Knowledge and Proportion of COVID-19 Vaccination and Associated Factors Among Cancer Patients Attending Public Hospitals of Addis Ababa, Ethiopia, 2021: A Multicenter Study

COVID-19 vaccine acceptance and its association with knowledge and attitude among patients with chronic diseases in Ethiopia

COVID-19 vaccine acceptance is crucial for patients with chronic diseases, but previous studies in Ethiopia have yielded inconsistent and inconclusive findings. To fill this gap, we conducted a systematic review and meta-analysis following established guidelines. Our search included relevant articles published between 2019 and 2023 from various sources. We assessed study heterogeneity and publication bias, and performed subgroup and sensitivity analyses. Our findings indicate that the COVID-19 vaccine acceptance rate among patients with chronic diseases in Ethiopia was 55.4%. We also found that good knowledge and a favorable attitude toward the vaccine were positively associated with the acceptance rate. Based on these results, we recommend that healthcare professionals, policymakers, and healthcare guide developers should work more to address the relatively low acceptance rate. Improving the knowledge and attitude further about the COVID-19 vaccines is crucial. Future research should include community-based and qualitative studies to enhance our understanding of vaccines acceptance.

Understanding the COVID-19 vaccine uptake, acceptance, and hesitancy in Ethiopia and Tanzania: a scoping review

Background

The development and implementation of COVID-19 vaccines have been a breakthrough in controlling the pandemic. However, the vaccination coverage in most low-income countries remains very low due to critical vaccine shortage and profound hesitancy. In this scoping review, we aimed to assess COVID-19 vaccine uptake, acceptance, and hesitancy in Ethiopia and Tanzania.

Methods

The search was made in PubMed, Scopus, Embase, and Web of Science. Only original research articles focusing on vaccine acceptance and hesitancy were included. The studies selected for a full read were analysed using a thematic analysis approach.

Findings

A total of 76 articles were included in the study, with 74 of them coming from Ethiopia. The study found an increasing trend in vaccine uptake over time. However, there was also an increase in hesitancy and a decline in willingness to receive the vaccine. The willingness to receive the COVID-19 vaccine in Ethiopia ranged from 18.5 to 88%. The main reasons for "vaccine hesitancy" included fear of side effects, concerns about long-term safety, doubts about vaccine effectiveness, lack of information, vaccine fast-tracking, and religious beliefs. The study also found that younger individuals, females, and pregnant women were less willing to receive the vaccine. The adverse events reported among vaccinated individuals were mostly mild. Most of the studies operationalised vaccine acceptance-hesitancy as dichotomous variables. However, the historical, political, and socio-cultural context in which vaccine acceptance and hesitancy occur was not given any attention. While there is a good amount of data from Ethiopia describing patterns of vaccine acceptance and hesitancy among different populations over time, there is limited information from Tanzania due to the late arrival of the vaccine and limited published articles.

Conclusion

We have observed a paradox involving two seemingly conflicting trends: an increase in vaccination rates/coverage and "anti-vax." Most studies have simplified vaccine acceptance-hesitancy as an "either-or" incident, without considering its dynamic nature and occurrence within a broader political, social, and cultural context. Therefore, it is crucial to explore approaches that can enhance our understanding of the vaccine acceptance-hesitancy phenomenon, in order to improve vaccine trust and uptake.

The risk perception of COVID-19 and vaccine uptake among patients with chronic illnesses at a tertiary health facility in Nigeria

Objectives

This study assessed the risk perception of COVID-19 and the uptake of the COVID-19 vaccine among patients with chronic illnesses in a tertiary health facility.

Design

A hospital-based cross-sectional study.

Setting

The outpatient clinics in a tertiary health facility in Ilorin, North-Central Nigeria.

Participants

Patients with chronic diseases attending outpatient clinics in UITH, Ilorin from November- December 2022, excluding patients under 18 years of age, using simple random sampling by balloting for outpatient clinics, proportional allocation for participants from each clinic, and systematic sampling method for eligible respondents.

Main outcome measure

Risk perception of COVID-19 and vaccine uptake among patients with chronic illnesses in Nigeria.

Results

Respondents believed that older people were most at risk of COVID-19. Over two-thirds, 278 (69.5%) of the respondents had received the COVID-19 vaccine. Fear of the unknown (36.0%) and fear of side effects 30 (24.6%) were the most common reasons for not taking the vaccine. Those married were more likely to have received at least one dose of the vaccine (p=0.007).

Conclusion

COVID-19 risk perception and COVID-19 vaccine uptake were relatively above average. Fear of the unknown and side effects were significant reasons for not taking the vaccines.

Funding

None declared.

Effect of chronic diseases on willingness to receive the second COVID-19 vaccine booster dose among cancer patients: A multicenter cross-sectional survey in China

BACKGROUND

Cancer patients and those with chronic diseases face severe outcomes from SARS-CoV-2 infection. However, their willingness to receive a second booster dose remains low. This study identified factors affecting the willingness of cancer patients with chronic diseases (CPCD) and cancer patients without chronic diseases (non-CPCD) to receive the second COVID-19 booster vaccine dose.

METHODS

A multicenter cross-sectional study was conducted across 4 tertiary care hospitals in China. Based on the Health Belief Model, a questionnaire assessed respondents' perceptions of the second booster dose. Multivariable logistic regression analyzed factors influencing the willingness to receive a second vaccine dose.

RESULTS

Out of 171 CPCD and 722 non-CPCD, CPCD showed a higher willingness to receive the second booster dose than non-CPCD (46.8% vs 32.3%, P < .001). Factors influencing CPCD's willingness included the belief that vaccination was detrimental to cancer treatment and the perceived higher infection risk compared to healthy individuals. Fear of vaccination's negative impact on cancer treatment was the main factor affecting non-CPCD's willingness (each P < .05).

CONCLUSIONS

Different factors influenced the willingness of the 2 groups. Health education interventions should be implemented alongside vaccination, involving patients' relatives and medical staff, for both CPCD and non-CPCD populations. Additionally, health management service interventions should emphasize the benefits of vaccination for CPCD to improve their second dose coverage.

Cross-sectional survey evaluating the psychological impact of the COVID-19 vaccination campaign in patients with cancer: The VACCINATE study

The COVID-19 pandemic has profoundly impacted on cancer patients' psychological well-being and clinical status. We assessed the levels of anxiety, depression, and distress and the attitude towards COVID-19 vaccination in cancer patients, accepting vaccination at the Verona University Hospital and Camposampiero Hospital in the Veneto region. Self-reported questionnaires were administered to patients undergoing COVID-19 vaccination between March and May 2021 (first and second dose). Twenty-seven items were investigated: i) demographics/clinical characteristics; ii) anxiety, depression, and distress (Hospital Anxiety and Depression Scale-HADS-and Distress Thermometer-DT); iii) four specific items regarding awareness about infection risks, interference with anticancer treatments, and vaccine side effects. Sixty-two and 57% of the patients who accepted to be vaccinated responded to the survey in the two participating Hospitals, respectively. Mean age was 63 years (SD: 12 years; range 19-94 years), women were slightly more prevalent (57.6%), most participants were married (70%), and either worker or retired (60%). Borderline and clinical levels of anxiety were recorded in 14% and 10% of respondents; borderline and clinical levels of depression in 14% and 8%; and moderate and severe distress levels in 33% and 9%. Overall, there was high confidence that vaccination would reduce the risk of contracting COVID-19 (70%), which would make patients feel less worried about contracting the infection (60%). Fear that vaccine-related side effects would interfere with anticancer treatment and/or global health status was low (10% and 9% for items 3 and 4, respectively) and significantly associated with baseline levels of anxiety, depression, and distress at multivariate analysis. Results did not differ between the Verona and Camposampiero cohorts. During the COVID-19 vaccination campaign, adult cancer patients demonstrated high levels of confidence towards vaccination; baseline levels of anxiety, depression, and distress were the only significant predictors of reduced confidence.

Knowledge and attitude towards Covid-19 vaccine in Ethiopia: Systematic review and meta-analysis

The biggest threat to the effectiveness of vaccination initiatives is a lack of information about and trust in immunization. This study aimed to determine the prevalence of knowledge of and positive attitudes toward the COVID-19 vaccine in Ethiopia. PubMed, Web of Science, Google Scholar, EMBASE, and the Ethiopian University online library were searched. To look for heterogeneity, I² values were computed and an overall estimated analysis was carried out. Although 2108 research articles were retrieved, only 12 studies with a total of 5,472 participants met the inclusion criteria for this systematic review and meta-analysis. The pooled estimates of participants with good knowledge of and positive attitudes toward the COVID-19 vaccine were found to be 65.06% (95% CI: 56.69-73.44%; I² = 82.3%) and 60.15% (95% CI: 45.56-74.74%; I² = 89.4%), respectively, revealing that there is a gap in knowledge of and positive attitudes toward the COVID-19 vaccine in Ethiopia. A holistic and multi-sectoral partnership is necessary for a successful COVID-19 vaccination campaign.

Predictors of willingness to accept COVID-19 vaccine among adults

Background

Vaccines are an effective and ultimate solution that can decrease the burden of coronavirus disease 2019 worldwide. However, poor knowledge and unwillingness to accept this vaccine are key barriers to manage the COVID-19 pandemic in different countries including Ethiopia. Control of the pandemic will depend on the acceptance of coronavirus disease vaccine. However, there is a paucity of evidence on coronavirus disease vaccine acceptance in the study area. The current study was aimed to assess willingness to accept the COVID-19 vaccine and associated factors among adult clients attending Bule Hora University Teaching Hospital, West Guji Zone, southern Ethiopia.

Methods

An institution-based cross-sectional study was conducted among 385 study participants selected by a systematic random sampling technique. Data was collected through observation and structured questionnaires from April 10 to May 30, 2022. The collected data was cleaned and entered into EpiData 3.1 software before being exported to SPSS 25 statistical software for analysis. Bi-variable and multi-variable binary logistic regression model was used to identify the predictors of COVID-19 vaccine acceptance. The strength of association was measured using AOR with 95% confidence interval and significance was declared at p- value < 0.05.

Result

Magnitude of willingness to accept coronavirus disease-19 vaccine was 67.5% (95%Cl: 63-72). Good knowledge [AOR = 2.07, (1.17-3.64)], history of chronic disease [AOR = 2.59, (1.4-4.78)], being a government employee [AOR = 2.35 (1.1-5)], having a favorable attitude [AOR = 14.15 (5.25-37.46)], and good adherence [AOR = 1.74 (1.02-2.97)] were factors that significantly associated with willingness to accept the coronavirus disease 2019 vaccine.

Conclusion

Magnitude of willingness to accept the COVID-19 vaccine was considerable and needs to be improved. Knowledge, attitude, chronic illness, adherence, and being a government employee were factors that associated with willingness to accept the vaccine. Community awareness, advocacy, social mobilization and health education should be given at different levels.

Vaccination status and attitudes towards COVID-19 vaccination in patients undergoing active cancer treatment in a referral center in Mexico: a survey study

BACKGROUND

COVID-19 vaccination refusal/hesitancy among patients with cancer has been reported to be high. This study aimed to assess vaccination status and attitudes towards COVID-19 vaccines in patients with cancer undergoing active treatment in a single center in Mexico.

METHODS

A cross-sectional, 26-item survey evaluating vaccination status and attitudes towards COVID-19 vaccination was conducted among patients undergoing active cancer treatment. Descriptive statistics were used to analyze the sociodemographic characteristics, vaccination status, and attitudes. X2 tests and multivariate analysis were used to evaluate associations between characteristics and attitudes with adequate vaccination status.

RESULTS

Of 201 respondents, 95% had received at least one dose, and 67% had adequate COVID-19 vaccination status (≥ 3 doses). Thirty-six percent of patients had at least one reason for doubting/rejecting vaccination, and the main reason was being afraid of side effects. On multivariate analysis, age ≥ 60 years (odds ratio (OR) 3.77), mass media as main source of information on COVID-19 (OR 2.55), agreeing vaccination against COVID-19 is safe in patients with cancer (OR 3.11), and not being afraid of the composition of the COVID-19 vaccines (OR 5.10) statistically increased the likelihood of adequate vaccination status.

CONCLUSIONS

Our study shows high vaccination rates and positive attitudes towards COVID-19 vaccines, with a significant proportion of patients undergoing active cancer treatment with adequate vaccination status (≥ 3 doses). Older age, use of mass media as main source of COVID-19 information, and positive attitudes towards COVID-19 vaccines were significantly associated with a higher likelihood of adequate COVID-19 vaccination status among patients with cancer.

COVID-19 vaccine hesitancy in Ethiopia in 2021: a multicenter cross-sectional study

Introduction

Worldwide, hesitancy to be immunized against SARS-CoV-2 is the most common barrier to reducing COVID-19 incidence. Our study investigated determinants for hesitancy and will be helpful to community mobilizers, health professionals and policymakers.

Objective

To assess the prevalence and determinants of hesitancy to COVID-19 vaccination among patients attending public hospitals in South Gondar zone, Ethiopia.

Methods

A multicenter facility-based cross-sectional study was conducted from 1 November to 30 December 2021 to assess the prevalence and determinants of hesitancy to COVID-19 vaccination. Chi-square test and multivariable logistic regression methods were employed using SPSS 23. Significance level was examined using an odds ratio at 95% CI. Multi-collinearity and model fitness were also checked.

Results

A total of 415 participants were included in the study, with a questionnaire response rate of 100%. The prevalence of hesitancy to COVID-19 vaccination was 46.02%. Age of >49 years, rural residency, fear of the adverse effects of the vaccines, myths about vaccine ineffectiveness and poor practices in COVID-19 prevention were the most common determinants of hesitancy.

Conclusions

Despite increased global morbidity and mortality due to COVID-19, the prevalence of vaccine hesitancy is still high. Therefore, it is important to create awareness in highly hesitant groups.

COVID-19 vaccine acceptance in sub-Saharan African countries: A systematic review and meta-analysis

Vaccination is the most effective intervention for the primary prevention of COVID-19. Several studies have been conducted in sub-Saharan African countries on the acceptance and associated factors of COVID-19 vaccine. This review and meta-analysis aimed to recapitulate the pooled magnitude of vaccine acceptance and its favoring factors in sub-Saharan African countries. PUBMED, MEDLINE, Science Direct, Web of Science, and SCOPUS were the main databases searched from 15 March to 5 June 2022; and all the articles written in the English language were included. Also, some articles were retrieved from biomedical peer-reviewed journal sites and Google scholar. The quality of thirty-five selected articles was evaluated using an adapted scale for evaluating cross-sectional studies based on the Newcastle-Ottawa Scale. The result of the review and meta-analysis revealed that COVID-19 vaccine acceptance rate varied across studies. In a pooled analysis, factors such as; higher-level perception of infection risk (OR (95% CI (2.7 (2.1, 3.4))), perceived vaccine safety (13.9 (9.2, 20.9)), virus-related good knowledge (2.7 (2.3, 3.2)) and appropriate attitude (5.9 (4.4, 7.8)), adherence to safety precautions (5.5 (4.8, 6.2)), and infection experience (4.4 (2.8, 6.9)) were positively affected the COVID-19 vaccine acceptance. Also, vaccine acceptance was found to be high among males and chronically ill individuals. Thus, understanding factors that enhance vaccine acceptance would support planners to augment vaccine uptake in the region.

COVID-19 vaccine hesitancy among adults in Hawassa City Administration, Sidama Region, Ethiopia: A community-based study

Objective

The COVID-19 vaccine is one of the key measures to control the disease. However, some people are hesitant to take the vaccine. The objective of this study was to assess COVID-19 vaccine hesitancy and associated factors among adults in Hawassa City Administration, South Ethiopia.

Method

From March 1 to 30, 2022, we conducted a community-based cross-sectional study among randomly selected 622 adults in Hawassa City Administration. A multi-stage sampling technique was used to recruit the study participants. Data were collected through a pretested structured questionnaire that was administered by four trained high school graduates. Data entry and analysis were done using the SPSS version 20 statistical package. Descriptive statistics and logistic regression analysis were performed. Statistically significant associations were reported at p-value <0.05.

Result

Among the participants, 400 of them (64.3%) had a high level of knowledge about the COVID-19 vaccine) and 425 of them (68.3%) had a positive attitude toward the COVID-19 vaccine. The level of vaccine hesitancy was 165 (26.5%) and vaccine acceptance was 457 (73.5%). The main reason for willingness to take the vaccine was to protect oneself from COVID-19 (364 participants, 58.5%), and for unwillingness, it was fear of the vaccine (154 participants, 24.8%). Mass media was the main source of information about the vaccine (472 participants, 75.9%). Age (adjusted odds ratio (AOR): 2.1, 95% CI: 1.2-3.7), religion (AOR: 2.6, 95% CI: 1.1-5.9), history of COVID-19 disease (AOR: 4.6, 95% CI: 1.4-14.9), knowledge related to the COVID-19 vaccine (AOR: 1.9, 95% CI: 1.2-3.1), and attitude toward the COVID-19 vaccine (AOR: 13.2, 95% CI: 8.3-20.9) were factors associated with vaccine hesitancy.

Conclusion

A low proportion of COVID-19 vaccine hesitancy was observed among our study participants. Improving people's awareness could help to improve vaccine acceptance. It is important to focus interventions on the identified risk factors of vaccine hesitancy.

Attitude and level of COVID-19 vaccination and its determinants among patients with chronic disease visiting Debre Tabor Comprehensive Specialized Hospital, Northwest Ethiopia: A cross-sectional study

INTRODUCTION

Coronavirus disease is a fatal viral disease caused by severe acute respiratory syndrome coronavirus 2. This study was aimed to assess the attitude, level of COVID-19 vaccine uptake, and its determinants among patients with chronic diseases visiting Debre Tabor Comprehensive Specialized Hospital, Northwest Ethiopia.

METHODS

An institutional-based cross-sectional study was conducted among 422 randomly selected patients with chronic disease visiting Debre Tabor Comprehensive Specialized Hospital from February 1 to March 30, 2022. Bivariable and multivariable binary logistic regression analyses were done to identify associations between dependent and independent variables.

RESULTS

Among all participants, only 29.6% of patients were vaccinated with any of the COVID-19 vaccines at least one dose. Age from 31 to 40 years (AOR = 6.26, 95% CI: 2.69-14.56), attended collage and above (AOR = 6.3, 95% CI: 1.37, 28.68), positive attitude towards COVID-19 vaccine (AOR = 9.07, 95% CI: 4.51-18.22), good knowledge (AOR = 7.63, 95% CI: 1.08-16.85), history of COVID-19 (AOR = 4.33, 95% CI: 1.85-10.17), family history of COVID-19 (AOR = 3.99, 95% CI = 1.89-8.48), ever been tested for COVID-19 (AOR = 0.33, 95% CI: 0.15-0.74) were determinant factors for COVID-19 vaccine uptake.

CONCLUSION

COVID-19 vaccine uptake among patients with chronic disease was very low. The main reasons for not being vaccinated were doubts about vaccine efficacy, the vaccine may cause disease by itself, and fear of adverse effects. Therefore, different stakeholders should enforce vaccine uptake and awareness creation.

Experiences of cancer care in COVID-19: A longitudinal qualitative study

PURPOSE

This study aimed to explore the cancer care experiences of people living with and beyond cancer during COVID-19 in Ireland.

METHODS

The study adopted a longitudinal qualitative design using semi-structured interviews with sixteen participants. Interviews were undertaken on three occasions over six months (January-June 2021). The National Comprehensive Cancer Network Distress Thermometer (NCCN DT), and Connor-Davidson-Resilience Scale (CD-RISC2) were also used as part of the interviews to measure distress and resilience. Thematic analysis of interview data was conducted and participants' self-rating for distress and resilience was analysed using descriptive statistics.

RESULTS

Sixteen patients participated. The findings revealed participants' constant fear of COVID-19 over time and efforts to stay safe by following the 'rules'. Isolation was a common experience as COVID-19 restrictions resulted in being alone when attending the hospital for treatment and limited support from family and friends. Telephone follow-up was limited in terms of support and patients' opportunity to ask questions. For a minority, COVID-19 restrictions meant they were 'not missing out'. On average, participants reported moderate to high levels of resilience at all time points. Distress scores were low but trended upwards from T1 to T2.

CONCLUSIONS

The findings highlight the need to avoid restrictions on carers accompanying their close relatives to the hospital for treatment. An evaluation of the effects of the rapid introduction of telephone follow-up on patient outcomes is warranted.

COVID-19 vaccination perception and uptake among cancer patients in Guangzhou, China

Patients with cancer are considered at high risk of COVID-19 related complications with higher mortality rates than healthy individuals. This study investigated the perception, acceptance, and influencing factors of COVID-19 vaccination among cancer patients in Guangzhou, China. A cross-sectional survey was conducted in Guangzhou, China from August to November 2021 in two tertiary medical centers. Outpatients were recruited through hospital posters to complete a questionnaire including demographics, medical history, knowledge, and attitude toward COVID-19 vaccines and COVID-19 vaccination status. Chi-square tests and multivariable logistic regression were used to analyze predictors for acceptance of COVID-19 vaccination. In total, only 75 out of 343 patients (21.87%) had received at least one dose of COVID-19 vaccine. Twenty-one patients (6.12%) had received a recommendation about COVID-19 vaccination from their physicians. Patients who were recommended by physicians to get vaccinated (aOR = 11.71 95% CI: 2.71-50.66), with a monthly income of more than CNY 5000 (aOR = 3.94, 95% CI: 1.88-8.26) were more likely to have received COVID-19 vaccination. Cancer patients who had been diagnosed for more than one year (aOR = 0.21, 95% CI: 0.09-0.51), had received multiple cancer treatment strategies (aOR = 0.34, 95% CI: 0.16-0.74), worried about the safety of COVID-19 vaccines (aOR = 0.21, 95% CI: 0.11-0.40), were less likely to have received COVID-19 vaccination. COVID-19 vaccination uptake among cancer patients was insufficient. The proportion of cancer patients receiving vaccination recommendations from physicians remains inadequate. Physicians are expected to play an essential role in patients' knowledge of the safety and effectiveness of COVID-19 vaccines.

Vaccine-Related adverse events following AZD1222 (ChAdOx1-nCoV-19) Covid-19 vaccine in solid malignancy patients receiving cancer treatment, as compared to age-matched healthy controls

The study aimed to evaluate vaccine-related adverse events (VRAEs) following ChAdOx1-nCoV-19 vaccine in solid cancer patients receiving treatment compared to healthy controls. 399 cancer patients and 90 healthy volunteers were enrolled. In the overall population, the incidence of VRAEs was significantly lower in cancer patients than in healthy volunteers (57% vs 80%, P < .001). Because the mean age of the cancer patients was higher than the healthy volunteers (59 vs 48 years, P < .001), we analyzed age-matched comparison and found that there was no significant difference of VRAEs between two groups (74% vs 79%, P .32). Most VRAEs were of mild severity in both groups. The most common local VRAE was pain at the injection site in both groups, and the most common systemic VRAE was fatigue in the cancer cohort, while myalgia was the most common VRAE among the healthy controls. In the cancer cohort, fever was the only VRAE that led to interruption of the cancer treatment (in two cases). Among the cancer treatment types, patients undergoing chemotherapy-containing regimens had a lower likelihood of experiencing VRAEs. In summary, the overall incidence of VRAEs following ChAdOx1-nCoV-19 vaccine in actively treated cancer patients was comparable to healthy controls after adjusting for age. The VRAEs that occurred rarely interfered with the cancer treatment. These findings substantiate that vaccination with AZD1222 is safe in cancer patients undergoing treatment.

COVID-19 vaccine acceptance and hesitancy among patients with cancer: a systematic review and meta-analysis

OBJECTIVES

Patients with cancer are more vulnerable to COVID-19 morbidity and morbidity than the general population and have been prioritised in COVID-19 vaccination programmes. This study aims to investigate COVID-19 vaccine acceptance and hesitancy among patients with cancer.

STUDY DESIGN

This was a systematic review and meta-analysis.

METHODS

PubMed, ScienceDirect and the Cochrane COVID-19 study registry were searched in addition to secondary literature using a predefined search method. Two authors independently performed the study identification, screening and eligibility assessment. This study followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses 2020 guidelines and Joanna Brides' Institute quality appraisal tools.

RESULTS

A total of 29 studies and reports were selected for the final review. The pooled prevalence of vaccine acceptance was 59% (95% confidence interval 52-67%, I2: 99%). Concerns about vaccine-related side-effects, uncertainty about vaccine efficacy and safety, ongoing active anticancer therapies and scepticism about rapid vaccine development were the leading causes for vaccine hesitancy. Female gender and undergoing active anticancer treatments were significant factors associated with COVID-19 vaccine hesitancy. Early cancer stages (stages I and II) and good compliance with prior influenza vaccinations were significant factors associated with the acceptance of the COVID-19 vaccine.

CONCLUSIONS

Many patients with cancer are hesitant about COVID-19 vaccination. Well-designed problem-based educational interventions will increase compliance with COVID-19 vaccination.

Prevalence and Assessment of Factors Associated with COVID-19 Vaccine Hesitancy in an Ethnic Minority Oncology Patient Population

BACKGROUND

Complicating the COVID-19 pandemic are the healthcare disparities experienced by ethnic minorities, especially those with comorbidities including cancer. The introduction of COVID-19 vaccines has been instrumental in blunting the morbidity and mortality from the pandemic; however, vaccine hesitancy, particularly among ethnic minorities, has been a major concern. Thus, we sought to evaluate the knowledge and perspectives of COVID-19 and vaccines among our ethnic minority cancer patient population.

METHODS

Following an IRB approved protocol, questionnaires were completed by patients in a predominantly ethnic minority population at a single institution between 1 February and 30 June 2021. Included were any adult cancer patients with either a solid or hematologic malignancy.

RESULTS

Among the 84 patients that were offered the questionnaires, 52 patients responded, with a median age of 63.5 years. Overall, 36% were non-Hispanic Blacks and 30% were Hispanics; 65% were receiving active treatment for their cancer. Seventy-nine percent believed COVID-19 to be dangerous or harmful to them, 61% were concerned about the side effects, yet 65% considered COVID-19 vaccines as safe. Among the seven patients that refused the vaccine, (71%, n = 5) cited side effects and/or (57%, n = 4) believed that the vaccine was not needed. Overall, there was a significantly higher chance of being vaccinated if patients were receiving active cancer treatment, believed COVID-19 was harmful, or that the vaccine was safe, and knew COVID-19 was a virus.

CONCLUSIONS

This exploratory study demonstrates that most ethnic minority cancer patients are receptive to vaccines, with a majority being vaccinated. However, we also discovered various reasons why this group of patients may not want be vaccinated, including concerns about side effects and perception that COVID-19 is not harmful. These findings can help us further understand the complex nature of vaccine hesitancy in ethnic minority cancer patients, and aid in developing future vaccine awareness strategies as the COVID-19 pandemic continues to evolve.

COVID-19 Vaccine Acceptance Level in Ethiopia: A Systematic Review and Meta-Analysis

Background

The coronavirus disease 2019 pandemic has had a devastating impact on the everyday lives of the world's population and to this end, the development of curative vaccines was upheld as a welcome panacea. Despite the undeniable negative impact of the disease on human beings, lower than expected proportions of people have taken up the vaccines, particularly in the developing non-Western world. Ethiopia represents an interesting case example, of a nation where COVID-19 vaccine acceptance levels have not been well investigated and a need exists to assess the overall level of vaccine acceptance.

Methods

A systematic multidatabase search for relevant articles was carried out across Google Scholar, Web of Science, Science Direct, Hinari, EMBASE, Boolean operator, and PubMed. Two reviewers independently selected, reviewed, screened, and extracted data by using a Microsoft Excel spreadsheet. The Joanna Briggs Institute prevalence critical appraisal tools and the modified NewcastleOttawa Scale (NOS) were used to assess the quality of evidence. All studies conducted in Ethiopia, reporting vaccine acceptance rates were incorporated. The extracted data were imported into the comprehensive meta-analysis version 3.0 for further analysis. Heterogeneity was confirmed using Higgins's method, and publication bias was checked by using Beggs and Eggers tests. A random-effects meta-analysis model with a 95% confidence interval was computed to estimate the pooled prevalence. Furthermore, subgroup analysis based on the study area and sample size was done. Results and Conclusion. After reviewing 67 sources, 18 articles fulfilled the inclusion criteria and were included in the meta-analysis. The pooled prevalence of COVID-19 vaccine acceptance in Ethiopia was 57.8% (95% CI: 47.2%–67.8%). The level of COVID-19 vaccine acceptance in Ethiopia was at a lower rate than necessary to achieve herd immunity. The highest level of vaccine acceptance rate was reported via online or telephone surveys followed by the southern region of Ethiopia. The lowest vaccine acceptance patterns were reported in Addis Ababa.

COVID-19 vaccine hesitancy in Africa: a scoping review

Background

Vaccination against the novel coronavirus is one of the most effective strategies for combating the global Coronavirus disease (COVID-19) pandemic. However, vaccine hesitancy has emerged as a major obstacle in several regions of the world, including Africa. The objective of this rapid review was to summarize the literature on COVID-19 vaccine hesitancy in Africa.

Methods

We searched Scopus, Web of Science, African Index Medicus, and OVID Medline for studies published from January 1, 2020, to March 8, 2022, examining acceptance or hesitancy towards the COVID-19 vaccine in Africa. Study characteristics and reasons for COVID-19 vaccine acceptance were extracted from the included articles.

Results

A total of 71 articles met the eligibility criteria and were included in the review. Majority (n = 25, 35%) of the studies were conducted in Ethiopia. Studies conducted in Botswana, Cameroun, Cote D’Ivoire, DR Congo, Ghana, Kenya, Morocco, Mozambique, Nigeria, Somalia, South Africa, Sudan, Togo, Uganda, Zambia, Zimbabwe were also included in the review. The vaccine acceptance rate ranged from 6.9 to 97.9%. The major reasons for vaccine hesitancy were concerns with vaccine safety and side effects, lack of trust for pharmaceutical industries and misinformation or conflicting information from the media. Factors associated with positive attitudes towards the vaccine included being male, having a higher level of education, and fear of contracting the virus.

Conclusions

Our review demonstrated the contextualized and multifaceted reasons inhibiting or encouraging vaccine uptake in African countries. This evidence is key to operationalizing interventions based on facts as opposed to assumptions. Our paper provided important considerations for addressing the challenge of COVID-19 vaccine hesitancy and blunting the impact of the pandemic in Africa.

Supplementary Information

The online version contains supplementary material available at 10.1186/s41256-022-00255-1.

First COVID-19 Booster Dose in the General Population: A Systematic Review and Meta-Analysis of Willingness and Its Predictors

The emergence of breakthrough infections and new highly contagious variants of SARS-CoV-2 threaten the immunization in individuals who had completed the primary COVID-19 vaccination. This systematic review and meta-analysis investigated, for the first time, acceptance of the first COVID-19 booster dose and its associated factors among fully vaccinated individuals. We followed the PRISMA guidelines. We searched Scopus, Web of Science, Medline, PubMed, ProQuest, CINAHL and medrxiv from inception to 21 May 2022. We found 14 studies including 104,047 fully vaccinated individuals. The prevalence of individuals who intend to accept a booster was 79.0%, while the prevalence of unsure individuals was 12.6%, and the prevalence of individuals that intend to refuse a booster was 14.3%. The main predictors of willingness were older age, flu vaccination in the previous season, and confidence in COVID-19 vaccination. The most important reasons for decline were adverse reactions and discomfort experienced after previous COVID-19 vaccine doses and concerns for serious adverse reactions to COVID-19 booster doses. Considering the burden of COVID-19, a high acceptance rate of booster doses could be critical in controlling the pandemic. Our findings are innovative and could help policymakers to design and implement specific COVID-19 vaccination programs in order to decrease booster vaccine hesitancy.

Prevalence and Determinants of COVID-19 Vaccine Hesitancy Among the Ethiopian Population: A Systematic Review

Introduction

Although vaccination is the most effective way to end the COVID-19 pandemic, there are growing concerns that vaccine hesitancy may undermine its effectiveness. In Ethiopia, vaccine hesitancy forms a major challenge to the uptake of COVID-19 vaccines. This systematic review examined the prevalence and determinants of the COVID-19 vaccine hesitancy among the Ethiopian population.

Methods

A systematic search of articles was conducted in PubMed, EBSCO, Google Scholar, and Semantic Scholar. Studies that evaluated the prevalence and determinants of COVID-19 vaccine hesitancy in Ethiopia were included. The identified determinants of COVID-19 vaccine hesitancy were analyzed based on the frequency of occurrence in the included studies.

Results

The overall COVID-19 vaccine hesitancy level in the Ethiopian population ranged from 14.1% to 68.7%. The high COVID-19 vaccine hesitancy rate observed in this study was due to contextual factors, individual factors, and vaccine-specific factors. Young age, female sex, living in rural areas, lack of adequate information, and lower education are the most common contextual determinants of the COVID-19 vaccine hesitancy. Lack of awareness about the COVID-19 vaccine, low risk of COVID-19, poor adherence to COVID-19 prevention strategies, and negative attitude towards the COVID-19 vaccine are the most frequently reported personal factors. Common vaccine-specific determinants of COVID-19 vaccine hesitation are the side effects of the vaccine and doubts about its effectiveness of the vaccine.

Conclusion

Our review showed that COVID-19 vaccine hesitancy remains highly prevalent and varied across regions of Ethiopia, with a wide variety of factors associated with it. Potential interventions on the benefits of vaccination and the adverse effects of vaccine rejection are crucial to enhance COVID-19 vaccine uptake among the Ethiopian population.

Determinants of COVID-19 vaccine acceptance in Ethiopia: A systematic review and meta-analysis

BACKGROUND

Vaccination is the promising strategy to control the coronavirus disease 2019 (COVID-19) pandemic. However, the success of this strategy will rely mainly on the rate of vaccine acceptance among the general population. Therefore, this systematic review and meta-analysis aimed to estimate the pooled prevalence of COVID-19 vaccine acceptance and its determinants in Ethiopia.

METHODS

We searched PubMed, Scopus, Google Scholar, African Journals Online, and Web of Sciences database to retrieve related articles. Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines were used for this study. Funnel plot and Eggers test were done to assess publication bias. Cochrane Q-test and I2 statistic were done to chick evidence of heterogeneity. Subgroup analysis was computed based on the study region and the study population. Data were extracted using a Microsoft Excel spreadsheet and analyzed using STATA version 14 statistical software. Weighted inverse variance random effect model was run to estimate the pooled prevalence of COVID-19 vaccine acceptance.

RESULTS

A total of 12 studies with 5,029 study participants were included. The pooled prevalence of COVID-19 vaccine acceptance in Ethiopia was 51.64% (95%CI; 43.95%-59.34%). Being male (AOR = 4.46, 1.19-16.77, I2 = 88%), having secondary and above educational status (AOR = 3.97, 1.94-8.12, I2 = 69%), good knowledge (AOR = 3.36, 1.71-6.61, I2 = 93%), and positive attitude (AOR = 5.40, 2.43-12.00, I2 = 87%) were determinants of COVID-19 vaccine acceptance in Ethiopia.

CONCLUSION

The pooled prevalence of COVID-19 vaccine acceptance was low. Being male, having secondary and above educational status, good knowledge, and positive attitude were the determinants of COVID-19 vaccine acceptance. High level of COVID-19 vaccine acceptance among the general population is crucial to achieve herd immunity in the community. Therefore, policymakers, vaccine campaign program planners, and stakeholders should target to improve public awareness of vaccination that enhances vaccine acceptance and in turn helps to control the pandemic.

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.

Acceptance of COVID-19 Vaccine and Its Associated Factors Among Ethiopian Population: A Systematic Review

INTRODUCTION

Coronavirus disease 2019 (COVID-19) is a global health threat. Millions of lives were lost to COVID-19 and it has caused a substantial economic crisis throughout the world. The development of coronavirus vaccines has pinned a new hope in combating the pandemic. The success of vaccination and development of herd immunity highly depend on the willingness to be vaccinated, not merely on the availability of a vaccine. This review aims to provide comprehensive evidence on acceptance of COVID-19 vaccine and its associated factors in Ethiopia.

METHODS

Literature searching was done using PubMed, Google scholar and Science direct databases. Studies conducted in Ethiopia, published in English language from inception until January 9, 2022 were included. Retrieved articles were screened based on titles, abstracts and full text reading to identify studies that met the inclusion criteria. About 21 eligible studies were included in this systematic review. The data were extracted using a data extraction checklist.

RESULTS

A total of 2058 records were retrieved, of which 21 were eligible for this systematic review. All of the articles were cross-sectional studies published in 2021. In Ethiopia, the level of COVID-19 vaccine acceptance ranged from 31.4% to 92.33%. The vaccine acceptance level was significantly associated with age groups, sex, educational status, perceived susceptibility, perceived benefit, knowledge about COVID-19 vaccine, and other socio-demographic factors.

CONCLUSION

A significant portion of the studies revealed vaccine acceptance level was low. Variation of vaccine acceptance was associated with socio-demographic factors (age, sex, educational status, etc.), information-related factors, and other health-related behaviors. Dissemination of clear and adequate information concerning the vaccine might be the required prior activity to increase acceptance of the vaccine. Hence, there should be a coordinated effort to halt the pandemic through increasing the acceptance of COVID-19 vaccine.