Acceptance of COVID-19 vaccine in Pakistan among health care workers

COVID-19 vaccine hesitancy, trust, and communication in Sarlahi District, Nepal

BACKGROUND

Strategies to increase COVID-19 vaccine coverage require an understanding of the extent and drivers of vaccine hesitancy and trust in government related to COVID-19 vaccine programs, especially in low-resource communities.

METHODS

We conducted a cross-sectional household survey post-COVID-19 vaccine introduction among adults (n = 362) in four municipalities in Sarlahi District, Nepal from August to December 2022. The survey included modules on participant demographics and socioeconomic factors and vaccine hesitancy, information seeking, and trust in authorities related to COVID-19 vaccination.

RESULTS

Of the study participants, 38.4 % expressed hesitancy related to COVID-19 vaccination. The adjusted odds of being "vaccine hesitant" were significantly lower among the older adults (51+ years) relative to younger (<30 years) (aOR: 0.49, CI: 0.24-0.97) and among males relative to females (aOR: 0.51, CI: 0.26, 0.95). The study population highly trusted the government's handling of the COVID-19 pandemic. While for most, self-reported access to vaccination opportunities was high (88.4 %), 70.4 % of participants did not know if vaccines were in stock at their local vaccination facility. Commonly reported statements of misinformation include the vaccine being developed in a rush or too fast (21.5 %), COVID-19 infection can be effectively treated with ayurvedic medicine(16.3 %) and obtaining immunity from natural infection is better than through vaccination (19.9 %). The primary sources of information on COVID-19 programs were family and friends (98.6 %), healthcare professionals (67.7 %), Female Community Health Volunteers (FCHVs) (61.9 %), television (56.4 %), and radio (43.1 %).

CONCLUSION

Although many respondents expressed concerns about COVID-19 effectiveness and safety, a high proportion trusted COVID-19 information provided by healthcare workers and approved of the government's response to the pandemic. This study highlights an opportunity to design new evidence-based communication strategies to improve vaccine confidence delivered through frontline government healthcare workers. Approaches could be targeted to certain communities in the region shown to have higher vaccine hesitancy, including younger people and women.

Building confidence in the COVID-19 vaccine in a polio-endemic country: strategic communication lessons from Pakistan

In a health emergency, governments rely on public trust in their policy, and anticipate its compliance to protect health and save lives. Vaccine hesitancy compromises this process when an emergency involves infections. The prevailing discourse on vaccine hesitancy often describes it as a static phenomenon, ignoring its expanse and complexity, and neglecting the exploration of tools to address it. This article diverges from the conventional perspective by explaining the case of Pakistan and its communication strategy for the COVID-19 vaccine. Decades of polio vaccine hesitancy, rooted in the country's fight against terrorism, constitute its history. On the other hand, the first-ever launch of typhoid conjugate vaccine involving 35 million kids during 2019-2021 was a success. Against this backdrop, the country considered vaccine hesitancy as a dynamic phenomenon, interwoven with the social ecology and the responsiveness of the healthcare system. Its communication strategy facilitated those willing to receive the vaccine, while being responsive to the information needs of those still in the decision-making process. In the face of both hesitancy and a scarcity of vaccine doses, the country successfully inoculated nearly 70% (160 million) of its population in just over 1 year. People's perceptions about the COVID-19 vaccine also improved over time. This achievement offers valuable insights and tools for policymakers and strategists focused on the demand side of vaccine programmes. The lessons can significantly contribute to the global discourse on improving vaccine confidence and bolstering global health security.

Role of vaccination in patients with human monkeypox virus and its cardiovascular manifestations

Human monkeypox, caused by the monkeypox virus (MPXV), is an emerging infectious disease with the potential for human-to-human transmission and diverse clinical presentations. While generally considered milder than smallpox, it can lead to severe cardiovascular complications. The virus primarily spreads through contact with infected animals or through human-to-human transmission. Cardiovascular involvement in human monkeypox is rare but has been associated with myocarditis, pericarditis, arrhythmias, and even fulminant myocardial infarction. Vaccination plays a crucial role in preventing and controlling monkeypox, but the eradication of smallpox has left global populations vulnerable. This review explores the cardiovascular manifestations of human monkeypox, the role of vaccination in disease prevention, and the importance of continued research and development of effective vaccines to protect against this emerging infectious threat. The global impact of monkeypox outbreaks, particularly on vulnerable populations, further highlights the importance of understanding and addressing this disease.

Assessment of COVID-19 vaccine take-up and its predictors among healthcare professionals in public hospitals, Addis Ababa, Ethiopia: Facility-based cross-sectional study

Healthcare professionals (HCPs) are among the highly exposed groups for the COVID-19 pandemic and have been identified as the target population to get vaccination against the spread of the infection. Aimed to assess COVID-19 vaccine take-up and its predictors among HCPs in public hospitals in Addis Ababa, Ethiopia, 2021. A facility-based cross-sectional study was conducted among 403 randomly selected participants from October 1st to November 30, 2021. Data was entered into Epi-info version 7 and analyzed using SPSS version 25. An AOR along with a 95% confidence level was estimated, and a P value <.05 was considered to declare the statistical significance. About 71% of the participants had taken any of the COVID-19 vaccines at least once. Being married (AOR: 10.79; 95% CI: 1.32-18.05); educational status of MSc degree (AOR = 7.7; CI: 2.08-15.1.6), medical doctors/GP (AOR = 5.88; CI: 1.60-15.54), MD with MSc (AOR = 9.63; CI: 2.17-17.76), PHD (AOR = 13.33; CI: 1.23-24.21) and specialist and above 3 (AOR = 3.45; CI: 2.34-42.8) holder HCPs; perceived severity of COVID-19 infection as moderate (AOR = 0.23; CI: 0.08-0.65) and mild (AOR = 0.28; CI: 0.11-0.74) and poor knowledge toward COVID-19 vaccination (AOR = 0.03; CI: 0.01-0.12) were statistically associated. This study showed that COVID-19 vaccine take-up among HCPs was relatively low to achieve herd immunity. Participants' marital status, educational status, perception of the severity of COVID-19 infection, and level of knowledge toward COVID-19 vaccines were the predictors of the COVID-19 vaccine take-up.

Understanding factors influencing healthcare workers' intention towards the COVID-19 vaccine

Globally, healthcare workers (HCWs) are at high risk of acquiring Coronavirus infection. In addition, they are role models for the general public concerning attitudes towards the COVID-19 vaccine. In addition, they play a critical role in successfully promoting practices aiming to reduce the transmission of COVID-19 infection. Therefore, this study broadly based on the theory of planned behavior (TPB) explores the factors influencing HCWs' intention to be vaccinated. An online survey was administered using Google Form to collect data from HCWs working in the public health sector of Pakistan. The sample included 813 participants, two-thirds were female, and one-third were male. In addition, 41.5% of them were aged between 26-35 years, 32.6% had master's level education, 25% were nurses, and 57.7% of them were living in urban areas. Data analysis was run using Partial Least Squares Structural Equation Modeling (PLS-SEM). The research findings reveal the positive and significant effect of the TPB factors (attitude, subjective norms, and perceived behavioral control) and the extended factor of vaccine confidence on HCWs' intention to be vaccinated. This study's model explains 66.4% of variations in HCWs' intention to be vaccinated.

Uptake of the COVID-19 Vaccination and Associated Factors Among Health Care Providers in Addis Ababa, Ethiopia

Background

The COVID-19 vaccine is intended to provide acquired immunity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). As a result, 12 billion doses of the COVID-19 vaccination have been given globally as of August 1, 2022. Due to occupational exposure, health professionals obtained priority for COVID-19 vaccination. However, despite the availability of COVID-19 vaccines in countries, there is a discrepancy in the uptake of vaccine among different populations including Health-Care Providers.

Objective

Assessments of the factors associated with uptake of COVID-19 vaccination among health-care providers in Addis Ababa, Ethiopia in 2022.

Methods

From June 10 to July 10, 2022, a facility-based cross-sectional study was carried out in Addis Ababa, Ethiopia, involving 473 health-care professionals, used descriptive statistics to summarize the participant's characteristics, and multivariable logistic regression to analyze factors affecting COVID-19 vaccination uptake. P-value <0.05 was used to determine the level of significance.

Results

The response rate of the participants was 94.2%. The uptake rate of COVID-19 vaccine among health-care providers was 359 (75.8%). Vaccine uptake was positively associated with higher perceived concerns regarding COVID-19 [AOR = 7.45, (4.041-13.754)], higher monthly income, [AOR: 2.623 (1.398 -4.923)] compared those who earned lower, being married [AOR: 2.114, (1.068-4.181)] and being advanced age (36-45) years old [AOR =0.486 (0.258-0.916)] compared to 18-26 years old. However, being female professional reduced the odds of vaccine uptake [AOR = 0.486 (CI; 0.258-0.916)] in contrast of their counterpart.

Conclusion

The uptake of COVID-19 vaccine among health professionals is relatively higher than in earlier reports. However, this was not yet sufficient for the level required to achieve herd immunity. Hence, the Ministry of health should work in collaboration to address concerns about the safety and effectiveness of COVI D-19 vaccine to increase COVID-19 vaccine uptake. Moreover, Health professionals, social media, regular media outlet should strengthen health education on concerns of covid-19 infection.

Death Anxiety Among Pakistani HCWs: The Role of COVID-19 Vaccine Acceptance and Positive Religious Coping Strategy

Background: The mental health of healthcare workers (HCWs) has been significantly impacted by the COVID-19 pandemic. To address this, spirituality and religious coping mechanisms have been suggested as a way to maintain well-being and reduce anxiety levels. Additionally, vaccination has been shown to play an essential role in lowering anxiety levels, including death anxiety. However, there is a lack of evidence on how positive religious coping strategies and COVID-19 immunization affect death anxiety levels. To fill this gap, this study uses a Pakistani HCWs sample. Methods: This study collected cross-sectional data from 389 HCWs on socio-demographics, positive religious coping strategies, vaccine acceptance, and death anxiety. Hypothesis testing was done using Statistical Package for the Social Sciences (SPSS) and Partial Least Squares (PLS) by adopting the Structural Equation Modeling (SEM) technique. Results: The results showed that the positive religious coping strategy and acceptance of the COVID-19 vaccine reduced death anxiety among HCWs in Pakistan. HCWs practicing the positive religious coping strategy and vaccine acceptance had lower levels of death anxiety symptoms. Thus, the positive religious coping strategy has a direct effect on reducing death anxiety. Conclusion: In conclusion, COVID-19 immunization positively affects individual mental health by reducing death anxiety. Vaccines protect individuals from COVID-19 infection, providing a sense of security that reduces the chance of death anxiety among HCWs attending to COVID-19 patients.

COVID-19 vaccine hesitancy and social contact patterns in Pakistan: results from a national cross-sectional survey

BACKGROUND

Vaccination is a key tool against COVID-19. However, in many settings it is not clear how acceptable COVID-19 vaccination is among the general population, or how hesitancy correlates with risk of disease acquisition. In this study we conducted a nationally representative survey in Pakistan to measure vaccination perceptions and social contacts in the context of COVID-19 control measures and vaccination programmes.

METHODS

We conducted a vaccine perception and social contact survey with 3,658 respondents across five provinces in Pakistan, between 31 May and 29 June 2021. Respondents were asked a series of vaccine perceptions questions, to report all direct physical and non-physical contacts made the previous day, and a number of other questions regarding the social and economic impact of COVID-19 and control measures. We examined variation in perceptions and contact patterns by geographic and demographic factors. We describe knowledge, experiences and perceived risks of COVID-19. We explored variation in contact patterns by individual characteristics and vaccine hesitancy, and compared to patterns from non-pandemic periods.

RESULTS

Self-reported adherence to self-isolation guidelines was poor, and 51% of respondents did not know where to access a COVID-19 test. Although 48.1% of participants agreed that they would get a vaccine if offered, vaccine hesitancy was higher than in previous surveys, and greatest in Sindh and Baluchistan provinces and among respondents of lower socioeconomic status. Participants reported a median of 5 contacts the previous day (IQR: 3-5, mean 14.0, 95%CI: 13.2, 14.9). There were no substantial differences in the number of contacts reported by individual characteristics, but contacts varied substantially among respondents reporting more or less vaccine hesitancy. Contacts were highly assortative, particularly outside the household where 97% of men's contacts were with other men. We estimate that social contacts were 9% lower than before the COVID-19 pandemic.

CONCLUSIONS

Although the perceived risk of COVID-19 in Pakistan is low in the general population, around half of participants in this survey indicated they would get vaccinated if offered. Vaccine impact studies which do not account for correlation between social contacts and vaccine hesitancy may incorrectly estimate the impact of vaccines, for example, if unvaccinated people have more contacts.

Vaccine hesitancy and post-vaccination adherence to safety measures: A mixed-method study

Background

Despite being recognized as one of the most successful public health measures, vaccination is still considered to be unnecessary and unreliable in the context of the COVID-19 pandemic. The current study utilized a two-pronged approach in analyzing vaccine hesitancy and health behaviors after vaccination by employing a mixed-method design. Phase 1 was aimed at identifying predictors of COVID-19 vaccine hesitancy and acceptance among the Pakistani population using protection motivation theory (PMT), whereas Phase 2 was aimed at exploring the factors related to the vaccination of COVID-19.

Method

A convenient sample of 1,736 individuals from the vaccine-eligible population (12 years and above) was selected to collect data on vaccine hesitancy and acceptance (Phase 1). Phase 2 of the study explored post-vaccination health behaviors, especially adherence to safety measures for COVID-19, through 23 in-depth interviews with the vaccinated population.

Results

Multiple regression analyses showed that response cost is a major predictor of vaccine hesitancy (in Phase 1). In terms of the role of demographic variables, the results showed that being male (for severity: B = −0.481; threat appraisal: B = −0.737), old age (B = −0.044), not vaccinated, and not infected with COVID-19 (themselves and family members) are strongly associated with vaccination hesitancy. Results of thematic analysis in Phase 2 revealed that perceived individual experience and insensitivity toward the severity of the disease are strongly associated with a lack of adherence to safety measures of COVID-19. Faith and religious beliefs and reliance on traditional remedies are also key predictors of people's general non-compliance to health behaviors. One interesting aspect that was revealed in the analysis was the general financially and socially destabilized situation in the context of developing countries that contributed to general apathy in the pandemic situation.

Conclusion

The findings of the current study may help in devising a health model for the public from the developing world to deal with future pandemic situations.

Effect of religious fatalism and concern about new variants on the acceptance of COVID-19 vaccines

Introduction

To protect public health, it is important that the population be vaccinated against COVID-19; however, certain factors can affect vaccine acceptance.

Objective

The objective of this study was to determine whether religious fatalism and concern about new variants have a significant effect on the acceptance of COVID-19 vaccines.

Methodology

An explanatory study was conducted with 403 adults of legal age captured through non-probabilistic convenience sampling in vaccination centers in the 13 health networks of the Regional Health Directorate of Puno, Peru. Data were collected through a brief scale of religious fatalism, a scale of acceptance of vaccines against COVID-19 and a scale of concern about a new variant of COVID-19.

Results

The proposed model obtained an adequate fit. There was a negative effect of religious fatalism on vaccine acceptance, a positive effect of fatalism on vaccine rejection, a positive effect of concern about new variants on the acceptance of vaccines, and a positive effect of concern about new variants on vaccine rejection.

Conclusion

These findings provide evidence for the usefulness of considering both religious fatalism and concern about new variants affect the intention to receive the COVID-19 vaccine in adults in southern Peru.

Perception and Acceptance of COVID-19 Vaccine Among Nurses in Jordan

Introduction

Vaccination against coronavirus disease (COVID-19) is a key factor in protecting vulnerable populations, reducing healthcare burdens, and mitigating the economic and social impacts of the pandemic.

Objective

This study aims to investigate Jordanian nurses' perceptions, acceptance, and factors affecting their decisions toward the COVID-19 vaccines.

Methods

In this study, we conducted a cross-sectional design. Data have been investigated between July 1, 2021 and August 30, 2021. Nurses at three private hospitals in Jordan were surveyed online. The online survey, created using Google Forms, was distributed to nurses via email and social media sites (e.g., WhatsApp and Facebook). Participants were eligible if they were a RN nurse and/or nursing assistance, and had access to the internet via computer and/or smartphone.

Results

Out of 189 responses, 50.6% agreed to receive the COVID-19 vaccine, while 25.5% disagreed, and 23.9% were undecide to receive the vaccine. A large proportion (84.66%) of the respondents had a negative perception toward the vaccine, while only a small minority (15.34%) had a positive perception of it. The older nurses, those with more experience, and those with a higher level of education were more likely to accept the vaccine, with acceptance rates of 56.1%, 54.8%, and 63.9%, respectively.

Conclusion

Of the nurses surveyed, 84.66% had a negative perception of the COVID-19 vaccine, and only 50.6% reported that they would be willing to get vaccinated. It is crucial to address the concerns and reduce apprehension among nurses about the vaccine. Efforts to increase awareness about the importance of vaccination in controlling the disease through workshops and online meetings are needed.

Knowledge, attitude, and practices of front line health workers after receiving a COVID-19 vaccine: a cross-sectional study in Pakistan

Background

Globally, there is an increased risk of COVID-19 infection among front-line health workers (FHW). This study aimed to evaluate the knowledge, attitude, and practices of FHW of Pakistan after receiving the COVID-19 vaccine.

Methods

A population web-based survey on COVID-19 vaccine was conducted on 635 FHW in Pakistan between April 15, 2021, and July 15, 2021. The survey focused on four main sections consisting of socio-demographic data, knowledge, attitude, and practices after receiving the COVID-19 vaccine. The data was analyzed on SPSS. p < 0.05 was considered significant.

Results

Overall, 60% of FHW were nervous before getting vaccinated, with the leading reason to get vaccinated being their concern to protect themselves and their community (53.4%). A majority of FHW had fear about the unseen side effects of the COVID-19 vaccine (59.7%) used in Pakistan, with the most common side effect reported as soreness at the injection site (39%). It has been noted that almost all of the FHW observed preventive practices after getting vaccinated. The results showed that married respondents had favorable practices towards COVID-19 vaccines (B = 0.53, p < 0.01) (B, unstandardized regression coefficient). It was also found that more informational sources (B = 0.19, p < 0.01), higher knowledge of vaccination (B = 0.15, p < 0.001), and favorable attitude toward vaccine (B = 0.12, p < 0.001) significantly predicted favorable practices toward COVID-19 vaccination.

Conclusion

The findings reflect that FHW, though they were worried about its side effects, have good knowledge and a positive attitude after getting the COVID-19 vaccine. This study is significant as the FHWs are a symbol for guidance, a reliable source of information, and an encouraging means of receiving COVID-19 vaccine for the general public. This study also reported that post-vaccination side effects were mild which will aid in reducing the vaccine hesitancy among the general Pakistani population.

Determinants of coronavirus disease 2019 vaccine acceptance, hesitancy, and barriers among healthcare workers in Ismailia, Egypt: a mixed methods study

BACKGROUND

Coronavirus disease 2019 vaccine acceptance among healthcare workers (HCWs) plays a fundamental role in combating the COVID-19 pandemic. Vaccination acceptance depends on perceptions of competence and motives of the providers, producers, health professionals, and policymakers. This study aimed to identify the frequency and determinants of COVID-19 vaccine uptake acceptance, hesitancy, and barriers among HCWs.

METHODS

A total of 500 HCWs from 3 different hospital affiliations in Ismailia Governorate, Egypt, were included in this mixed methods study. The study was conducted between March and April 2021 through two phases. Phase 1 included a cross-sectional study using a self-administered questionnaire with inquiries about different determinants of vaccine acceptance, hesitancy, and barriers, which was completed either electronically in a Google form or a hard printed copy. Phase 2 included four focus group discussions to explore the determinants in depth.

RESULTS

The mean age of participants was 33.9 ± 7.9 years, 70% were females, 51.2% were nurses, and 28.6% were physicians. Of the 500 HCWs, only 27.8% accepted taking the vaccine immediately, 49.2% refused, and 23% were hesitant. Vaccine safety was the highest associated factor with vaccine acceptance (odds ratio (OR) = 6.3, 95% confidence interval (CI) 3.132-12.619), followed by previous uptake of influenza vaccine (OR = 3.3, 95% CI 2.048-5.217) and vaccine effectiveness (OR = 2.6, 95% CI 1.282-5.262). The main barriers to vaccine acceptance were mistrust in governmental policies during the pandemic or in the healthcare facility they work in. Hesitancy was common among females and nurses and was attributed to three prominent factors, including safety concerns, negative stories, and personal knowledge.

CONCLUSIONS

The vaccine acceptance frequency among HCWs was considered low, as the majority either refused or was hesitant about taking the vaccine. Concerns about vaccine safety and effectiveness were significant determinants of vaccine acceptance. Factors related to trust were the main barriers to vaccine uptake. The health authority should establish a surveillance system for side effects of the COVID-19 vaccine and communicate this information between HCWs to decrease their worries about safety and increase vaccine uptake.

An Insight Into the Acceptance and Hesitancy of COVID-19 Vaccines in Pakistan: A Cross-Sectional Survey

BACKGROUND

COVID-19 vaccines are found to be effective interventions to tackle COVID-19. However, the hesitancy towards its acceptance has been rising in Pakistan. This study highlights the opinion of the general population in Pakistan regarding the acceptance and hesitancy of COVID-19 vaccination.

METHODS

A descriptive cross-sectional survey study was conducted among Pakistanis from December 2021 to January 2022. Adult respondents that have and have not received COVID-19 vaccinations were included in this study. Data collection was obtained through questionnaires that assessed acceptance and hesitancy toward COVID-19 vaccines. Statistical analysis was performed using IBM SPSS software version 25 for Windows.

RESULTS

We obtained 367 respondents with 333 respondents completing the questionnaire. There were 259 respondents who have been vaccinated. A total of 67.9% of responses agreed that vaccines could control the COVID-19 pandemic. The reasons for not getting vaccination were afraid of adverse effects (48.6%) and COVID-19 vaccines not being tested thoroughly (30.9%). The main reason for vaccine acceptance was awareness about vaccines (23.1%), a belief that vaccines can stop severe COVID-19 disease (16.8%), and self-protection (14.7%).

CONCLUSION

Most Pakistanis agreed that vaccines could manage the pandemic. Vaccine acceptance was contributed by the awareness and belief regarding the protective effects of vaccines while vaccine hesitancy was due to the public's doubt about the vaccines' side effects and testing. The Pakistan government should focus on emphasizing knowledge about vaccines, educating the vaccines' adverse effects, and utilizing social media in doing so.

COVID-19 vaccine acceptance rate and its predictors in Ethiopia: A systematic review and meta-analysis

Coronavirus disease (COVID-19) is a global pandemic caused by the SARS-CoV-2 virus. COVID-19 vaccine is the best strategy for prevention. However, it remained the main challenge. Therefore, this systematic review and meta-analysis aimed to determine the overall pooled estimate of COVID-19 vaccine acceptance and its predictors in Ethiopia. Consequently, we have searched articles from PubMed, EMBASE, Web of Science, Google Scholar, reference lists of included studies, and Ethiopian universities' research repository. The weighted inverse variance random effects model was employed. The quality of studies and the overall variation between studies were checked through Joanna Briggs Institute (JBI) quality appraisal criteria and heterogeneity test (I²), respectively. The funnel plot and Egger's regression test were also conducted. Following that, a total of 14 studies with 6,773 participants were considered in the study and the overall pooled proportion of COVID-19 vaccine acceptance was 51.2% (95% CI: 43.9, 58.5). Having good knowledge (Odds ratio: 2.7; 95% CI: 1.1, 7.1; P.

VALUE

0.00), chronic disease (Odds ratio: 2; 95% CI: 1.3, 3.1), older age (Odds ratio: 1.8; 95% CI: 1.1, 3.0; P.

VALUE

0.02), and secondary education and above (Odds ratio: 3.3; 95% CI: 1.7, 6.7; P.

VALUE

0.00) were significantly associated with the acceptance of COVID-19 vaccine. In conclusion, Having good knowledge, chronic disease, older age, and secondary education and above were significantly associated with COVID-19 vaccine acceptance. Therefore, special attention and a strengthened awareness, education, and training about COVID-19 vaccine benefits had to be given to uneducated segments of the population.

A longitudinal study of vaccine hesitancy attitudes and social influence as predictors of COVID-19 vaccine uptake in the US

Background

In many countries with high levels of COVID-19 vaccine access, uptake remains a major issue. We examined prospective predictors of COVID-19 vaccine uptake in a United States longitudinal study.

Methods

An online longitudinal study on COVID-19 and well-being assessed vaccine hesitancy attitudes, social norms, and uptake among 444 respondents who had completed both survey waves in March and June 2021.

Results

The mean sample age was 41, with 55% female, 71% white, 13% Black, and 6% Latinx. In March 2021, 14% had received at least one COVID-19 vaccine dose. By June 2021, 64% reported receiving at least one dose. In prospectively assessing predictors of vaccine uptake, we found strong correlations among five different vaccine hesitancy questions. In multivariable logistic regression models, family and friends discouraging vaccination (adjusted odds ratios [aOR] = .26, 95% CI = .07, .98), not knowing whom to believe about vaccine safety (aOR = .51, 95% CI = .27, .95), and concerns that shortcuts were taken with vaccine development (aOR = .43, 95% CI = .23, .81) were all independent predictors of lower vaccine uptake. Political conservatism, gender, education, and income were also independent predictors of reduced uptake. Vaccine hesitancy items were also modeled as a scale, and the scale was found to be strongly predictive of vaccine uptake.

Conclusions

The findings highlight the importance of social norm interventions and suggest general and specific vaccine hesitancy attitudes, especially trust, should be considered in developing vaccine uptake programs.

COVID-19 vaccine acceptance rates and predictors among the Egyptian general population and Healthcare workers, the intersectionality of age and other factors

The promise of COVID-19 vaccines in ending the pandemic can only be achieved by overcoming the challenge of vaccine refusal. Healthcare workers (HCWs) are the trusted advisors of vaccination decisions. Recommendations for vaccinating children against COVID-19 are recently gaining more public health attention due to the role of children in disease transmission and associated morbidities. Vaccination is one of the first medical decisions parents or guardians make on behalf of their children. To investigate the determinants associated with vaccine acceptability among the general population through a direct interview questionnaire and assess guardians' views towards childhood COVID-19 vaccinations. This cross-sectional study included 2919 participants A pre-designed structured questionnaire about COVID-19 vaccination acceptability was completed by trained interviewers and interviewing the participants or their guardians (for those below 18 years old). Nearly two-thirds of participants (66.5%) accepted vaccination, 20.2% were refusing and 13.3% were hesitant. Most participants who were guardians of children below 12 years and from 13 to 17 years reported that they would accept vaccination of their children (72.5% and 70.5%, respectively). The acceptance rate among HCWs was 58.2%. The main reasons beyond vaccine refusal were mistrust of vaccine efficacy (39.5%) and having concerns regarding vaccine safety (38.8%). In a multivariable regression model, being male (OR 1.362, 95% CI 1.082-1.714, p = 0.008) resident in rural area (OR 1.796, 95% CI 1.435-2.247, p = 0.000), and lower education (OR 1.245, 95% CI 1.018-1.523, p = 0.033) were associated with an increased acceptance to be vaccinated. The acceptance rate for vaccinating children reported among their guardians was higher than adults for themselves. Extremes of age showed higher vaccine acceptance compared to young adults. Upper Egypt governorates (Faiyum and Giza) were outpacing Lower Egypt governorates in vaccination acceptance rates.

Continued disruptions in health care services and mental health among health care providers during the COVID-19 pandemic in five sub-Saharan African countries

Background

Continuous monitoring of the pandemic’s impact on health service provision and mental health, COVID-19 perceptions, and compliance with prevention measures among health care providers (HCPs) can help with mitigating the pandemic’s negative effects.

Methods

A computer-assisted telephone interviewing (CATI) survey was conducted among 1499 HCPs in Burkina Faso (Ouagadougou), Ethiopia (Addis Ababa), Nigeria (Lagos and Ibadan), Tanzania (Dar es Salaam), and Ghana (Kintampo). Self-reported mental health, perceptions of the COVID-19 pandemic, and prevention measures available in the workplace were assessed. HCPs’ responses to questions regarding the impact of COVID-19 on nine essential health services were summed into a score; high service disruption was defined as a score higher than the total average score across all sites. Modified Poisson regression was used to identify potential factors related to high service disruption.

Results

Overall, 26.9% of HCPs reported high service disruption, with considerable differences across sites (from 1.6% in Dar es Salaam to 45.0% in Addis Ababa). A considerable proportion of HCPs reported experiencing mild psychological distress (9.4%), anxiety (8.0%), and social avoidance or rejection (13.9%) due to their profession. Participants in Addis Ababa (absolute risk ratio (ARR) = 2.10; 95% confidence interval (CI) = 1.59-2.74), Lagos (ARR = 1.65; 95% CI = 1.24-2.17), and Kintampo (ARR = 2.61; 95% CI = 1.94-3.52) had a higher likelihood of reporting high service disruption compared to those in Ouagadougou. Reporting ever-testing for COVID-19 (ARR = 0.82; 95% CI = 0.69-0.97) and the presence of COVID-19 guidelines in the workplace (ARR = 0.63; 95% CI = 0.53-0.77) were both associated with lower reported health service disruption among HCPs.

Conclusion

The COVID-19 pandemic continues to disrupt essential health services and present a challenge to HCPs’ mental health, with important differences across countries and settings; interventions are needed to mitigate these negative effects of the pandemic.

Acceptance of COVID-19 vaccine and associated factors among health care workers at public hospitals in Eastern Ethiopia using the health belief model

Introduction

Acceptance of COVID-19 vaccination among Health Care Workers is mandatory to lessen and curve the spread of transmission of COVID-19. Even though the Health Belief Model is one of the most widely used models for understanding vaccination behavior against COVID-19 disease, COVID-19 vaccine acceptance among Health Care Workers in Ethiopia was not adequately explored by using the Health Belief Model domains.

Purpose

This study aimed to assess COVID-19 vaccine acceptance and associated factors among Health care workers in eastern, Ethiopia.

Methods

Institutional-based cross-sectional study design was used among 417 health care workers selected by a systematic random sampling method from June 1- 30/2021. The data were collected by face-to-face interviews using semi-structured questionnaires and analyzed using STATA version 14 statistical software. Multivariable binary logistic regression analysis with a 95% confidence interval was carried out to identify factors associated with willingness to COVID-19 vaccine acceptance and a statistical significance was declared at a P-value < 0.05.

Results

The willingness of health care workers to accept the COVID-19 vaccine was 35.6%. Age 30-39 (AOR = 4.16;95% CI: 2.51, 6.88), age ≥ 40 years (AOR = 3.29;95% CI: 1.47, 7.39), good attitude (AOR = 1.97; 95% CI: 1.00, 3.55), perceived susceptibility (AOR = 1.93; 95% CI: 1.12, 3.32), and perceived severity (AOR = 1.78; 95% CI: 1.03, 3.10) were factors significantly associated with Health Care Workers acceptance of COVID-19 vaccine.

Conclusion

The willingness to accept the COVID-19 vaccine among HCWs was low. Factors significantly associated with the willingness to accept the COVID-19 vaccine were age, good attitude, perceived susceptibility, and perceived severity of the disease. The low willingness of Health Care Workers to accept the COVID-19 vaccine was alarming and it needs more emphasis from the government in collaboration with other stakeholders to provide reliable information to avert misconceptions and rumors about the vaccine to improve the vaccine status of Health Care Workers to protect the communities.

COVID-19 vaccine hesitancy: A narrative review of four South Asian countries

Objectives

Vaccine hesitancy remains a global issue, especially within poverty-stricken countries where there's an interplay of financial and non-financial barriers. This narrative review aims to understand attitudes and behaviors toward COVID-19 vaccination in four South Asian countries and make context-specific recommendations to vaccine program drivers and decision-makers.

Methods

A search was conducted using PubMed and Science Direct, and CINHAL from January 2020 up to May 2022 restricted to the English language for terms: "Afghanistan" OR "Pakistan" OR "India" OR "Bangladesh" in combination with "COVID-19 vaccine" and other related terms. All articles were initially included, and those with relevance were included in the synthesis of this paper.

Results

A narrative review was performed for this study. Our narrative review included a total of eighteen studies with a sample size (n = 223-5,237) averaging about 1,325 participants per study conducted. The studies included revealed public hesitancy to receive the COVID-19 vaccine ranging from 6.3 to 56.2% with an average of 31.63% across all eighteen studies. Several reasons were linked to this observation in these four South Asian countries, and the predominant ones included: Insufficient information provided to the general public about the side effects of the vaccines, concerns regarding vaccine safety, and skepticism of vaccine efficacy.

Conclusion

Vaccine hesitancy is a global problem within the context of COVID-19, and issues regarding equity, misinformation, and poverty in South Asian countries makes it difficult to meet goals for herd immunity. Policymakers and governments should aim toward financial and non-financial incentives to drive the public toward vaccination.

Predictors of COVID-19 Vaccine Acceptance among Healthcare Workers in Nigeria

Healthcare workers (HCWs) are regarded as role models regarding health-related issues, including vaccination. Therefore, it is essential to identify the predictors for COVID-19 vaccine acceptance among them. A cross-sectional study to assess the risk perception, attitudes and knowledge of HCWs toward COVID-19 vaccination was carried out. A total of 710 responses were received between September 2021 and March 2022, from HCWs in the Northern, Western and Eastern regions of Nigeria. Cross tabulations were performed to determine statistical relations between sociodemographic variables, knowledge, attitudes and risk perceptions concerning COVID-19 vaccine acceptance. Multinomial logistic regression analysis was performed to determine the predictive variables for COVID-19 vaccine acceptance. Statistical analyses were performed and P-values less than 0.05 were considered statistically significant at a CI of 95%. Results showed that 59.3% of the participants were amenable to COVID-19 vaccines. Multinomial regression analysis identified 14 variables at α < 0.05 as predictors for vaccine acceptance. Male HCWs were 2.8 times more likely to accept the vaccine than their female counterparts. HCWs that were knowledgeable of the different kinds of vaccines, were willing to recommend the vaccines to their patients, believed that the timing of COVID-19 vaccination was appropriate and had recent vaccination history within three years were 1.6, 24.9, 4.4 and 3.1 times more likely to take COVID-19 vaccine than those not sure. The study found a relatively high trust (51.3%) in the Nigerian Center for Disease Control (NCDC) for information regarding COVID-19 vaccines. Therefore, the NDCD should disseminate more robust insights regarding the safety profiles of various COVID-19 vaccines.

Vaccine Acceptance and Hesitancy among Hospitalized COVID-19 Patients in Punjab, Pakistan

Vaccine hesitancy is widespread in many parts of the globe, particularly in low–middle-income countries. Therefore, we surveyed a sample of hospitalized COVID-19 patients to assess COVID-19 vaccine acceptance and vaccine hesitancy in a low–middle-income country. A cross-sectional sample of 385 confirmed reverse transcriptase–polymerase chain reaction COVID-19 patients treated at secondary and tertiary care hospitals in Punjab, Pakistan, were analyzed to assess COVID-19 vaccine uptake and vaccine hesitancy. The construct validity and reliability of the 11-item vaccine hesitancy questionnaire were also examined. In addition, multivariate logistic regression was used. The majority of the COVID-19 patients admitted to hospitals were not vaccinated (84%). Of those who were willing to receive vaccination, the majority (55%) considered vaccines an effective way to protect people from COVID-19. However, those who were not willing to receive their COVID-19 vaccine had significantly higher hesitancy than those willing to receive their COVID-19 vaccine. In addition, older hospitalized COVID-19 patients aged 60 years or above (20–29 years: OR 0.10; 95% CI 0.01–0.72, p = 0.001) and patients from urban areas (OR 3.16 95% CI 1.27–7.87, p = 0.013) were more likely to receive the COVID-19 vaccine than younger patients and patients from rural areas. Patients with no formal education had significantly higher hesitancy (OR 5.26; 96% CI 1.85–14.97, p = 0.002) than participants with graduation and above education. More than half of the study’s participants did not trust information shared on social media about COVID-19 vaccines and cited newspapers/news channels as their main source of information. The study provides important insights into COVID-19 vaccine acceptance and the impact of vaccination campaigns. Many unvaccinated COVID-19 patients in hospitals highlight the need for an effective vaccination drive to protect people from acquiring infection and subsequent hospitalization.

Survey data of public in Sindh Pakistan regarding willingness to accept COVID-19 vaccination

Objective

The COVID-19 pandemic has badly affected the world with its devastating effects, including Sindh, Pakistan. A massive vaccination campaign against COVID-19 is considered one of the effective ways to curtail the spread of the disease. However, the acceptability of the COVID-19 vaccine is based on the general population’s knowledge, attitude, perception and willingness for vaccination. Therefore, a survey among the public in Sindh, Pakistan, was done to evaluate their knowledge, attitude, perception and willingness to accept COVID-19 vaccination.

Method

The online survey was conducted among the residents of Sindh, Pakistan, in July 2021 through a survey tool designed using Google Forms and sent to the population through various social media.

Results

Of 926 study participants, 59.0% were male, and 68.6% were aged between 18 and 31 years. Higher percentages of responses were recorded from the Hyderabad division (37.5%), and 60.0% of respondents were graduates, with 34.8% of them in the private sector. The results showed that 36.4% of respondents had good knowledge, and 30.3% had a positive attitude toward COVID-19 vaccination. Almost 77% of respondents perceived that everyone should get vaccinated in the country and those health care workers on priority. A majority (80.8%) of respondents were willing to accept COVID-19 vaccination.

Conclusion

Despite having insufficient knowledge and a low percentage of positive attitude public in Sindh are willing to be vaccinated. Based on this finding, more effort has to be done to promote vaccination among the public, especially among the less educated population.

Beliefs, barriers and hesitancy towards the COVID-19 vaccine among Bangladeshi residents: Findings from a cross-sectional study

Background

COVID‐19 vaccination acceptance is important, and combating hesitancy which is generally based on the individuals’ beliefs and perceptions is essential in the present pandemic. This study assesses COVID‐19 vaccine hesitancy and associated factors, beliefs and barriers associated with COVID-19 vaccination.

Methods

A cross-sectional study was carried out among 492 Bangladeshi residents (76% male; mean age = 24.21 ± 4.91 years; age range = 18–50 years) prior to the nationwide mass COVID-19 vaccination campaign (September 28, 2021). A semi-structured e-questionnaire included three sections (demographic variables, beliefs around the vaccination, and perceived barriers regarding COVID-19 vaccination).

Results

More than a quarter of participants (26.42%) were hesitant, 70.33% reported to accept the vaccine, and 3.25% refused to be vaccinated. While (54%) believed that mass vaccination would be the most effective method to combat the COVID-19 pandemic, concerns regarding the side effects of the vaccine (58%), inadequate vaccine trials before human administration (43%), commercial profiteering (42%), and mistrust of the benefits of the vaccine (20%) were also reported. In addition, other barriers including a short supply of vaccines, unknown future adverse effects (55%), low confidence in the health system (51%), doubts regarding its effectiveness (50%) and safety (45%), and insufficient information regarding potential adverse effects (44.7%) were reported. In bivariate analysis, variables such as current political affiliation, previous vaccination history, and health status were significantly associated with the COVID-19 vaccine uptake variable (acceptance, hesitancy, refusal). Regression analysis showed that participants who identified with the opposing current political parties, and not having been vaccinated since the age of 18 years were significantly more likely to report vaccine hesitancy.

Conclusions

The current findings relating to COVID-19 vaccination demonstrate that government and policy makers need to take all necessary measures to ensure the effectiveness of the vaccination program among the Bangladeshi people.

COVID-19 vaccine acceptance among healthcare workers in China: A systematic review and meta-analysis

Background

Since the successful development of Coronavirus Disease (COVID-19) vaccine, COVID-19 vaccination has been actively advocated all over the world. As the key population for COVID-19 vaccination, the acceptance of Healthcare Workers (HCWs) is not only related to their risk of contracting COVID-19 infection at work, but also affects the decision of the general population on COVID-19 vaccination. Currently, a series of observational studies have been conducted on the acceptance of COVID-19 vaccines among HCWs in China, but there are presently no all-inclusive reviews. Therefore, this paper reviewed to identify a reliable estimate of acceptance rate of COVID-19 vaccine among HCWs in China.

Methods

We conducted a search on PubMed, EMbase, The Cochrane Library, Web of Science, CNKI (Chinese National Knowledge Infrastructure), Wanfang Database, CBM (Chinese Biomedical Literature Database) and VIP database (Chinese Scientific Journal Database) from January 2020 to June 2022. The quality of included articles was estimated using the Newcastle-Ottawa Quality Assessment tool suitable for cross-sectional studies and STATA 16 was used for analysis, A random-effects model was used to calculate acceptance rate for COVID-19 vaccine, as well as subgroup analysis and sensitivity analysis.

Result

This review included 18 studies involving 45,760 subjects, all of which were of medium or high quality. Meta-analysis results represented that, the pooled estimated acceptance rate of COVID-19 vaccine among HCWs in China was 78% (95%CI: 73–83%), and the pooled acceptance rate in 2021 (82%, 95%CI: 78–86%) was significantly higher than that in 2020 (73%, 95%CI: 65%-81%). Subgroup analysis showed different acceptance rates for COVID-19 vaccine among HCWs with different characteristics.

Conclusion

The result revealed that HCWs in China generally have a high acceptance rate of COVID-19 vaccines, but the acceptance rate varies with different characteristics of the population. Therefore, corresponding training should be carried out for HCWs with different characteristics, and they should play an exemplary and leading role in COVID-19 vaccination, so as to improve the vaccination rate of the whole population and form an immune barrier at an early date.

Perceived risk and perceptions of COVID-19 vaccine: A survey among general public in Pakistan

Background

The coronavirus disease has become a global pandemic, and it continues to wreak havoc on global health and the economy. The development of vaccines may offer a potential eradication of COVID-19. This study evaluated the general knowledge, attitude, and perception of COVID-19 vaccines in the Pakistani population.

Methods

A self-reporting e-survey and questionnaire-based survey from vaccination centers of different cities of Pakistan among 502 participants were conducted. The questionnaire comprised four sections inquiring demographics, vaccination status, and perception or attitude towards the vaccine. Univariate logistic regression was applied to predict the knowledge, attitude and behavior of participants.

Results

The mean age of participants was 50.8±20.3 years. 53% of the participants have both doses of vaccine administered. Pain on the site of injection (49.8%) was the most common symptom, followed by asthenia (43.0%), muscle pain (29.5%), and swelling (24.5%) on the site of vaccine administration. Females complain of more symptoms than males. More severe symptoms were reported after the first dose of vaccine administration; these symptoms subsided within a week for most participants. Overall, the respondents have a positive attitude towards the vaccine. 47.4% are sure about the vaccine’s efficacy, 48.6% said getting vaccinated was their own decision, and 79.9% also recommended others to get vaccinated.

Conclusion

The study concluded that the Pakistani population has a positive attitude but inadequate knowledge towards COVID-19 vaccines. Immediate awareness and vaccination education programs should be conducted by the authorities to complete the mass vaccination schedule.

Gender Differences in Health Care Workers' Risk-Benefit Trade-Offs for COVID-19 Vaccination

Background

Gender differences in vaccine acceptance among health care workers (HCWs) are well documented, but the extent to which these depend on occupational group membership is less well studied. We aimed to determine vaccine acceptance and reasons of hesitancy among HCWs of respiratory clinics in Germany with respect to gender and occupational group membership.

Methods

An online questionnaire for hospital staff of all professional groups was created to assess experiences with and attitudes towards COVID-19 and the available vaccines. Employees of five clinics were surveyed from 15 to 28 March 2021.

Results

962 employees (565 [72%] female) took part in the survey. Overall vaccination acceptance was 72.8%. Nurses and physicians showed greater willingness to be vaccinated than members of other professions (72.8%, 84.5%, 65.8%, respectively; p = 0.006). In multivariate analyses, worries about COVID-19 late effects (odds ratio (OR) 2.86; p < 0.001) and affiliation with physicians (OR 2.20; p = 0.025) were independently associated with the willingness for vaccination, whereas age <35 years (OR 0.61; p = 0.022) and worries about late effects of vaccination (OR 0.13; p < 0.001) predicted vaccination hesitancy; no differences were seen with respect to gender. In separate analyses for men and women, only for men worries about COVID-19 late effects were relevant, while among women, age <35 years, worries about late effects of vaccination and worries about COVID-19 late effects played a role.

Conclusions

There was no overall difference in vaccination acceptance between male and female HCWs, but there were gender-specific differences in the individual reasons on which this decision-making was based.

Factors Associated With Psychological Outcomes Among Vaccinated and Unvaccinated Health Care Workers Against COVID-19 Infection in Bangladesh

Background

Vaccination of healthcare workers (HCWs) is recommended during the COVID-19 pandemic to reduce the risk of infection for themselves and their patients, as well as to encourage their patients to get immunized. The present study aimed to investigate the psychological outcomes and associated factors among vaccinated and unvaccinated HCWs against COVID-19 infection in Bangladesh.

Methods

From March to August 2021, an online nationwide survey was conducted with a total of 2,038 Bangladeshi HCWs. The frequency of symptoms of general health problems, depression, anxiety, stress, post-traumatic stress disorder, insomnia, and loneliness was assessed using the Bangla versions of the GHQ-12, PHQ-2, GAD-2, PSS-4, PC-PTSD-5, ISI, and UCLA-LS scales, respectively.

Results

Compared with unvaccinated HCWs (n = 1,058), vaccinated HCWs (n = 980) had a statistically significant lower prevalence of general health problems (16.7 vs. 59.1%), depression (15.6 vs. 31.9%), post-traumatic stress disorder (22.3 vs. 30.8%), insomnia (23.8 vs. 64.9%), and loneliness symptoms (13.9 vs. 21.8%). Among vaccinated HCWs, females were significantly associated with a higher risk of symptoms of general health problems (AOR, 2.71; 95% CI, 0.97-7.60), anxiety (AOR, 2.17; 95% CI, 1.14-4.13), and loneliness (AOR, 2.52; 95% CI, 1.11-5.73). Except for anxiety and post-traumatic stress disorder symptoms, participants living in urban areas had a significantly lower risk of all psychological outcomes (e.g., depression: AOR, 0.43; 95% CI, 0.27-0.67; stress: AOR, 0.64; 95% CI, 0.47-0.88). Respondents who were married were significantly less likely to experience symptoms of general health problems (AOR, 0.10; 95% CI, 0.02-0.39), depression (AOR, 0.31; 95% CI, 0.22-0.82), insomnia (AOR, 0.46; 95% CI, 0.20-1.03), and loneliness (AOR, 0.31; 95% CI, 0.10-0.92). Participants who worked as doctors were significantly less chance of experiencing symptoms of general health problems (AOR, 0.18; 95% CI, 0.08-0.37), depression (AOR, 0.51; 95% CI, 0.30-0.87), and anxiety (AOR, 0.54; 95% CI, 0.37-0.78). On the other hand, unvaccinated HCWs who were 18-29 years old and had <5 years of work experience were significantly associated with a higher risk of all psychological outcomes except anxiety and insomnia symptoms (e.g., depression among 18-29 years old: AOR, 1.83; 95% CI, 0.27-2.60; stress among those with <5 years of work experience: AOR, 2.37; 95% CI, 0.93-6.07). Participants who worked as nurses were significantly more likely to suffer from depression (AOR, 1.44; 95% CI, 0.84-2.46), anxiety (AOR, 1.42; 95% CI, 0.24-1.73), and stress (AOR, 1.55; 95% CI, 0.31-0.89) symptoms. Except for anxiety and stress symptoms, respondents who worked as frontline workers and provided direct care to infected patients were the significantly higher chance of experiencing all psychological outcomes (e.g., depression among who worked as frontline workers: AOR, 2.41; 95% CI, 0.23-3.73; insomnia among those who provide direct care to infected patients: AOR, 2.60; 95% CI, 0.34-3.06). Participants who were infected with COVID-19 had a significantly less chance of experiencing symptoms of general health problems (AOR, 0.89; 95% CI, 0.65-1.22), depression (AOR, 0.66; 95% CI, 0.48-0.92), and anxiety (AOR, 0.63; 95% CI, 0.46-0.87).

Conclusions

To control the infection and improve psychological outcomes, this study suggests emphasizing the vaccinated to unvaccinated HCWs as soon as possible. They also required special attention, health-related education, and psychological support.

Status of COVID-19 vaccination around South Asia

The public health sector and the global economy are facing the challenges of the epidemic of coronavirus disease 19 (COVID-19) since December 2019. Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is an emerging outbreak and spreading rapidly across the globe. The COVID-19 pandemic of unprecedented proportions has devastated almost all countries and pervaded globally. However, various vaccines have been developed to achieve immunity against the virus and limit transmissibility. By 18 November 2021, 52.6% of the world population got first dose of the COVID-19 vaccine. South Asia shares 15% fully vaccinated and 22.6% partially vaccinated population in the world. The 56.5% of South Asian Association Regional Cooperation (SAARC) regions, consisting of Pakistan, Afghanistan, Bangladesh, India, Sri Lanka, Nepal, Maldives, and Bhutan, got the first shot of COVID-19 vaccine, whereas 30.5% were fully vaccinated. India has the highest percentage of the vaccinated population of about 46.5% among SAARC countries. Although South Asian countries have unstable multiple socio-economic factors, including poverty, overpopulation, low literacy about medical care and medical systems, etc., the increasing trend in vaccination status has been observed. The high percentage of health budgets of SAARC countries was utilized for purchasing COVID-19 vaccines. This report observes that South Asian countries have been significantly tackling the threats of COVID-19.

A Global Map of COVID-19 Vaccine Acceptance Rates per Country: An Updated Concise Narrative Review

The delay or refusal of vaccination, which defines vaccine hesitancy, is a major challenge to successful control of COVID-19 epidemic. The huge number of publications addressing COVID-19 vaccine hesitancy necessitates periodic review to provide a concise summary of COVID-19 vaccine acceptance rates worldwide. In the current narrative review, data on COVID-19 vaccine acceptance rates were retrieved from surveys in 114 countries/territories. In East and Southern Africa (n = 9), the highest COVID-19 vaccine acceptance rate was reported in Ethiopia (92%), while the lowest rate was reported in Zimbabwe (50%). In West/Central Africa (n = 13), the highest rate was reported in Niger (93%), while the lowest rate was reported in Cameroon (15%). In Asia and the Pacific (n = 16), the highest rates were reported in Nepal and Vietnam (97%), while the lowest rate was reported in Hong Kong (42%). In Eastern Europe/Central Asia (n = 7), the highest rates were reported in Montenegro (69%) and Kazakhstan (64%), while the lowest rate was reported in Russia (30%). In Latin America and the Caribbean (n = 20), the highest rate was reported in Mexico (88%), while the lowest rate was reported in Haiti (43%). In the Middle East/North Africa (MENA, n = 22), the highest rate was reported in Tunisia (92%), while the lowest rate was reported in Iraq (13%). In Western/Central Europe and North America (n = 27), the highest rates were reported in Canada (91%) and Norway (89%), while the lowest rates were reported in Cyprus and Portugal (35%). COVID-19 vaccine acceptance rates ≥60% were seen in 72/114 countries/territories, compared to 42 countries/territories with rates between 13% and 59%. The phenomenon of COVID-19 vaccine hesitancy appeared more pronounced in the MENA, Europe and Central Asia, and Western/Central Africa. More studies are recommended in Africa, Eastern Europe and Central Asia to address intentions of the general public to get COVID-19 vaccination.

Covid-19 Vaccine Acceptance and Determinant Factors among General Public in East Africa: A Systematic Review and Meta-Analysis

Background

Vaccines are an effective and ideal solution that can reduce the burden of disease worldwide. Although vaccines are the most effective way to prevent infectious diseases. Anti-vaccine conspiracy theories impair vaccination acceptance intentions. Several studies were conducted in East Africa. However, these studies had reported inconsistent findings. Therefore, this systematic review aimed to pool the prevalence of COVID-19 vaccine acceptance and identify its determinants.

Methods

PubMed, Google Scholar, and GLOBAL HEALTH databases were used to retrieve previously published studies. All papers published in the English language up to February 28, 2022 were included. The result was written and reported according to the PRISMA updated guideline. A random-effect model was used to estimate the pooled prevalence and effect sizes. Heterogeneity was assessed using I² test statistics. Publication bias was assessed using funnel plot and egger’s test statistics. Statistical tests result at P-value<0.05 were declared as having significance.

Result: A total of 25 Cross-sectional studies with a total sample size of 33,044 were included in this study. The pooled prevalence of Covid-19 vaccine acceptance was 60.2%, (95%CI: 52.8- 67.3). Egger’s test statistics (P = 0.003) showed there is a significant publication bias. Attending above secondary school (AOR: 2.1, 95%CI: 1.37, 2.96), having good knowledge about the vaccine (AOR: 2.1, 95%CI: 1.6, 2.8), having a positive attitude towards vaccine (AOR: 3.8, 95%CI: 2.3, 6.2), history of COVID-19 infection (AOR: 2.7, 95%CI: 1.6, 4.7) and being male (AOR: 1.8, 95%CI: 1.2, 2.7) were found to have a significant association with COVID-19 vaccine acceptance.

Conclusion

The COVID-19 vaccination acceptance rate was good, but it could be improved. The findings could help governments to figure out the best way to carry out COVID-19 mass vaccination campaigns. There is a lack of data in most countries. Therefore, we suggest more studies be conducted in the future.

Global acceptance and hesitancy of COVID-19 vaccination: A narrative review

The coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a major global health threat to human civilization and has disrupted many aspects of the community around the globe. Vaccination is one of the prominent measures to control the COVID-19 pandemic. More than 120 vaccines have entered human clinical trials and at least 8 vaccines have been fully approved. However, the success of the COVID-19 vaccination programs depends on how the community accepts the vaccines. Despite COVID-19 vaccination having been initiated for a while now, more than 50% of the global population have not been vaccinated. In some low- and middle-income countries (LMICs), the vaccine coverage is less than 20%. Since the decision to accept the new vaccine is complex, understanding the factors underpinning vaccine acceptance is critical. This review aimed to summarize the COVID-19 vaccine acceptance rate around the globe as well as its associated determinants. Information from this study might be important to formulate effective strategies to increase the COVID-19 vaccine coverage, and to be able to achieve herd immunity.

A rapid review of evidence on the determinants of and strategies for COVID-19 vaccine acceptance in low- and middle-income countries

BACKGROUND

Vaccine acceptance and hesitancy among the general population and health care workers play an important role in successfully controlling the Coronavirus Disease (COVID)-19 pandemic. While there is evidence for vaccine hesitancy across the globe, wide variation in factors influencing vaccine acceptance has been reported, mainly from High-Income Countries (HIC). However, the evidence from Low- and Middle-Income Countries (LMICs) remains unclear. The objective of this review was to describe the determinants of vaccine acceptance and strategies to address those in an LMIC context.

METHODS

The World Health Organization's (WHO) Measuring Behavioral and Social Drivers of Vaccination (BeSD) Increasing Vaccination Model was employed to identify factors that influenced vaccine acceptance. All evidence related to supply-side and demand-side determinants and social and health system processes were examined. A comprehensive search for published literature was conducted in three databases and grey literature in relevant websites of government, multinational agencies, and COVID-19 resource aggregators, followed by a narrative synthesis.

RESULTS

Overall, the results showed that the vaccine acceptance rates differed across LMICs, with a wide variety of reasons cited for vaccine hesitancy. Vaccine acceptance was reportedly greater among males, those with higher education, elevated socio-economic status, the unmarried, those employed as health care workers. Evidence suggested that exposure to misinformation about COVID-19 vaccines and public concerns over the safety of vaccines may contribute to lower acceptance rates. Strategies to increase vaccine acceptance rates included direct engagement with communities through influencers, including community leaders and health experts; clear and transparent communication about COVID-19 vaccines, financial and non-financial incentives; and strong endorsement from health care workers. Trust in government was identified as a significant enabler of vaccine acceptance.

CONCLUSIONS

There is a need for measures to address public acceptability, trust and concern over the safety and benefit of approved vaccines. Local context is essential to consider while developing programs to promote vaccine uptake. The governments worldwide also need to strategize to develop plans to address the anxiety and vaccine related concerns of community regarding vaccine hesitancy. There is a need for further research to evaluate strategies to address vaccine hesitancy in LMIC.

The Acceptance Rate Toward COVID-19 Vaccine in Africa: A Systematic Review and Meta-analysis

Background: The Coronavirus Disease 2019 (COVID-19) pandemic remains serious public issue. COVID-19 vaccine is a vital strategy to prevent this critical pandemic. However, unwillingness to take this vaccine are key barriers to manage the COVID-19 pandemic. The control of this pandemic will depend principally on the people acceptance of COVID-19 vaccine. Therefore, this systematic review and meta-analysis was intended to determine the acceptance rate toward COVID-19 vaccine in Africa. Methods: African Journals OnLine, PubMed, Cochrane Review, HINARI, EMBASE, Google Scholar, Web of Science, and Scopus were used to retrieve related articles. The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines were used for this study. Random-effect model, a funnel plot, Egger's test, I 2 statistic, subgroup analysis was done. The study was performed by using a STATA version 11 statistical software. Results: A total of 22 studies with 33,912 study participants were included in this systematic review and meta-analysis. From this finding, the pooled prevalence of acceptance toward COVID-19 vaccine among adults in Africa was 48.93% (95% CI: [39.49, 58.37]). The subgroup analysis revealed that the pooled prevalence of COVID-19 vaccine acceptance among adults in Africa was highest (66.03%, 95% CI [62.84, 69.22]) in Southern Africa, and Lowest (24.28%, 95% CI [3.26, 45.30]) in Northern Africa. Conclusion: This study showed that the estimate of the pooled prevalence of acceptance toward COVID-19 vaccine among adults in Africa was very low. All concerned bodies should be actively involved to improve the acceptance rate of COVID-19 vaccine.