.6 times more likely to get vaccinated than those aged 16-29. Medical and dental staff, and Allied Health Practitioners were 1.5 and 1.1 times more likely to get vaccinated, compared to nursing and midwifery staff. The effectiveness of the BNT162b2 vaccine was found to be strong and consistent across the characteristics considered; 52% three to six weeks after first dose, 86% from two weeks after second dose, though this declined to 53% from 22 weeks after the second dose. CONCLUSIONS With some variation in rate of uptake, those who were vaccinated had a reduced risk of PCR-confirmed SARS-CoV-2 infection, compared to those unvaccinated. Second dose has provided stronger protection for longer than first dose but our study is consistent with waning from seven weeks onwards.
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Affiliation(s)
- Stuart Bedston
- Population Data Science, Swansea University Medical School, Swansea University, UK.
| | - Ashley Akbari
- Population Data Science, Swansea University Medical School, Swansea University, UK
| | | | - Emily Lowthian
- Population Data Science, Swansea University Medical School, Swansea University, UK
| | - Fatemeh Torabi
- Population Data Science, Swansea University Medical School, Swansea University, UK
| | - Laura North
- Population Data Science, Swansea University Medical School, Swansea University, UK
| | - Jane Lyons
- Population Data Science, Swansea University Medical School, Swansea University, UK
| | - Malorie Perry
- Vaccine Preventable Disease Programme, Public Health Wales, Cardiff, UK
| | - Lucy J Griffiths
- Population Data Science, Swansea University Medical School, Swansea University, UK
| | - Rhiannon K Owen
- Population Data Science, Swansea University Medical School, Swansea University, UK
| | - Jillian Beggs
- Patient & Public Involvement (PPI) BREATHE - The Health Data Research Hub for Respiratory Health, UK
| | - Antony Chuter
- Patient & Public Involvement (PPI) BREATHE - The Health Data Research Hub for Respiratory Health, UK
| | | | - Simon de Lusignan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, UK
| | - Richard Fry
- Population Data Science, Swansea University Medical School, Swansea University, UK
| | - F D Richard Hobbs
- MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, UK
| | - Joe Hollinghurst
- Population Data Science, Swansea University Medical School, Swansea University, UK
| | | | - Siobhán Murphy
- Centre for Public Health, Queen's University Belfast, UK
| | - Dermot O'Reily
- Centre for Public Health, Queen's University Belfast, UK
| | - Chris Robertson
- Department of Mathematics and Statistics, Strathclyde University, Glasgow and Public Health Scotland, UK
| | - Ting Shi
- Usher Institute, University of Edinburgh, UK
| | - Ruby S M Tsang
- Nuffield Department of Primary Care Health Sciences, University of Oxford, UK
| | - Aziz Sheikh
- Usher Institute and HDR UK BREATHE Hub, University of Edinburgh, UK
| | - Ronan A Lyons
- Population Data Science, Swansea University Medical School, Swansea University, UK
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29
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Gomes IA, Soares P, Rocha JV, Gama A, Laires PA, Moniz M, Pedro AR, Dias S, Goes AR, Leite A, Nunes C. Factors Associated with COVID-19 Vaccine Hesitancy after Implementation of a Mass Vaccination Campaign. Vaccines (Basel) 2022; 10:vaccines10020281. [PMID: 35214739 PMCID: PMC8879669 DOI: 10.3390/vaccines10020281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 01/29/2022] [Accepted: 02/07/2022] [Indexed: 01/27/2023] Open
Abstract
An online cross-sectional study on COVID-19 vaccination adhesion was conducted in Portugal nine months after vaccination rollout (September–November 2021). Logistic regression was used to identify factors associated with hesitancy to take the COVID-19 vaccine in the community-based survey, “COVID-19 Barometer: Social Opinion”. Hesitancy was 11%; however, of those, 60.5% stated that they intended to take the vaccine. Hesitancy was associated with factors such as lower monthly household income; no intention of taking the flu vaccine this year; perceived reasonable health status; having two or more diseases; low confidence in the health service response; worse perception of the adequacy of anti-COVID-19 government measures; low or no perceived risk of getting COVID-19; feeling agitated, anxious or sad some days; and lack of trust in the safety and efficacy of the vaccines. Confidence in vaccines, namely against COVID-19, is paramount for public health and should be monitored during vaccination rollout. Clear communication of the risks and benefits of vaccination needs improvement to increase adherence and public confidence.
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Affiliation(s)
- Inês Afonso Gomes
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal; (P.S.); (J.V.R.); (A.G.); (P.A.L.); (M.M.); (A.R.P.); (S.D.); (A.R.G.); (A.L.); (C.N.)
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Av. Padre Cruz, 1600-560 Lisboa, Portugal
- Laboratórios Pfizer Lda., Lagoas Park, 2740-271 Porto Salvo, Portugal
- Correspondence:
| | - Patricia Soares
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal; (P.S.); (J.V.R.); (A.G.); (P.A.L.); (M.M.); (A.R.P.); (S.D.); (A.R.G.); (A.L.); (C.N.)
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Av. Padre Cruz, 1600-560 Lisboa, Portugal
| | - João Victor Rocha
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal; (P.S.); (J.V.R.); (A.G.); (P.A.L.); (M.M.); (A.R.P.); (S.D.); (A.R.G.); (A.L.); (C.N.)
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Av. Padre Cruz, 1600-560 Lisboa, Portugal
| | - Ana Gama
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal; (P.S.); (J.V.R.); (A.G.); (P.A.L.); (M.M.); (A.R.P.); (S.D.); (A.R.G.); (A.L.); (C.N.)
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Av. Padre Cruz, 1600-560 Lisboa, Portugal
| | - Pedro Almeida Laires
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal; (P.S.); (J.V.R.); (A.G.); (P.A.L.); (M.M.); (A.R.P.); (S.D.); (A.R.G.); (A.L.); (C.N.)
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Av. Padre Cruz, 1600-560 Lisboa, Portugal
| | - Marta Moniz
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal; (P.S.); (J.V.R.); (A.G.); (P.A.L.); (M.M.); (A.R.P.); (S.D.); (A.R.G.); (A.L.); (C.N.)
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Av. Padre Cruz, 1600-560 Lisboa, Portugal
| | - Ana Rita Pedro
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal; (P.S.); (J.V.R.); (A.G.); (P.A.L.); (M.M.); (A.R.P.); (S.D.); (A.R.G.); (A.L.); (C.N.)
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Av. Padre Cruz, 1600-560 Lisboa, Portugal
| | - Sónia Dias
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal; (P.S.); (J.V.R.); (A.G.); (P.A.L.); (M.M.); (A.R.P.); (S.D.); (A.R.G.); (A.L.); (C.N.)
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Av. Padre Cruz, 1600-560 Lisboa, Portugal
| | - Ana Rita Goes
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal; (P.S.); (J.V.R.); (A.G.); (P.A.L.); (M.M.); (A.R.P.); (S.D.); (A.R.G.); (A.L.); (C.N.)
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Av. Padre Cruz, 1600-560 Lisboa, Portugal
| | - Andreia Leite
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal; (P.S.); (J.V.R.); (A.G.); (P.A.L.); (M.M.); (A.R.P.); (S.D.); (A.R.G.); (A.L.); (C.N.)
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Av. Padre Cruz, 1600-560 Lisboa, Portugal
| | - Carla Nunes
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal; (P.S.); (J.V.R.); (A.G.); (P.A.L.); (M.M.); (A.R.P.); (S.D.); (A.R.G.); (A.L.); (C.N.)
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Av. Padre Cruz, 1600-560 Lisboa, Portugal
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Bell S, Clarke RM, Ismail SA, Ojo-Aromokudu O, Naqvi H, Coghill Y, Donovan H, Letley L, Paterson P, Mounier-Jack S. COVID-19 vaccination beliefs, attitudes, and behaviours among health and social care workers in the UK: A mixed-methods study. PLoS One 2022; 17:e0260949. [PMID: 35073312 PMCID: PMC8786153 DOI: 10.1371/journal.pone.0260949] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 11/20/2021] [Indexed: 01/24/2023] Open
Abstract
Background The UK began delivering its COVID-19 vaccination programme on 8 December 2020, with health and social care workers (H&SCWs) given high priority for vaccination. Despite well-documented occupational exposure risks, however, there is evidence of lower uptake among some H&SCW groups. Methods We used a mixed-methods approach—involving an online cross-sectional survey and semi-structured interviews–to gain insight into COVID-19 vaccination beliefs, attitudes, and behaviours amongst H&SCWs in the UK by socio-demographic and employment variables. 1917 people were surveyed– 1656 healthcare workers (HCWs) and 261 social care workers (SCWs). Twenty participants were interviewed. Findings Workplace factors contributed to vaccination access and uptake. SCWs were more likely to not be offered COVID-19 vaccination than HCWs (OR:1.453, 95%CI: 1.244–1.696). SCWs specifically reported uncertainties around how to access COVID-19 vaccination. Participants who indicated stronger agreement with the statement ‘I would recommend my organisation as a place to work’ were more likely to have been offered COVID-19 vaccination (OR:1.285, 95%CI: 1.056–1.563). Those who agreed more strongly with the statement ‘I feel/felt under pressure from my employer to get a COVID-19 vaccine’ were more likely to have declined vaccination (OR:1.751, 95%CI: 1.271–2.413). Interviewees that experienced employer pressure to get vaccinated felt this exacerbated their vaccine concerns and increased distrust. In comparison to White British and White Irish participants, Black African and Mixed Black African participants were more likely to not be offered (OR:2.011, 95%CI: 1.026–3.943) and more likely to have declined COVID-19 vaccination (OR:5.550, 95%CI: 2.294–13.428). Reasons for declining vaccination among Black African participants included distrust in COVID-19 vaccination, healthcare providers, and policymakers. Conclusion H&SCW employers are in a pivotal position to facilitate COVID-19 vaccination access, by ensuring staff are aware of how to get vaccinated and promoting a workplace environment in which vaccination decisions are informed and voluntary.
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Affiliation(s)
- Sadie Bell
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
- * E-mail:
| | | | - Sharif A. Ismail
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Oyinkansola Ojo-Aromokudu
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Habib Naqvi
- NHS Race and Health Observatory, London, United Kingdom
| | | | | | - Louise Letley
- Immunisation, Hepatitis & Blood Safety Department, National Infection Service, Public Health England, London, United Kingdom
| | - Pauline Paterson
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Sandra Mounier-Jack
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
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31
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Blake H, Fecowycz A, Starbuck H, Jones W. COVID-19 Vaccine Education (CoVE) for Health and Care Workers to Facilitate Global Promotion of the COVID-19 Vaccines. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:653. [PMID: 35055476 PMCID: PMC8775929 DOI: 10.3390/ijerph19020653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 12/30/2021] [Accepted: 01/01/2022] [Indexed: 11/16/2022]
Abstract
The COVID-19 vaccine is being rolled out globally. High and ongoing public uptake of the vaccine relies on health and social care professionals having the knowledge and confidence to actively and effectively advocate it. An internationally relevant, interactive multimedia training resource called COVID-19 Vaccine Education (CoVE) was developed using ASPIRE methodology. This rigorous six-step process included: (1) establishing the aims, (2) storyboarding and co-design, (3) populating and producing, (4) implementation, (5) release, and (6) mixed-methods evaluation aligned with the New World Kirkpatrick Model. Two synchronous consultations with members of the target audience identified the support need and established the key aim (Step 1: 2 groups: n = 48). Asynchronous storyboarding was used to co-construct the content, ordering, presentation, and interactive elements (Step 2: n = 14). Iterative two-stage peer review was undertaken of content and technical presentation (Step 3: n = 23). The final resource was released in June 2021 (Step 4: >3653 views). Evaluation with health and social care professionals from 26 countries (survey, n = 162; qualitative interviews, n = 15) established that CoVE has high satisfaction, usability, and relevance to the target audience. Engagement with CoVE increased participants' knowledge and confidence relating to vaccine promotion and facilitated vaccine-promoting behaviours and vaccine uptake. The CoVE digital training package is open access and provides a valuable mechanism for supporting health and care professionals in promoting COVID-19 vaccination uptake.
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Affiliation(s)
- Holly Blake
- School of Health Sciences, University of Nottingham, Nottingham NG7 2HA, UK; (A.F.); (W.J.)
- NIHR Nottingham Biomedical Research Centre, Nottingham NG7 2UH, UK
| | - Aaron Fecowycz
- School of Health Sciences, University of Nottingham, Nottingham NG7 2HA, UK; (A.F.); (W.J.)
| | - Hollie Starbuck
- High Wycombe Campus, School of Nursing, Midwifery and Allied Health, Buckinghamshire New University, Buckinghamshire HP11 2JZ, UK;
| | - Wendy Jones
- School of Health Sciences, University of Nottingham, Nottingham NG7 2HA, UK; (A.F.); (W.J.)
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32
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Uzer F, Yesil O, Gokmen Y, Sayan MR, Cengiz M. Knowledge Levels, Attitudes, and Behaviors of Health Care Professionals regarding COVID-19 Vaccines. LIBYAN INTERNATIONAL MEDICAL UNIVERSITY JOURNAL 2022. [DOI: 10.1055/s-0042-1747909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
Background Shortly after the coronavirus disease 2019 (COVID-19) pandemic, vaccines were developed. Vaccination of the society in a short time may be the most important step in the fight against the pandemic. Health workers can be considered role models for society.
Aim We aimed to investigate the COVID-19 vaccination status of health care workers.
Methods The universe of our cross-sectional and descriptive study consisted of doctors, nurses, secretaries, interns, and other health care professionals. In the light of the literature, a questionnaire was prepared that questioned the attitudes and behaviors of the participants about vaccines. Face-to-face interviews were conducted during the visits. SPSS was used for statistical analysis.
Results A total of 806 volunteers, 51.4% (414) male and 48.6% (392) female, with a mean age of 32.7 ± 9.3 years, were included in the study. In total, 4.6% (37) of the participants in the study had not received any COVID-19 vaccine. Male participants were vaccinated statistically significantly more than female participants (p = 0.044). Of those vaccinated against COVID-19, 98.3% (774) had received at least two doses. Also, 26.9% (217) of health care workers had COVID-19 disease. The rate of those whose first-degree relatives had COVID-19 was 42.2% (340). A total of 87.3% (704) of health care workers reported that COVID-19 vaccines were safe. Also, 25.3% (204), 29.5% (238), and 35.0% (282) of the participants reported that state officials' vaccination in front of the media, social media news, and national media news, respectively, affected the decision to vaccinate.
Conclusion Although male health care workers have received more COVID-19 vaccines than female health care workers, vaccination rates of health care workers are at an acceptable level. Health workers comply with the calendar recommended by the ministry.
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Affiliation(s)
- Fatih Uzer
- Department of Respiratory Disease, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Omer Yesil
- Department of Respiratory Disease, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Yasin Gokmen
- Department of Respiratory Disease, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Mehmet Reşit Sayan
- Department of Respiratory Disease, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Mucahit Cengiz
- Department of Respiratory Disease, Akdeniz University Faculty of Medicine, Antalya, Turkey
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Alali WQ, Ali LA, AlSeaidan M, Al-Rashidi M. Effectiveness of BNT162b2 and ChAdOx1 Vaccines against Symptomatic COVID-19 among Healthcare Workers in Kuwait: A Retrospective Cohort Study. Healthcare (Basel) 2021; 9:1692. [PMID: 34946418 PMCID: PMC8701668 DOI: 10.3390/healthcare9121692] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 11/28/2021] [Accepted: 12/03/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Estimating vaccine effectiveness (VE) against severe, acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among healthcare workers (HCWs) is necessary to demonstrate protection from the disease. Between 24 December 2020 and 15 June 2021, we determined the factors associated with vaccine coverage and estimated VE against SARS-CoV-2 infection in HCWs at a secondary hospital in Kuwait. METHODS We extracted sociodemographic, occupational, SARS-CoV-2 infection, and vaccination data for eligible HCWs from the hospital records. Vaccine coverage percentages were cross-tabulated with the HCW factors. Cox regression was used to estimate hazard ratios in vaccinated versus unvaccinated. RESULTS 3246 HCWs were included in the analysis, of which 82.1% received at least one vaccine dose (50.4% only one dose of ChAdOx1, 3.3% only one dose of BNT162b2, and 28.3% two doses of BNT162b2). However, 17.9% of HCWs were unvaccinated. A significantly lower vaccination coverage was reported amongst female HCWs, younger age group (20-30 years), and administrative/executive staff. The adjusted VE of fully vaccinated HCWs was 94.5% (95% CI = 89.4-97.2%), while it was 75.4% (95% CI = 67.2-81.6%) and 91.4% (95% CI = 65.1-97.9%) in partially vaccinated for ChAdOx1 and BNT162b2, respectively. CONCLUSIONS BNT162b2 and ChAdOx1 vaccines prevented most symptomatic infections in HCWs across age groups, nationalities, and occupations.
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Affiliation(s)
- Walid Q. Alali
- Department of Epidemiology & Biostatistics, Faculty of Public Health, Kuwait University, Kuwait City 13060, Kuwait
| | - Lamiaa A. Ali
- Department of Public Health, Faculty of Medicine, Fayoum University, Fayoum 63514, Egypt;
| | - Mohammad AlSeaidan
- Department of Public Health, Ministry of Health, Kuwait City 12009, Kuwait;
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Krishnamurthy K, Sobers N, Kumar A, Ojeh N, Scott A, Cave C, Gupta S, Bradford-King J, Sa B, Adams OP, Campbell MH, Majumder MAA. COVID-19 Vaccine Intent Among Health Care Professionals of Queen Elizabeth Hospital, Barbados. J Multidiscip Healthc 2021; 14:3309-3319. [PMID: 34876817 PMCID: PMC8643144 DOI: 10.2147/jmdh.s336952] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 11/17/2021] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Due to increased exposure risk and the potential impact of COVID-19 infection, health care professionals (HCP) are a target group for COVID-19 vaccination. This study aimed to examine the acceptability of COVID-19 vaccines among HCP at the Queen Elizabeth Hospital, Barbados. DESIGN AND METHODS A cross-sectional survey of HCP was conducted between February 14 and 27, 2021 using an online questionnaire. The questionnaire included demographic information, knowledge of novel coronavirus, intention to accept the COVID-19 vaccination, vaccine literacy (VL), and perceptions and attitudes regarding COVID-19 vaccines. Mean VL scores were calculated. The relationship between socio-demographic variables and vaccine intent was assessed using a multivariable logistic regression model. RESULTS Of 343 HCPs, 55.1% indicated they would accept the COVID-19 vaccine if it were available; 44.9% expressed hesitancy towards the COVID-19 vaccine. We assessed the impact of socio-demographic factors and previous vaccine behavior on vaccine intent; after adjustment of the multivariable logistic regression model, non-Barbadian nationality and previous flu vaccine uptake were statistically significant predictors of reported intent to take the COVID-19 vaccine. Persons who indicated that they would take the vaccine had a higher mean vaccine literacy score [3.46 95% CI (3.40, 3.52)] than those who were not ready to take the vaccine immediately [3.23 95% CI (3.15, 3.30)]. VL scores were higher among the 29.5% of HCPs who believed vaccines should be mandatory. CONCLUSION This study highlighted vaccine hesitancy among HCPs in the sole public tertiary hospital of Barbados. As HCP perceptions may help or hinder the campaign to promote vaccine uptake in Barbados, vaccine promotion programs targeting HCPs are needed to ensure the success of the country's COVID-19 vaccination drive.
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Affiliation(s)
- Kandamaran Krishnamurthy
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados
| | - Natasha Sobers
- Caribbean Institute for Health Research, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados
| | - Alok Kumar
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados
| | - Nkemcho Ojeh
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados
| | - Andrea Scott
- The Queen Elizabeth Hospital, Bridgetown, Barbados
| | - Clyde Cave
- The Queen Elizabeth Hospital, Bridgetown, Barbados
| | - Subir Gupta
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados
| | | | - Bidyadhar Sa
- Faculty of Medical Sciences, The University of the West Indies, St Augustine, Trinidad and Tobago
| | - Oswald Peter Adams
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados
| | - Michael H Campbell
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados
| | - Md Anwarul Azim Majumder
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados
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Byrne T, Patel P, Shrotri M, Beale S, Michie S, Butt J, Hawkins N, Hardelid P, Rodger A, Aryee A, Braithwaite I, Fong WLE, Fragaszy E, Geismar C, Kovar J, Navaratnam AMD, Nguyen V, Hayward A, Aldridge RW. Trends, patterns and psychological influences on COVID-19 vaccination intention: Findings from a large prospective community cohort study in England and Wales (Virus Watch). Vaccine 2021; 39:7108-7116. [PMID: 34728095 PMCID: PMC8498741 DOI: 10.1016/j.vaccine.2021.09.066] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 09/27/2021] [Accepted: 09/28/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND Vaccination intention is key to the success of any vaccination programme, alongside vaccine availability and access. Public intention to take a COVID-19 vaccine is high in England and Wales compared to other countries, but vaccination rate disparities between ethnic, social and age groups has led to concern. METHODS Online survey of prospective household community cohort study participants across England and Wales (Virus Watch). Vaccination intention was measured by individual participant responses to 'Would you accept a COVID-19 vaccine if offered?', collected in December 2020 and February 2021. Responses to a 13-item questionnaire collected in January 2021 were analysed using factor analysis to investigate psychological influences on vaccination intention. RESULTS Survey response rate was 56% (20,785/36,998) in December 2020 and 53% (20,590/38,727) in February 2021, with 14,880 adults reporting across both time points. In December 2020, 1,469 (10%) participants responded 'No' or 'Unsure'. Of these people, 1,266 (86%) changed their mind and responded 'Yes' or 'Already had a COVID-19 vaccine' by February 2021. Vaccination intention increased across all ethnic groups and levels of social deprivation. Age was most strongly associated with vaccination intention, with 16-24-year-olds more likely to respond "Unsure" or "No" versus "Yes" than 65-74-year-olds in December 2020 (OR: 4.63, 95 %CI: 3.42, 6.27 & OR 7.17 95 %CI: 4.26, 12.07 respectively) and February 2021 (OR: 27.92 95 %CI: 13.79, 56.51 & OR 17.16 95 %CI: 4.12, 71.55). The association between ethnicity and vaccination intention weakened, but did not disappear, over time. Both vaccine- and illness-related psychological factors were shown to influence vaccination intention. CONCLUSIONS Four in five adults (86%) who were reluctant or intending to refuse a COVID-19 vaccine in December 2020 had changed their mind in February 2021 and planned to accept, or had already accepted, a vaccine.
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Affiliation(s)
- Thomas Byrne
- Centre for Public Health Data Science, Institute of Health Informatics, University College, 222 Euston Rd, London NW1 2DA, UK.
| | - Parth Patel
- Centre for Public Health Data Science, Institute of Health Informatics, University College, 222 Euston Rd, London NW1 2DA, UK.
| | - Madhumita Shrotri
- Centre for Public Health Data Science, Institute of Health Informatics, University College, 222 Euston Rd, London NW1 2DA, UK
| | - Sarah Beale
- Centre for Public Health Data Science, Institute of Health Informatics, University College, 222 Euston Rd, London NW1 2DA, UK; Institute of Epidemiology and Health Care, University College London, 1-19 Torrington Place, London WC1E 7HB, UK
| | - Susan Michie
- Centre for Behaviour Change, University College London, 1-19 Torrington Place, London WC1E 7HB, UK
| | - Jabeer Butt
- Race Equality Foundation, 27 Greenwood Pl, London NW5 1LB, UK
| | | | - Pia Hardelid
- Department of Population, Policy and Practice, UCL Great Ormond Street Institute of Child Health, 30 Guilford St, London WC1N 1EH, UK
| | - Alison Rodger
- Institute for Global Health, University College London, 30 Guilford St, London WC1N 1EH, UK; Royal Free London NHS Foundation Trust, Pond Street, London, NW3 2QG, UK
| | - Anna Aryee
- Centre for Public Health Data Science, Institute of Health Informatics, University College, 222 Euston Rd, London NW1 2DA, UK
| | - Isobel Braithwaite
- Centre for Public Health Data Science, Institute of Health Informatics, University College, 222 Euston Rd, London NW1 2DA, UK
| | - Wing Lam Erica Fong
- Centre for Public Health Data Science, Institute of Health Informatics, University College, 222 Euston Rd, London NW1 2DA, UK
| | - Ellen Fragaszy
- Centre for Public Health Data Science, Institute of Health Informatics, University College, 222 Euston Rd, London NW1 2DA, UK; Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel St, London WC1E 7HT, UK
| | - Cyril Geismar
- Centre for Public Health Data Science, Institute of Health Informatics, University College, 222 Euston Rd, London NW1 2DA, UK; Institute of Epidemiology and Health Care, University College London, 1-19 Torrington Place, London WC1E 7HB, UK
| | - Jana Kovar
- Institute of Epidemiology and Health Care, University College London, 1-19 Torrington Place, London WC1E 7HB, UK
| | - Annalan M D Navaratnam
- Centre for Public Health Data Science, Institute of Health Informatics, University College, 222 Euston Rd, London NW1 2DA, UK; Institute of Epidemiology and Health Care, University College London, 1-19 Torrington Place, London WC1E 7HB, UK
| | - Vincent Nguyen
- Centre for Public Health Data Science, Institute of Health Informatics, University College, 222 Euston Rd, London NW1 2DA, UK; Institute of Epidemiology and Health Care, University College London, 1-19 Torrington Place, London WC1E 7HB, UK
| | - Andrew Hayward
- Institute of Epidemiology and Health Care, University College London, 1-19 Torrington Place, London WC1E 7HB, UK
| | - Robert W Aldridge
- Centre for Public Health Data Science, Institute of Health Informatics, University College, 222 Euston Rd, London NW1 2DA, UK.
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Saban M, Myers V, Ben-Shetrit S, Wilf-Miron R. Socioeconomic gradient in COVID-19 vaccination: evidence from Israel. Int J Equity Health 2021; 20:242. [PMID: 34749718 PMCID: PMC8574141 DOI: 10.1186/s12939-021-01566-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 10/03/2021] [Indexed: 11/24/2022] Open
Abstract
Background Low socioeconomic status (SES) groups have been disproportionately affected by the COVID-19 pandemic. We aimed to examine COVID-19 vaccination rate by neighborhood SES and ethnicity in Israel, a country which has achieved high vaccination rates. Methods Data on vaccinations were obtained from the Israeli Ministry of Health’s open COVID-19 database, for December 20, 2020 to August 31, 2021. Correlation between vaccination rate and neighborhood SES was analyzed. Difference in vaccination rate between the first and second vaccine dose was analyzed by neighborhood SES and ethnicity. Findings A clear socioeconomic gradient was demonstrated, with higher vaccination rates in the higher SES categories (first dose: r = 0.66; second dose: r = 0.74; third dose: r = 0.92). Vaccination uptake was lower in the lower SES groups and in the Arab population, with the largest difference in uptake between Jewish and Arab localities for people younger than 60, and with the gap widening between first and third doses. Conclusions Low SES groups and the Arab ethnic minority demonstrated disparities in vaccine uptake, which were greater for the second and third, compared with the first vaccine dose. Strategies to address vaccination inequity will need to identify barriers, provide targeted information, and include trust-building in disadvantaged communities.
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Affiliation(s)
- Mor Saban
- Gertner Insititute of Epidemiology & Health Policy Research, Sheba Medical Center, Emek Dotan 1, 5262100, Ramat Gan, Israel.
| | - Vicki Myers
- Gertner Insititute of Epidemiology & Health Policy Research, Sheba Medical Center, Emek Dotan 1, 5262100, Ramat Gan, Israel
| | | | - Rachel Wilf-Miron
- Gertner Insititute of Epidemiology & Health Policy Research, Sheba Medical Center, Emek Dotan 1, 5262100, Ramat Gan, Israel.,School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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