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Allen LP, Kelly C, Hatala AR. Answering tough questions: Why is qualitative research essential for public health? Aust N Z J Public Health 2024; 48:100157. [PMID: 38797134 DOI: 10.1016/j.anzjph.2024.100157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 04/09/2024] [Accepted: 04/21/2024] [Indexed: 05/29/2024] Open
Affiliation(s)
- Lindsay P Allen
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Christine Kelly
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Andrew R Hatala
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada.
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2
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Morgan G, Casalino S, Chowdhary S, Frangione E, Fung CYJ, Lapadula E, Arnoldo S, Bearss E, Binnie A, Borgundvaag B, Briollais L, Dagher M, Devine L, Friedman SM, Khan Z, Mighton C, Nirmalanathan K, Richardson D, Stern S, Taher A, Wolday D, Lerner-Ellis J, Taher J. COVID-19 vaccine reactogenicity among participants enrolled in the GENCOV study. Vaccine 2024; 42:2733-2739. [PMID: 38521677 DOI: 10.1016/j.vaccine.2024.03.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 03/04/2024] [Accepted: 03/11/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND GENCOV is a prospective, observational cohort study of COVID-19-positive adults. Here, we characterize and compare side effects between COVID-19 vaccines and determine whether reactogenicity is exacerbated by prior SARS-CoV-2 infection. METHODS Participants were recruited across Ontario, Canada. Participant-reported demographic and COVID-19 vaccination data were collected using a questionnaire. Multivariable logistic regression was performed to assess whether vaccine manufacturer, type, and previous SARS-CoV-2 infection are associated with reactogenicity. RESULTS Responses were obtained from n = 554 participants. Tiredness and localized side effects were the most common reactions across vaccine doses. For most participants, side effects occurred and subsided within 1-2 days. Recipients of Moderna mRNA and AstraZeneca vector vaccines reported reactions more frequently compared to recipients of a Pfizer-BioNTech mRNA vaccine. Previous SARS-CoV-2 infection was independently associated with developing side effects. CONCLUSIONS We provide evidence of relatively mild and short-lived reactions reported by participants who have received approved COVID-19 vaccines.
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Affiliation(s)
- Gregory Morgan
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON M5G 1X5, Canada; Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Selina Casalino
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON M5G 1X5, Canada; Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada
| | - Sunakshi Chowdhary
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 2C4, Canada
| | - Erika Frangione
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON M5G 1X5, Canada; Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada
| | - Chun Yiu Jordan Fung
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON M5G 1X5, Canada; Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada
| | - Elisa Lapadula
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON M5G 1X5, Canada; Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada
| | - Saranya Arnoldo
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A8, Canada; William Osler Health System, Brampton, ON L6R 3J7, Canada
| | - Erin Bearss
- Mount Sinai Academic Family Health Team, Mount Sinai Hospital, Toronto, ON M5T 3L9, Canada; Department of Family and Community Medicine, University of Toronto, Toronto, ON M5G 1V7, Canada
| | - Alexandra Binnie
- Department of Critical Care, William Osler Health System, Etobicoke, ON M9V 1R8, Canada
| | - Bjug Borgundvaag
- Schwartz/Reisman Emergency Medicine Institute, Sinai Health System, Toronto, ON M5G 2A2, Canada
| | | | - Marc Dagher
- Department of Family and Community Medicine, University of Toronto, Toronto, ON M5G 1V7, Canada; Women's College Hospital, Toronto, ON M5S 1B2, Canada
| | - Luke Devine
- Division of General Internal Medicine, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada; Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Steven M Friedman
- Department of Family and Community Medicine, University of Toronto, Toronto, ON M5G 1V7, Canada; Emergency Medicine, University Health Network, Toronto, ON M5G 2C4, Canada
| | - Zeeshan Khan
- Mackenzie Health, Richmond Hill, ON L4C 4Z3, Canada
| | - Chloe Mighton
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON M5B 1A6, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON M5T 3M6, Canada
| | | | | | - Seth Stern
- Mackenzie Health, Richmond Hill, ON L4C 4Z3, Canada
| | - Ahmed Taher
- Mackenzie Health, Richmond Hill, ON L4C 4Z3, Canada; Division of Emergency Medicine, University of Toronto, Toronto, ON M5S 3H2, Canada
| | - Dawit Wolday
- Department of Biochemistry & Biomedical Sciences, McMaster University, Hamilton, ON L8S 4K1, Canada
| | - Jordan Lerner-Ellis
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON M5G 1X5, Canada; Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Jennifer Taher
- Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A8, Canada.
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Dehshiri M, Mansouri M, Jarahzadeh MH, Hatamizadeh N. Determinants of Non-Acceptance of the COVID-19 Vaccine During Pregnancy in Pregnant and Postpartum Women: A Descriptive Cross-Sectional Study. J Family Reprod Health 2024; 18:67-74. [PMID: 38863837 PMCID: PMC11162888 DOI: 10.18502/jfrh.v18i1.15441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2024] Open
Abstract
Objective The rate of COVID-19 vaccination hesitation among Iranian pregnant women is around 50%. The objective of the present study was to determine the reasons for the refusal of COVID-19 vaccination among pregnant and postpartum women. Materials and methods This descriptive cross-sectional study was performed on 304 pregnant and postpartum women in the comprehensive health centers of Yazd, Iran, between October 2022 and April 2023. Researchers collected the data of unvaccinated women through phone calls using a validated questionnaire. Data was collected using a questionnaire consisting of baseline characteristics and reasons for refusing vaccination. Descriptive statistics were used to analyze the data using SPSS version 22. Results The mean age of the pregnant and postpartum women participating in this study was 28.31 ± 6.47 years. The most common reasons for refusing the COVID-19 vaccine included fear of harming the fetus (32.2%), fear of side effects in the mother (25.7%), disbelief in COVID-19 disease and vaccine (13.8%), lack of information about the vaccine (12.8%), and negative opinions of the media and society (12.8%). Less common reasons included husband's disagreement (8.2%), history of COVID-19 infection (6.9%), gynecologists' disagreement (6.3%), history of infertility (5.9%), and underlying disease (3.3%). Astonishingly, among participants who did not inject a booster dose of the vaccine, 76% reported they didn't receive any training and recommendation on booster dose injection from health providers. Conclusion Findings highlight that the most common reasons for refusing the COVID-19 vaccine were fear of harming the fetus and fear of side effects in the mother.
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Affiliation(s)
- Maryam Dehshiri
- Department of Midwifery, Islamic Azad University, Meybod, Iran
| | | | | | - Nooshin Hatamizadeh
- Department of Obstetrics and Gynecology, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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McAdam E, Hayashi K, Barker B, Reddon H, Choi J, Kerr T, DeBeck K. COVID-19 vaccination among young people who use drugs in Vancouver, Canada. Vaccine 2024; 42:864-870. [PMID: 38225183 PMCID: PMC10922946 DOI: 10.1016/j.vaccine.2024.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 11/28/2023] [Accepted: 01/02/2024] [Indexed: 01/17/2024]
Abstract
OBJECTIVES SARS-CoV-2 vaccines provide significant protection against severe illness and death from COVID-19, in addition to reducing community transmission. Emerging research has identified factors associated with vaccine uptake among adults who use drugs; however, less is known about youth and young adults who use drugs (YWUD). To address this gap, we sought to characterize factors associated with vaccine uptake and explore vaccine hesitancy among YWUD. METHODS Data were derived from the At-Risk Youth Study, a prospective cohort of street-involved YWUD in Vancouver, Canada. Using multivariable logistic regression, we characterized factors associated with SARS-CoV-2 vaccine uptake between June and November 2021. Data on vaccine hesitancy were also collected. RESULTS Among 301 participants enrolled in this study (median age: 29 [min and max: 20-40]), 151 (50.2%) self-reported receipt of at least one dose of a SARS-CoV-2 vaccine. In multivariable analysis, vaccine uptake was significantly associated with recent addiction treatment engagement (adjusted odds ratio [AOR] = 2.46, 95% confidence interval [CI]: 1.47-4.14) and receiving prescribed safer supply (e.g., opioids, stimulants) (AOR = 2.33, 95% CI: 1.03-5.62). Those who reported at least weekly crack use were significantly less likely to be vaccinated (AOR = 0.35, 95% CI: 0.12-0.92). The most reported reason for vaccine hesitancy was safety concerns, specifically regarding long-term side effects (27.4%). CONCLUSION Vaccine uptake was significantly lower among YWUD than adults who use drugs in Vancouver and the general population in British Columbia, among whom 75% and 93% received at least one dose during the same period. Study findings suggest connecting YWUD to healthcare and novel harm reduction interventions may increase vaccine uptake. Responses to vaccine hesitancy questions revealed complex perspectives of vaccines that were aligned with sources of vaccine hesitancy among the general population. Broader strategies combatting misinformation and promoting evidence-based vaccine information could be tailored to address the unique needs and barriers experienced by YWUD.
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Affiliation(s)
- Erica McAdam
- British Columbia Centre on Substance Use, 400-1045 Howe St, Vancouver, BC V6Z 2A9, Canada
| | - Kanna Hayashi
- British Columbia Centre on Substance Use, 400-1045 Howe St, Vancouver, BC V6Z 2A9, Canada; Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC V5A 1S6, Canada
| | - Brittany Barker
- British Columbia Centre on Substance Use, 400-1045 Howe St, Vancouver, BC V6Z 2A9, Canada; Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC V5A 1S6, Canada; School of Public Health and Social Policy, University of Victoria, PO Box 1700 STN CSC, Victoria, BC V8W 2Y2, Canada; Health Surveillance, First Nations Health Authority, #540-757 West Hastings St, Vancouver, BC V7T 1A2, Canada
| | - Hudson Reddon
- British Columbia Centre on Substance Use, 400-1045 Howe St, Vancouver, BC V6Z 2A9, Canada; Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - JinCheol Choi
- British Columbia Centre on Substance Use, 400-1045 Howe St, Vancouver, BC V6Z 2A9, Canada
| | - Thomas Kerr
- British Columbia Centre on Substance Use, 400-1045 Howe St, Vancouver, BC V6Z 2A9, Canada; Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Kora DeBeck
- British Columbia Centre on Substance Use, 400-1045 Howe St, Vancouver, BC V6Z 2A9, Canada; School of Public Policy, Simon Fraser University, 515 West Hastings St, Vancouver, BC V6B 5K3, Canada.
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5
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Harris MJ, Murtfeldt R, Wang S, Mordecai EA, West JD. Perceived experts are prevalent and influential within an antivaccine community on Twitter. PNAS NEXUS 2024; 3:pgae007. [PMID: 38328781 PMCID: PMC10847722 DOI: 10.1093/pnasnexus/pgae007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 12/29/2023] [Indexed: 02/09/2024]
Abstract
Perceived experts (i.e. medical professionals and biomedical scientists) are trusted sources of medical information who are especially effective at encouraging vaccine uptake. The role of perceived experts acting as potential antivaccine influencers has not been characterized systematically. We describe the prevalence and importance of antivaccine perceived experts by constructing a coengagement network of 7,720 accounts based on a Twitter data set containing over 4.2 million posts from April 2021. The coengagement network primarily broke into two large communities that differed in their stance toward COVID-19 vaccines, and misinformation was predominantly shared by the antivaccine community. Perceived experts had a sizable presence across the coengagement network, including within the antivaccine community where they were 9.8% of individual, English-language users. Perceived experts within the antivaccine community shared low-quality (misinformation) sources at similar rates and academic sources at higher rates compared to perceived nonexperts in that community. Perceived experts occupied important network positions as central antivaccine users and bridges between the antivaccine and provaccine communities. Using propensity score matching, we found that perceived expertise brought an influence boost, as perceived experts were significantly more likely to receive likes and retweets in both the antivaccine and provaccine communities. There was no significant difference in the magnitude of the influence boost for perceived experts between the two communities. Social media platforms, scientific communications, and biomedical organizations may focus on more systemic interventions to reduce the impact of perceived experts in spreading antivaccine misinformation.
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Affiliation(s)
- Mallory J Harris
- Department of Biology, Stanford University, Stanford, CA 94305, USA
- Center for an Informed Public, University of Washington, Seattle, WA 98195, USA
| | - Ryan Murtfeldt
- Information School, University of Washington, Seattle, WA 98105, USA
| | - Shufan Wang
- Information School, University of Washington, Seattle, WA 98105, USA
| | - Erin A Mordecai
- Department of Biology, Stanford University, Stanford, CA 94305, USA
| | - Jevin D West
- Department of Biology, Stanford University, Stanford, CA 94305, USA
- Center for an Informed Public, University of Washington, Seattle, WA 98195, USA
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Burns KE, Dubé È, Godinho Nascimento H, Meyer SB. Examining vaccine hesitancy among a diverse sample of Canadian adults. Vaccine 2024; 42:129-135. [PMID: 38103960 DOI: 10.1016/j.vaccine.2023.12.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 06/26/2023] [Accepted: 12/08/2023] [Indexed: 12/19/2023]
Abstract
The aim of this study was to explore the sociodemographic and individual-level factors associated with vaccine hesitancy in general, including political affiliation and beliefs in vaccine conspiracy theories, in a diverse group of Canadian adults within the context of the COVID-19 pandemic. 641 responses were included in the analysis, with those self-identifying as Indigenous, Black Canadian, and low-income (household income <$40,000) being sampled to yield data from historically marginalized populations. Demographic variables and responses to questions on vaccine hesitancy, and beliefs in vaccine conspiracy theories were used to explore explanatory variables of vaccine hesitancy. General linear regression models were fit using the method of least squares via PROC GLM and used to examine sociodemographic and individual explanatory variables of vaccine hesitancy. Age, ethnicity, political affiliation, and beliefs in vaccine conspiracies were associated with vaccine hesitancy. Findings are discussed in relation to the critical role of distrust and misinformation in hesitancy. Our data provide insight into how Canadian provincial governments may promote uptake of vaccines in ways that target diverse groups that may differ from those developed in a pre-pandemic context.
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Affiliation(s)
- Kathleen E Burns
- University of Waterloo, 200 University Ave W, Waterloo, ON N2L 3G1, Canada.
| | - Ève Dubé
- Laval University, 2325 Rue de l'Université, Québec, QC G1V 0A6, Canada.
| | | | - Samantha B Meyer
- University of Waterloo, 200 University Ave W, Waterloo, ON N2L 3G1, Canada.
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7
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Zhou X, Zhang X, Larson HJ, de Figueiredo A, Jit M, Fodeh S, Vermund SH, Zang S, Lin L, Hou Z. Spatiotemporal trends in COVID-19 vaccine sentiments on a social media platform and correlations with reported vaccine coverage. Bull World Health Organ 2024; 102:32-45. [PMID: 38164328 PMCID: PMC10753281 DOI: 10.2471/blt.23.289682] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 07/22/2023] [Accepted: 09/18/2023] [Indexed: 01/03/2024] Open
Abstract
Objective To assess spatiotemporal trends in, and determinants of, the acceptance of coronavirus disease 2019 (COVID-19) vaccination globally, as expressed on the social media platform X (formerly Twitter). Methods We collected over 13 million posts on the platform regarding COVID-19 vaccination made between November 2020 and March 2022 in 90 languages. Multilingual deep learning XLM-RoBERTa models annotated all posts using an annotation framework after being fine-tuned on 8125 manually annotated, English-language posts. The annotation results were used to assess spatiotemporal trends in COVID-19 vaccine acceptance and confidence as expressed by platform users in 135 countries and territories. We identified associations between spatiotemporal trends in vaccine acceptance and country-level characteristics and public policies by using univariate and multivariate regression analysis. Findings A greater proportion of platform users in the World Health Organization's South-East Asia, Eastern Mediterranean and Western Pacific Regions expressed vaccine acceptance than users in the rest of the world. Countries in which a greater proportion of platform users expressed vaccine acceptance had higher COVID-19 vaccine coverage rates. Trust in government was also associated with greater vaccine acceptance. Internationally, vaccine acceptance and confidence declined among platform users as: (i) vaccination eligibility was extended to adolescents; (ii) vaccine supplies became sufficient; (iii) nonpharmaceutical interventions were relaxed; and (iv) global reports on adverse events following vaccination appeared. Conclusion Social media listening could provide an effective and expeditious means of informing public health policies during pandemics, and could supplement existing public health surveillance approaches in addressing global health issues.
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Affiliation(s)
- Xinyu Zhou
- School of Public Health, NHC Key Laboratory of Health Technology Assessment, and Global Health Institute, Fudan University, 130 Dong’an Road, Shanghai, 200032, China
| | - Xu Zhang
- School of Public Health, NHC Key Laboratory of Health Technology Assessment, and Global Health Institute, Fudan University, 130 Dong’an Road, Shanghai, 200032, China
| | - Heidi J Larson
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, England
| | - Alexandre de Figueiredo
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, England
| | - Mark Jit
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, England
| | - Samah Fodeh
- Department of Emergency Medicine, Yale School of Medicine, New Haven, United States of America (USA)
| | - Sten H Vermund
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, USA
| | - Shujie Zang
- School of Public Health, NHC Key Laboratory of Health Technology Assessment, and Global Health Institute, Fudan University, 130 Dong’an Road, Shanghai, 200032, China
| | - Leesa Lin
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, England
| | - Zhiyuan Hou
- School of Public Health, NHC Key Laboratory of Health Technology Assessment, and Global Health Institute, Fudan University, 130 Dong’an Road, Shanghai, 200032, China
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Brody C, Szieff J, Abu-Alrub B. "If it wasn't forced upon me, I would have given it a second thought": Understanding COVID-19 vaccine hesitancy in an outlier county in the Bay Area, California. PLoS One 2023; 18:e0290469. [PMID: 38127963 PMCID: PMC10735040 DOI: 10.1371/journal.pone.0290469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 08/08/2023] [Indexed: 12/23/2023] Open
Abstract
While the San Francisco Bay Area counties rank very low in vaccine hesitancy and high in vaccination rates when compared to national numbers, Solano County has the most residents who are hesitant (6.3%) and the least who are fully vaccinated (51.6%) among Bay Area counties, according to the CDC. No studies to date have been able to provide the in-depth, localized information that would inform county-level public health interventions. This study aims to explore reasons and consequences for remaining unvaccinated in Solano County. Using a qualitative in-depth interview approach, we conducted 32 interviews with unvaccinated adults from Solano County. We used a grounded theory approach to our analysis. Using the socio-ecological model as a framework, we found that reasons for not getting vaccinated were primarily structural (mistrust of public information) and individual (bodily autonomy, personal choice) while consequences were primarily interpersonal (discrimination and stigma from friends, family, and employers). An overarching theme was that the vaccine rollout and messaging felt like an encroachment on personal choice and the feeling of being forced created more mistrust. Participants reported feeling like their decisions made them minorities among their colleagues, friends and family and that they were not persuaded by groupthink or by their relationships. Future public health responses to epidemics and pandemics might consider if a vaccine mandate is the best approach for reaching all county residents.
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Affiliation(s)
- Carinne Brody
- Public Health Program, College of Education and Health Sciences, Touro University California, Vallejo, California, United States of America
| | - Julian Szieff
- Public Health Program, College of Education and Health Sciences, Touro University California, Vallejo, California, United States of America
| | - Bilal Abu-Alrub
- Public Health Program, College of Education and Health Sciences, Touro University California, Vallejo, California, United States of America
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Krastev S, Krajden O, Vang ZM, Pérez-Gay Juárez F, Solomonova E, Goldenberg M, Weinstock D, Smith MJ, Turk L, Lin X, Gold I. Navigating the uncertainty: A novel taxonomy of vaccine hesitancy in the context of COVID-19. PLoS One 2023; 18:e0295912. [PMID: 38127862 PMCID: PMC10734916 DOI: 10.1371/journal.pone.0295912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 12/01/2023] [Indexed: 12/23/2023] Open
Abstract
Vaccine hesitancy remains a significant and evolving public health challenge. The COVID-19 pandemic has created a unique decision context with significant uncertainty caused by the novelty of the disease being targeted, unfamiliarity with the vaccines being offered, misinformation, and strong handed government measures. In an effort to extend our understanding of vaccine hesitancy to the high uncertainty decision environment presented by COVID-19, we present a novel taxonomy of the determinants of vaccine hesitancy, based on an inductive analysis of qualitative data gathered during the COVID-19 pandemic. We report on focus group data from a purposive sample of 18 Canadians with varying sociodemographic characteristics and COVID-19 vaccination attitudes. An inductive thematic analysis of this data reveals eight core themes related to vaccine hesitancy: values, trust, social environment, personal anecdotes, environmental fluctuation, prior knowledge, perceived risk & systems of care. We explore these core themes as well as 25 sub-themes, contrasting them with previous models of vaccine hesitancy and suggesting potential strategies for public health professionals.
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Affiliation(s)
- Sekoul Krastev
- Integrated Program in Neuroscience, McGill University, Montreal, QC, Canada
| | - Oren Krajden
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Zoua M. Vang
- Civil Society and Community Studies, School of Human Ecology, University of Wisconsin-Madison, Madison, WI, United States of America
| | | | - Elizaveta Solomonova
- Neurophilosophy Lab, Division of Social and Transcultural Psychiatry, Department of Philosophy, McGill University, Montreal, Quebec, Canada
| | - Maya Goldenberg
- Department of Philosophy, University of Guelph, Guelph, Ontario, Canada
| | | | - Maxwell J. Smith
- School of Health Studies, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Lindsey Turk
- Dyson School of Applied Economics and Management, Cornell University, Ithaca, New York, United States of America
| | - Xingyan Lin
- Goldman School of Public Policy, University of California, Berkeley, Berkeley, California, States of America
| | - Ian Gold
- Neurophilosophy Lab, Division of Social and Transcultural Psychiatry, Department of Philosophy, McGill University, Montreal, Quebec, Canada
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10
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ERİŞ H, KARASU F, AYAR D. Perceptions of vaccine trust and conspiracy among those with COVID-19 vaccine hesitancy and resistance: a cross-sectional study. Glob Health Promot 2023; 30:6-15. [PMID: 37208910 PMCID: PMC10200806 DOI: 10.1177/17579759231174750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 04/20/2023] [Indexed: 05/21/2023]
Abstract
BACKGROUND Individuals' beliefs in conspiracy theories and anti-vaccination defense play a role in the rates of COVID-19 spread. PURPOSE This study aims to determine the perception of trust in, and the perception of conspiracy theories regarding vaccines among those with COVID-19 vaccine hesitancy and resistance in a province in Turkey. METHODS This study was conducted with 1244 individuals who agreed to participate in the study in the province with the lowest vaccination rate in Turkey. The 'Personal Information Form' and the 'COVID-19 Vaccine Perception and Attitude Scale' were used to collect data. FINDINGS Those who were resistant to vaccines had a low mean score on the Perception of Trust and a high mean score on the Perception of Conspiracy. The variable of conspiracy perception had a significantly negative and high effect on the perception of trust. CONCLUSION The participants were highly resistant to COVID-19 vaccines. Their perception level of trust in COVID-19 vaccines was moderate and their perception level of conspiracy was high.
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Affiliation(s)
- Hüseyin ERİŞ
- Vocational School of Health Services,
Harran University, Sanlıurfa, Turkey
| | - Fatma KARASU
- Yusuf Şerefoğlu Faculty of Health
Sciences, Department of Nursing, Kilis 7 Aralık University, Kilis, Turkey
| | - Duygu AYAR
- Faculty of Health Sciences, Department
of Nursing, Gaziantep Islam Science and Technology University, Gaziantep,
Turkey
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11
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Déom N, Vanderslott S, Kingori P, Martin S. Online on the frontline: A longitudinal social media analysis of UK healthcare workers' attitudes to COVID-19 vaccines using the 5C framework. Soc Sci Med 2023; 339:116313. [PMID: 37984178 DOI: 10.1016/j.socscimed.2023.116313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 09/07/2023] [Accepted: 10/05/2023] [Indexed: 11/22/2023]
Abstract
This paper explores vaccine hesitancy among healthcare workers (HCWs) in the UK, where different COVID-19 vaccines were being rolled out through a national vaccination campaign from 2020 to 2022, consisting of a first and second dose programme. Through a mixed-method approach using qualitative discourse analysis and network analysis of Twitter data, we assessed HCW perceptions and views about the administration and delivery of COVID-19 vaccines in the United Kingdom (UK). We were also interested in exploring HCWs' personal experiences and attitudes towards taking COVID-19 vaccines themselves. We drew upon sociology, ethics, communication studies and used research methods concentrating on social media and media analysis. By employing the '5C framework' of 'confidence, complacency, constraints, calculation, and collective responsibility' we evaluated a longitudinal selection of tweets to capture relevant factors driving vaccination views and behaviours among HCWs. We found differing positions expressed about COVID-19 vaccines and policy during the first dose compared with the second, through a drop in confidence compounded by supply and access issues, as well the news of a vaccine mandate for HCWs by the UK government in 2021. HCWs asked calculation questions to the community or brought forward competing pieces of information about vaccine policy and guidelines. Constraint levels in access issues were noted, especially for those with work and caregiving responsibilities, and student nurses found they did not have equal vaccination access. HCWs also displayed collective responsibility on social platforms to both encourage vaccination and express concerns through the organisation of social action against vaccine mandates.
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Affiliation(s)
- Noémie Déom
- Department of Targeted Intervention, University College London, London, UK; Oxford Vaccine Group, Department of Paediatrics, Oxford University, Oxford, UK
| | - Samantha Vanderslott
- Oxford Vaccine Group, Department of Paediatrics, Oxford University, Oxford, UK; NIHR Oxford Biomedical Research Centre, Oxford, Oxfordshire, UK.
| | - Patricia Kingori
- Wellcome Centre for Ethics and Humanities, University of Oxford, Oxford, UK
| | - Sam Martin
- Department of Targeted Intervention, University College London, London, UK; Oxford Vaccine Group, Department of Paediatrics, Oxford University, Oxford, UK
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12
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Giwa A, Adeagbo M, Tate SA, Tulli-Shah M, Salami B. COVID-19 Vaccine Mandates and Vaccine Hesitancy among Black People in Canada. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7119. [PMID: 38063549 PMCID: PMC10706298 DOI: 10.3390/ijerph20237119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 11/20/2023] [Accepted: 11/24/2023] [Indexed: 12/18/2023]
Abstract
OBJECTIVES COVID-19 vaccine mandates increased vaccination rates globally. Implemented as a one-size-fits-all policy, these mandates have unintended harmful consequences for many, including Black Canadians. This article reports findings on the interconnectedness of vaccine mandates and vaccine hesitancy by describing a range of responses to mandatory COVID-19 vaccination policies among Black people in Canada. METHODS Using qualitative research methods, semi-structured interviews with 36 Black people living in Canada aged 18 years and over across 6 provinces in Canada were conducted. Participants were selected across intersectional categories including migration status, income, religion, education, sex, and Black ethnicity. Thematic analysis informed the identification of key themes using Foucauldian notions of biopower and governmentality. RESULTS Our results show how the power relations present in the ways many Black people actualize vaccine intentions. Two main themes were identified: acceptance of the COVID-19 vaccine in the context of governmentality and resistance to vaccine mandates driven by oppression, mistrust, and religion. CONCLUSION COVID-19 vaccine mandates may have reinforced mistrust of the government and decreased confidence in the COVID-19 vaccine. Policy makers need to consider non-discriminatory public health policies and monitor how these policies are implemented over time and across multiple sectors to better understand vaccine hesitancy.
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Affiliation(s)
- Aisha Giwa
- College of Health Sciences, School of Public Health University of Alberta, Edmonton, AB T6G 1C9, Canada (M.T.-S.); (B.S.)
| | - Morolake Adeagbo
- College of Health Sciences, School of Public Health University of Alberta, Edmonton, AB T6G 1C9, Canada (M.T.-S.); (B.S.)
| | - Shirley Anne Tate
- Department of Sociology, University of Alberta, Edmonton, AB T6G 2R3, Canada;
| | - Mia Tulli-Shah
- College of Health Sciences, School of Public Health University of Alberta, Edmonton, AB T6G 1C9, Canada (M.T.-S.); (B.S.)
| | - Bukola Salami
- College of Health Sciences, School of Public Health University of Alberta, Edmonton, AB T6G 1C9, Canada (M.T.-S.); (B.S.)
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13
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Caserotti M, Girardi P, Sellaro R, Rubaltelli E, Tasso A, Lotto L, Gavaruzzi T. To vaccinate or not to vaccinate? The interplay between pro- and against- vaccination reasons. BMC Public Health 2023; 23:2207. [PMID: 37946143 PMCID: PMC10634164 DOI: 10.1186/s12889-023-17112-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 10/30/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND By mid 2023, European countries reached 75% of vaccine coverage for COVID-19 and although vaccination rates are quite high, many people are still hesitant. A plethora of studies have investigated factors associated with COVID-19 vaccine hesitancy, however, insufficient attention has been paid to the reasons why people get vaccinated against COVID-19. Our work aims to investigate the role of reasons in the decision to get vaccinated against COVID-19 in a representative sample of 1,689 adult Italians (March-April 2021) balanced in terms of age, gender, educational level and area of residence. METHODS Through an online questionnaire, we asked participants to freely report up to three reasons for and against COVID-19 vaccination, and the weight each had in the decision to get vaccinated. We first investigated the role of emotional competence and COVID-19 risk perception in the generation of both reasons using regression models. Next, we studied the role that the different reasons had in the vaccination decision, considering both the intention to vaccinate (using a beta regression model) and the decision made by the participants who already had the opportunity to get vaccinated (using a logistic regression model). Finally, two different classification tree analyses were carried out to characterize profiles with a low or high willingness to get vaccinated or with a low or high probability to accept/book the vaccine. RESULTS High emotional competence positively influences the generation of both reasons (ORs > 1.5), whereas high risk perception increases the generation of positive reasons (ORs > 1.4) while decreasing reasons against vaccination (OR = 0.64). As pro-reasons increase, vaccination acceptance increases, while the opposite happens as against-reasons increase (all p < 0.001). One strong reason in favor of vaccines is enough to unbalance the decision toward acceptance of vaccination, even when reasons against it are also present (p < 0.001). Protection and absence of distrust are the reasons that mostly drive willingness to be vaccinated and acceptance of an offered vaccine. CONCLUSIONS Knowing the reasons that drive people's decision about such an important choice can suggest new communication insights to reduce possible negative reactions toward vaccination and people's hesitancy. Results are discussed considering results of other national and international studies.
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Affiliation(s)
- Marta Caserotti
- Department of Developmental Psychology and Socialization, University of Padova, Padua, Italy.
| | - Paolo Girardi
- Department of Environmental Sciences, Informatics and Statistics, Ca' Foscari University of Venezia, Venice, Italy
| | - Roberta Sellaro
- Department of Developmental Psychology and Socialization, University of Padova, Padua, Italy
| | - Enrico Rubaltelli
- Department of Developmental Psychology and Socialization, University of Padova, Padua, Italy
| | | | - Lorella Lotto
- Department of Developmental Psychology and Socialization, University of Padova, Padua, Italy
| | - Teresa Gavaruzzi
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
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Aggarwal M, Katz A, Kokorelias KM, Wong ST, Aghajafari F, Ivers NM, Martin-Misener R, Aubrey-Bassler K, Breton M, Upshur REG, Kwong JC. What are effective vaccine distribution approaches for equity-deserving and high-risk populations during COVID-19? Exploring best practices and recommendations in Canada: protocol for a mixed-methods multiple case codesign study. BMJ Open 2023; 13:e072238. [PMID: 37940159 PMCID: PMC10632871 DOI: 10.1136/bmjopen-2023-072238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 10/18/2023] [Indexed: 11/10/2023] Open
Abstract
INTRODUCTION The WHO has stated that vaccine hesitancy is a serious threat to overcoming COVID-19. Vaccine hesitancy among underserved and at-risk communities is an ongoing challenge in Canada. Public confidence in vaccine safety and effectiveness and the principles of equity need to be considered in vaccine distribution. In Canada, governments of each province or territory manage their own healthcare system, providing an opportunity to compare and contrast distribution strategies. The overarching objective of this study is to identify effective vaccine distribution approaches and advance knowledge on how to design and implement various strategies to meet the different needs of underserved communities. METHODS AND ANALYSIS Multiple case studies in seven Canadian provinces will be conducted using a mixed-methods design. The study will be informed by Experience-Based CoDesign techniques and theoretically guided by the Socio-Ecological Model and the Vaccine Hesitancy Matrix frameworks. Phase 1 will involve a policy document review to systematically explore the vaccine distribution strategy over time in each jurisdiction. This will inform the second phase, which will involve (2a) semistructured, in-depth interviews with policymakers, public health officials, researchers, providers, groups representing patients, researchers and stakeholders and (2b) an analysis of population-based administrative health data of vaccine administration. Integration of qualitative and quantitative data will inform the identification of effective vaccine distribution approaches for various populations. Informed by this evidence, phase 3 of the study will involve conducting focus groups with multiple stakeholders to codesign recommendations for the design and implementation of effective vaccine delivery strategies for equity-deserving and at-risk populations. ETHICS AND DISSEMINATION This study is approved by the University of Toronto's Health Sciences Research Ethics Board (#42643), University of British Columbia Behavioural Research Ethics Board (#H22-01750-A002), Research Ethics Board of the Nova Scotia Health Authority (#48272), Newfoundland and Labrador Health Research Ethics Board (#2022.126), Conjoint Health Research Ethics Board, University of Calgary (REB22-0207), and University of Manitoba Health Research Board (H2022-239). The outcome of this study will be to produce a series of recommendations for implementing future vaccine distribution approaches from the perspective of various stakeholders, including equity-deserving and at-risk populations.
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Affiliation(s)
- Monica Aggarwal
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Alan Katz
- Department of Community Health Sciences, Rady Faculty of Health Sciences University of Manitoba, Winnipeg, Manitoba, Canada
- Department of Family Medicine, Rady Faculty of Health Sciences University of Manitoba, Winnipeg, Manitoba, Canada
| | - Kristina Marie Kokorelias
- Rehabiliation Sciences Institute, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Rehabiliation Sciences Institute, University of Toronto Temerty Faculty of Medicine, Toronto, Ontario, Canada
| | - Sabrina T Wong
- Centre for Health Services and Policy Research, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Noah M Ivers
- Department of Family and Community Medicine, Women's College Hospital, Toronto, Ontario, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | | | - Kris Aubrey-Bassler
- Primary Healthcare Research Unit, Memorial University, St. John's, Newfoundland, Canada
| | - Mylaine Breton
- Department of Community Health Sciences, University of Sherbrooke, Longueuil, Quebec, Canada
| | - Ross E G Upshur
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Jeffrey C Kwong
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
- Institute for Clinical Evaluative Sciences (ICES), Toronto, Ontario, Canada
- Public Health Ontario, Toronto, Ontario, Canada
- University Health Network, Toronto, Ontario, Canada
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15
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Canaparo M, Ronchieri E, Scarso L. A natural language processing approach for analyzing COVID-19 vaccination response in multi-language and geo-localized tweets. HEALTHCARE ANALYTICS (NEW YORK, N.Y.) 2023; 3:100172. [PMID: 37064254 PMCID: PMC10088351 DOI: 10.1016/j.health.2023.100172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 03/27/2023] [Accepted: 04/05/2023] [Indexed: 04/18/2023]
Abstract
Social media platforms, such as Twitter, have been paramount in the COVID-19 context due to their ability to collect public concerns about the COVID-19 vaccination campaign, which has been underway to end the COVID-19 pandemic. This worldwide campaign has heavily relied on the actual willingness of individuals to get vaccinated independently of the language they speak or the country they reside. This study analyzes Twitter posts about Pfizer/BioNTech, Moderna, AstraZeneca/Vaxzevria, and Johnson & Johnson vaccines by considering the most spoken western languages. Tweets were sampled between April 15 and September 15, 2022, after the injections of at least three doses, collecting 9,513,063 posts that contained vaccine-related keywords. To determine the success of vaccination, temporal and sentiment analysis have been conducted, reporting opinion changes over time and their corresponding events whenever possible concerning each vaccine. Furthermore, we have extracted the main topics over languages providing potential bias due to the language-specific dictionary, such as Moderna in Spanish, and grouped them per country. Once performed the pre-processed procedure we worked with 8,343,490 tweets. Our findings show that Pfizer has been the most debated vaccine worldwide, and the main concerns have been the side effects on pregnant women and children and heart diseases.
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Affiliation(s)
- Marco Canaparo
- INFN-CNAF, Viale Berti Pichat 6/2, Bologna, 40126, Italy
| | - Elisabetta Ronchieri
- INFN-CNAF, Viale Berti Pichat 6/2, Bologna, 40126, Italy
- Department of Statistical Sciences, University of Bologna, Via Belle Arti 41, Bologna, Italy
| | - Leonardo Scarso
- Department of Medical and Surgical Sciences, University of Bologna, Via Pelagio Palagi 9, Bologna, Italy
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16
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Nascimento LG, Dubé È, Burns KE, Brown P, Calnan M, Ward PR, Filice E, Herati H, Ike NAU, Rotolo B, Meyer SB. Informing efforts beyond tailored promotional campaigns by understanding contextual factors shaping vaccine hesitancy among equity-deserving populations in Canada: an exploratory qualitative study. Int J Equity Health 2023; 22:209. [PMID: 37805472 PMCID: PMC10559625 DOI: 10.1186/s12939-023-02025-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 09/26/2023] [Indexed: 10/09/2023] Open
Abstract
BACKGROUND Vaccine hesitancy exists on a continuum ranging between complete adherence and complete refusal due to doubts or concerns within a heterogeneous group of individuals. Despite widespread acknowledgement of the contextual factors influencing attitudes and beliefs shaping COVID-19 vaccine hesitancy, qualitative research with equity-deserving groups, accounting for unique lived experiences, remains a gap in the literature. We aim to identify and begin to understand and document the unique contextual factors shaping hesitancy by equity-deserving groups as it relates to relationships with government and health authorities. METHODS Participants were recruited and interviewed between Aug-Dec 2021. Semi-structured interviews using a convergent interviewing technique were conducted with individuals from the general population, as well as individuals who identify as First Nations, Métis, or Inuit, members of the LGBT2SQ + community, low-income Canadians, Black Canadians, and newcomers. Interviews were audio recorded and transcribed by a team of researchers. Memos were written following interviews and used to complement the thematic analysis of the interview data. Themes are presented in the results section. RESULTS The rationale for hesitancy among equity-deserving groups is consistent with literature documenting hesitancy in the general population. Contextual factors surrounding equity-deserving groups' attitudes and beliefs, however, are unique and relate to a history of oppression, discrimination, and genocide. We identified factors unique to subgroups; for example, religious or fatalistic beliefs among participant who identify as FNMI, fear associated with lack of testing and speed of vaccines' production among participants who identify as FNMI, Black, and LGBT2SQ + , distrust of the healthcare system for LGBT2SQ + and Black Canadians, and distrust of the government and opposition to vaccine mandates for participating who identify as LGBT2SQ + , low-income, FNMI, or Black Canadian. Newcomers stood out as very trusting of the government and accepting of COVID-19 vaccination. CONCLUSIONS While our data on vaccine hesitancy largely mirror concerns reported in the vast body of literature citing rationale for COVID-19 hesitancy in high-income countries, the contextual factors identified in our work point to the need for wider systemic change. Our results may be used to support efforts, beyond tailored promotion campaigns, to support the confident acceptance of vaccines for COVID-19 and the acceptance of novel vaccines as future infectious diseases emerge.
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Affiliation(s)
| | - Ève Dubé
- Institut National de Santé Publique du Québec, Québec City, Canada
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17
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Xu S, Hong V, Sy LS, Bruxvoort KJ, Lewin B, Han B, Holmquist KJ, Qian L. Risk Factors for Not Completing a 2-Dose Primary Series of Messenger RNA COVID-19 Vaccination in a Large Health Care System in Southern California: Retrospective Cohort Study. JMIR Public Health Surveill 2023; 9:e46318. [PMID: 37792452 PMCID: PMC10563864 DOI: 10.2196/46318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 07/22/2023] [Accepted: 08/29/2023] [Indexed: 10/05/2023] Open
Abstract
BACKGROUND COVID-19 vaccination is crucial in combating the COVID-19 pandemic. Messenger RNA COVID-19 vaccines were initially authorized as a 2-dose primary series and have been widely used in the United States; completing the 2-dose primary series offers protection against infection, severe illness, and death. Understanding the risk factors for not completing the 2-dose primary series is critical to evaluate COVID-19 vaccination programs and promote completion of the 2-dose primary series. OBJECTIVE This study examined potential risk factors for not completing a 2-dose primary series of mRNA COVID-19 vaccination. METHODS We conducted a retrospective cohort study among members aged ≥18 years from a large integrated health care system, Kaiser Permanente Southern California, from December 14, 2020, to June 30, 2022. Noncompletion of the 2-dose primary series was defined as not completing the second dose within 6 months after receipt of the first dose. Crude noncompletion rates were estimated overall and by demographic characteristics, health care use patterns, comorbidity, and community-level socioeconomic factors. A Poisson regression model was fit to examine associations of individual-level and community-level risk factors with noncompletion of the 2-dose primary series. RESULTS Among 2.5 million recipients of ≥1 dose of mRNA COVID-19 vaccines, 3.3% (n=81,202) did not complete the second dose within 6 months. Members aged 25-44 years, 65-74 years, and ≥75 years were less likely to not complete the 2-dose primary series than those aged 18-24 years, while members aged 45-64 years were more likely to not complete the 2-dose primary series (adjusted risk ratio [aRR] 1.13, 95% CI 1.10-1.15). Male sex was associated with a higher risk of noncompletion (aRR 1.17, 95% CI 1.15-1.19). Hispanic and non-Hispanic Black race/ethnicity were associated with a lower risk of noncompletion (range aRR 0.78-0.91). Having Medicaid and prior influenza vaccination were associated with a higher risk of noncompletion. Having SARS-CoV-2 infection, experiencing an adverse event, or having an inpatient and emergency department visit during the minimum recommended dose intervals were associated with a higher risk of not completing the 2-dose primary series (aRR 1.98, 95% CI 1.85-2.12; 1.99, 95% CI 1.43-2.76; and 1.85, 95% CI 1.77-1.93, respectively). Those who received the first dose after June 30, 2021, were more likely to not complete the 2-dose primary series within 6 months of receipt of the first dose. CONCLUSIONS Despite limitations such as being a single-site study and the inability to consider social factors such as employment and vaccine attitudes, our study identified several risk factors for not completing a 2-dose primary series of mRNA vaccination, including being male; having Medicaid coverage; and experiencing SARS-CoV-2 infection, adverse events, or inpatient and emergency department visits during the minimum recommended dose intervals. These findings can inform future efforts in developing effective strategies to enhance vaccination coverage and improve the completion rate of necessary doses.
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Affiliation(s)
- Stanley Xu
- Department of Research & Evaluation, Southern California Permanente Medical Group, Pasadena, CA, United States
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, United States
| | - Vennis Hong
- Department of Research & Evaluation, Southern California Permanente Medical Group, Pasadena, CA, United States
| | - Lina S Sy
- Department of Research & Evaluation, Southern California Permanente Medical Group, Pasadena, CA, United States
| | - Katia J Bruxvoort
- Department of Research & Evaluation, Southern California Permanente Medical Group, Pasadena, CA, United States
- School of Public Health, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Bruno Lewin
- Department of Research & Evaluation, Southern California Permanente Medical Group, Pasadena, CA, United States
| | - Bing Han
- Department of Research & Evaluation, Southern California Permanente Medical Group, Pasadena, CA, United States
| | - Kimberly J Holmquist
- Department of Research & Evaluation, Southern California Permanente Medical Group, Pasadena, CA, United States
| | - Lei Qian
- Department of Research & Evaluation, Southern California Permanente Medical Group, Pasadena, CA, United States
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18
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Fox S. How misinformation exposure influences vaccine status. Evid Based Nurs 2023; 26:137. [PMID: 37438086 DOI: 10.1136/ebnurs-2021-103505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2022] [Indexed: 07/14/2023]
Affiliation(s)
- Sarah Fox
- School of Nursing, Saskatchewan Institute of Applied Science and Technology - Wascana Campus, Regina, Canada
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19
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Hirabayashi M, Shibata D, Shinohara E, Kawazoe Y. Influence of Tweets Indicating False Rumors on COVID-19 Vaccination: Case Study. JMIR Form Res 2023; 7:e45867. [PMID: 37669092 PMCID: PMC10482055 DOI: 10.2196/45867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 07/27/2023] [Accepted: 08/01/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND As of December 2022, the outbreak of COVID-19 showed no sign of abating, continuing to impact people's lives, livelihoods, economies, and more. Vaccination is an effective way to achieve mass immunity. However, in places such as Japan, where vaccination is voluntary, there are people who choose not to receive the vaccine, even if an effective vaccine is offered. To promote vaccination, it is necessary to clarify what kind of information on social media can influence attitudes toward vaccines. OBJECTIVE False rumors and counterrumors are often posted and spread in large numbers on social media, especially during emergencies. In this paper, we regard tweets that contain questions or point out errors in information as counterrumors. We analyze counterrumors tweets related to the COVID-19 vaccine on Twitter. We aimed to answer the following questions: (1) what kinds of COVID-19 vaccine-related counterrumors were posted on Twitter, and (2) are the posted counterrumors related to social conditions such as vaccination status? METHODS We use the following data sets: (1) counterrumors automatically collected by the "rumor cloud" (18,593 tweets); and (2) the number of COVID-19 vaccine inoculators from September 27, 2021, to August 15, 2022, published on the Prime Minister's Office's website. First, we classified the contents contained in counterrumors. Second, we counted the number of COVID-19 vaccine-related counterrumors from data set 1. Then, we examined the cross-correlation coefficients between the numbers of data sets 1 and 2. Through this verification, we examined the correlation coefficients for the following three periods: (1) the same period of data; (2) the case where the occurrence of the suggestion of counterrumors precedes the vaccination (negative time lag); and (3) the case where the vaccination precedes the occurrence of counterrumors (positive time lag). The data period used for the validation was from October 4, 2021, to April 18, 2022. RESULTS Our classification results showed that most counterrumors about the COVID-19 vaccine were negative. Moreover, the correlation coefficients between the number of counterrumors and vaccine inoculators showed significant and strong positive correlations. The correlation coefficient was over 0.7 at -8, -7, and -1 weeks of lag. Results suggest that the number of vaccine inoculators tended to increase with an increase in the number of counterrumors. Significant correlation coefficients of 0.5 to 0.6 were observed for lags of 1 week or more and 2 weeks or more. This implies that an increase in vaccine inoculators increases the number of counterrumors. These results suggest that the increase in the number of counterrumors may have been a factor in inducing vaccination behavior. CONCLUSIONS Using quantitative data, we were able to reveal how counterrumors influence the vaccination status of the COVID-19 vaccine. We think that our findings would be a foundation for considering countermeasures of vaccination.
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Affiliation(s)
- Mai Hirabayashi
- Artificial Intelligence in Healthcare, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Daisaku Shibata
- Artificial Intelligence in Healthcare, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Emiko Shinohara
- Artificial Intelligence in Healthcare, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yoshimasa Kawazoe
- Artificial Intelligence in Healthcare, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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20
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Fasce A, Schmid P, Holford DL, Bates L, Gurevych I, Lewandowsky S. A taxonomy of anti-vaccination arguments from a systematic literature review and text modelling. Nat Hum Behav 2023; 7:1462-1480. [PMID: 37460761 DOI: 10.1038/s41562-023-01644-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 05/25/2023] [Indexed: 09/23/2023]
Abstract
The proliferation of anti-vaccination arguments is a threat to the success of many immunization programmes. Effective rebuttal of contrarian arguments requires an approach that goes beyond addressing flaws in the arguments, by also considering the attitude roots-that is, the underlying psychological attributes driving a person's belief-of opposition to vaccines. Here, through a pre-registered systematic literature review of 152 scientific articles and thematic analysis of anti-vaccination arguments, we developed a hierarchical taxonomy that relates common arguments and themes to 11 attitude roots that explain why an individual might express opposition to vaccination. We further validated our taxonomy on coronavirus disease 2019 anti-vaccination misinformation, through a combination of human coding and machine learning using natural language processing algorithms. Overall, the taxonomy serves as a theoretical framework to link expressed opposition of vaccines to their underlying psychological processes. This enables future work to develop targeted rebuttals and other interventions that address the underlying motives of anti-vaccination arguments.
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Affiliation(s)
- Angelo Fasce
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
| | - Philipp Schmid
- Institute for Planetary Health Behaviour, University of Erfurt, Erfurt, Germany
- Department of Implementation Research, Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany
| | - Dawn L Holford
- School of Psychological Science, University of Bristol, Bristol, UK
- Department of Psychology, University of Essex, Colchester, UK
| | - Luke Bates
- Ubiquitous Knowledge Processing Lab/Department of Computer Science and Hessian Center for AI (hessian.AI), Technical University of Darmstadt, Darmstadt, Germany
| | - Iryna Gurevych
- Ubiquitous Knowledge Processing Lab/Department of Computer Science and Hessian Center for AI (hessian.AI), Technical University of Darmstadt, Darmstadt, Germany
| | - Stephan Lewandowsky
- School of Psychological Science, University of Bristol, Bristol, UK
- School of Psychological Science, University of Western Australia, Perth, Western Australia, Australia
- Department of Psychology, University of Potsdam, Potsdam, Germany
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21
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Harris MJ, Murtfeldt R, Wang S, Mordecai EA, West JD. The role and influence of perceived experts in an anti-vaccine misinformation community. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.07.12.23292568. [PMID: 37546922 PMCID: PMC10398812 DOI: 10.1101/2023.07.12.23292568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
The role of perceived experts (i.e., medical professionals and biomedical scientists) as potential anti-vaccine influencers has not been characterized systematically. We describe the prevalence and importance of anti-vaccine perceived experts by constructing a coengagement network based on a Twitter data set containing over 4.2 million posts from April 2021. The coengagement network primarily broke into two large communities that differed in their stance toward COVID-19 vaccines, and misinformation was predominantly shared by the anti-vaccine community. Perceived experts had a sizable presence within the anti-vaccine community and shared academic sources at higher rates compared to others in that community. Perceived experts occupied important network positions as central anti-vaccine nodes and bridges between the anti- and pro-vaccine communities. Perceived experts received significantly more engagements than other individuals within the anti- and pro-vaccine communities and there was no significant difference in the influence boost for perceived experts between the two communities. Interventions designed to reduce the impact of perceived experts who spread anti-vaccine misinformation may be warranted.
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Affiliation(s)
- Mallory J. Harris
- Department of Biology, Stanford University, Stanford, CA
- Center for an Informed Public, University of Washington, Seattle, WA
| | - Ryan Murtfeldt
- Information School, University of Washington, Seattle, WA
| | - Shufan Wang
- Information School, University of Washington, Seattle, WA
| | | | - Jevin D. West
- Center for an Informed Public, University of Washington, Seattle, WA
- Information School, University of Washington, Seattle, WA
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22
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Lin YCJ, Evans DH, Robbins NF, Orjuela G, Abe KT, Rathod B, Colwill K, Gingras AC, Tuite A, Yi QL, O’Brien SF, Drews SJ. Diminished Neutralization Capacity of SARS-CoV-2 Omicron BA.1 in Donor Plasma Collected from January to March 2021. Microbiol Spectr 2023; 11:e0525622. [PMID: 37289096 PMCID: PMC10434250 DOI: 10.1128/spectrum.05256-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 05/25/2023] [Indexed: 06/09/2023] Open
Abstract
The 50% plaque reduction neutralization assay (PRNT50) has been previously used to assess the neutralization capacity of donor plasma against wild-type and variant of concern (VOC) severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Emerging data suggest that plasma with an anti-SARS-CoV-2 level of ≥2 × 104 binding antibody units/mL (BAU/mL) protects against SARS-CoV-2 Omicron BA.1 infection. Specimens were collected using a cross-sectional random sampling approach. For PRNT50 studies, 63 previously analyzed specimens by PRNT50 versus SARS-CoV-2 wild-type, Alpha, Beta, Gamma, and Delta were analyzed by PRNT50 versus Omicron BA.1. The 63 specimens plus 4,390 specimens (randomly sampled regardless of serological evidence of infection) were also tested using the Abbott SARS-CoV-2 IgG II Quant assay (anti-spike [S]; Abbott, Chicago, IL, USA; Abbott Quant assay). In the vaccinated group, the percentages of specimens with any measurable PRNT50 versus wild-type or VOC were wild type (21/25 [84%]), Alpha (19/25 [76%]), Beta (18/25 [72%]), Gamma (13/25 [52%]), Delta (19/25 [76%]), and Omicron BA.1 (9/25 [36%]). In the unvaccinated group, the percentages of specimens with any measurable PRNT50 versus wild type or VOC were wild-type SARS-CoV-2 (16/39 [41%]), Alpha (16/39 [41%]), Beta (10/39 [26%]), Gamma (9/39 [23%]), Delta (16/39 [41%]), and Omicron BA.1 (0/39) (Fisher's exact tests, vaccinated versus unvaccinated for each variant, P < 0.05). None of the 4,453 specimens tested by the Abbott Quant assay had a binding capacity of ≥2 × 104 BAU/mL. Vaccinated donors were more likely than unvaccinated donors to neutralize Omicron when assessed by a PRNT50 assay. IMPORTANCE SARS-CoV-2 Omicron emergence occurred in Canada during the period from November 2021 to January 2022. This study assessed the ability of donor plasma collected earlier (January to March 2021) to generate any neutralizing capacity against Omicron BA.1 SARS-CoV-2. Vaccinated individuals, regardless of infection status, were more likely to neutralize Omicron BA.1 than unvaccinated individuals. This study then used a semiquantitative binding antibody assay to screen a larger number of specimens (4,453) for individual specimens that might have high-titer neutralizing capacity against Omicron BA.1. None of the 4,453 specimens tested by the semiquantitative SARS-CoV-2 assay had a binding capacity suggestive of a high-titer neutralizing capacity against Omicron BA.1. These data do not imply that Canadians lacked immunity to Omicron BA.1 during the study period. Immunity to SARS-CoV-2 is complex, and there is still no wide consensus on correlation of protection to SARS-CoV-2.
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Affiliation(s)
- Yi-Chan J. Lin
- Department of Medical Microbiology & Immunology, University of Alberta, Edmonton, Canada
| | - David H. Evans
- Department of Medical Microbiology & Immunology, University of Alberta, Edmonton, Canada
| | | | | | - Kento T. Abe
- Lunenfeld-Tanenbaum Research Institute at Mt. Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Bhavisha Rathod
- Lunenfeld-Tanenbaum Research Institute at Mt. Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
| | - Karen Colwill
- Lunenfeld-Tanenbaum Research Institute at Mt. Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
| | - Anne-Claude Gingras
- Lunenfeld-Tanenbaum Research Institute at Mt. Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Ashleigh Tuite
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Qi-Long Yi
- Epidemiology and Surveillance, Canadian Blood Services, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Sheila F. O’Brien
- Epidemiology and Surveillance, Canadian Blood Services, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Steven J. Drews
- Canadian Blood Services, Microbiology, Edmonton, Alberta, Canada
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
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23
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Maughan-Brown B, Eyal KC, Njozela L, Buttenheim AM. Predictors of COVID-19 vaccine uptake among adults in South Africa: multimethod evidence from a population-based longitudinal study. BMJ Glob Health 2023; 8:e012433. [PMID: 37541692 PMCID: PMC10407380 DOI: 10.1136/bmjgh-2023-012433] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 06/25/2023] [Indexed: 08/06/2023] Open
Abstract
BACKGROUND COVID-19 vaccine coverage remains low in many low and middle-income countries despite widespread access. To understand the dynamic decision-making process around vaccination and provide evidence for future vaccine promotion campaigns, we identified predictors of COVID-19 vaccine uptake among South African adults, including those who did not believe in the vaccine's safety or efficacy. METHODS Data from two longitudinal telephone surveys in late 2021 and early 2022 of unvaccinated South African adults were used to model COVID-19 uptake. Predictors of interest informed by the theory of planned behaviour included vaccine attitudes and beliefs, social norms, perceived behavioural control and vaccine intentions. Responses to open-ended questions provided insights into key reasons for getting vaccinated. RESULTS Among panel participants (n=1772), 19% reported being vaccinated between Survey 1 and Survey 2. Vaccine uptake was greater among participants who reported wanting to get vaccinated 'as soon as possible' (+27 percentage points, p<0.01). Vaccine uptake was greater among participants who believed that the vaccine is effective in preventing COVID-19 infection and/or death (+12 percentage points, p<0.01) and lower among those who believed that the vaccine is unsafe (-9 percentage points, p<0.01). Among participants who did not believe the vaccine is safe, living with someone already vaccinated against COVID-19 increased vaccine uptake (+6 percentage points, p<0.05). At Survey 1, the intention to get vaccinated as soon as possible was positively associated with perceived risk of illness from COVID-19 (+9.2 percentage points, p<0.05), the belief that most people in their area had been vaccinated (+7.0 percentage points, p<0.05) and living with someone already vaccinated against COVID-19 (+6.6 percentage points, p<0.05). CONCLUSION Study findings underscore the predictive power of intentions and of beliefs about disease risk, vaccine safety and vaccine efficacy. Social proof interventions hold promise for increasing vaccination intentions and overcoming concerns about vaccine safety.
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Affiliation(s)
- Brendan Maughan-Brown
- Southern Africa Labour and Development Research Unit, University of Cape Town, Cape Town, South Africa
| | - Katherine Claire Eyal
- Southern Africa Labour and Development Research Unit, School of Economics, University of Cape Town, Cape Town, South Africa
| | | | - Alison M Buttenheim
- Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
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Saleh SN, McDonald SA, Basit MA, Kumar S, Arasaratnam RJ, Perl TM, Lehmann CU, Medford RJ. Public perception of COVID-19 vaccines through analysis of Twitter content and users. Vaccine 2023; 41:4844-4853. [PMID: 37385887 PMCID: PMC10288320 DOI: 10.1016/j.vaccine.2023.06.058] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 05/03/2023] [Accepted: 06/15/2023] [Indexed: 07/01/2023]
Abstract
BACKGROUND With the global continuation of the COVID-19 pandemic, the large-scale administration of a SARS-CoV-2 vaccine is crucial to achieve herd immunity and curtail further spread of the virus, but success is contingent on public understanding and vaccine uptake. We aim to understand public perception about vaccines for COVID-19 through the wide-scale, organic discussion on Twitter. METHODS This cross-sectional observational study included Twitter posts matching the search criteria (('covid*' OR 'coronavirus') AND 'vaccine') posted during vaccine development from February 1st through December 11th, 2020. These COVID-19 vaccine related posts were analyzed with topic modeling, sentiment and emotion analysis, and demographic inference of users to provide insight into the evolution of public attitudes throughout the study period. FINDINGS We evaluated 2,287,344 English tweets from 948,666 user accounts. Individuals represented 87.9 % (n = 834,224) of user accounts. Of individuals, men (n = 560,824) outnumbered women (n = 273,400) by 2:1 and 39.5 % (n = 329,776) of individuals were ≥40 years old. Daily mean sentiment fluctuated congruent with news events, but overall trended positively. Trust, anticipation, and fear were the three most predominant emotions; while fear was the most predominant emotion early in the study period, trust outpaced fear from April 2020 onward. Fear was more prevalent in tweets by individuals (26.3 % vs. organizations 19.4 %; p < 0.001), specifically among women (28.4 % vs. males 25.4 %; p < 0.001). Multiple topics had a monthly trend towards more positive sentiment. Tweets comparing COVID-19 to the influenza vaccine had strongly negative early sentiment but improved over time. INTERPRETATION This study successfully explores sentiment, emotion, topics, and user demographics to elucidate important trends in public perception about COVID-19 vaccines. While public perception trended positively over the study period, some trends, especially within certain topic and demographic clusters, are concerning for COVID-19 vaccine hesitancy. These insights can provide targets for educational interventions and opportunity for continued real-time monitoring.
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Affiliation(s)
- Sameh N Saleh
- Department of Internal Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, United States; Clinical Informatics Center, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, United States.
| | - Samuel A McDonald
- Clinical Informatics Center, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, United States; Department of Emergency Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, United States
| | - Mujeeb A Basit
- Department of Internal Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, United States; Clinical Informatics Center, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, United States
| | - Sanat Kumar
- Clinical Informatics Center, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, United States; Lebanon Trail High School, 5151 Ohio Dr, Frisco, TX 75035, United States
| | - Reuben J Arasaratnam
- Department of Internal Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, United States
| | - Trish M Perl
- Department of Internal Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, United States
| | - Christoph U Lehmann
- Clinical Informatics Center, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, United States; Departments of Pediatrics, Bioinformatics, Population & Data Sciences, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, United States
| | - Richard J Medford
- Department of Internal Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, United States; Clinical Informatics Center, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, United States
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25
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Leonardelli M, Mele F, Marrone M, Germinario CA, Tafuri S, Moscara L, Bianchi FP, Stefanizzi P. The Effects of the COVID-19 Pandemic on Vaccination Hesitancy: A Viewpoint. Vaccines (Basel) 2023; 11:1191. [PMID: 37515007 PMCID: PMC10386622 DOI: 10.3390/vaccines11071191] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 06/23/2023] [Accepted: 06/30/2023] [Indexed: 07/30/2023] Open
Abstract
Vaccination hesitancy is considered by the World Health Organization as a danger to global health. In recent years, vaccine hesitancy rates to COVID-19 have been studied worldwide. In our study, we aim to provide an overview of the concept of vaccine hesitancy, with regard to the post-COVID era, and to provide prevention and management strategies. A search of the international literature until March 2023 was conducted in the PubMed database. The 5723 papers found were divided into two groups: prior to the COVID-19 era and from 2021 onward. Papers about the vaccine hesitation phenomenon are becoming more common during the SARS-CoV-2 pandemic and following the marketing that the vaccine companies have carried out on the different types of COVID-19 vaccines. It is advisable that healthcare authorities, at the national and international level, as well as healthcare professionals, at the local level, should promote a series of activities to reduce the vaccine hesitancy rate.
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Affiliation(s)
- Mirko Leonardelli
- Section of Legal Medicine, Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Federica Mele
- Section of Legal Medicine, Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Maricla Marrone
- Section of Legal Medicine, Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | | | - Silvio Tafuri
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, 70124 Bari, Italy
| | - Lorenza Moscara
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, 70124 Bari, Italy
| | | | - Pasquale Stefanizzi
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, 70124 Bari, Italy
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26
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Kwon S, Park A. Examining thematic and emotional differences across Twitter, Reddit, and YouTube: The case of COVID-19 vaccine side effects. COMPUTERS IN HUMAN BEHAVIOR 2023; 144:107734. [PMID: 36942128 PMCID: PMC10016349 DOI: 10.1016/j.chb.2023.107734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 01/31/2023] [Accepted: 03/11/2023] [Indexed: 03/17/2023]
Abstract
Social media discourse has become a key data source for understanding the public's perception of, and sentiments during a public health crisis. However, given the different niches which platforms occupy in terms of information exchange, reliance on a single platform would provide an incomplete picture of public opinions. Based on the schema theory, this study suggests a 'social media platform schema' to indicate users' different expectations based on previous usages of platform and argues that a platform's distinct characteristics foster distinct platform schema and, in turn, distinct nature of information. We analyzed COVID-19 vaccine side effect-related discussions from Twitter, Reddit, and YouTube, each of which represents a different type of the platform, and found thematic and emotional differences across platforms. Thematic analysis using k-means clustering algorithm identified seven clusters in each platform. To computationally group and contrast thematic clusters across platforms, we employed modularity analysis using the Louvain algorithm to determine a semantic network structure based on themes. We also observed differences in emotional contexts across platforms. Theoretical and public health implications are then discussed.
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Affiliation(s)
- Soyeon Kwon
- Department of Management Information System, College of Business, Dongguk University, 30, Pildong-ro 1gil, Jung-gu, Seoul, 04620, Republic of Korea
| | - Albert Park
- Department of Software and Information Systems, College of Computing and Informatics, UNC Charlotte, Woodward 310H, 9201 University City Blvd, Charlotte, NC, 28223, USA
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27
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García-Iglesias JJ, Allande-Cussó R, Camacho Vega JC, Yıldırım M, Gómez-Salgado C, Fagundo-Rivera J, Gómez-Salgado J. [Sources used to obtain information on COVID-19 and its impact on mental health.]. Rev Esp Salud Publica 2023; 97:e202306049. [PMID: 37325913 PMCID: PMC10540901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 05/17/2023] [Indexed: 06/17/2023] Open
Abstract
With the rise of COVID-19, the society has had the need to search for information about the pandemic and the sources used to obtain information have been very diverse, with a greater predominance of social media, traditional media and consultation with loved ones. In addition, an excess of information has been observed in the media that made access and understanding difficult, as well as a constant concern and anxiety about health that caused a need to search excessively or repeatedly for information on health and disease. This information was not always endorsed by the scientific community and during the pandemic there has been the spread of misinformation, fake news and conspiracy theories about COVID-19 disseminated, mainly through social media. In this sense, both the knowledge and the beliefs apprehended have been able to impact the mental health of the population.
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Affiliation(s)
- Juan Jesús García-Iglesias
- Departamento de Sociología, Trabajo Social y Salud Pública; Universidad de Huelva.Universidad de HuelvaHuelvaSpain
| | - Regina Allande-Cussó
- Departamento de Enfermería; Facultad de Enfermería, Podología y Fisioterapia; Universidad de Sevilla.Universidad de SevillaSevillaSpain
| | - Juan Carlos Camacho Vega
- Departamento de Construcciones Arquitectónicas II; Escuela Técnica Superior de Ingeniería de Edificación; Universidad de Sevilla.Universidad de SevillaSevillaSpain
| | - Murat Yıldırım
- Departamento de Psicología; Facultad de Ciencias y Letras; Universidad Agrı Ibrahim Çeçen.Universidad Agrı Ibrahim ÇeçenMerkez/AgrıTürkiye
| | | | - Javier Fagundo-Rivera
- Centro Universitario de Enfermería Cruz Roja; Universidad de Sevilla.Universidad de SevillaSevillaSpain
| | - Juan Gómez-Salgado
- Departamento de Sociología, Trabajo Social y Salud Pública; Universidad de Huelva.Universidad de HuelvaHuelvaSpain
- Programa de Posgrado de Seguridad y Salud; Universidad Espíritu Santo.Universidad Espíritu SantoGuayaquilEcuador
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28
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Lohiniva AL, Pensola A, Hyökki S, Sivelä J, Härmä V, Tammi T. Identifying factors influencing COVID-19 vaccine uptake in Finland - a qualitative study using social media data. Front Public Health 2023; 11:1138800. [PMID: 37361144 PMCID: PMC10288145 DOI: 10.3389/fpubh.2023.1138800] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 05/23/2023] [Indexed: 06/28/2023] Open
Abstract
Introduction Vaccine demand creation requires understanding what is driving the uptake of the vaccine. 24 Qualitative research methods are paramount to gaining a localized understanding of behavioral 25 drivers and barriers to vaccine uptake, but they are often underutilized. Methods This is a qualitative study that 26 used public comments on the Facebook and Twitter posts of the Finnish Institute for Health and 27 Welfare (THL) as data sources to identify behavioral drivers for COVID-19 vaccine uptake in 28 Finland. The participatory data analysis utilized thematic analysis and the Theoretical Domains 29 Framework (TDF). NVIVO was used to assist in the coding process. Results The greatest number of FB and 30 Twitter comments were linked with six TDF domains: knowledge, environmental context and 31 resources, beliefs in consequences, beliefs in capabilities, social and professional role, and social 32 influences. The domains included 15 themes that were interlinked. The knowledge domain 33 overlapped with all other domains. Discussion By using public discourse on Facebook and Twitter, and rapid 34 qualitative data analysis methods within a behavioral insight framework, this study adds to the 35 emerging knowledge about behavioral drivers of COVID-19 vaccines that can be used by public 36 health experts to enhance the uptake of vaccines during future pandemics and epidemics.
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29
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Sullivan P, Starr V, Dubois E, Starr A, Acharibasam JB, McIlduff C. Where past meets present: Indigenous vaccine hesitancy in Saskatchewan. MEDICAL HUMANITIES 2023; 49:321-331. [PMID: 36604166 PMCID: PMC10439261 DOI: 10.1136/medhum-2022-012501] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/07/2022] [Indexed: 06/17/2023]
Abstract
In Canada, colonisation, both historic and ongoing, increases Indigenous vaccine hesitancy and the threat posed by infectious diseases. This research investigated Indigenous vaccine hesitancy in a First Nation community in Saskatchewan, ways it can be overcome, and the influence of a colonial history as well as modernity. Research followed Indigenous research methodologies, a community-based participatory research design, and used mixed methods. Social media posts (interventions) were piloted on a community Facebook page in January and February (2022). These interventions tested different messaging techniques in a search for effective strategies. The analysis that followed compared the number of likes and views of the different techniques to each other, a control post, and community-developed posts implemented by the community's pandemic response team. At the end of the research, a sharing circle occurred and was followed by culturally appropriate data analysis (Nanâtawihowin Âcimowina Kika-Môsahkinikêhk Papiskîci-Itascikêwin Astâcikowina procedure). Results demonstrated the importance of exploring an Indigenous community's self-determined solution, at the very least, alongside the exploration of external solutions. Further, some sources of vaccine hesitancy, such as cultural barriers, can also be used to promote vaccine confidence. When attempting to overcome barriers, empathy is crucial as vaccine fears exist, and antivaccine groups are prepared to take advantage of empathetic failures. Additionally, the wider community has a powerful influence on vaccine confidence. Messaging, therefore, should avoid polarising vaccine-confident and vaccine-hesitant people to the point where the benefits of community influence are limited. Finally, you need to understand people and their beliefs to understand how to overcome hesitancy. To gain this understanding, there is no substitute for listening.
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Affiliation(s)
- Patrick Sullivan
- College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Victor Starr
- Kihew Kawaskasit Health Services, Star Blanket Cree Nation, Saskatchewan, Canada
| | - Ethel Dubois
- Star Blanket Cree Nation, Star Blanket Cree Nation, Saskatchewan, Canada
| | - Alyssa Starr
- College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | | | - Cari McIlduff
- College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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30
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Hasanzad M, Namazi H, Larijani B. COVID-19 anti-vaccine attitude and hesitancy. J Diabetes Metab Disord 2023; 22:1-4. [PMID: 36373157 PMCID: PMC9638374 DOI: 10.1007/s40200-022-01018-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 02/13/2022] [Accepted: 02/28/2022] [Indexed: 11/08/2022]
Abstract
High vaccination rates are required around the world to create herd immunity and terminate the current COVID-19 pandemic growth. With the steady rise in COVID-19 vaccine supplies, hesitancy and rejection to be vaccinated has become a problem worldwide for large vaccine coverage. Understanding the causes of vaccine avoidance or hesitancy can help to increase vaccination intentions in the general population. A number of factors contributed to increasing hesitancy. Some causes of COVID-19 vaccine hesitancy include anti-vaccine myths and confusing messages about some severe side effects of few vaccines, confusion over protection levels, poor health literacy (lack of accurate knowledge about vaccines and virus), deficient legal liability from the vaccine manufacturers, political and economic intentions, mistrust and suspicion of medical companies, concern of efficacy against to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) variants, safety concerns (elderly, people with preexisting comorbidities) and some socio-demographic factors. Urgent interventions and policies targeting the corresponding factors are needed. Recognizing obstacles to vaccine uptake helps in the development of effective solutions to solve them. Evidence-based and behaviorally guided approaches should be used to achieve high acceptance and uptake. Supplementary Information The online version contains supplementary material available at 10.1007/s40200-022-01018-y.
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Affiliation(s)
- Mandana Hasanzad
- Medical Genomics Research Center, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
- Personalized Medicine Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamidreza Namazi
- Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Personalized Medicine Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Marani H, Song MY, Jamieson M, Roerig M, Allin S. Public Officials' Engagement on Social Media During the Rollout of the COVID-19 Vaccine: A Content Analysis of Tweets. JMIR INFODEMIOLOGY 2023. [PMID: 37315194 PMCID: PMC10361259 DOI: 10.2196/41582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND Social media is an important way for governments to communicate with the public. This is particularly true in times of crisis such as the COVID-19 pandemic, during which time government officials had a strong role in promoting public health measures such as vaccines. OBJECTIVE In Canada, provincial COVID-19 vaccine rollout was delivered in three phases aligned with federal government COVID-19 vaccine guidance for priority populations. In this study, we examined how Canadian public officials used Twitter to engage with the public about vaccine rollout and how this engagement has shaped public response to vaccines across jurisdictions. METHODS We conducted a content analysis of tweets posted between December 28, 2020, and August 31, 2021. Leveraging social media artificial intelligence (AI) tool Brandwatch Analytics©, we constructed a list of public officials in three jurisdictions (Ontario, Alberta and British Columbia) organized across six public official types, then conducted an English/French keyword search for tweets about vaccine rollout and delivery that mentioned, retweeted, or replied to the public officials. We identified the top 30 tweets with the highest impressions in each jurisdiction in each of the three phases (approximately a 26-day window) of the vaccine rollout. The metrics of engagement (impressions, retweets, likes, and replies) from the top 30 tweets per phase in each jurisdiction were then extracted for additional annotation. We specifically annotated sentiment towards public officials' vaccine response (I.e., positive, negative, neutral) in each tweet, and also annotated the type of social media engagement. A thematic analysis of tweets was then conducted to add nuance to extracted data characterizing sentiment and interaction type. RESULTS Of the six categories of public officials, 142 prominent accounts were included from Ontario, Alberta and British Columbia. 270 tweets were included in the content analysis. Public officials mostly used Twitter for information provision (65.6%), followed by horizontal engagement (17.5%), citizen engagement (11.3%), and public service announcements (5.7%). Information provision by government bodies (e.g., provincial government and public health authorities) or municipal leaders are more prominent than tweets by other public official groups. Neutral sentiment accounted for 51.1% of all tweets, while positive sentiment (43.2%) was the second most common sentiment. In Ontario, 60% of the tweets were positive. Negative sentiment (e.g., public officials criticizing vaccine rollout) accounted for 12.6% of all tweets. CONCLUSIONS As governments continue to promote the uptake of the COVID-19 "booster" doses, findings from this study are useful in informing how governments can best utilize social media to engage with the public to achieve democratic goals. CLINICALTRIAL
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Affiliation(s)
- Husayn Marani
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, CA
- North American Observatory on Health Systems and Policies, University of Toronto, Toronto, CA
| | - Melodie Yunju Song
- North American Observatory on Health Systems and Policies, University of Toronto, Toronto, CA
| | - Margaret Jamieson
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, CA
- North American Observatory on Health Systems and Policies, University of Toronto, Toronto, CA
| | - Monika Roerig
- North American Observatory on Health Systems and Policies, University of Toronto, Toronto, CA
| | - Sara Allin
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, CA
- North American Observatory on Health Systems and Policies, University of Toronto, Toronto, CA
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Wang Y, Willis E, Yeruva VK, Ho D, Lee Y. A case study of using natural language processing to extract consumer insights from tweets in American cities for public health crises. BMC Public Health 2023; 23:935. [PMID: 37226165 DOI: 10.1186/s12889-023-15882-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 05/11/2023] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic was a "wake up" call for public health agencies. Often, these agencies are ill-prepared to communicate with target audiences clearly and effectively for community-level activations and safety operations. The obstacle is a lack of data-driven approaches to obtaining insights from local community stakeholders. Thus, this study suggests a focus on listening at local levels given the abundance of geo-marked data and presents a methodological solution to extracting consumer insights from unstructured text data for health communication. METHODS This study demonstrates how to combine human and Natural Language Processing (NLP) machine analyses to reliably extract meaningful consumer insights from tweets about COVID and the vaccine. This case study employed Latent Dirichlet Allocation (LDA) topic modeling, Bidirectional Encoder Representations from Transformers (BERT) emotion analysis, and human textual analysis and examined 180,128 tweets scraped by Twitter Application Programming Interface's (API) keyword function from January 2020 to June 2021. The samples came from four medium-sized American cities with larger populations of people of color. RESULTS The NLP method discovered four topic trends: "COVID Vaccines," "Politics," "Mitigation Measures," and "Community/Local Issues," and emotion changes over time. The human textual analysis profiled the discussions in the selected four markets to add some depth to our understanding of the uniqueness of the different challenges experienced. CONCLUSIONS This study ultimately demonstrates that our method used here could efficiently reduce a large amount of community feedback (e.g., tweets, social media data) by NLP and ensure contextualization and richness with human interpretation. Recommendations on communicating vaccination are offered based on the findings: (1) the strategic objective should be empowering the public; (2) the message should have local relevance; and, (3) communication needs to be timely.
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Affiliation(s)
- Ye Wang
- Department of Communication and Journalism, University of Missouri-Kansas City, 202 Haag Hall, 5120 Rockhill Road, 816-235-2735, Kansas City, MO, 64110, USA.
| | - Erin Willis
- Department of Advertising, Public Relations & Media Design, University of Colorado Boulder, 478 UCB, 1511 University Avenue, Boulder, CO, 80309-0200, USA
| | - Vijaya K Yeruva
- Division of Computing, Analytics, and Mathematics, University of Missouri-Kansas City, 801 E51st St, Kansas City, MO, 64110, USA
| | - Duy Ho
- Division of Computing, Analytics, and Mathematics, University of Missouri-Kansas City, 801 E51st St, Kansas City, MO, 64110, USA
| | - Yugyung Lee
- Division of Computing, Analytics, and Mathematics, University of Missouri-Kansas City, 801 E51st St, Kansas City, MO, 64110, USA
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Wu X, Li Z, Xu L, Li P, Liu M, Huang C. COVID-19 Vaccine-Related Information on the WeChat Public Platform: Topic Modeling and Content Analysis. J Med Internet Res 2023; 25:e45051. [PMID: 37058349 PMCID: PMC10132036 DOI: 10.2196/45051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 03/04/2023] [Accepted: 03/23/2023] [Indexed: 04/15/2023] Open
Abstract
BACKGROUND The COVID-19 vaccine is an effective tool in the fight against the COVID-19 outbreak. As the main channel of information dissemination in the context of the epidemic, social media influences public trust and acceptance of the vaccine. The rational application of health behavior theory is a guarantee of effective public health information dissemination. However, little is known about the application of health behavior theory in web-based COVID-19 vaccine messages, especially from Chinese social media posts. OBJECTIVE This study aimed to understand the main topics and communication characteristics of hot papers related to COVID-19 vaccine on the WeChat platform and assess the health behavior theory application with the aid of health belief model (HBM). METHODS A systematic search was conducted on the Chinese social media platform WeChat to identify COVID-19 vaccine-related papers. A coding scheme was established based on the HBM, and the sample was managed and coded using NVivo 12 (QSR International) to assess the application of health behavior theory. The main topics of the papers were extracted through the Latent Dirichlet Allocation algorithm. Finally, temporal analysis was used to explore trends in the evolution of themes and health belief structures in the papers. RESULTS A total of 757 papers were analyzed. Almost all (671/757, 89%) of the papers did not have an original logo. By topic modeling, 5 topics were identified, which were vaccine development and effectiveness (267/757, 35%), disease infection and protection (197/757, 26%), vaccine safety and adverse reactions (52/757, 7%), vaccine access (136/757, 18%), and vaccination science popularization (105/757, 14%). All papers identified at least one structure in the extended HBM, but only 29 papers included all of the structures. Descriptions of solutions to obstacles (585/757, 77%) and benefit (468/757, 62%) were the most emphasized components in all samples. Relatively few elements of susceptibility (208/757, 27%) and the least were descriptions of severity (135/757, 18%). Heat map visualization revealed the change in health belief structure before and after vaccine entry into the market. CONCLUSIONS To the best of our knowledge, this is the first study to assess the structural expression of health beliefs in information related to the COVID-19 vaccine on the WeChat public platform based on an HBM. The study also identified topics and communication characteristics before and after the market entry of vaccines. Our findings can inform customized education and communication strategies to promote vaccination not only in this pandemic but also in future pandemics.
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Affiliation(s)
- Xiaoqian Wu
- College of Medical Informatics, Chongqing Medical University, Chongqing, China
| | - Ziyu Li
- College of Medical Informatics, Chongqing Medical University, Chongqing, China
| | - Lin Xu
- Department of Information, Xiaoqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Pengfei Li
- School of Public Health, Weifang Medical University, Weifang, China
| | - Ming Liu
- College of Medical Informatics, Chongqing Medical University, Chongqing, China
| | - Cheng Huang
- College of Medical Informatics, Chongqing Medical University, Chongqing, China
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Zhou Y, Li R, Shen L. Psychological profiles of COVID vaccine-hesitant individuals and implications for vaccine message design strategies. Vaccine X 2023; 13:100279. [PMID: 36910012 PMCID: PMC9987601 DOI: 10.1016/j.jvacx.2023.100279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 03/02/2023] [Accepted: 03/03/2023] [Indexed: 03/08/2023] Open
Abstract
COVID-19 has caused tremendous consequences in the U.S., and combating the pandemic requires a significant number of Americans to receive COVID-19 vaccines. Guided by prominent health communication theories, this project took a formative evaluation approach and employed a national sample (N = 1041) in the U.S. to explore the potential differences between vaccine-inclined vs. -hesitant individuals and to generate profiles of hesitant individuals as the foundation for audience segmentation and message targeting. Five distinct profiles emerged in the sample. Characteristics of each profile were described, and appropriate messaging strategies were identified to target each group. Theoretical and practical implications were discussed.
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Affiliation(s)
- Yanmengqian Zhou
- Department of Communication Studies, Louisiana State University, 229 Coates Hall, Baton Rouge, LA 70803, United States
| | - Ruobing Li
- School of Communication and Journalism Stony Brook University Frank Melville, Jr. Memorial Library, John S. Toll Drive N-4011, Stony Brook, NY 11794, United States
| | - Lijiang Shen
- Department of Communication Arts & Sciences College of the Liberal Arts, Pennsylvania State University, 221 Sparks Building, University Park, PA 16802, United States
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Davidson PD, Muniandy T, Karmegam D. Perception of COVID-19 vaccination among Indian Twitter users: computational approach. JOURNAL OF COMPUTATIONAL SOCIAL SCIENCE 2023:1-20. [PMID: 37363805 PMCID: PMC10047476 DOI: 10.1007/s42001-023-00203-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 03/01/2023] [Indexed: 06/28/2023]
Abstract
Vaccination has been a hot topic in the present COVID-19 context. The government, public health stakeholders and media are all concerned about how to get the people vaccinated. The study was intended to explore the perception and emotions of the Indians citizens toward COVID-19 vaccine from Twitter messages. The tweets were collected for the period of 6 months, from mid-January to June, 2021 using hash-tags and keywords specific to India. Topics and emotions from the tweets were extracted using Latent Dirichlet Allocation (LDA) method and National Research Council (NRC) Lexicon, respectively. Theme, sentiment and emotion wise engagement and reachability metrics were assessed. Hash-tag frequency of COVID-19 vaccine brands were also identified and evaluated. Information regarding 'Co-WIN app and availability of vaccine' was widely discussed and also received highest engagement and reachability among Twitter users. Among the various emotions, trust was expressed the most, which highlights the acceptance of vaccines among the Indian citizens. The hash-tags frequency of vaccine brands shows that Covishield was popular in the month of March 2021, and Covaxin in April 2021. The results from the study will help stakeholders to efficiently use social media to disseminate COVID-19 vaccine information on popular concerns. This in turn will encourage citizens to be vaccinated and achieve herd immunity. Similar methodology can be adopted in future to understand the perceptions and concerns of people in emergency situations. Supplementary Information The online version contains supplementary material available at 10.1007/s42001-023-00203-0.
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Affiliation(s)
| | | | - Dhivya Karmegam
- School of Public Health, SRM Institute of Science and Technology, Kattankulathur, Chennai, India
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Yildiz Durak H, Şimşir Gökalp Z, Saritepeci M, Dilmaç B, Durak A. Investigation of personal variables, technology usage, vaccine-related variables, social media-specific epistemological beliefs, media literacy, social impact strategies variables affecting vaccine hesitancy beliefs in the Covid-19 pandemic. ZEITSCHRIFT FUR GESUNDHEITSWISSENSCHAFTEN = JOURNAL OF PUBLIC HEALTH 2023:1-14. [PMID: 37361268 PMCID: PMC10013284 DOI: 10.1007/s10389-023-01872-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 02/24/2023] [Indexed: 03/16/2023]
Abstract
Aim In this study, personal variables, technology use cases, vaccine-related variables, social media-specific epistemological beliefs, media literacy, and social influence strategies were examined as predictors of Covid-19 vaccination hesitancy (VH) beliefs. Subject and methods The prediction design research model is used to detect the predictors of the dependent variable. The study group consists of 378 participants. Five different scales were used together with the self-description form as a data collection tool. Results According to the results of the research, individuals who have positive perceptions about the safety of Covid-19 vaccines and who have received the Covid-19 vaccine have lower anti-vaccine beliefs. It is another situation that prevents the opposition to vaccination of those who research the source of information on social media. As a result, age, education and income level, social media usage experience, media literacy, and social influence strategies were not effective on the participants' anti-vaccine beliefs. Conclusion According to the findings of the study, positive perceptions about the safety of Covid-19 vaccines, being vaccinated against Covid-19, and researching a source of information on social media variables seem to be effective in laying the foundations for constructive interventions such as using anti-vaccine beliefs to guide, reduce or eliminate negative beliefs about vaccines.
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Affiliation(s)
- Hatice Yildiz Durak
- Eregli Faculty of Education, Department of Educational Science, Necmettin Erbakan University, Konya, Turkey
| | - Zeynep Şimşir Gökalp
- Faculty of Education, Department of Educational Sciences, Selçuk University, Konya, Turkey
| | - Mustafa Saritepeci
- Eregli Faculty of Education, Department of Educational Science, Necmettin Erbakan University, Konya, Turkey
| | - Bülent Dilmaç
- Eregli Faculty of Education, Department of Educational Science, Necmettin Erbakan University, Konya, Turkey
| | - Aykut Durak
- Eregli Faculty of Education, Necmettin Erbakan University, Konya, Turkey
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Borghouts J, Huang Y, Gibbs S, Hopfer S, Li C, Mark G. Understanding underlying moral values and language use of COVID-19 vaccine attitudes on twitter. PNAS NEXUS 2023; 2:pgad013. [PMID: 36896130 PMCID: PMC9991494 DOI: 10.1093/pnasnexus/pgad013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 12/23/2022] [Accepted: 01/09/2023] [Indexed: 03/11/2023]
Abstract
Public sentiment toward the COVID-19 vaccine as expressed on social media can interfere with communication by public health agencies on the importance of getting vaccinated. We investigated Twitter data to understand differences in sentiment, moral values, and language use between political ideologies on the COVID-19 vaccine. We estimated political ideology, conducted a sentiment analysis, and guided by the tenets of moral foundations theory (MFT), we analyzed 262,267 English language tweets from the United States containing COVID-19 vaccine-related keywords between May 2020 and October 2021. We applied the Moral Foundations Dictionary and used topic modeling and Word2Vec to understand moral values and the context of words central to the discussion of the vaccine debate. A quadratic trend showed that extreme ideologies of both Liberals and Conservatives expressed a higher negative sentiment than Moderates, with Conservatives expressing more negative sentiment than Liberals. Compared to Conservative tweets, we found the expression of Liberal tweets to be rooted in a wider set of moral values, associated with moral foundations of care (getting the vaccine for protection), fairness (having access to the vaccine), liberty (related to the vaccine mandate), and authority (trusting the vaccine mandate imposed by the government). Conservative tweets were found to be associated with harm (around safety of the vaccine) and oppression (around the government mandate). Furthermore, political ideology was associated with the expression of different meanings for the same words, e.g. "science" and "death." Our results inform public health outreach communication strategies to best tailor vaccine information to different groups.
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Affiliation(s)
- Judith Borghouts
- Department of Medicine, University of California Irvine, Irvine, CA 92617, USA
| | - Yicong Huang
- Department of Computer Science, University of California Irvine, Irvine, CA 92697, USA
| | - Sydney Gibbs
- Department of Computer Science, University of California Irvine, Irvine, CA 92697, USA
| | - Suellen Hopfer
- Department of Health, Society & Behavior in the Program in Public Health, University of California Irvine, Irvine, CA 92697, USA
| | - Chen Li
- Department of Computer Science, University of California Irvine, Irvine, CA 92697, USA
| | - Gloria Mark
- Department of Computer Science, University of California Irvine, Irvine, CA 92697, USA
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Zhou Y, Li R, Shen L. Targeting COVID-19 vaccine-hesitancy in college students: An audience-centered approach. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-10. [PMID: 36853986 DOI: 10.1080/07448481.2023.2180988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 12/27/2022] [Accepted: 02/10/2023] [Indexed: 06/18/2023]
Abstract
Objective: The study tested potential factors that differentiated the COVID-19 vaccine-hesitant and -inclined college students and, based on these factors, identified subgroups of the vaccine-hesitant students. Participants: Participants were 1,183 U.S. college students attending four-year universities or community colleges recruited through Qualtrics between January 25 and March 3, 2021. Methods: Participants completed an online survey assessing their COVID-19 vaccination intention, perceived risks of COVID-19 and the COVID-19 vaccines, efficacy beliefs regarding COVID-19 and the COVID-19 vaccines, and emotions toward taking the COVID-19 vaccines. Results: Vaccine-hesitant and -inclined college students varied in their emotions, risk perceptions, and efficacy beliefs regarding the virus and the vaccines. Using these factors as indicators, vaccine-hesitant college students were classified into five latent subgroups with distinct characteristics. Conclusions: In identifying subgroups of the vaccine-hesitant college students, the study has important insights to offer regarding the design of vaccine-promotion messaging strategies targeting the college student population.
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Affiliation(s)
- Yanmengqian Zhou
- Department of Communication Studies, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Ruobing Li
- School of Communication & Journalism, Stony Brook University, Stony Brook, New York, USA
| | - Lijiang Shen
- Department of Communication Arts & Sciences, Pennsylvania State University, University Park, Pennsylvania, USA
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Beirakdar S, Klingborg L, Herzig van Wees S. Attitudes of Swedish Language Twitter Users Toward COVID-19 Vaccination: Exploratory Qualitative Study. JMIR INFODEMIOLOGY 2023; 3:e42357. [PMID: 37012999 PMCID: PMC9996415 DOI: 10.2196/42357] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 12/05/2022] [Accepted: 01/10/2023] [Indexed: 02/24/2023]
Abstract
Background
Social media have played an important role in shaping COVID-19 vaccine choices during the pandemic. Understanding people’s attitudes toward the vaccine as expressed on social media can help address the concerns of vaccine-hesitant individuals.
Objective
The aim of this study was to understand the attitudes of Swedish-speaking Twitter users toward COVID-19 vaccines.
Methods
This was an exploratory qualitative study that used a social media–listening approach. Between January and March 2022, a total of 2877 publicly available tweets in Swedish were systematically extracted from Twitter. A deductive thematic analysis was conducted using the World Health Organization’s 3C model (confidence, complacency, and convenience).
Results
Confidence in the safety and effectiveness of the COVID-19 vaccine appeared to be a major concern expressed on Twitter. Unclear governmental strategies in managing the pandemic in Sweden and the belief in conspiracy theories have further influenced negative attitudes toward vaccines. Complacency—the perceived risk of COVID-19 was low and booster vaccination was unnecessary; many expressed trust in natural immunity. Convenience—in terms of accessing the right information and the vaccine—highlighted a knowledge gap about the benefits and necessity of the vaccine, as well as complaints about the quality of vaccination services.
Conclusions
Swedish-speaking Twitter users in this study had negative attitudes toward COVID-19 vaccines, particularly booster vaccines. We identified attitudes toward vaccines and misinformation, indicating that social media monitoring can help policy makers respond by developing proactive health communication interventions.
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Affiliation(s)
- Safwat Beirakdar
- Karolinska Institute Department of Global Public Health Stockholm Sweden
| | - Leon Klingborg
- Karolinska Institute Department of Global Public Health Stockholm Sweden
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40
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Zang S, Zhang X, Xing Y, Chen J, Lin L, Hou Z. Applications of Social Media and Digital Technologies in COVID-19 Vaccination: Scoping Review. J Med Internet Res 2023; 25:e40057. [PMID: 36649235 PMCID: PMC9924059 DOI: 10.2196/40057] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 12/18/2022] [Accepted: 01/13/2023] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Social media and digital technologies have played essential roles in disseminating information and promoting vaccination during the COVID-19 pandemic. There is a need to summarize the applications and analytical techniques of social media and digital technologies in monitoring vaccine attitudes and administering COVID-19 vaccines. OBJECTIVE We aimed to synthesize the global evidence on the applications of social media and digital technologies in COVID-19 vaccination and to explore their avenues to promote COVID-19 vaccination. METHODS We searched 6 databases (PubMed, Scopus, Web of Science, Embase, EBSCO, and IEEE Xplore) for English-language articles from December 2019 to August 2022. The search terms covered keywords relating to social media, digital technology, and COVID-19 vaccines. Articles were included if they provided original descriptions of applications of social media or digital health technologies/solutions in COVID-19 vaccination. Conference abstracts, editorials, letters, commentaries, correspondence articles, study protocols, and reviews were excluded. A modified version of the Appraisal Tool for Cross-Sectional Studies (AXIS tool) was used to evaluate the quality of social media-related studies. The review was undertaken with the guidance of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. RESULTS A total of 178 articles were included in our review, including 114 social media articles and 64 digital technology articles. Social media has been applied for sentiment/emotion analysis, topic analysis, behavioral analysis, dissemination and engagement analysis, and information quality analysis around COVID-19 vaccination. Of these, sentiment analysis and topic analysis were the most common, with social media data being primarily analyzed by lexicon-based and machine learning techniques. The accuracy and reliability of information on social media can seriously affect public attitudes toward COVID-19 vaccines, and misinformation often leads to vaccine hesitancy. Digital technologies have been applied to determine the COVID-19 vaccination strategy, predict the vaccination process, optimize vaccine distribution and delivery, provide safe and transparent vaccination certificates, and perform postvaccination surveillance. The applied digital technologies included algorithms, blockchain, mobile health, the Internet of Things, and other technologies, although with some barriers to their popularization. CONCLUSIONS The applications of social media and digital technologies in addressing COVID-19 vaccination-related issues represent an irreversible trend. Attention should be paid to the ethical issues and health inequities arising from the digital divide while applying and promoting these technologies.
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Affiliation(s)
- Shujie Zang
- School of Public Health, Fudan University, Shanghai, China
- Global Health Institute, Fudan University, Shanghai, China
| | - Xu Zhang
- School of Public Health, Fudan University, Shanghai, China
- Global Health Institute, Fudan University, Shanghai, China
| | - Yuting Xing
- School of Public Health, Fudan University, Shanghai, China
- Global Health Institute, Fudan University, Shanghai, China
| | - Jiaxian Chen
- School of Public Health, Fudan University, Shanghai, China
| | - Leesa Lin
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, Hong Kong, SAR, China
| | - Zhiyuan Hou
- School of Public Health, Fudan University, Shanghai, China
- Global Health Institute, Fudan University, Shanghai, China
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Powis M, Sutradhar R, Patrikar A, Cheung M, Gong I, Vijenthira A, Hicks LK, Wilton D, Krzyzanowska MK, Singh S. Factors associated with timely COVID-19 vaccination in a population-based cohort of patients with cancer. J Natl Cancer Inst 2023; 115:146-154. [PMID: 36321960 PMCID: PMC9905967 DOI: 10.1093/jnci/djac204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 09/21/2022] [Accepted: 10/31/2022] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND In many jurisdictions, cancer patients were prioritized for COVID-19 vaccination because of increased risk of infection and death. To understand sociodemographic disparities that affected timely receipt of COVID-19 vaccination among cancer patients, we undertook a population-based study in Ontario, Canada. METHODS Patients older than 18 years and diagnosed with cancer January 2010 to September 2020 were identified using administrative data; vaccination administration was captured between approval (December 2020) up to February 2022. Factors associated with time to vaccination were evaluated using multivariable Cox proportional hazards regression. RESULTS The cohort consisted of 356 535 patients, the majority of whom had solid tumor cancers (85.9%) and were not on active treatment (74.1%); 86.8% had received at least 2 doses. The rate of vaccination was 25% lower in recent (hazard ratio [HR] = 0.74, 95% confidence interval [CI] = 0.72 to 0.76) and nonrecent immigrants (HR = 0.80, 95% CI = 0.79 to 0.81). A greater proportion of unvaccinated patients were from neighborhoods with a high concentration of new immigrants or self-reported members of racialized groups (26.0% vs 21.3%, standardized difference = 0.111, P < .001), residential instability (27.1% vs 23.0%, standardized difference = 0.094, P < .001), or material deprivation (22.1% vs 16.8%, standardized difference = 0.134, P < .001) and low socioeconomic status (20.9% vs 16.0%, standardized difference = 0.041, P < .001). The rate of vaccination was 20% lower in patients from neighborhoods with the lowest socioeconomic status (HR = 0.82, 95% CI = 0.81 to 0.84) and highest material deprivation (HR = 0.80, 95% CI = 0.78 to 0.81) relative to those in more advantaged neighborhoods. CONCLUSIONS Despite funding of vaccines and prioritization of high-risk populations, marginalized patients were less likely to be vaccinated. Differences are likely due to the interplay between systemic barriers to access and cultural or social influences affecting uptake.
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Affiliation(s)
- Melanie Powis
- Cancer Quality Lab (CQuaL), Princess Margaret Cancer Centre—University Health Network, Toronto, ON, Canada
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre—University Health Network, Toronto, ON, Canada
| | - Rinku Sutradhar
- Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Aditi Patrikar
- Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
| | - Matthew Cheung
- Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Division of Medical Oncology and Hematology, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Inna Gong
- Division of Medical Oncology and Hematology, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Abi Vijenthira
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre—University Health Network, Toronto, ON, Canada
- Division of Medical Oncology and Hematology, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Lisa K Hicks
- Division of Medical Oncology and Hematology, Department of Medicine, University of Toronto, Toronto, ON, Canada
- Division of Hematology/Oncology, St. Michael’s Hospital—Unity Health, Toronto, ON, Canada
| | - Drew Wilton
- Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
| | - Monika K Krzyzanowska
- Cancer Quality Lab (CQuaL), Princess Margaret Cancer Centre—University Health Network, Toronto, ON, Canada
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre—University Health Network, Toronto, ON, Canada
- Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
- Division of Medical Oncology and Hematology, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Simron Singh
- Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Division of Medical Oncology and Hematology, Department of Medicine, University of Toronto, Toronto, ON, Canada
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Gregory PA, Gill M, Datta D, Austin Z. A typology of vaccine hesitancies: Results from a study of community pharmacists administering COVID-19 vaccinations during the pandemic. Res Social Adm Pharm 2023; 19:332-342. [PMID: 36266175 PMCID: PMC9547396 DOI: 10.1016/j.sapharm.2022.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 09/12/2022] [Accepted: 09/28/2022] [Indexed: 11/06/2022]
Abstract
Pharmacists were integral to the vaccine administration process during the first two years of the COVID-19 pandemic. As such, they encountered a variety of different forms of vaccine resistance. This qualitative study explored 33 community pharmacists (from varying geographical and practice types) responses to vaccine resistance and tactics utilized to support vaccination amongst diverse community members. A typology of 8 different variants of vaccine hesitancy emerged, each with its own root cause and potential opportunities for intervention. Pharmacists in this study described techniques to support adherence to public health guidance based on their assessment of root causes for resistance demonstrated by patients. Importantly, all pharmacists in this study described feelings of anger towards truly anti-vax patients and unwillingness to actually engage or even try to address this group in their practice.
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Affiliation(s)
| | - Manmohit Gill
- Leslie Dan Faculty of Pharmacy, University of Toronto, Canada
| | - Dhruv Datta
- Leslie Dan Faculty of Pharmacy, University of Toronto, Canada
| | - Zubin Austin
- Leslie Dan Faculty of Pharmacy and the Institute for Health Policy, Management, and Evaluation – Temerty Faculty of Medicine at the University of Toronto, Canada,Corresponding author
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Kemei J, Tulli M, Olanlesi-Aliu A, Tunde-Byass M, Salami B. Impact of the COVID-19 Pandemic on Black Communities in Canada. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1580. [PMID: 36674335 PMCID: PMC9862348 DOI: 10.3390/ijerph20021580] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 01/09/2023] [Accepted: 01/13/2023] [Indexed: 06/17/2023]
Abstract
The COVID-19 pandemic has resulted in differential impacts on the Black communities in Canada and has unmasked existing race-related health inequities. The purpose of this study was to illuminate the impacts of the COVID-19 pandemic on Black people in Canada. Historically, social inequalities have determined the impacts of pandemics on the population, and in the case of the COVID-19 pandemic, disproportionate infections and mortalities have become evident among racialized communities in Canada. This qualitative descriptive study utilized an intersectionality framework. We invited Black stakeholders across Canada to participate in semi-structured interviews to deepen our knowledge of the impacts of the COVID-19 pandemic on Black communities in Canada. A total of 30 interviews were recorded, transcribed verbatim, and analyzed using content analysis. Our findings fell into three categories: (1) increased vulnerability to COVID-19 disease, (2) mental impacts, and (3) addressing impacts of the COVID-19 pandemic. The findings show the underlying systemic inequities in Canada and systemic racism exacerbated health inequities among the Black communities and undermined interventions by public health agencies to curb the spread of COVID-19 and associated impacts on Black and other racialized communities. The paper concludes by identifying critical areas for future intervention in policy and practice.
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Affiliation(s)
- Janet Kemei
- Faculty of Nursing, University of Alberta, Edmonton, AB T6G 1C9, Canada
| | - Mia Tulli
- Faculty of Nursing, University of Alberta, Edmonton, AB T6G 1C9, Canada
| | | | - Modupe Tunde-Byass
- Department of Obstetrics and Gynaecology, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Bukola Salami
- Faculty of Nursing, University of Alberta, Edmonton, AB T6G 1C9, Canada
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AlShurman BA, Butt ZA. Proposing a New Conceptual Syndemic Framework for COVID-19 Vaccine Hesitancy: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1561. [PMID: 36674314 PMCID: PMC9864682 DOI: 10.3390/ijerph20021561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/09/2023] [Accepted: 01/12/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Discussions regarding syndemics have dominated research in recent years. Vaccine hesitancy has also been propelled to the forefront. In this narrative review, we aim to frame a novel syndemic framework to understand the interaction between vaccine hesitancy, COVID-19, and negative health outcomes. METHODS A non-systematic electronic search was conducted in PubMed and Google Scholar. Search criteria were limited to articles published between November 2019 and June 2022. Articles related to the COVID-19 syndemic and vaccine hesitancy were included. RESULTS Our review revealed that the adherence to COVID-19 regulations-although they were effective in preventing COVID-19 transmission, cases, and deaths-created a dynamically unstable 'vicious cycle' between undesirable health, economic, and social outcomes. The "accumulation" of complex stressors decreased individuals' cognitive flexibility and hindered them from making decisions and getting vaccinated. Furthermore, it increased individuals' risk of acquiring COVID-19, losing their employment, increasing poverty, and decreasing healthcare utilization. We illustrated how the amalgamation of sociodemographic and contextual factors associated with COVID-19 might impact people's vaccine decisions, making them more hesitant toward COVID-19 vaccination. Failing to receive vaccinations increases the chances of COVID-19 transmission, hospitalization, and other negative health outcomes. CONCLUSIONS Understanding the interaction between these factors is essential to provide policymakers with inspiration to set appropriate interventions for promoting COVID-19 vaccination acceptance to decrease the overall burden of pandemics.
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Affiliation(s)
| | - Zahid Ahmad Butt
- School of Public Health Sciences, University of Waterloo, Waterloo, ON N2L 3G1, Canada
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Sussman KL, Bouchacourt L, Bright LF, Wilcox GB, Mackert M, Norwood AS, Allport Altillo BS. COVID-19 topics and emotional frames in vaccine hesitation: A social media text and sentiment analysis. Digit Health 2023; 9:20552076231158308. [PMID: 36896330 PMCID: PMC9989441 DOI: 10.1177/20552076231158308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 01/17/2023] [Indexed: 03/06/2023] Open
Abstract
Objective Addressing gaps in COVID-19 vaccine-hesitancy research, the current study aimed to add depth and nuance to the exploratory research examining vaccine-hesitant groups. Using a larger, but more focused conversation occurring on social media, the results can be used by health communicators to frame emotionally resonant messaging to improve COVID-19 vaccine advocacy while also mitigating negative concerns for vaccine-hesitant individuals. Methods Social media mentions were collected using a social media listening software, Brandwatch, to examine topics and sentiments in COVID-19 hesitancy discourse during a period of September 1, 2020, through December 31, 2020. The results from this query included publicly available mentions on two popular social media sites, Twitter and Reddit. The dataset of 14,901 global, English language messages were analyzed using a computer-assisted process in SAS text-mining and Brandwatch software. The data revealed eight unique topics before being analyzed by sentiment. Results Among the COVID-19 hesitancy data, trust-related topics emerged that included declining vaccine acceptance, a parallel pandemic of distrust, and a call for politicians to let the scientific process work, among others. Positive sentiment revealed interest in the sources which included healthcare professionals, doctors, and government organizations. Pfizer was found to elicit both positive and negative emotions in the vaccine-hesitancy data. The negative sentiment tended to dominate the hesitancy conversation, accelerating once vaccines hit the market. Conclusions Relevant topics were identified to help support targeted communication, strategically accelerate vaccine acceptance, and mitigate COVID-19 vaccine hesitancy among the public. Strategic methods of online and offline messaging tactics are suggested to reach diverse, malleable populations of interest. Topics of personal anecdotes of safety, effectiveness, and recommendations among families are identified as persuasive communication opportunities.
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Affiliation(s)
- Kristen L Sussman
- School of Journalism and Mass Communication at Texas State University, San Marcos, TX, USA
| | - Lindsay Bouchacourt
- Stan Richards School of Advertising and Public Relations at The University of Texas at Austin, Moody College of Communication at the University of Texas at Austin, Austin, TX, USA
| | - Laura F Bright
- Stan Richards School of Advertising and Public Relations at The University of Texas at Austin, Moody College of Communication at the University of Texas at Austin, Austin, TX, USA
| | - Gary B Wilcox
- Stan Richards School of Advertising and Public Relations at The University of Texas at Austin, Moody College of Communication at the University of Texas at Austin, Austin, TX, USA
| | - Michael Mackert
- Stan Richards School of Advertising and Public Relations & Center for Health Communication at The University of Texas at Austin, Austin, TX, USA
| | | | - Brandon Shaun Allport Altillo
- Departments of Population Health, Internal Medicine, and Pediatrics, Primary Care, Family, and Community Medicine Clerkship, Primary Care Internist and Pediatrician, Lone Star Circle of Care at Collinfield, Dell Medical School at The University of Texas at Austin, Austin, TX, USA
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Chi DL, Kerr D, Patiño Nguyen D, Shands ME, Cruz S, Edwards T, Carle A, Carpiano R, Lewis F. A conceptual model on caregivers' hesitancy of topical fluoride for their children. PLoS One 2023; 18:e0282834. [PMID: 36947522 PMCID: PMC10032489 DOI: 10.1371/journal.pone.0282834] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 02/23/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Topical fluoride hesitancy is a well-documented and growing public health problem. Despite extensive evidence that topical fluoride is safe and prevents tooth decay, an increasing number of caregivers are hesitant about their children receiving topical fluoride, leading to challenges in clinical settings where caregivers refuse preventive care. PURPOSE To explore the determinants of topical fluoride hesitancy for caregivers with dependent children. METHODS In this qualitative study, we interviewed 56 fluoride-hesitant caregivers to develop an inductive conceptual model of reasons why caregivers are hesitant. RESULTS The core construct of the conceptual model of topical fluoride hesitancy centered on caregivers "wanting to protect and not mess up their child". Six domains comprised this core construct: thinking topical fluoride is unnecessary, wanting to keep chemicals out of my child's body, thinking fluoride is harmful, thinking there is too much uncertainty about fluoride, feeling pressured to get topical fluoride, and feeling fluoride should be a choice. CONCLUSIONS Topical fluoride hesitancy is complex and multifactorial. Study findings provide insight for future efforts to understand and optimize caregivers' preventive care decision making.
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Affiliation(s)
- Donald L Chi
- Department of Oral Health Sciences, University of Washington School of Dentistry, Seattle, Washington, United States of America
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, Washington, United States of America
| | - Darragh Kerr
- Department of Oral Health Sciences, University of Washington School of Dentistry, Seattle, Washington, United States of America
| | - Daisy Patiño Nguyen
- Department of Oral Health Sciences, University of Washington School of Dentistry, Seattle, Washington, United States of America
| | - Mary Ellen Shands
- Department of Oral Health Sciences, University of Washington School of Dentistry, Seattle, Washington, United States of America
| | - Stephanie Cruz
- Department of Oral Health Sciences, University of Washington School of Dentistry, Seattle, Washington, United States of America
| | - Todd Edwards
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, Washington, United States of America
| | - Adam Carle
- James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States of America
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States of America
- Department of Psychology, University of Cincinnati College of Arts and Sciences, Cincinnati, Ohio, United States of America
| | - Richard Carpiano
- University of California Riverside, School of Public Policy, Riverside, California, United States of America
| | - Frances Lewis
- Department of Child, Family and Population Health Nursing, University of Washington School of Nursing, Seattle, Washington, United States of America
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Thaivalappil A, Young I, MacKay M, Pearl DL, Papadopoulos A. A qualitative study exploring healthcare providers’ and trainees’ barriers to COVID-19 and influenza vaccine uptake. Health Psychol Behav Med 2022; 10:695-712. [PMID: 35957955 PMCID: PMC9359157 DOI: 10.1080/21642850.2022.2106231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background Vaccines are effective biological interventions which reduce health burdens and protect healthcare providers from vaccine-preventable diseases. However, there are concerns about varying levels of vaccination coverage of influenza and COVID-19 vaccines among those working in healthcare. The aim of this study was to identify barriers and facilitators to COVID-19 and influenza vaccinations among healthcare providers and trainees using the Theoretical Domains Framework (TDF). Methods Semi-structured interviews (n = 18) were carried out with healthcare providers and trainees in Canada. A thematic analysis approach was used to code interview transcripts and match findings to TDF domains and broader categories. Results Three overarching themes were generated from six TDF domains and three inductively generated categories: (1) making informed health decisions with an added responsibility to protect oneself and patients; (2) a pro-vaccine social network, widespread accessibility, and pursuing a sense of normalcy; and (3) seeking a more nuanced, respectful, and calculated approach to vaccine communication and policy implementation. Conclusion These findings help to identify factors associated with influenza and COVID-19 vaccine uptake among individuals in the healthcare field. Addressing these factors may improve healthcare provider sentiments surrounding vaccines, lead to better patient education, and increased uptake of vaccinations with the potential for seasonal booster doses.
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Affiliation(s)
| | - Ian Young
- School of Occupational and Public Health, Ryerson University, Toronto, Canada
| | - Melissa MacKay
- Department of Population Medicine, University of Guelph, Guelph, Canada
| | - David L. Pearl
- Department of Population Medicine, University of Guelph, Guelph, Canada
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Capurro G, Tustin J, Jardine CG, Driedger SM. When good messages go wrong: Perspectives on COVID-19 vaccines and vaccine communication from generally vaccine accepting individuals in Canada. Hum Vaccin Immunother 2022; 18:2145822. [PMID: 36452995 PMCID: PMC9762838 DOI: 10.1080/21645515.2022.2145822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Vaccines are one of the most important and successful public health interventions to reduce the spread of infectious diseases. However, unlike childhood diseases and routine vaccines, COVID-19 is a novel threat, and COVID-19 vaccines may elicit specific anxieties. Through focus groups, we examine the concerns and attitudes toward the COVID-19 vaccine expressed by individuals who accept routine vaccinations in Canada. We also conducted a pre-focus group survey to document participant attitudes towards vaccines in general. While most participants had received at least one dose of the COVID-19 vaccine or had the intention to get it, many had concerns. First, participants felt anxious about the quick development and approval of the vaccines, even if they recognized that the vaccines have undergone clinical trials. Second, participants felt confused about shifting public health guidelines regarding vaccine safety, changing the interval between doses, and mixing different vaccine brands. Finally, participants said they felt abandoned when deciding whether to get vaccinated or not. People who generally accept vaccines expressed concerns about COVID-19 vaccines, mostly related to the inevitable uncertainties of a new vaccine (i.e. novelty, safety, mandates, etc.). COVID-19 vaccine hesitancy, understood as concerns about the novelty of a vaccine and the rapid implementation of it, could be useful for understanding questioning attitudes towards COVID-19 vaccines from people who accept routine vaccinations. Understanding COVID-19 vaccine hesitancy can also provide valuable insights as booster doses are periodically needed and people may not be as accepting of these additional doses.
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Affiliation(s)
- Gabriela Capurro
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Jordan Tustin
- School of Occupational and Public Health, Toronto Metropolitan University, Toronto, Canada
| | - Cindy G. Jardine
- Faculty of Health Sciences, University of Fraser Valley, Chilliwack, Canada
| | - S. Michelle Driedger
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada,CONTACT S. Michelle Driedger Department of Community Health Sciences, University of Manitoba, S113-750 Bannatyne Ave, Winnipeg, Manitoba R3E 0W3, Canada
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Ezezika O, Girmay B, Adedugbe T, Jonas I, Thullah Y, Thompson C. Examining the barriers, facilitators and attitudes towards COVID-19 vaccine and public health measures for black communities in Canada: a qualitative study protocol. BMJ Open 2022; 12:e063528. [PMID: 36576190 PMCID: PMC9723414 DOI: 10.1136/bmjopen-2022-063528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/07/2022] Open
Abstract
INTRODUCTION Black communities claim the highest number of cases and deaths due to COVID-19 in Canada. Generating culturally/contextually appropriate public health measures and strategies for vaccine uptake in black communities within Canada can better support the disproportionate impact of this pandemic. This study explores the barriers and enablers to public health measures limited to mask-wearing, disinfection, sanitation, social distancing and handwashing, as well as the barriers and attitudes towards COVID-19 vaccines among the black community. METHODS AND ANALYSIS We will use qualitative approaches informed by the widely accepted Consolidated Framework for Implementation Research (CFIR) to aid our investigation. We will conduct 120 semistructured interviews and five focus groups with black populations across the major provinces of Canada to understand the barriers and facilitators to public health measures, including barriers and attitudes towards COVID-19 vaccines. Data will be organised and analysed based on the CFIR. Facilitators and barriers to COVID-19 preventative measures and the barriers, facilitators and attitudes towards COVID-19 vaccines will be organised to explore relationships across the data. ETHICS AND DISSEMINATION This study was approved by the Social Sciences, Humanities and Education Research Ethics Board at the University of Toronto (41585). All participants are given information about the study and will sign a consent form in order to be included; participants are informed of their right to withdraw from the study. Research material will be accessible to all researchers involved in this study as no personal identifiable information will be collected during the key informant semistructured interviews and focus groups. The study results will be provided to participants and published in peer-reviewed journals.
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Affiliation(s)
- Obidimma Ezezika
- School of Health Studies, Faculty of Health Sciences, Western University, London, Ontario, Canada
- Department of Health and Society, University of Toronto Scarborough, Toronto, Ontario, Canada
| | - Bethelehem Girmay
- School of Health Studies, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | | | - Isaac Jonas
- Federation of Black Canadians (FBC), Brampton, Ontario, Canada
| | | | - Chris Thompson
- Federation of Black Canadians (FBC), Brampton, Ontario, Canada
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Mavundza EJ, Ndwandwe D, Wiysonge CS. COVID-19 vaccine demand protest might have increased vaccine acceptance and uptake in South Africa. Hum Vaccin Immunother 2022; 18:2064691. [PMID: 35435798 PMCID: PMC9897633 DOI: 10.1080/21645515.2022.2064691] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Safe and efficacious COVID-19 vaccines exist, but their success against the disease depends on public willingness to receive them. Vaccine hesitancy is one major obstacle to the achievement of herd immunity. On 25 June 2021, about 2000 supporters of the Economic Freedom Fighters (EFF) (the third biggest political party in South Africa) marched to the offices of the national regulatory authority (NRA) supporting COVID-19 vaccination and demanding approval of two additional vaccines (Sputnik V and Sinovac) in South Africa. The march was led by EFF leader, Julius Malema. By then, only three COVID-19 vaccines had received emergency use authorization in the country-the Janssen, AstraZeneca and Pfizer-BioNtech vaccines. It is worth noting that NRAs should only approve a vaccine if they are satisfied that its benefits outweigh any potential risks and not through political pressure. Nevertheless, we believe that this march might have increased COVID-19 vaccine acceptance and uptake among EFF supporters. The endorsement of COVID-19 vaccines by Malema, an influential political figure in South Africa, probably convinced some vaccine hesitant South Africans that COVID-19 vaccination is important. Therefore, we suggest vaccine endorsement by influential individuals in South Africa as one of the strategies to increase COVID-19 vaccine uptake.
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Affiliation(s)
- Edison Johannes Mavundza
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa,CONTACT Edison Johannes Mavundza Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
| | - Duduzile Ndwandwe
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
| | - Charles Shey Wiysonge
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
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