Factors Influencing COVID-19 Vaccination Demand and Intent in Resource-Limited Settings: Based on Health Belief Model

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.

Optimization Modeling for Pandemic Vaccine Supply Chain Management: A Review and Future Research Opportunities

During various stages of the COVID-19 pandemic, countries implemented diverse vaccine management approaches, influenced by variations in infrastructure and socio-economic conditions. This article provides a comprehensive overview of optimization models developed by the research community throughout the COVID-19 era, aimed at enhancing vaccine distribution and establishing a standardized framework for future pandemic preparedness. These models address critical issues such as site selection, inventory management, allocation strategies, distribution logistics, and route optimization encountered during the COVID-19 crisis. A unified framework is employed to describe the models, emphasizing their integration with epidemiological models to facilitate a holistic understanding. This article also summarizes evolving nature of literature, relevant research gaps, and authors' perspectives for model selection. Finally, future research scopes are detailed both in the context of modeling and solutions approaches.

Parents' willingness to pay for their children's COVID-19 vaccine in Taiwan, China: A cross-sectional study

Most COVID-19 studies aim to assess factors influencing willingness to pay for vaccines between the public and medical staff. However, few studies focus on parents' willingness to pay for their children's COVID-19 vaccine. The current study aimed to assess parents' willingness to pay for their children's vaccination against COVID-19 and its influencing factors. This population-based cross-sectional study used a self-administered questionnaire. The inclusion criterion was parents with at least one child younger than 18 years. The final analysis included 384 valid data points. A total of 89.1% of the parents indicated that they are willing to pay for their children's vaccination against COVID-19. Among them, both fathers' and mothers' willingness to pay for their children's COVID-19 vaccine was 89.6%. The mean and median willingness to pay were% would pay for their children. Excluding other confounding factors, willingness to pay for the COVID-19 vaccine for themselves and hesitation to vaccinate their children were significantly associated with parents' willingness to pay for their children's COVID-19 vaccine. We found that 89.1% of the parents in Taiwan would pay for their children's COVID-19 vaccine. Parents' willingness to pay for themselves and hesitation to vaccinate their children were associated with willingness to pay. Reducing hesitation about vaccines and developing policies for vaccine payment may have a positive impact on willingness to pay for vaccines and promoting COVID-19 vaccination.

Micropollutant Removal Efficiency of Advanced Wastewater Treatment Plants: A Systematic Review

Introduction

Various review papers have been published regarding the occurrence and fate of micropollutants (MPs). MPs in the aquatic environment are still not well reviewed to generate comprehensive summaries with a special focus on their removal from wastewater using conventional and advanced treatment processes. Therefore, this review aimed to provide a synopsis of the efficiency of the advanced wastewater treatment plants in the removal of MPs.

Materials and methods

A systematic search of published literature was conducted on the National Library of Medicine (NLM) database, Web of Science, Joanna Briggs Institute (JBI) database, Scopus, and Google Scholar, based on studies with evidence of removal of MPs in the wastewater treatment process. Screening of the published articles was made using pre-specified inclusion and exclusion criteria.

Results

Amongst the 1545 studies searched, 21 full-length articles were analyzed that showed 7 treatment options related to the removal of MPs from wastewater. MPs from wastewater effluents were successfully and effectively removed by advanced treatment techniques. Advanced Oxidation Processes (AOPs), membrane processes, and adsorption processes have all been shown to be potential solutions for the removal of MPs in advanced treatment plants (WWTPs). But, there are 2 critical issues associated with the application of the advanced treatment options which are high operational cost and the formation of dangerous by-products and concentrated residues.

Conclusion

This study identified that the removal of MPs using WWTPs was commonly incomplete with varying removal efficiency. Therefore, the adaptation and scale-up of the cost-effective and efficient combined wastewater treatment technology are vital to creating an absolute barrier to MPs emissions.

Barriers and Intention to Get Vaccinated for COVID-19 and Associated Factors Among Adults in Southwest Ethiopia: A Theory of Planned Behavior Approach

Background

Different vaccines have been approved for use against coronavirus disease and distributed globally in different regions. Efforts should be made on the vaccination to control the spread and impacts of the coronavirus pandemic. However, the general population's attitudes and intention to uptake coronavirus disease 2019 (COVID-19) vaccinations were poor.

Objective

This study aimed to assess the barriers to and intention to be vaccinated against COVID-19 and the associated factors among adults in the Jimma zone, Ethiopia.

Methods

A community-based cross-sectional study with multistage sampling was conducted with 621 participants from 16 April to 17 May 2022. Multivariable logistic regression was used to identify factors associated with the outcome of interest. Statistical p-value ≤0.05 was set at p ≤ 0.05. Qualitative data were supplemented with quantitative results.

Results

The majority of the study participants (382 [61.5%]) intended to uptake the COVID-19 vaccine. In this study, travel history (Adjusted Odds Ratio (AOR) = 2.18, 95% CI 1.23-3.87), vaccination history (AOR = 2.64, 95% CI 1.69-4.12), perceptions of infection prevention for COVID-19 (AOR = 1.97, 95% CI 1.28-3.03), subjective norm (AOR = 2.27, 95% CI 1.52-3.39), and perceived behavioral control (PBC) (AOR = 2.30, 95% CI 1.55-3.41) were significantly associated with the intention to be vaccinated against COVID-19.

Conclusion

More than half of the adult participants intended to be vaccinated against COVID-19. The study participant's traveling history, vaccination history, perception of infection prevention for COVID-19, subjective norms, and Perceived Behavioral Control were significantly associated with the intention to be vaccinated.

COVID-19 vaccine hesitancy in Latin America and Africa: a scoping review

Vaccination has played an important role in the containment of COVID-19 pandemic advances. However, SARS-CoV-2 vaccine hesitancy has caused a global concern. This scoping review aims to map the scientific literature on COVID-19 vaccine hesitancy in Latin America and Africa from a Global Health perspective, observing the particularities of the Global South and using parameters validated by the World Health Organization (WHO). The review reporting observes the recommendations of the PRISMA for Scoping Reviews (PRISMA-ScR) model. Search was conducted in PubMed, Scopus, Web of Science, and Virtual Health Library (VHL) databases, selecting studies published from January 1, 2020 to January 22, 2022. Selected studies indicate that COVID-19 vaccine hesitancy involves factors such as political scenario, spread of misinformation, regional differences in each territory regarding Internet access, lack of access to information, history of vaccination resistance, lack of information about the disease and the vaccine, concern about adverse events, and vaccine efficacy and safety. Regarding the use of conceptual and methodology references from the WHO for vaccine hesitancy, few studies (6/94) use research instruments based on these references. Then, the replication in Global South of conceptual and methodological parameters developed by experts from the Global North contexts has been criticized from the perspective of Global Health because of it may not consider political and sociocultural particularities, the different nuances of vaccine hesitancy, and issues of access to vaccines.

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.

How Well the Constructs of Health Belief Model Predict Vaccination Intention: A Systematic Review on COVID-19 Primary Series and Booster Vaccines

This systematic review synthesizes the findings of quantitative studies examining the relationships between Health Belief Model (HBM) constructs and COVID-19 vaccination intention. We searched PubMed, Medline, CINAHL, Web of Science, and Scopus using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and identified 109 eligible studies. The overall vaccination intention rate was 68.19%. Perceived benefits, perceived barriers, and cues to action were the three most frequently demonstrated predictors of vaccination intention for both primary series and booster vaccines. For booster doses, the influence of susceptibility slightly increased, but the impact of severity, self-efficacy, and cues to action on vaccination intention declined. The impact of susceptibility increased, but severity's effect declined sharply from 2020 to 2022. The influence of barriers slightly declined from 2020 to 2021, but it skyrocketed in 2022. Conversely, the role of self-efficacy dipped in 2022. Susceptibility, severity, and barriers were dominant predictors in Saudi Arabia, but self-efficacy and cues to action had weaker effects in the USA. Susceptibility and severity had a lower impact on students, especially in North America, and barriers had a lower impact on health care workers. However, cues to action and self-efficacy had a dominant influence among parents. The most prevalent modifying variables were age, gender, education, income, and occupation. The results show that HBM is useful in predicting vaccine intention.

Implications for COVID-19 vaccine uptake: A systematic review

BACKGROUND

Globally, increasing coronavirus disease (COVID-19) vaccination coverage remains a major public health concern in the face of high rates of COVID-19 hesitancy among the general population. We must understand the impact of the determinants of COVID-19 vaccine uptake when designing national vaccination programmes. We aimed to synthesise nationwide evidence regarding COVID-19 infodemics and the demographic, psychological, and social predictors of COVID-19 vaccination uptake.

METHODS

We systematically searched seven databases between July 2021 and March 2022 to retrieve relevant articles published since COVID-19 was first reported on 31 December 2019 in Wuhan, China. Of the 12,502 peer-reviewed articles retrieved from the databases, 57 met the selection criteria and were included in this systematic review. We explored COVID-19 vaccine uptake determinants before and after the first COVID-19 vaccine roll-out by the Food and Drug Authority (FDA).

RESULTS

Increased COVID-19 vaccine uptake rates were associated with decreased hesitancy. Concerns about COVID-19 vaccine safety, negative side effects, rapid development of the COVID-19 vaccine, and uncertainty about vaccine effectiveness were associated with reluctance to be vaccinated. After the US FDA approval of COVID-19 vaccines, phobia of medical procedures such as vaccine injection and inadequate information about vaccines were the main determinants of COVID-19 vaccine hesitancy.

CONCLUSION

Addressing effectiveness and safety concerns regarding COVID-19 vaccines, as well as providing adequate information about vaccines and the impacts of pandemics, should be considered before implementation of any vaccination programme. Reassuring people about the safety of medical vaccination and using alternative procedures such as needle-free vaccination may help further increase vaccination uptake.

Effect of Health Insurance Uptake on Hesitancy toward COVID-19 Vaccines in Nigeria: A Recursive Bivariate Probit and Decomposition Estimation

Moral hazard remains one of the major challenges of health insurance administration. This paper recursively analyzed the effect of health insurance on the willingness to take COVID-19 vaccines in Nigeria. The data comprised 1892 unvaccinated respondents in the 2021/2022 National Longitudinal Phone Survey (NLPS). The data were analyzed with Coban's recursive probit regression and decomposition approaches. The results revealed that 5.87% were health insured, and 7.93% were willing to take COVID-19 vaccines. Health insurance uptake significantly increased (p < 0.05) with an adult being the decision-maker on vaccination, requiring family planning, and urban residence, while it reduced with loss of jobs and residence in the southeast and southwest zones. In addition, health insurance significantly (p < 0.01) increased the willingness to take COVID-19 vaccines, along with each adult, all adults, and households' heads being the major vaccination decision-makers, loss of jobs, and support for making COVID-19 vaccines compulsory. The average treatment effects (ATEs) and average treatment effect on the treated (ATET) of health insurance were significant (p < 0.01), with positive impacts on willingness to be vaccinated. It was concluded that policy reforms to promote access to health insurance would enhance COVID-19 vaccination in Nigeria. In addition, hesitancy toward COVID-19 vaccines can be reduced by targeting adults and household heads with adequate information, while health insurance uptake should target southern states and rural areas.

COVID-19 vaccine acceptance in the second wave of the pandemic among university students in Ethiopia: application of the health belief model

Background

The first case of COVID-19 virus was reported in Africa on 14 February 2020. The pandemic became more aggressive in the continent during the second wave than the first wave. Promoting vaccination behavior is an unparalleled measure to curb the spread of the pandemic. Regarding this, the health belief model (HBM) is the major model for understanding health behaviors. This study aimed to examine predictors of intended COVID-19 vaccine acceptance in the second wave of the pandemic among university students in Ethiopia using HBM.

Methods

A cross-sectional study was conducted among 423 randomly selected medical and health science students at the University of Gondar from 21 August to 15 September 2020. Analysis of data was performed using STATA 14.0. Linear regression analysis was applied and a p value of less than 0.05 was used to declare statistical significance.

Results

Among the total participants, 293 [72.2% (95.0%: CI: 67.2-76.8)] of them scored above the mean of COVID-19 vaccine acceptance. HBM explained nearly 46.3% (adjusted R2 = 0.463) variance in intention to receive the COVID-19 vaccine. Year of study (β = 0.288; 95% CI: 0.144-0.056), using social media (β = 0.58; 95% CI: 1.546-2.804), existing chronic disease (β = 0.12; 95% CI: 0.042-0.433), perceived overall health condition (β = 0.117; 95% CI: 0.307-0.091), perceived susceptibility (β = 0.58; 95% CI: 1.546-2.804), perceived benefit (β = 0.338; 95% CI: 1.578-2.863), and cues to action (β = 0.49; 95% CI: 0.388-0.99) were significantly associated with intended COVID-19 vaccine acceptance at p value < 0.5.

Conclusion

Approximately, three-quarters of the participants were above the mean score of COVID-19 vaccine acceptance, which is higher compared to previous reports in resource-limited settings. Interventions in this study setting chould include placing emphasis on the risks of acquiring COVID-19, enhancing perceived benefits of COVID-19 vaccination and improving cues to action by advocating COVID-19 vaccination. Our findings also implied that social media health campaigns are significant factor in COVID-19 vaccination behavioral change in this study setting.

Assessing the spatial variability of raising public risk awareness for the intervention performance of COVID-19 voluntary screening: A spatial simulation approach

The rapid spread of a (re)emerging pandemic (e.g., COVID-19) is usually attributed to the invisible transmission caused by asymptomatic cases. Health authorities rely on large-scale voluntary screening to identify and isolate invisible spreaders as well as symptomatic people as early as possible to control disease spread. Raising public awareness is beneficial for improving the effectiveness of epidemic prevention because it could increase the usage and demand for testing kits. However, the effectiveness of testing could be influenced by the spatial demand for medical resources in different periods. Spatial demand could also be triggered by public awareness in areas with two geographical factors, including spatial proximity to resources and attractiveness of human mobility. Therefore, it is necessary to explore the spatial variations in raising public awareness on the effectiveness of COVID-19 screening. We implemented spatial simulation models to integrate various levels of public awareness and pandemic dynamics in time and space. Moreover, we also assessed the effects of the spatial proximity of testing kits and the ease of human mobility on COVID-19 testing at various levels of public awareness. Our results indicated that high public awareness promotes high willingness to be tested. This causes the demand to not be fully satisfied at the peak times during a pandemic, yet the shortage of tests does not significantly increase pandemic severity. We also found that when public awareness is low, concentrating on unattractive areas (such as residential or urban fringe areas) could promote a higher benefit of testing. On the other hand, when awareness is high, the factor of distances to testing stations is more important for promoting the benefit of testing; allocating additional testing resources in areas distant from stations could have a higher benefit of testing. This study aims to provide insights for health authorities into the allocation of testing resources against disease outbreaks with respect to various levels of public awareness.

Variations in COVID-19 Vaccine Attitudes and Acceptance among Refugees and Lebanese Nationals Pre- and Post-Vaccine Rollout in Lebanon

Vaccine hesitancy among displaced populations is associated with inequitable access to services and mistrust of authorities, among other factors. This study evaluated variations in attitudes toward COVID-19 vaccines and factors associated with vaccine acceptance among refugees and Lebanese nationals accessing 60 International Medical Corps-supported health facilities through two cross-sectional surveys pre- (n = 3927; Survey 1) and post- (n = 4174; Survey 2) vaccine rollout. Logistic regression was used to assess predictors of vaccine acceptance using the health beliefs model. Refugees comprised 52.9% (Survey 1) and 54.2% (Survey 2) of respondents. Vaccine acceptance was low among both groups in Survey 1 (25.9% refugees vs. 23.1% Lebanese nationals), but higher in Survey 2 in Lebanese (57.6%) versus refugees (32.9%). Participants reported greater perceived benefits of vaccination, higher perceived COVID-19 susceptibility, and lower perceived vaccination barriers in Survey 2 versus Survey 1. Post-vaccine rollout, refugees had lower odds of vaccine acceptance compared to Lebanese (OR 0.50, 95%CI 0.41–0.60), while older age (OR 1.37, 95%CI 1.06–1.78, ≥51 years vs. 18–30 years) was associated with greater vaccine acceptance. Health beliefs model variables were associated with vaccine acceptance in both surveys. Tailored strategies to respond dynamically to changes in vaccine attitudes among vulnerable groups in Lebanon are essential for equitable vaccine uptake.

Cross-sectional assessment of predictors for COVID-19 vaccine uptake: an online survey in Greece

Objective

To estimate the percentage of the general population vaccinated against the COVID-19 and to investigate the factors associated with COVID-19 vaccine uptake.

Material and methods

We conducted an online cross-sectional study in Greece during August 2021. We included individuals over 18 years of age. Independent variables included socio-demographic data of the participants and attitudes towards COVID-19 vaccination and pandemic. Our outcome variable was COVID-19 vaccination status, measured through "yes/no" answers.

Results

Most participants had been vaccinated against the COVID-19 (87.8%). Multivariate analysis identified that increased age and a higher level of education were associated with an increased likelihood of COVID-19 vaccination. Also, participants working in health services, participants without a previous COVID-19 diagnóstico, and those with previous seasonal influenza vaccination history had a greater probability to take a COVID-19 vaccine. Additionally, increased self-perceived severity of COVID-19, knowledge regarding COVID-19, and trust in COVID-19 vaccines and scientists were associated with COVID-19 vaccine uptake. On the other hand, the likelihood of vaccination was lower for participants who were more concerned about the side effects of COVID-19 vaccination.

Conclusions

Understanding the factors affecting individuals' decision to take a COVID-19 vaccine is essential to improve the COVID-19 vaccination coverage rate. Policymakers and scientists should scale up their efforts to increase the COVID-19 vaccination rate among specific population groups such as young people, people with a low level of education, etc.

COVID-19 vaccine acceptance and its determinants: A cross-sectional study among the socioeconomically disadvantaged communities living in Delhi, India

Background

Vaccination against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is the most desired solution to combat COVID-19. We examined the willingness to accept the vaccine and reasons for vaccine hesitancy, and identified some factors associated with the vaccine hesitancy among the socio-economically disadvantaged urban population from Delhi, India.

Methods

We conducted a cross-sectional survey of a randomly selected sample of 1539 households from 31 urban clusters. Data on socio-demographics, health beliefs, and willingness to accept the SARS-CoV-2 vaccine were collected through a face-to-face interviewer-administered, pre-tested questionnaire from an adult member. Vaccine acceptance/hesitancy was analysed by various socio-demographic and health belief variables. Multinomial regressions were carried out to identify the factors associated with the vaccine hesitancy.

Results

Overall, 64.9% (95% CI: 62.5 to 67.3) of the respondents would accept the vaccine, 17.4% (95% CI: 15.6 to 19.4) were undecided, and 17.7% (95% CI: 15.8 to 19.7) would not accept the vaccine. The reasons for not accepting the vaccine were: belief that they had immunity (12.9%), the corona was a hoax (11.8%), the vaccine was not necessary (7.4%), and did not want to disturb the natural bodily systems by the vaccine (5.6%). The undecided group mainly would like to wait and see (37.7%), decide when the vaccine become available (11.6%), will take if everyone in their community takes (10.4%). Multinomial logistic regression identified older age, low perceived susceptibility of contracting COVID-19, low perceived severity of COVID-19, low self-efficacy to protect against COVID-19, and unawareness and non-use of Arogyasetu App as significant predictors of vaccine hesitancy.

Conclusions

Two-thirds of Delhi's low-income groups would accept the vaccine against SARS-CoV-2. Vaccine hesitancy was associated with older age, low perceived susceptibility, low perceived severity, and low self-efficacy to protect themselves from COVID-19. Hence, efforts are needed to address these issues and vaccine concerns to increase the vaccine uptake.

A study on willingness to take the COVID-19 vaccine at a tertiary institution community in Johannesburg, South Africa

BACKGROUND

 South Africa is aiming to achieve herd immunity against the coronavirus disease 2019 (COVID-19) by the first quarter of 2022. The success of the COVID-19 vaccination roll-out depends primarily on the willingness of the population to take the vaccines.

AIM

 This study aimed to examine the willingness to take the COVID-19 vaccine, along with the factors of concern, efficacy and preferences of the individual, which may increase the willingness to be vaccinated.

SETTING

 This study was conducted at the University of the Witwatersrand, Johannesburg, amongst adult students and academic and professional staff.

METHODS

 A cross-sectional online survey from 27 July 2021 to 14 August 2021 was conducted. We performed descriptive and inferential analysis to determine the factors associated with willingness to take the COVID-19 vaccine.

RESULTS

 A total of 2364 participants responded to a survey link and 82.0% were students, 66.8% were in the 18-29 years age band and females represented 64.0%. A total of 1965 participants (83.3%) were willing to receive a COVID-19 vaccine, the most preferred vaccines were Pfizer (41%) and JJ (23%), local pharmacy (29%) and General Practitioner (GP) (17%) were the preferred places for vaccination and the trusted sources of information on COVID-19 vaccines were the general practitioners (40.6%) and specialists (19.2%). Perceptions that vaccines are safe (adjusted odds ratio [aOR] = 31.56, 95% confidence interval [CI]: 16.02-62.12 for affirmative agreement) and effective (aOR = 5.92, 95% CI: 2.87-12.19 for affirmative agreement) were the main determinants of willingness to taking a COVID-19 vaccine.

CONCLUSION

 It is imperative to reinforce the message of COVID-19 vaccine safety and efficacy and to include the GPs and the community pharmacies in the vaccination roll-out in South Africa.

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.

Impact of Coronavirus Disease of 2019 Vaccine on Health and Physical Activities Among Physical Education Students in China

Purpose

This research focused primarily on the impact of the SARS-CoV-2 Vaccine (VeroCell) on Chinese physical education (PE) students' health and physical activity (PA) performance.

Methods

This study used quantitative methods and phenomenological procedures to collect and analyze data. Survey techniques were the main method used for collecting data from Chinese university students, using a self-designed questionnaire with a Cronbach's alpha α value of 0.76. To ensure the quality of the study, confirmatory factor analyses (CFA) were conducted, and the internal consistency reliability of the instrument was measured (alpha coefficient = 0.82). The determined sample size was 490 and around 90% as the minimum sample size was determined with the help of a sample size calculator. The author using factor loadings with h2 and an independent-sample t-test analyzed the responses of the remaining valid participants (n = 443 with a response rate of 90.40).

Results

Most participants (around 94%) did not experience any adverse reactions that impacted their daily life activities, health, or performance during physical activity. However, about 30–40% of students felt lethargy, weakness, muscle pain, or swelling. Regarding the impact of the vaccine on daily life, there was no difference in the responses between participants who had only received one shot of the coronavirus disease 2019 (COVID-19) vaccine and those who had received two shots (p &gt; 0.05 in most cases).

Conclusion

The study concluded that the COVID-19 vaccine had no significant effect on PE students' daily activities, health, and PA performance. The results of this study could be used by policymakers to encourage people to get vaccinated and eradicate the isolation caused by COVID-19, which leads many people to develop various non-communicable diseases (NCDs).

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.

Willingness to receive the COVID-19 vaccine and associated factors among residents of Southwestern Ethiopia: A cross-sectional study

Introduction

The COVID-19 vaccine is a key intervention toward containing the pandemic. Vaccines are thought to be a form of defense. One of the major challenges to managing the COVID-19 pandemic is the uncertainty or willingness to accept vaccinations. Our study aimed willingness to get the COVID-19 vaccine and the factors that influence it in Mettu Woreda, Ilu Ababor Zone, Ethiopia.

Methodology

Cross-sectional study design was conducted from August 1, 2021, to September 1, 2021, among rural residents of Mettu woreda's of Ilu Ababor Zone, Oromia, Ethiopia. The semi-structured data collection format was prepared to assess the magnitude of the communities' acceptance of the COVID-19 vaccine. A multivariable logistic regression analysis was used to determine the predictors of communities' acceptance of the COVID-19 vaccine at 95% CI.

Results

Of 350 participants from the study area, 59% of them were males and 41% females. Less than one-third (29.8%) of participants were willing to accept the COVID-19 vaccine. The results multivariable logistic regression revealed that the age group of ≥50 years (OR=0.29; 95% CI: -3.1-0.34) as compare with the 18-29 years, low monthly income (OR=0.85; 95% CI: -0.74-2.33), low perception level (OR=0.35; 95% CI: -2.03-0.24), government unemployed (OR=0.86; 95% CI: -0.72-0.1), low Level of acceptance (OR=0.72; 95% CI: -0.67, 0.08) and unwillingness to test COVID-19 (OR=0.13; 95% CI: -4.47, 0.58) were predictors of willingness to receive COVID-19 vaccine.

Conclusion

Less than one-third of the study, participants were willing to accept the COVID-19 vaccine. The likelihood of Willingness to accept the COVID-19 vaccine was low in the study area. Overall; low education, low vaccination perception, low income, jobless occupation, older age, and unwillingness to test for COVID-19 were associated with greater willingness to take the COVID-19 vaccine and are significantly associated with willingness to get the COVID-19 immunization.

High COVID-19 Vaccine Acceptance among Eye Healthcare Workers in Uganda

Background: Protecting healthcare workers against COVID-19 disease is crucial, and COVID-19 vaccination is the most effective method to do so. Eye healthcare workers provide routine care in proximity, increasing infection risk, hence their need for full vaccination. This study determined COVID-19 vaccine acceptance and barriers to its uptake among eye healthcare workers practicing in Uganda. Methods: This was a cross-sectional online and telephone survey based on the health belief model (HBM), conducted in June–August 2021. A modified Poisson regression model with robust standard errors was used to determine the factors associated with COVID-19 vaccine acceptance. Results: In total, 300 (85%) of the 357 eye healthcare workers participated in the study with mean age 43 ± 8 years and 182 (60.7%) were men. Overall, 97.6% (95% CI: 95.9–99.4) had accepted and/or were willing to take the COVID-19 vaccine, 65.3% had received a shot of the COVID-19 vaccine, and 97 (32.3%) reported the intention to accept the vaccine when it became available. Among the HBM constructs, high perceived susceptibility and high perceived benefits were significantly associated with COVID-19 vaccine acceptance. Conclusions: The acceptance of the COVID-19 vaccine among eye healthcare workers in Uganda is very high. There is a dire need to make vaccines available to developing nations like Uganda.

Information Framing Effect on Public's Intention to Receive the COVID-19 Vaccination in China

The aims of the study were (1) to explore information framing effect on the public's intention to receive the COVID-19 vaccination and (2) to understand the key factors influencing the intention of COVID-19 vaccinations in China. An online questionnaire survey was conducted to explore the influence of demographic characteristics, individual awareness, social relationship, risk disclosure, perceived vaccine efficacy, and protection duration under the assumptions of information framing. The results showed that (1) the persuasion effect under loss frame was higher than that under gain frame (B = 0.616 vs. 0.552); (2) there was no significant difference between sex, age, income, occupation, educational background and residence for the participants' intention to be vaccinated; whether family members/friends were vaccinated had a strong correlation with their vaccination intention under the gain frame; (3) the higher the understanding of COVID-19 and the compliance with government COVID-19 prevention and control measures were, the higher the vaccination intention was; (4) risk disclosure had the greatest impact on people's COVID-19 vaccination intention; (5) perceived vaccine effectiveness and duration of protection had little effect on people's intention to receive vaccination. The influence of information framing on the intention of COVID-19 vaccination is different. The publicity of relevant health information should pay attention to the influence of information framing and contents on the behavior of public vaccination, so as to enhance public health awareness and promote the vaccination of the whole population.