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Shandera WX. COVID-19 ethics: unique aspects and a review as of early 2024. Monash Bioeth Rev 2024:10.1007/s40592-024-00199-x. [PMID: 39003388 DOI: 10.1007/s40592-024-00199-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2024] [Indexed: 07/15/2024]
Abstract
COVID-19 presents a variety of ethical challenges in a set of arenas, arenas not always considered in past pandemics. These challenges include issues related to autonomy, distributive ethics, and the establishment of policies of equity and justice. Methods are a literature review based on regular editing of an online textbook during the COVID-19 outbreak and a literature review using key ethical terms. Patients are confronted with new issues related to autonomy. Providers need to expand their concepts of ethical issues to include decisions based on proportionality and public health ethics. The public health sector needs to assess the beneficence of alternative modes of disease control. The research community needs to redefine the concept of informed consent in emergent conditions. All elements of the medical spectrum-physicians, scientists, and the community-at-large including the pharmaceutical industry-need to consider the multifaceted methods for preventing future pandemics. This will require giving particular emphasis to public health funding and ending the documented discrimination that exists in the provision of proven therapies. The developing world is especially at risk for most of the ethical issues, especially those related to equity and justice. The ethical issues associated with the COVID-19 outbreak are not unique but provide a diverse set of issues that apply to patients, providers, social groups, and investigators. The further study of such issues can help with preventing future outbreaks.
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Abdow VP, Marable JK, Moore ES. A Qualitative Study of Factors Influencing Hospital Participation in the Healthcare Equality Index. J Healthc Qual 2024; 46:177-187. [PMID: 38214608 DOI: 10.1097/jhq.0000000000000426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
Abstract
ABSTRACT Gender and sexual minority individuals experience higher rates of mistreatment and discrimination in healthcare compared with their non-lesbian, gay, bisexual, transgender, queer, and other nonheterosexual (LGBTQ+) peers. The Healthcare Equality Index (HEI) aims to create more inclusive environments and to provide metrics for quality improvement. Currently, only one adult hospital in the District of Columbia has earned the highest recognition from the HEI. Our institution is part of the same regional health system as this hospital, yet has never been evaluated by the HEI. This study explores the knowledge, attitudes, and perceptions surrounding the HEI at our institution to assess the feasibility of its participation. During the study period of July 2021 to June 2022, a total of 12 physicians, administrators, and educators from both hospitals and our affiliated school of medicine were interviewed. All participants expressed support after HEI requirements and improving inclusivity for LGBTQ+ patients. Participants at the other hospital cited unanimous support amongst hospital administrators as key for successful HEI implementation. Participants also mentioned cost, staff shortages, and the school of medicine's religious affiliation as potential barriers to this goal. Ultimately, hospital implementation of HEI guidelines is feasible despite shifting institutional priorities and resource limitations through greater stakeholder buy-in and streamlining a systemwide approach.
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D'souza S, Ghatole B, Raghuram H, Parakh S, Tugnawat D, Shaikh A, Singh S, Bandewar SS, Bhan A. COVID-19 Vaccine decision-making: trust among the transgender and disability communities in India. JOURNAL OF COMMUNICATION IN HEALTHCARE 2024:1-10. [PMID: 38597810 DOI: 10.1080/17538068.2024.2335784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
BACKGROUND Historical marginalisation and ongoing trust deficits in health and government systems shape present-day vaccine perceptions among marginalised communities. This paper sought to understand the role of trust in decision-making about COVID-19 vaccine uptake in the transgender and disability communities in India. METHODS Using a participatory approach we interviewed 24 community representatives, identifying themselves as transgender individuals or as persons with disability, and 21 key informants such as vaccine programme managers, vaccine providers, and community advocates. We undertook an inductive thematic analysis of the data using a socio-ecological model. RESULTS Fear of side effects in relation to specific needs of the two communities and mistrust of systems involved in vaccination shaped four different pathways for vaccine decision-making. Mistrust of systems was influenced by past negative experiences with the health system, creating contexts in which information and misinformation are shared and interpreted. Participants negotiated their doubts about safety and mistrust of systems by interacting with different sources of influence showing patterns of decision-making that are dynamic, context-dependent, and intersectional. CONCLUSION These findings will help in determining the content, strategies and approaches to equitable vaccine communication for these two communities. The two communities ought to be included in vaccine trials. Vaccine information must respond to the specific needs of these two communities which could be enabled by collaboration and engagement with community members and influencers. Finally, long-term investment towards the needs of marginalised communities is vital to dismantle cycles of marginalisation and distrust and in turn improve vaccine acceptance and uptake.
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Affiliation(s)
- Sharin D'souza
- Initiative for Health Equity Advocacy and Research, Bhopal Hub, Sangath, Bhopal, India
| | - Bhakti Ghatole
- Initiative for Health Equity Advocacy and Research, Bhopal Hub, Sangath, Bhopal, India
| | - Harikeerthan Raghuram
- Initiative for Health Equity Advocacy and Research, Bhopal Hub, Sangath, Bhopal, India
| | - Sana Parakh
- Initiative for Health Equity Advocacy and Research, Bhopal Hub, Sangath, Bhopal, India
| | - Deepak Tugnawat
- Initiative for Health Equity Advocacy and Research, Bhopal Hub, Sangath, Bhopal, India
| | - Aqsa Shaikh
- Initiative for Health Equity Advocacy and Research, Bhopal Hub, Sangath, Bhopal, India
- Department of Community Medicine, Hamdard Institute of Medical Sciences and Research, New Delhi, India
| | - Satendra Singh
- Initiative for Health Equity Advocacy and Research, Bhopal Hub, Sangath, Bhopal, India
- Department of Physiology, University College of Medical Sciences, Delhi, India
| | - Sunita Sheel Bandewar
- Initiative for Health Equity Advocacy and Research, Bhopal Hub, Sangath, Bhopal, India
- Forum for Medical Ethics Society, Mumbai, India
- Vidhayak Trust, Pune, India
| | - Anant Bhan
- Initiative for Health Equity Advocacy and Research, Bhopal Hub, Sangath, Bhopal, India
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Yu H, Bauermeister JA, Oyiborhoro U, Aryal S, Lipman TH, Tan ASL, Glanz K, Villarruel AM, Bonett S. Trust in federal COVID-19 vaccine oversight and parents' willingness to vaccinate their children against COVID-19: a cross-sectional study. BMC Public Health 2024; 24:830. [PMID: 38493101 PMCID: PMC10943829 DOI: 10.1186/s12889-024-18342-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: 12/21/2023] [Accepted: 03/12/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND Over half of the youth population in the United States, aged 6 months to 17 years, have not received the Coronavirus Disease 2019 (COVID-19) vaccine. Given parents' central role in vaccinating their children, we examined associations between parents' trust of the federal oversight of COVID-19 vaccine safety and their willingness to vaccinate their children against COVID-19. METHODS This cross-sectional study included 975 parents of minor children residing in Philadelphia who completed the online survey between September 2021 and February 2022. Trust was measured using a four-point Likert scale ranging from 'do not trust' to 'fully trust' for two variables: (1) trust in federal oversight of COVID-19 vaccine safety for children and (2) trust in federal oversight of COVID-19 vaccine safety for the general public. A multiple logistic regression evaluated associations between trust and parents' willingness to vaccinate their children, which was measured on a five-point Likert scale ranging from 'strongly disagree' to 'strongly agree.' The analysis was adjusted for race/ethnicity, age, sexual orientation, gender, education, insurance, and parents' vaccination status. RESULTS Analyses included 975 parents whose children had not previously been vaccinated against COVID-19 (mean age 36.79, standard deviation 6.4; 42.1% racial/ethnic minorities; 93.2% heterosexual; and 73.7% with a college degree). Greater trust regarding federal oversight of COVID-19 vaccine safety for children [adjusted odds ratio (aOR) = 1.52, 95% confidence interval (CI): 1.13-2.04] and for the public (aOR = 1.58, 95% CI: 1.17-2.14) were each associated with increased willingness to have their child vaccinated against COVID-19. Unvaccinated parents had decreased willingness compared to parents who had received at least one dose of the vaccine (aOR = 0.14, 95% CI: 0.04-0.41). College-graduate parents exhibited increased willingness compared to those without a college degree (aOR = 2.07, 95% CI: 1.52-2.81). Non-heterosexual parents showed increased willingness compared to heterosexual parents (aOR = 2.30, 95% CI: 1.20-4.76). CONCLUSIONS Trust in federal COVID-19 vaccine oversight was associated with parental willingness to vaccinate their children against COVID-19 among parents whose children have not yet been vaccinated. Identifying and addressing causes of mistrust are crucial next steps to promote child vaccination. Intervention efforts to address trust gaps should remain a public health priority.
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Affiliation(s)
- Hyunmin Yu
- School of Nursing, University of Pennsylvania, 418 Curie Blvd, Philadelphia, Pennsylvania, 19104, USA.
| | - José A Bauermeister
- School of Nursing, University of Pennsylvania, 418 Curie Blvd, Philadelphia, Pennsylvania, 19104, USA
| | - Ufuoma Oyiborhoro
- School of Nursing, University of Pennsylvania, 418 Curie Blvd, Philadelphia, Pennsylvania, 19104, USA
| | - Subhash Aryal
- School of Nursing, University of Pennsylvania, 418 Curie Blvd, Philadelphia, Pennsylvania, 19104, USA
| | - Terri H Lipman
- School of Nursing, University of Pennsylvania, 418 Curie Blvd, Philadelphia, Pennsylvania, 19104, USA
| | - Andy S L Tan
- Annenberg School for Communication, University of Pennsylvania, 3620 Walnut Street, Philadelphia, Pennsylvania, 19104, USA
| | - Karen Glanz
- School of Nursing, University of Pennsylvania, 418 Curie Blvd, Philadelphia, Pennsylvania, 19104, USA
- Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, Pennsylvania, 19104, USA
| | - Antonia M Villarruel
- School of Nursing, University of Pennsylvania, 418 Curie Blvd, Philadelphia, Pennsylvania, 19104, USA
| | - Stephen Bonett
- School of Nursing, University of Pennsylvania, 418 Curie Blvd, Philadelphia, Pennsylvania, 19104, USA
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5
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Xu J, Narla SS, Davoudpour S, Ruprecht MM, Curtis MG, Phillips Ii G. COVID-19 testing and vaccination uptake among youth and young adults: Disparities by age, race/ethnicity, sexual orientation, and gender identity. Am J Infect Control 2024; 52:312-319. [PMID: 37741292 PMCID: PMC10925914 DOI: 10.1016/j.ajic.2023.09.010] [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: 06/29/2023] [Revised: 09/18/2023] [Accepted: 09/19/2023] [Indexed: 09/25/2023]
Abstract
BACKGROUND The COVID-19 pandemic disproportionately impacts youth and young adults (YYA) and YYA with multiple marginalized identities, yet little is known about differences in uptake, testing access, and vaccine concerns among YYA by diverse demographic identities. METHODS Between 2/2021 and 2/2022, we conducted a national, cross-sectional online survey focused on diverse YYA ages 14 to 24 (n = 983). We explored the prevalence of COVID-19 testing and vaccination among YYA by age, race/ethnicity, and sexual and gender identities. Bivariate and multivariable logistic regression models were developed to estimate associations between individual variables and COVID-19 testing and vaccination. RESULTS The overall COVID-19 testing and vaccination rates in our sample were high (75.99% and 69.07%, respectively). No differences in testing by demographics were found. Compared to individuals aged 14 to 17 years, those aged 18 to 21 years and 22 to 24 years were over 2 times and 4 times as likely to report receiving a vaccine, respectively. All race/ethnicity groups except for Asian individuals were more likely to report being vaccinated compared to their white peers. CONCLUSIONS Our findings showed critical disparities in COVID-19 vaccination among YYA with marginalized identities and emphasized the urgency for data collection and research on pandemic prevention for vulnerable YYA populations.
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Affiliation(s)
- Jiayi Xu
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL.
| | - Shreya S Narla
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Shahin Davoudpour
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Megan M Ruprecht
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Michael G Curtis
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Gregory Phillips Ii
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
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Traister T. COVID-19 Vaccine Accessibility, Perceptions, and Attitudes in the LGBTQ+ Community. West J Nurs Res 2023; 45:1130-1138. [PMID: 37909671 DOI: 10.1177/01939459231211473] [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] [Indexed: 11/03/2023]
Abstract
BACKGROUND Lesbian, gay, bisexual, transgender, and queer populations have historically experienced challenges accessing, trusting, and receiving health care services, which can negatively impact successful uptake of the COVID-19 vaccine series among this population. OBJECTIVE This research aimed to examine the perceptions and attitudes regarding the acceptability, accessibility, and efficacy of the COVID-19 vaccine among persons who self-identify within this community. METHODS A multidisciplinary, community-focused mixed-methods study was conducted. The quantitative portion of the study was conducted via an online survey throughout the United States for 2 months. The quantitative portion of the study consisted of multiple online focus group sessions after the completion of the survey. RESULTS The online survey had an sample of 3868 participants, with 31 participants in the focus groups. High levels of acceptability toward COVID-19 vaccines were found within this community. Concerns highlighted included the need for culturally competent care, side effects of the vaccine, and unknown effects of the vaccine with hormone replacement therapy. Racial and ethnic minority, transgender, and nonbinary participants reported higher levels of uncertainty about vaccination. CONCLUSION Findings demonstrate that most lesbian, gay, bisexual, transgender, and queer individuals felt comfortable with the COVID-19 vaccine, had a positive experience with the vaccination process, and believe that the vaccine can protect them and others from COVID-19. When developing future COVID-19 vaccination strategies and rollouts, public health officials should consider prioritizing lesbian, gay, bisexual, transgender, and queer individuals and other marginalized populations by partnering with local organizations to identify trusted organizations.
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Affiliation(s)
- Tyler Traister
- School of Nursing, Quinnipiac University, Hamden, CT, USA
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Hong C. Mpox on Reddit: a Thematic Analysis of Online Posts on Mpox on a Social Media Platform among Key Populations. J Urban Health 2023; 100:1264-1273. [PMID: 37580545 PMCID: PMC10728031 DOI: 10.1007/s11524-023-00773-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/13/2023] [Indexed: 08/16/2023]
Abstract
The 2022-2023 mpox outbreak has disproportionately impacted gay, bisexual, and other men who have sex with men (GBMSM). The US CDC recommended individuals to explore safer sexual practices that minimize the potential risk of exposure and also strongly encouraged for eligible individuals to prioritize vaccination. This study aimed to analyze social media data related to mpox on Reddit since the mpox outbreak and identify themes associated with the impact on social behaviors and social processes among targeted population. Publicly available data were collected from the social media Reddit. We extracted the summarized mpox-related posts since the beginning of May 2022 from popular subreddits that were popular among GBMSM. We thematically analyzed the content to identify the overall themes related to the GBMSM's responses to the outbreak. There is an overall increase in the number of daily mpox-related posts, with three upticks in late May, late July, and early August 2022, which may correspond to the dates that the first mpox case was identified in the USA, the WHO declared a global public health emergency, and the US Department of Health and Human Services declared a public health emergency. Four themes were identified: (1) changes in sexual behaviors and social activities; (2) mpox vaccine attitude, uptake, and hesitancy; (3) perceived and experienced stigma and homophobia, and mental distress; and (4) online information-seeking and mutual aid and support. GBMSM changed their sexual behaviors and social activities to mitigate their exposure to the virus during this outbreak and actively sought and shared information about mpox vaccination in their respective settings, while some were hesitant due to concerns about side effects and potential effectiveness. Perceived and experienced stigma and discrimination on gay- and same sex-identify have impacted GBMSM's mental health. Interventions to promote the mpox vaccine must address the historical medical mistrust and vaccine hesitancy among GBMSM.
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Affiliation(s)
- Chenglin Hong
- Department of Social Welfare, UCLA Luskin School of Public Affairs, 3250 Public Affairs Building, Los Angeles, CA, USA.
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Acharya AK, Bryson Clark J, Behera SS. COVID-19 pandemic and transgender migrant women in India: Socio-economic vulnerability and vaccine hesitancy. J Migr Health 2023; 8:100204. [PMID: 38028887 PMCID: PMC10654218 DOI: 10.1016/j.jmh.2023.100204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 08/02/2023] [Accepted: 11/02/2023] [Indexed: 12/01/2023] Open
Abstract
In India, transgender women, often referred to as hijra or kinnar, remain a marginalized group and encounter interpersonal and structural barriers that subject them to social exclusion, discrimination, lack of access to education and health care, and fewer job opportunities compared with the general population. During the COVID-19 pandemic these disparities were heightened and the livelihood of transgender migrant women were severely hit and disrupted, causing further financial and physical hardship. The present study aims to explore the socio-economic vulnerability faced by these women during the pandemic and the factors that contribute to vaccine hesitancy in order to assist government officials and policy makers in the formulation of more inclusive policies for transgender people. Results indicate that the pandemic has adversely impacted their livelihood as most of them depend on sex work and begging. In order to fulfil their daily needs during the lockdown, they have borrowed loans from multiple sources with a higher interest rates and remain in debt. On vaccination status, only seven out of 43 transgender migrant women have taken one vaccine dose, and the rest are not willing to visit vaccine centres because of societal stigma and discrimination including from healthcare personnel. The study reported that these migrant women suffered intensified social stigma, verbal hostility and transphobia attitudes from healthcare professionals whihc caused panic, fear, anxiety and depression among them, and thus they evade these spaces for further consultation or to obtain any other services. Many of them have decided not to take the COVID-19 vaccine in order to stay away from hostility. Further, the lack of trust in medical professionals is also one of the principal concerns leading to vaccine hesitancy among transgender migrant women. Thus a systemic inclusive healthcare services policy is required to address the factors that may influence the vaccine acceptance among transgender women in India.
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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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Saleem M, Marimuthu J, Gandhi AP. Uptake and impact of COVID-19 vaccination among HIV key populations: a cohort study from Tamil Nadu, India. J Rural Med 2023; 18:215-221. [PMID: 37854511 PMCID: PMC10579930 DOI: 10.2185/jrm.2023-008] [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: 04/07/2023] [Accepted: 06/12/2023] [Indexed: 10/20/2023] Open
Abstract
Objective Human Immunodeficiency Virus (HIV) Key Populations (KPs) include Female Sex Workers (FSWs), men who have sex with men (MSM), transgender (TG), and transsexual (TS) persons. This study assessed coronavirus disease 2019 (COVID-19) vaccine uptake among KPs for HIV in India, adverse events following immunization (AEFI), and breakthrough infections among the vaccinated. Materials and Methods This retrospective cohort study was conducted among 421 KPs enrolled in 41 Targeted Intervention (TI) clusters in 31 districts of the Tamil Nadu State Acquired Immunodeficiency Syndrome (AIDS) Control Society (TANSACS), India, from June to September 2022. A semi-structured, bilingual (English and Tamil), interviewer-administered questionnaire was used to collect data on socio-demographic characteristics, vaccination status, AEFIs, and breakthrough infections among the KPs under the TIs. Results Among the KPs, 45.4% were FSWs, 37.1% were MSM, 16.2% were TG, and 1.4% were TS persons. Among them, 4.3% had HIV, and 2.9% had syphilis or other sexually transmitted infections (STIs). The COVID-19 vaccine uptake rate was 96%. Among the KPs, TG/TS persons had the highest vaccine uptake (98.6%), followed by FSWs (96.3%) and MSM (94.2%). AEFIs were reported by 85.4% of the participants. HIV positive status was significantly associated with the incidence of AEFI. The breakthrough infection rate was 5.4% among the vaccinated participants. Conclusion The COVID-19 vaccine uptake among HIV KPs was high in Tamil Nadu. AEFIs and breakthrough infections among COVID-19 vaccinated HIV KPs may be low, with mild AEFIs.
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Affiliation(s)
- M Saleem
- Department of Community Medicine, Government Dindigul Medical
College, India
| | - Janakiram Marimuthu
- Department of Community Medicine, Government Dindigul Medical
College, India
- Department of Community Medicine, Government Vellore Medical
College, India
- Targeted Intervention and Strategic Information Management
Unit, Tamil Nadu AIDS Control Society, India
| | - Aravind P Gandhi
- Department of Community Medicine, ESIC Medical College &
Hospital, Hyderabad, India
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Ryan GW, Askelson NM, Woodworth KR, Lindley MC, Gedlinske A, Parker AM, Gidengil CA, Petersen CA, Scherer AM. Unvaccinated Adolescents' COVID-19 Vaccine Intentions: Implications for Public Health Messaging. J Adolesc Health 2023; 73:679-685. [PMID: 37395695 PMCID: PMC10529916 DOI: 10.1016/j.jadohealth.2023.05.023] [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: 11/14/2022] [Revised: 04/20/2023] [Accepted: 05/22/2023] [Indexed: 07/04/2023]
Abstract
PURPOSE COVID-19 vaccine uptake remains low for US adolescents and contributes to excess morbidity and mortality. Most research has assessed parental intention to vaccinate their children. We explored differences between vaccine-acceptant and vaccine-hesitant unvaccinated US adolescents using national survey data. METHODS A nonprobability, quota-based sample of adolescents, aged 13-17 years, was recruited through an online survey panel in April 2021. One thousand nine hundred twenty seven adolescents were screened for participation and the final sample included 985 responses. We assessed responses from unvaccinated adolescents (n = 831). Our primary measure was COVID-19 vaccination intent ("vaccine-acceptant" defined as "definitely will" get a COVID-19 vaccine and any other response classified as "vaccine-hesitant") and secondary measures included reasons for intending or not intending to get vaccinated and trusted sources of COVID-19 vaccine information. We calculated descriptive statistics and chi-square tests to explore differences between vaccine-acceptant and vaccine-hesitant adolescents. RESULTS Most (n = 831; 70.9%) adolescents were hesitant, with more hesitancy observed among adolescents with low levels of concern about COVID-19 and high levels of concern about side effects of COVID-19 vaccination. Among vaccine-hesitant adolescents, reasons for not intending to get vaccinated included waiting for safety data and having parents who would make the vaccination decision. Vaccine-hesitant adolescents had a lower number of trusted information sources than vaccine-acceptant adolescents. DISCUSSION Differences identified between vaccine-acceptant and vaccine-hesitant adolescents can inform message content and dissemination. Messages should include accurate, age-appropriate information about side effects and risks of COVID-19 infection. Prioritizing dissemination of these messages through family members, state and local government officials, and healthcare providers may be most effective.
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Affiliation(s)
- Grace W Ryan
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts.
| | - Natoshia M Askelson
- Department of Community and Behavioral Health, University of Iowa, Iowa City, Iowa
| | | | | | - Amber Gedlinske
- Department of Internal Medicine, University of Iowa, Iowa City, Iowa
| | | | - Courtney A Gidengil
- RAND Corporation, Boston, Massachusetts; Division of Infectious Diseases, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Christine A Petersen
- Department of Internal Medicine, University of Iowa, Iowa City, Iowa; Department of Epidemiology, University of Iowa, Iowa City, Iowa
| | - Aaron M Scherer
- Department of Internal Medicine, University of Iowa, Iowa City, Iowa
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12
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Zucker R, Wolff-Sagy Y, Ramot N, Raviv Y, Lavie G, Netzer D, Hammerman A, Arbel R. Examining the Patterns of Mpox Vaccine Uptake in a Vulnerable Population. Sex Transm Dis 2023; 50:680-684. [PMID: 37255258 DOI: 10.1097/olq.0000000000001839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND The current Mpox outbreak presents unique vaccination challenges in vulnerable populations. Understanding factors associated with vaccine uptake in vulnerable populations is required for a successful vaccination campaign. METHODS This population-based cohort study was conducted in Clalit Health Services and included all individuals eligible for the Modified Vaccinia Ankara vaccine. Cox proportional hazards models were used to assess the characteristics associated with uptake of the first vaccine dose. RESULTS Attendance to a primary healthcare clinic in the Tel Aviv district, repeated sexually transmitted infection screening, and the recent purchase of HIV-PrEP or PDE5 inhibitors were associated with higher vaccine adherence, whereas previous nonadherence with recommended vaccines, low sociodemographic status, and history of HIV were associated with lower adherence. CONCLUSIONS These findings highlight the need for proactive patient and healthcare provider-oriented educational campaigns to curb vaccine hesitancy, and may help direct resources toward underserved populations, hence increasing equality in vaccine enrollment.
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Affiliation(s)
| | | | - Noga Ramot
- Branch of Planning and Strategy, Clalit Health Services
| | - Yuval Raviv
- Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv
| | | | - Doron Netzer
- From the Community Medical Services Division, Clalit Health Services
| | - Ariel Hammerman
- From the Community Medical Services Division, Clalit Health Services
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Herati H, Burns KE, Nascimento M, Brown P, Calnan M, Dubé È, Ward PR, Filice E, Rotolo B, Ike N, Meyer SB. Canadians' trust in government in a time of crisis: Does it matter? PLoS One 2023; 18:e0290664. [PMID: 37682915 PMCID: PMC10490979 DOI: 10.1371/journal.pone.0290664] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 08/11/2023] [Indexed: 09/10/2023] Open
Abstract
The ability of governments and nations to handle crises and protect the lives of citizens is heavily dependent on the public's trust in their governments and related social institutions. The aim of the present research was to understand public trust in government during a time of crisis, drawing on interview data (N = 56) collected during the COVID-19 pandemic (2021). In addition to the general public (n = 11), participants were sampled to obtain diversity as it relates to identifying as First Nations, Métis, and Inuit (n = 7), LGBT2SQ+ (n = 5), low-income (n = 8), Black Canadians (n = 7), young adult (n = 8), and newcomers to Canada (n = 10). Data were coded in consideration of social theories of trust, and specifically the nature of trust between individuals and institutions working with government in pandemic management. Canadians' trust in government was shaped by perceptions of pandemic communication, as well as decision-making and implementation of countermeasures. Data suggest that although participants did not trust government, they were accepting of measures and messages as presented through government channels, pointing to the importance of (re)building trust in government. Perhaps more importantly however, data indicate that resources should be invested in monitoring and evaluating public perception of individuals and institutions generating the evidence-base used to guide government communication and decision-making to ensure trust is maintained. Theoretically, our work adds to our understanding of the nature of trust as it relates to the association between interpersonal and institutional trust, and also the nature of trust across institutions.
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Affiliation(s)
- Hoda Herati
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Kathleen E. Burns
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Maria Nascimento
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Patrick Brown
- Department of Sociology, University of Amsterdam, Amsterdam, The Netherlands
| | - Michael Calnan
- School of Social Policy, Sociology and Social Research, University of Kent, Canterbury, United Kingdom
| | - Ève Dubé
- Laval University, Québec, Canada
| | - Paul R. Ward
- Research Centre for Public Health, Equity and Human Flourishing, Torrens University, Adelaide, Australia
| | - Eric Filice
- Department of Parks, Recreation and Tourism Management, North Carolina State University, Raleigh, North Carolina, United States of America
| | - Bobbi Rotolo
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Nnenna Ike
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Samantha B. Meyer
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
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14
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Powell R, Parker B, Moore M, Xiong T, Evans D, Sidibe T. Importance of Public and Private Partnership Supporting Data Disaggregation to Measure Racial, Sexual Orientation, and Gender Identity Disparities in COVID-19. Health Secur 2023; 21:S35-S41. [PMID: 37733289 DOI: 10.1089/hs.2023.0025] [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] [Indexed: 09/22/2023] Open
Abstract
The COVID-19 pandemic has exposed shortcomings in the US public health data system infrastructure, including incomplete or disparate processes related to data collection, management, sharing, and analysis. Public health data modernization is critical to ensure health equity is at the core of preparedness and response efforts and policies that prioritize equitable responses to health emergencies. To address the inequitable uptake and distribution of COVID-19 vaccinations in communities most disproportionately impacted by the pandemic, the CDC Foundation's Response Crisis and Preparedness Unit began partnering with community-based organizations in March 2021 to provide education and outreach and facilitate access to vaccines. These organizations engaged with partners and communities to address vaccine-related concerns, develop innovative and culturally appropriate communication strategies, and promote timely vaccination. Two grantees, Out Boulder County in Colorado and the Coalition of Asian American Leaders in Minnesota, experienced issues related to public health data collection standards and practices for COVID-19. Data collection tools often lack the appropriate or necessary demographic variables or level of disaggregation needed to be able to assess prioritization and disparities within racial and ethnic groups and across sexual orientation and gender identity categories. In this case study, both grantee organizations document their experiences, challenges, and strategies to overcome barriers to implementing their projects resulting from a lack of meaningful data. These examples identify inequities and systems-level changes related to data collection and surveillance, and they provide recommendations and lessons learned to improve data surveillance for more equitable public health responses.
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Affiliation(s)
- Rachel Powell
- Rachel Powell, PhD, MPH, is Senior Program Manager, Response, Crisis, and Preparedness Unit, National Foundation for the Centers for Disease Control and Prevention, Atlanta, GA
| | - Bruce Parker
- Bruce Parker, PhD, is Deputy Director, Out Boulder County, Boulder, CO
| | - Mardi Moore
- Mardi Moore is Executive Director, Out Boulder County, Boulder, CO
| | - ThaoMee Xiong
- ThaoMee Xiong, MPA, JD, is Executive and Network Director, The Coalition of Asian American Leaders, St. Paul, MN
| | - Dorothy Evans
- Dorothy Evans MPH, MEd, is Program Manager, Response, Crisis, and Preparedness Unit, National Foundation for the Centers for Disease Control and Prevention, Atlanta, GA
| | - Turquoise Sidibe
- Turquoise Sidibe, MPH, is Associate Vice President of Emergency Response, National Foundation for the Centers for Disease Control and Prevention, Atlanta, GA
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15
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Metheny N, Scott D, Buch J, Fallon S, Chavez J. Trusted Sources of Information and COVID-19 Vaccine Uptake in a Sample of Latinx Sexual and Gender Minorities in South Florida. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2023; 29:729-734. [PMID: 37104063 PMCID: PMC10524457 DOI: 10.1097/phh.0000000000001757] [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] [Indexed: 04/28/2023]
Abstract
OBJECTIVE To examine factors associated with COVID-19 vaccine uptake in a sample of Latino/a/x sexual and/or gender minority (SGM) individuals in South Florida. DESIGN Data were collected via an online survey from March 2021 to August 2022, as part of the Community Engagement Alliance Against COVID-19 Disparities. A multivariate regression analysis was fit using completion of a COVID-19 vaccine regimen as the outcome. Key covariates included trusted sources of information (eg, doctor, media), COVID-19-related challenges (eg, accessing medication, transportation), and dominant wave of SARS-CoV-2 at the time of data collection. SETTING Miami-Dade and Broward counties, Florida. RESULTS White Latino/a/x, bachelor's educated respondents, and those with high levels of trust in community organizations had significantly greater odds of vaccination. CONCLUSION Community organizations may be key to improving vaccine uptake among marginalized Latino/a/x SGM for COVID-19 and other emerging communicable diseases, such as meningitis and Mpox (monkeypox). The results of this study suggest that tailored public health messaging and additional funding for vaccine distribution are needed to better equip community organizations with the resources they need to serve this population.
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Affiliation(s)
- Nicholas Metheny
- School of Nursing and Health Studies, University of Miami, Coral Gables, Florida (Dr Metheny and Mr Scott); Latinos Salud, Miami, Florida (Mr Buch and Dr Fallon); and Miller School of Medicine, University of Miami, Miami, Florida (Ms Chavez)
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16
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Hong C, Holloway IW, Bednarczyk R, Javanbakht M, Shoptaw S, Gorbach PM. High Vaccine Confidence Is Associated with COVID-19 Vaccine Uptake in Gay, Bisexual, and Other Men Who Have Sex with Men Who Use Substances. LGBT Health 2023; 10:480-485. [PMID: 36976808 PMCID: PMC10468549 DOI: 10.1089/lgbt.2022.0255] [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] [Indexed: 03/29/2023] Open
Abstract
Purpose: We examined associations between vaccine confidence and COVID-19 vaccine uptake among gay, bisexual, and other men who have sex with men (GBMSM). Methods: Computer-assisted self-interviews were conducted among 249 GBMSM participating in mSTUDY from May to October 2021-a cohort of GBMSM with a history of substance use in Los Angeles. Data were collected using a vaccine confidence index. The association between vaccine confidence and COVID-19 vaccine uptake was assessed using multivariable log-binomial regression. Results: Two-thirds (64.7%) of GBMSM reported receiving at least one dose of COVID-19 vaccine. Vaccine confidence was positively associated with COVID-19 vaccine uptake. Participants expressed neutral attitudes on government trust and vaccine safety. Perceived health benefit and vaccine effectiveness were statistically significantly associated with vaccine uptake (adjusted prevalence ratio [APR] = 1.59, 95% confidence interval [CI]: 1.20-2.16; APR = 1.51, 95% CI: 1.07-2.15). Conclusions: Public health programs should prioritize public benefit and vaccine effectiveness messaging to advance vaccination among GBMSM who use substances.
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Affiliation(s)
- Chenglin Hong
- Department of Social Welfare, Luskin School of Public Affairs, University of California, Los Angeles, Los Angeles, California, USA
| | - Ian W. Holloway
- Department of Social Welfare, Luskin School of Public Affairs, University of California, Los Angeles, Los Angeles, California, USA
| | - Robert Bednarczyk
- Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, Georgia, USA
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, Georgia, USA
- Emory Vaccine Center, Emory University, Atlanta, Georgia, USA
| | - Marjan Javanbakht
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, USA
| | - Steven Shoptaw
- Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Pamina M. Gorbach
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, USA
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17
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Howard MC. Integrating the person-centered approach with the study of vaccine hesitancy: Applying latent profile analysis to identify vaccine hesitancy subpopulations and assess their relations with correlates and vaccination outcomes. Vaccine 2023:S0264-410X(23)00742-9. [PMID: 37357075 DOI: 10.1016/j.vaccine.2023.06.057] [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: 10/12/2022] [Revised: 05/26/2023] [Accepted: 06/15/2023] [Indexed: 06/27/2023]
Abstract
In scholarly and popular discussions of vaccine hesitancy, authors have repeatedly referred to different "types" of vaccine hesitant individuals; however, almost all modern research on vaccine hesitancy utilizes variable-centered approaches to identify the relation of variables rather than a person-centered approach to identify subpopulations, which suggests that a discrepancy exists between conceptual discussions and empirical research on vaccine hesitancy. For this reason, the current article conducts a latent profile analysis (LPA) on the dimensions of a well-supported vaccine hesitancy measure, which assess hesitancy towards vaccines in general. We also assess the relations of the resultant profiles (e.g., subpopulations) with relevant self-reported outcomes and correlates, wherein most of our outcomes are associated with COVID-19 and flu vaccines. Our LPA results support the existence of eight vaccine hesitancy profiles. The profile with the most unfavorable vaccination outcomes (e.g., willingness, receipt, and word-of-mouth) was associated with greater perceptions that vaccines cause health risks and unneeded when healthy; the profile with the most favorable vaccination outcomes was associated with low levels of all vaccine hesitancy dimensions. The other profiles produced a clear gradient between these two extremes. The profiles also differed regarding their standing on correlates, but the clearest difference was their relation with political orientation. Profiles with more unfavorable vaccination outcomes were associated with conservatism, whereas profiles with more favorable vaccinations outcomes were associated with liberalism. These results provide a new perspective for current understandings of vaccine hesitancy and open several avenues for future research.
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Affiliation(s)
- Matt C Howard
- The University of South Alabama, Mitchell College of Business, United States.
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18
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Soni GK, Seth S, Arora S, Singh K, Kumari A, Kanagat N, Fields R. Harnessing the Power of Collaboration to Expand the Coverage and Equity of COVID-19 Vaccinations in India: A Community Collaboration Model. Vaccines (Basel) 2023; 11:1022. [PMID: 37376411 PMCID: PMC10304198 DOI: 10.3390/vaccines11061022] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 04/28/2023] [Accepted: 05/19/2023] [Indexed: 06/29/2023] Open
Abstract
Early in 2021, India embarked on the uphill journey of the COVID-19 vaccination of the largest population group in the world in a prioritized manner and in the shortest possible time. Considering the endless variety of geography and diverse socio-economic demographic, religious, and community contexts, there was a high likelihood of certain population subgroups with known vulnerabilities facing inequities, which were anticipated to be further accentuated by a digital divide. This necessitated devising solutions for such communities in a localized manner to aid the local government in breaking the service access and uptake barriers with an inclusive approach. To bridge this vital gap, the Momentum Routine Immunization Transformation and Equity project implemented a three-tiered collaboration, viz., government, non-governmental organizations (NGOs), and a wide range of vulnerable and at-risk communities, utilizing knowledge exchange and use of data. The project implemented localization strategies through the NGOs for community engagement in conjunction with government vaccination teams to universalize COVID-19 vaccination uptake up to the last mile. The collaboration resulted in reaching close to 50 million beneficiaries through messaging and facilitated the administration of more than 14 million vaccine doses, including 6.1 million doses for vulnerable and marginalized communities in 18 States and Union territories in India, along with suggesting implications for public health practice and research.
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Affiliation(s)
- Gopal Krishna Soni
- John Snow India Pvt. Ltd. (JSIPL), Plot No. 5 & 6, First Floor Allied House, Pocket 10, Sector B, Vasant Kunj, Delhi 110070, India
| | - Surbhi Seth
- John Snow India Pvt. Ltd. (JSIPL), Plot No. 5 & 6, First Floor Allied House, Pocket 10, Sector B, Vasant Kunj, Delhi 110070, India
| | - Sonal Arora
- John Snow India Pvt. Ltd. (JSIPL), Plot No. 5 & 6, First Floor Allied House, Pocket 10, Sector B, Vasant Kunj, Delhi 110070, India
| | - Kapil Singh
- World Health Organization (WHO), Nirman Bhawan Maulana Azad Road, Delhi 110011, India
| | - Amrita Kumari
- John Snow India Pvt. Ltd. (JSIPL), Plot No. 5 & 6, First Floor Allied House, Pocket 10, Sector B, Vasant Kunj, Delhi 110070, India
| | - Natasha Kanagat
- John Snow Inc., 2733 Crystal Drive, 4th Floor, Arlington, VA 22202, USA
| | - Rebecca Fields
- John Snow Inc., 2733 Crystal Drive, 4th Floor, Arlington, VA 22202, USA
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19
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Ogaz D, Allen H, Reid D, Brown JRG, Howarth AR, Pulford CV, Mercer CH, Saunders J, Hughes G, Mohammed H. COVID-19 infection and vaccination uptake in men and gender-diverse people who have sex with men in the UK: analyses of a large, online community cross-sectional survey (RiiSH-COVID) undertaken November-December 2021. BMC Public Health 2023; 23:829. [PMID: 37147609 PMCID: PMC10161154 DOI: 10.1186/s12889-023-15779-5] [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: 01/19/2023] [Accepted: 04/28/2023] [Indexed: 05/07/2023] Open
Abstract
BACKGROUND Men and gender-diverse people who have sex with men are disproportionately affected by health conditions associated with increased risk of severe illness due to COVID-19 infection. METHODS An online cross-sectional survey of men and gender-diverse people who have sex with men in the UK recruited via social networking and dating applications from 22 November-12 December 2021. Eligible participants included self-identifying men, transgender women, or gender-diverse individuals assigned male at birth (AMAB), aged ≥ 16, who were UK residents, and self-reported having had sex with an individual AMAB in the last year. We calculated self-reported COVID-19 test-positivity, proportion reporting long COVID, and COVID-19 vaccination uptake anytime from pandemic start to survey completion (November/December 2021). Logistic regression was used to assess sociodemographic, clinical, and behavioural characteristics associated with SARS-CoV-2 (COVID-19) test positivity and complete vaccination (≥ 2 vaccine doses). RESULTS Among 1,039 participants (88.1% white, median age 41 years [interquartile range: 31-51]), 18.6% (95% CI: 16.3%-21.1%) reported COVID-19 test positivity, 8.3% (95% CI: 6.7%-10.1%) long COVID, and 94.5% (95% CI: 93.3%-96.1%) complete COVID-19 vaccination through late 2021. In multivariable models, COVID-19 test positivity was associated with UK country of residence (aOR: 2.22 [95% CI: 1.26-3.92], England vs outside England) and employment (aOR: 1.55 [95% CI: 1.01-2.38], current employment vs not employed). Complete COVID-19 vaccination was associated with age (aOR: 1.04 [95% CI: 1.01-1.06], per increasing year), gender (aOR: 0.26 [95% CI: 0.09-0.72], gender minority vs cisgender), education (aOR: 2.11 [95% CI: 1.12-3.98], degree-level or higher vs below degree-level), employment (aOR: 2.07 [95% CI: 1.08-3.94], current employment vs not employed), relationship status (aOR: 0.50 [95% CI: 0.25-1.00], single vs in a relationship), COVID-19 infection history (aOR: 0.47 [95% CI: 0.25-0.88], test positivity or self-perceived infection vs no history), known HPV vaccination (aOR: 3.32 [95% CI: 1.43-7.75]), and low self-worth (aOR: 0.29 [95% CI: 0.15-0.54]). CONCLUSIONS In this community sample, COVID-19 vaccine uptake was high overall, though lower among younger age-groups, gender minorities, and those with poorer well-being. Efforts are needed to limit COVID-19 related exacerbation of health inequalities in groups who already experience a greater burden of poor health relative to other men who have sex with men.
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Affiliation(s)
- Dana Ogaz
- Blood Safety, Hepatitis, STI & HIV Division, UK Health Security Agency, 61 Colindale Avenue, London, NW9 5EQ, UK.
- The National Institute for Health and Care Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the, UK Health Security Agency, London, UK.
| | - Hester Allen
- COVID-19 Vaccines and Epidemiology Division, UK Health Security Agency, London, UK
| | - David Reid
- The National Institute for Health and Care Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the, UK Health Security Agency, London, UK
- Institute for Global Health, University College London, London, UK
- Sigma Research, Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Jack R G Brown
- The National Institute for Health and Care Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the, UK Health Security Agency, London, UK
- Institute for Global Health, University College London, London, UK
| | - Alison R Howarth
- The National Institute for Health and Care Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the, UK Health Security Agency, London, UK
- Institute for Global Health, University College London, London, UK
| | - Caisey V Pulford
- Blood Safety, Hepatitis, STI & HIV Division, UK Health Security Agency, 61 Colindale Avenue, London, NW9 5EQ, UK
- The National Institute for Health and Care Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the, UK Health Security Agency, London, UK
| | - Catherine H Mercer
- The National Institute for Health and Care Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the, UK Health Security Agency, London, UK
- Institute for Global Health, University College London, London, UK
| | - John Saunders
- Blood Safety, Hepatitis, STI & HIV Division, UK Health Security Agency, 61 Colindale Avenue, London, NW9 5EQ, UK
- The National Institute for Health and Care Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the, UK Health Security Agency, London, UK
- Institute for Global Health, University College London, London, UK
| | - Gwenda Hughes
- Blood Safety, Hepatitis, STI & HIV Division, UK Health Security Agency, 61 Colindale Avenue, London, NW9 5EQ, UK
- The National Institute for Health and Care Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the, UK Health Security Agency, London, UK
- UK Public Health Rapid Support Team, London School of Hygiene & Tropical Medicine, London, UK
| | - Hamish Mohammed
- Blood Safety, Hepatitis, STI & HIV Division, UK Health Security Agency, 61 Colindale Avenue, London, NW9 5EQ, UK
- The National Institute for Health and Care Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the, UK Health Security Agency, London, UK
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20
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Krause KD, Pérez-Figueroa RE, Halkitis PN. Barriers and facilitators related to COVID-19 vaccine acceptance and uptake among people living with HIV. Curr Opin HIV AIDS 2023; 18:142-147. [PMID: 36943471 DOI: 10.1097/coh.0000000000000788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
PURPOSE OF REVIEW This review reports on the myriad barriers and facilitators related to COVID-19 vaccine hesitancy and factors contribution to uptake among people living with HIV (PLWH) globally published over the past year (2021-2022). RECENT FINDINGS Across the literature, participants indicated concerns about the safety, efficacy and overall rapid development of the COVID-19 vaccine as a reason for delaying or not being vaccinated. Medical mistrust and perceptions about the risk of COVID-19 immune response and severity also played a role in COVID-19 vaccine hesitancy among PLWH. Almost every study examined different sociodemographic characteristics associated with COVID-19 vaccination acceptance and uptake, and although strong themes emerged around race/ethnicity, sex and educational attainment, the results were mixed across other characteristics, including age. Some studies also examined medical factors specifically related to PLWH including CD4 + cell count and adherence to antiretroviral therapy. SUMMARY The findings highlight individual, structural and social differences in COVID-19 vaccine acceptance and uptake among PLWH, which are varied throughout the world. We call on researchers and interventionists to not just consider the role of medical mistrust and disinformation, but also how emotional, financial and political vulnerability plays into making decisions around COVID-19 vaccine uptake and overall healthcare.
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Affiliation(s)
- Kristen D Krause
- Center for Health, Identity, Behavior, and Prevention Studies (CHIBPS)
- Department of Urban-Global Health
| | - Rafael E Pérez-Figueroa
- Center for Health, Identity, Behavior, and Prevention Studies (CHIBPS)
- Department of Urban-Global Health
| | - Perry N Halkitis
- Center for Health, Identity, Behavior, and Prevention Studies (CHIBPS)
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Rutgers University, Piscataway, New Jersey, USA
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21
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Huff KA, Braun A, Salvaggio MR, McGough P, Frank-Pearce SG, Kendzor DE, Bui TC. Promoting HPV Vaccination in People with HIV: Factors to Consider. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5345. [PMID: 37047959 PMCID: PMC10094493 DOI: 10.3390/ijerph20075345] [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: 02/03/2023] [Revised: 03/12/2023] [Accepted: 03/15/2023] [Indexed: 06/19/2023]
Abstract
People with HIV (PWH) and their sexual partners have increased risk of human papillomavirus (HPV) infection. Despite recommended HPV vaccination for PWH aged 18-26 years, vaccination rates among PWH remain low. This qualitative study used the Information-Motivation-Behavioral Skills (IMBS) model to identify factors influencing the decisions of PWH around promoting HPV vaccination to their sexual partners. Fourteen PWH with diverse sociodemographic characteristics participated in four focus-group discussions. Data were analyzed using thematic content analysis; codes and themes included IMBS constructs. For the information construct, the need for improved HPV education emerged as the driving factor for HPV vaccine uptake and discussing HPV vaccines with partners. Focal reasons for being unvaccinated included low knowledge of HPV risk, asymptomatic cancer-causing HPV, HPV vaccines, and vaccine eligibility. Salient factors in the motivation construct included the preventive benefits of HPV vaccination to both self and sexual partners. Salient factors in the behavioral skills construct included: accessing vaccine, low self-confidence and skills for promoting vaccination, relationships with sexual partners, partners' vaccine hesitancy, and stigma. Race/ethnicity impacted HPV vaccination promotion; important determinants included perceptions of HPV-related diseases as "White people's diseases" among Black people, and discrimination against those with HPV-related diseases among the Hispanic population.
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Affiliation(s)
- Kinsey A. Huff
- Department of Family and Preventive Medicine, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (K.A.H.); (D.E.K.)
| | - Ashlea Braun
- Department of Nutritional Sciences, College of Education and Human Sciences, Oklahoma State University, Stillwater, OK 74078, USA;
| | - Michelle R. Salvaggio
- Infectious Diseases Section, Department of Internal Medicine, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA;
| | - Patrick McGough
- Oklahoma City-County Health Department, Oklahoma City, OK 73111, USA;
| | - Summer G. Frank-Pearce
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, 655 Research Parkway, Suite 400, Oklahoma City, OK 73104, USA;
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
| | - Darla E. Kendzor
- Department of Family and Preventive Medicine, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (K.A.H.); (D.E.K.)
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, 655 Research Parkway, Suite 400, Oklahoma City, OK 73104, USA;
| | - Thanh Cong Bui
- Department of Family and Preventive Medicine, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (K.A.H.); (D.E.K.)
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, 655 Research Parkway, Suite 400, Oklahoma City, OK 73104, USA;
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22
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Datta S, Mukherjee T. Impact of COVID-19 stress on the psychological health of sexual & gender minority individuals: A systematic review. Front Glob Womens Health 2023; 4:1132768. [PMID: 37066039 PMCID: PMC10090515 DOI: 10.3389/fgwh.2023.1132768] [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: 12/27/2022] [Accepted: 02/28/2023] [Indexed: 03/31/2023] Open
Abstract
Introduction The differential effect of the Covid-19 pandemic on the mental health of the population around the globe is well documented. Social isolation, loss of job, financial crisis, and fear of infection due to the pandemic have widely affected people across countries, and the sexual and gender minority (SGM) group is no exception. However, the additional stressors like stigma, discrimination, rejection, non-acceptance, and violence associated with diverse sexual orientation complicated the situation for the SGM group in the context of the Covid-19 pandemic. Method The present study conducted a systematic review of research (n = 16) investigating the impact of Covid-19 stress on the psychological health of SGM individuals. The review had two objectives: (a) to explore the effect of the stress associated with the pandemic on the psychological health of the SGM individuals; and (b) to identify potential stressors associated with the Covid-19 pandemic affecting the mental health of SGM individuals. Studies were selected following a PRISMA protocol and several inclusion criteria. Results The review provided new insights into the mental health issues of the SGM individual in the Covid-19 context. The outcome of the review focused on five aspects: (a) depression and anxiety symptoms related to Covid-19 symptoms; (b) perceived social support and Covid-19 stress; (c) family support and psychological distress related to Covid-19; (d) Covid-19 stress and disordered eating, and (e) problem drinking and substance abuse associated with Covid-19 stress. Discussion The present review indicated a negative association between Covid-19 stress and psychological distress among sexual and gender minority individuals. The findings have important implications for psychologists and social workers working with this population and policymakers around the globe.
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Affiliation(s)
- Sumona Datta
- Department of Psychology, Government General Degree College, Singur, Hooghly, India
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23
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Grimes T, Marcilly R, Bonnici West L, Cordina M. Medication-Related Outcomes and Health Equity: Evidence for Pharmaceutical Care. PHARMACY 2023; 11:pharmacy11020060. [PMID: 36961038 PMCID: PMC10037618 DOI: 10.3390/pharmacy11020060] [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: 02/01/2023] [Revised: 03/13/2023] [Accepted: 03/14/2023] [Indexed: 03/25/2023] Open
Abstract
Marginalised people experience diminished access to pharmaceutical care and worse medication-related outcomes than the general population. Health equity is a global priority. This article explores the key evidence of health inequity and medication use, structures the causes and contributory factors and suggests opportunities that can be taken to advance the pharmaceutical care agenda so as to achieve health equity. The causes of, and contributors to, this inequity are multi-fold, with patient- and person-related factors being the most commonly reported. Limited evidence is available to identify risk factors related to other aspects of a personal medication use system, such as technology, tasks, tools and the internal and the external environments. Multiple opportunities exist to enhance equity in medication-related outcomes through pharmaceutical care research and practice. To optimise the effects and the sustainable implementation of these opportunities, it is important to (1) ensure the meaningful inclusion and engagement of members of marginalised groups, (2) use a person-centred approach and (3) apply a systems-based approach to address all of the necessary components of a system that interact and form a network as work processes that produce system outcomes.
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Affiliation(s)
- Tamasine Grimes
- School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, D02PN40 Dublin, Ireland
| | - Romaric Marcilly
- Univ. Lille, CHU Lille, ULR 2694-METRICS: Évaluation des Technologies de Santé et des Pratiques Médicales, F-59000 Lille, France
- Inserm, CIC-IT 1403, F-59000 Lille, France
| | - Lorna Bonnici West
- Applied Research and Innovation Centre, Malta College of Arts, Science and Technology, PLA9032 Paola, Malta
| | - Maria Cordina
- Department of Clinical Pharmacology & Therapeutics, WHO Collaborating Centre for Health Professionals Education and Research, Faculty of Medicine and Surgery, University of Malta, 2080 Msida, Malta
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Adzrago D, Ormiston CK, Sulley S, Williams F. Associations between the Self-Reported Likelihood of Receiving the COVID-19 Vaccine, Likelihood of Contracting COVID-19, Discrimination, and Anxiety/Depression by Sexual Orientation. Vaccines (Basel) 2023; 11:vaccines11030582. [PMID: 36992166 DOI: 10.3390/vaccines11030582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 02/27/2023] [Accepted: 02/28/2023] [Indexed: 03/06/2023] Open
Abstract
There is limited evolving literature on COVID-19 vaccine uptake and its barriers among sexual minority populations (lesbian, gay, bisexual, transgender, and queer [LGBTQ]), despite their increased COVID-19 risk factors. We assessed the differences in intention to receive the COVID-19 vaccine by self-reported likelihood of contracting COVID-19, anxiety/depression, discrimination frequency, social distancing stress, and sociodemographic factors across sexual orientation. An online national cross-sectional survey was conducted in the United States between 13 May 2021, and 9 January 2022, among adults aged ≥18 (n = 5404). Sexual minority individuals had a lower intention of receiving the COVID-19 vaccine (65.62%) than heterosexual individuals (67.56%). Disaggregation by sexual orientation, however, showed that gay participants had a higher intention of COVID-19 vaccination (80.41%) and lesbian (62.63%), bisexual (64.08%), and non-heterosexual, non-LGB sexual minority (56.34%) respondents had lower intentions of receiving the COVID-19 vaccine than heterosexual respondents. Sexual orientation significantly moderated the association between the perceived likelihood of receiving the COVID-19 vaccine and the self-reported likelihood of contracting COVID-19, anxiety/depression symptoms, and discrimination. Our findings further underline the importance of improving vaccination efforts and access among sexual minority individuals and other vulnerable groups.
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Affiliation(s)
- David Adzrago
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Two White Flint North, Rockville, MD 20852, USA
| | - Cameron K Ormiston
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Two White Flint North, Rockville, MD 20852, USA
| | - Saanie Sulley
- National Healthy Start Association, 1325 G Street, Washington, WA 20005, USA
| | - Faustine Williams
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Two White Flint North, Rockville, MD 20852, USA
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25
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Nasrullah A, Gangu K, Garg I, Javed A, Shuja H, Chourasia P, Shekhar R, Sheikh AB. Trends in Hospitalization and Mortality for Influenza and Other Respiratory Viruses during the COVID-19 Pandemic in the United States. Vaccines (Basel) 2023; 11:vaccines11020412. [PMID: 36851289 PMCID: PMC9966237 DOI: 10.3390/vaccines11020412] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 02/04/2023] [Accepted: 02/09/2023] [Indexed: 02/15/2023] Open
Abstract
Seasonal epidemics of respiratory viruses, respiratory syncytial virus (RSV), influenza viruses, parainfluenza viruses (PIVs), and human metapneumovirus (MPV) are associated with a significant healthcare burden secondary to hundreds of thousands of hospitalizations every year in the United States (US) alone. Preventive measures implemented to reduce the spread of SARS-CoV-2 (COVID-19 infection), including facemasks, hand hygiene, stay-at-home orders, and closure of schools and local/national borders may have impacted the transmission of these respiratory viruses. In this study, we looked at the hospitalization and mortality trends for various respiratory viral infections from January 2017 to December 2020. We found a strong reduction in all viral respiratory infections, with the lowest admission rates and mortality in the last season (2020) compared to the corresponding months from the past three years (2017-2019). This study highlights the importance of public health interventions implemented during the COVID-19 pandemic, which had far-reaching public health benefits. Appropriate and timely use of these measures may help to reduce the severity of future seasonal respiratory viral outbreaks as well as their burden on already strained healthcare systems.
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Affiliation(s)
- Adeel Nasrullah
- Division of Pulmonology and Critical Care, Allegheny Health Network, Pittsburg, PA 15212, USA
| | - Karthik Gangu
- Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Ishan Garg
- Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM 87106, USA
| | - Anam Javed
- Department of Internal Medicine, Allegheny Health Network, Pittsburgh, PA 15512, USA
| | - Hina Shuja
- Department of Medicine, Karachi Medical and Dental College, Karachi 74700, Pakistan
| | - Prabal Chourasia
- Department of Hospital Medicine, Mary Washington Hospital, Fredericksburg, VA 22401, USA
| | - Rahul Shekhar
- Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM 87106, USA
| | - Abu Baker Sheikh
- Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM 87106, USA
- Correspondence: ; Tel.: +1-505-272-4661
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26
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Owens C, Hubach RD. An Exploratory Study of the Mpox Media Consumption, Attitudes, and Preferences of Sexual and Gender Minority People Assigned Male at Birth in the United States. LGBT Health 2023. [PMID: 36735618 DOI: 10.1089/lgbt.2022.0251] [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] [Indexed: 02/04/2023] Open
Abstract
Purpose: This study examined the consumption of, attitudes toward, and preferences for mpox media among U.S. sexual and gender minority (SGM) people assigned male at birth (AMAB). Methods: A total of 496 SGM people AMAB completed an online cross-sectional survey between August 6 and 15, 2022. Data were analyzed with descriptive statistics and logistic regressions. Results: Approximately two-thirds of participants overall agreed that media-related content about mpox targeted (66.3%) and stigmatized gay, bisexual, and other men who have sex with men (69.2%). The three most preferred mpox content were the destigmatization of SGM people (44.2%), mpox vaccine accessibility (25.2%), and mpox transmission and prevention (19.2%). Rural participants had a lower likelihood of consuming mpox-related media than urban participants. Conclusion: SGM people AMAB prefer mpox messaging campaigns to be grounded in stigma-reduction to ensure that messages do not perpetrate stigma against them. Stigmatizing content might foster SGM people AMAB to distrust mpox interventions.
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Affiliation(s)
- Christopher Owens
- Department of Health Behavior, School of Public Health, Texas A&M University, College Station, Texas, USA
| | - Randolph D Hubach
- Department of Public Health, College of Health and Human Sciences, Purdue University, West Lafayette, Indiana, USA
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27
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Polonijo AN, Vogelsang EM. Sexual Orientation and Gender Identity Differences in Influenza, Shingles, and Pneumococcal Vaccination Among U.S. Older Adults. LGBT Health 2023; 10:138-147. [PMID: 36301236 DOI: 10.1089/lgbt.2022.0191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: LGBT older adults face challenges accessing and receiving culturally competent health care and may be more vulnerable to serious outcomes from vaccine-preventable diseases. This study examines whether sexual orientation and gender identity are associated with older adult influenza, zoster ("shingles"), and pneumococcal vaccine uptake. Methods: Data come from the 2020 Behavioral Risk Factor Surveillance System. The sample included older adults aged 50+ (eligible for influenza and shingles vaccination; n = 136,528) and 65+ (eligible for pneumococcal vaccination; n = 74,779). We calculated rates of influenza, shingles, and pneumococcal vaccine uptake by gender-stratified sexual orientation groups and for transgender versus cisgender populations. Logistic regression models tested for associations between sexual orientation, gender identity, and vaccine uptake, controlling for key sociodemographic characteristics. Results: Transgender adults had the lowest rates of uptake across all three vaccines, including 46% lower odds of shingles vaccination and 61% lower odds of pneumococcal vaccination, when compared with cisgender adults. Gay (vs. straight) men had 1.5-1.9 times greater odds of flu and shingles vaccination. Bisexual (vs. straight) women had 32% lower odds of flu vaccination. Conclusion: Our findings indicate that vaccine uptake among LGBT older adults varies by sexual orientation, gender identity, and vaccine type. Bisexual women and transgender people are groups that tend to underutilize health care services and are at increased risk of nonvaccination, making them important targets for older adult vaccine promotion.
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Affiliation(s)
- Andrea N Polonijo
- Department of Sociology, University of California, Merced, Merced, California, USA.,Health Sciences Research Institute, University of California, Merced, Merced, California, USA
| | - Eric M Vogelsang
- Department of Sociology, California State University-San Bernardino, San Bernardino, California, USA.,Center on Aging, California State University-San Bernardino, San Bernardino, California, USA
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28
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A Scoping Review on COVID-19 Vaccine Hesitancy among the Lesbian, Gay, Bisexual, Transgender, Queer, Intersex and Asexual (LGBTQIA+) Community and Factors Fostering Its Refusal. Healthcare (Basel) 2023; 11:healthcare11020245. [PMID: 36673613 PMCID: PMC9859126 DOI: 10.3390/healthcare11020245] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 01/07/2023] [Accepted: 01/08/2023] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND The ramifications of the existing crisis caused by the coronavirus pandemic are sensed in all walks of life. Among the various efforts made to curb the spread of this novel infection, the development of COVID-19 vaccines had a profound role in flattening the pandemic curve. Even though the rapid vaccine drive received a highly welcoming response among people, the reluctance and ignorance of a part of the population towards available safe vaccines stand as impediments to achieving the desired outcome. The LGBTQIA+ (Lesbian, Gay, Bisexual, Transgender, Queer, Intersex and Asexual) communities are the least studied groups in this regard. OBJECTIVE The purpose of this study is to extensively review and report on COVID-19 vaccine uptake and refusal among the LGBTQIA+ population and enumerate the factors contributing to vaccine hesitancy. The study extends further to outline a conceptual framework for interventions to enhance COVID-19 vaccine acceptance among the LGBTQIA+ population. METHODS We performed a systematic search using key terms on Google Scholar and PubMed. The obtained results were filtered using the eligibility criteria framed for this study. The initial search provided an extensive result of 4510 articles which were later screened at various levels to arrive at the final inclusive collection of manuscripts adding to 17. The studies were analyzed by the authors individually, and the data were categorized using variables. The results are interpreted using charts and graphs. The whole manuscript has been structured in accordance with the PRISMA extension for scoping reviews. RESULT The comprehensive search yielded 17 eligible articles for this review. Most of the studies were conducted in the United States (n = 17), and predominantly cross-sectional studies have been conducted. The major comparative factor was the HIV status of the LGBTQIA+ population. HIV-affected patients were more willing to take up COVID-19 vaccination. However, social stigma, discrimination, lack of access and non-prioritization in vaccine drives were found to be the major factors contributing to vaccine hesitancy among this population. CONCLUSION The invention of the COVID-19 vaccination revolutionized the healthcare systems burdened with COVID-19. Although this is a breakthrough scientific contribution, many factors are associated with the rate of vaccine acceptance, especially among sexual and gender minorities. The reviewed studies have revealed numerous factors that influence vaccine uptake and refusal with the commonest being concerns on discrimination, social stigma, inequitable access to healthcare, vaccine safety, efficacy, potency, side effects and lack of trust in medical workers. These impediments in vaccine coverage should be meticulously addressed to ensure optimum LGBTQIA+ physical and mental health as well as for providing non-discriminative, equitable and quality healthcare service regardless of the gender or sexual orientation of individuals.
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29
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Ponjoan A, Jacques-Aviñó C, Medina-Perucha L, Romero V, Martí-Lluch R, Alves-Cabratosa L, Ramos R, Berenguera A, Garcia-Gil MDM. Axes of social inequities in COVID-19 clinical trials: A systematic review. Front Public Health 2023; 11:1069357. [PMID: 36891333 PMCID: PMC9987589 DOI: 10.3389/fpubh.2023.1069357] [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: 10/13/2022] [Accepted: 01/16/2023] [Indexed: 02/16/2023] Open
Abstract
Objective The representativeness of participants is crucial to ensure external validity of clinical trials. We focused on the randomized clinical trials which assessed COVID-19 vaccines to assess the reporting of age, sex, gender identity, race, ethnicity, obesity, sexual orientation, and socioeconomic status in the results (description of the participants' characteristics, loss of follow-up, stratification of efficacy and safety results). Methods We searched the following databases for randomized clinical trials published before 1st February 2022: PubMed, Scopus, Web of Science, and Excerpta Medica. We included peer-reviewed articles written in English or Spanish. Four researchers used the Rayyan platform to filter citations, first reading the title and abstract, and then accessing the full text. Articles were excluded if both reviewers agreed, or if a third reviewer decided to discard them. Results Sixty three articles were included, which assessed 20 different vaccines, mainly in phase 2 or 3. When describing the participants' characteristics, all the studies reported sex or gender, 73.0% race, ethnicity, 68.9% age groups, and 22.2% obesity. Only one article described the age of participants lost to follow-up. Efficacy results were stratified by age in 61.9%, sex or gender in 26.9%, race and/or, ethnicity in 9.5%, and obesity in 4.8% of the articles. Safety results were stratified by age in 41.0%, and by sex or gender in 7.9% of the analysis. Reporting of gender identity, sexual orientation or socioeconomic status of participants was rare. Parity was reached in 49.2% of the studies, and sex-specific outcomes were mentioned in 22.9% of the analysis, most of the latter were related to females' health. Conclusions Axes of social inequity other than age and sex were hardly reported in randomized clinical trials that assessed COVID-19 vaccines. This undermines their representativeness and external validity and sustains health inequities.
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Affiliation(s)
- Anna Ponjoan
- Grup en Salut Vascular de Girona (ISV-Girona), Institut Universitari d'Investigació en Atenció Primària (IDIAPJGol), Girona, Spain.,Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta (IDIBGI), Girona, Spain.,Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Constanza Jacques-Aviñó
- Universitat Autònoma de Barcelona, Bellaterra, Spain.,Institut Universitari d'Investigació en Atenció Primària (IDIAPJGol), Barcelona, Spain
| | - Laura Medina-Perucha
- Universitat Autònoma de Barcelona, Bellaterra, Spain.,Institut Universitari d'Investigació en Atenció Primària (IDIAPJGol), Barcelona, Spain
| | - Victor Romero
- Servicio Canario de la Salud, Santa Cruz de Tenerife, Spain
| | - Ruth Martí-Lluch
- Grup en Salut Vascular de Girona (ISV-Girona), Institut Universitari d'Investigació en Atenció Primària (IDIAPJGol), Girona, Spain.,Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta (IDIBGI), Girona, Spain.,Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Lia Alves-Cabratosa
- Grup en Salut Vascular de Girona (ISV-Girona), Institut Universitari d'Investigació en Atenció Primària (IDIAPJGol), Girona, Spain
| | - Rafel Ramos
- Grup en Salut Vascular de Girona (ISV-Girona), Institut Universitari d'Investigació en Atenció Primària (IDIAPJGol), Girona, Spain.,Department of Medical Sciences, School of Medicine, Universitat de Girona, Girona, Spain
| | - Anna Berenguera
- Institut Universitari d'Investigació en Atenció Primària (IDIAPJGol), Barcelona, Spain.,Department of Nursing, Universitat de Girona, Girona, Spain
| | - María Del Mar Garcia-Gil
- Grup en Salut Vascular de Girona (ISV-Girona), Institut Universitari d'Investigació en Atenció Primària (IDIAPJGol), Girona, Spain
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30
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Cogan N, Gallant AJ, Nicholls LAB, Rasmussen S, Young D, Williams L. Improving older adults' vaccination uptake: Are existing measures of vaccine hesitancy valid and reliable for older people? J Health Psychol 2022; 27:3136-3147. [PMID: 35410504 PMCID: PMC9720707 DOI: 10.1177/13591053221089104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
We sought to establish whether two recently developed measures, the 5C scale and the Vaccination Attitudes Examination (VAX) were reliable and valid for use with older adults. A total of 372 UK-dwelling participants (65-92 years, M = 70.5 years, SD = 4.6) completed a cross-sectional survey measuring health and socio-demographic characteristics in relation to vaccine uptake for influenza, pneumococcal and shingles. The 5C and VAX scales were administered to test their reliability, validity and dimensionality. Both scales showed good internal reliability and convergent, discriminant and concurrent validity. Their factor structures were also confirmed, supporting their use with older adult populations.
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Affiliation(s)
- Nicola Cogan
- University of Strathclyde, UK
- Nicola Cogan, School of Psychological Sciences and Health, University of Strathclyde, 40 George Street, Glasgow G1 1QE, UK.
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31
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Yu Y, Ling RHY, Ip TKM, Luo S, Lau JTF. Factors of COVID-19 Vaccination among Hong Kong Chinese Men Who Have Sex with Men during Months 5–8 since the Vaccine Rollout—General Factors and Factors Specific to This Population. Vaccines (Basel) 2022; 10:vaccines10101763. [PMID: 36298627 PMCID: PMC9609851 DOI: 10.3390/vaccines10101763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 10/14/2022] [Accepted: 10/17/2022] [Indexed: 11/16/2022] Open
Abstract
This study investigated an under-researched topic regarding the prevalence of COVID-19 vaccination behavior among Chinese men who have sex with men (MSM) and the associations of this with general and MSM-specific perceptions grounded in the health belief model (HBM) and the theory of planned behaviors (TPB). A total of 400 Chinese MSM were recruited from multiple sources (site recruitment, online recruitment, and peer referral) in Hong Kong from July to October 2021, who then participated in a structured telephone interview. Of all the participants, the prevalence of COVID-19 vaccination (i.e., taking at least one dose of COVID-19 vaccination) was 78.3%. Multivariable logistic regression analyses showed that, after adjusting for background factors, (1) the general and MSM-specific HBM variables of perceived benefits and self-efficacy were positively associated with COVID-19 vaccination behavior; (2) the items or scale of general/MSM-specific perceived barriers and social norms were negatively associated with COVID-19 vaccination behavior; (3) the general perceived severity and MSM-specific perceived susceptibility, perceived severity, and cue to action were not significantly associated with COVID-19 vaccination behavior. The findings suggest that the HBM and social norm construct of the TPB only partially explained the participant’s COVID-19 vaccination behavior. Health promotion may need to focus more on modifying perceptions related to COVID-19 vaccination rather than COVID-19.
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Affiliation(s)
- Yanqiu Yu
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, Shanghai 200032, China
- Key Laboratory of Public Health Safety, Fudan University, Shanghai 200032, China
| | - Rachel Hau Yin Ling
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Tsun Kwan Mary Ip
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Sitong Luo
- Vanke School of Public Health, Tsinghua University, Beijing 100084, China
| | - Joseph T. F. Lau
- Zhejiang Provincial Clinical Research Center for Mental Disorders, The Affiliated Wenzhou Kangning Hospital, Wenzhou Medical University, Wenzhou 325000, China
- School of Mental Health, Wenzhou Medical University, Wenzhou 325000, China
- School of Public Health, Zhejiang University, Hangzhou 310058, China
- Correspondence:
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32
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Kafadar AH, Tekeli GG, Jones KA, Stephan B, Dening T. Determinants for COVID-19 vaccine hesitancy in the general population: a systematic review of reviews. ZEITSCHRIFT FUR GESUNDHEITSWISSENSCHAFTEN = JOURNAL OF PUBLIC HEALTH 2022; 31:1-17. [PMID: 36160668 PMCID: PMC9483252 DOI: 10.1007/s10389-022-01753-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 09/04/2022] [Indexed: 11/30/2022]
Abstract
Aim Although multiple COVID-19 vaccines are approved for global use, vaccine hesitancy poses a substantial risk for global health. Therefore, the aim of this umbrella review is to identify those factors that influence COVID-19 vaccination hesitancy in the general population. This is necessary to improve the effectiveness of future vaccination programmes. Methods PubMed, Embase, Scopus, PsycInfo, the Cochrane Database of Systematic Reviews, Epistemonikos, and PROSPERO (International Prospective Register of Systematic Reviews) were searched on December 21, 2021. This review included reviews which investigated factors of intention, willingness, or hesitancy with regard to the COVID-19 vaccination in adult populations, with no restrictions on setting. Content-based structure was used to synthesise the extracted data. The findings were presented based on the Strategic Advisory Group of Experts (SAGE) Working Group Model for vaccine hesitancy. Results A total of 3,392 studies were identified, of which 31 met the inclusion criteria. The most frequently documented factors associated with COVID-19 vaccine hesitancy included contextual factors, such as sex, age, and social inequalities; individual and group factors, such as trust in the healthcare system, public health authorities, and governments, and history of vaccination; vaccine-specific factors, such as concern for vaccine safety, perceived vaccine barriers, perceived effectiveness of vaccines, and concern about the rapid development of the vaccine; and disease-specific factors, such as fear of being infected with COVID-19, perceived severity of COVID-19, and knowledge of COVID-19. Conclusion There are multiple factors associated with COVID-19 vaccine hesitancy. Our findings lay the foundation to further understand COVID-19 vaccination uptake and provide possible targets for intervention programmes. However, there are gaps in research concerning certain populations, including vaccination in people with mental disorders. Supplementary Information The online version contains supplementary material available at 10.1007/s10389-022-01753-9.
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Affiliation(s)
- Aysegul Humeyra Kafadar
- Academic Unit of Mental Health and Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
- Institute of Mental Health, Triumph Road, Nottingham, NG7 2TU UK
| | - Gamze Gizem Tekeli
- Academic Unit of Mental Health and Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
| | - Katy A. Jones
- Academic Unit of Mental Health and Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
| | - Blossom Stephan
- Academic Unit of Mental Health and Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
| | - Tom Dening
- Academic Unit of Mental Health and Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
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33
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Attia S, Mausbach K, Klugar M, Howaldt HP, Riad A. Prevalence and Drivers of COVID-19 Vaccine Booster Hesitancy Among German University Students and Employees. Front Public Health 2022; 10:846861. [PMID: 35462827 PMCID: PMC9021373 DOI: 10.3389/fpubh.2022.846861] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 03/07/2022] [Indexed: 12/13/2022] Open
Abstract
COVID-19 booster hesitancy (VBH) is a serious public health challenge which acts simultaneously with the waning vaccine-elicited immunity and the emerging viral variants to prolong the pandemic interval. Therefore, this study aimed to evaluate the prevalence of COVID-19 VBH among a highly educated subset of the German population and to explore the potential demographic, anamnestic, and psychosocial determinants of this problem. A cross-sectional survey-based study was conducted in December 2021 among German university students and employees to evaluate their attitudes toward COVID-19 vaccine booster (VB) doses. The study used a self-administered questionnaire that was developed and disseminated digitally, and the questionnaire inquired about participants' demographic characteristics, COVID-19-related anamnesis, COVID-19 vaccine-related anamnesis, and psychosocial predictors of COVID-19 VBH. A total of 930 participants were recruited, of which 608 (65.4%) were students, 682 (73.3%) were females, and their mean age was 29.08 ± 10.93 years. Fifty-five participants (5.9%) had been previously infected by COVID-19 and the vast majority of infections happened before the first vaccine dose. Over 95% of the participants had received at least one vaccine dose, and the most commonly administered vaccine was BNT162b2. The overall COVID-19 VB acceptance was satisfactory (87.8%) and induced by various altruistic promoters, e.g., family health protection, community health protection, and patients' health protection. The students (86.3%), the previously infected participants (76.4%), the participants who did not receive primer doses of COVID-19 vaccines (2.5 %), and those who were hospitalized (40%) and sought medical care/treatment after receiving primer doses (86.8%) were less likely to accept COVID-19 VB compared to the employees (90.7%), the participants who were not previously infected (88.6%) and those who received primer dose (91.7%), and the participants who were not hospitalized (92%) nor sought medical care/treatment after primer doses (92.9%), respectively. The perceived effectiveness of COVID-19 VB against severe illness (adjusted odds ratio “AOR”: 47.65–95% confidence interval “CI”: 23.65–96.49), symptomatic infection (AOR: 9.87–95% CI: 5.20–18.71), community transmission (AOR: 5.34–95% CI: 3.00–9.49) and emerging variants (AOR: 19.12–95% CI: 10.57–34.55) were key predictors for COVID-19 VB acceptance; therefore, it needs to be highlighted in vaccine messaging. In addition, the perceived safety of COVID-19 VB and ethical dilemmas of vaccine justice need to be addressed publicly.
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Affiliation(s)
- Sameh Attia
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Justus-Liebig-University, Giessen, Germany
- *Correspondence: Sameh Attia
| | - Katharina Mausbach
- Department of Prosthodontics, Faculty of Medicine, Justus-Liebig-University, Giessen, Germany
| | - Miloslav Klugar
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Faculty of Medicine, Institute of Biostatistics and Analyses, Masaryk University, Brno, Czechia
| | - Hans-Peter Howaldt
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Justus-Liebig-University, Giessen, Germany
| | - Abanoub Riad
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Faculty of Medicine, Institute of Biostatistics and Analyses, Masaryk University, Brno, Czechia
- Department of Public Health, Faculty of Medicine, Masaryk University, Brno, Czechia
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Zhang K, Chan PSF, Chen S, Fang Y, Cao H, Chen H, Hu T, Chen Y, Zhou X, Wang Z. Factors Predicting COVID-19 Vaccination Uptake Among Men Who Have Sex With Men in China: An Observational Prospective Cohort Study. Front Med (Lausanne) 2022; 9:838973. [PMID: 35360721 PMCID: PMC8963419 DOI: 10.3389/fmed.2022.838973] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 02/17/2022] [Indexed: 01/15/2023] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic has disproportionately affected sexual minorities including men who have sex with men (MSM). This study investigated factors associated with the uptake of COVID-19 vaccination among MSM in China. Methods Inclusion criteria were: (1) born biologically male, (2) had oral or anal sex with men in the past year, (3) aged at least 18 years, and (4) lived in Shenzhen, China. Prospective participants were recruited through outreach in gay bars and saunas, online recruitment, and peer referrals. Participants completed a baseline online survey between August and September 2020 and a follow-up online survey between April and May 2021. Logistic regression models were fitted for data analysis. Results Among 420 participants who completed the baseline survey, 303 completed the follow-up survey. Among participants being followed up, 113 (37%) received at least one dose of COVID-19 vaccination during the study period. After adjusting for significant sociodemographic characteristics, five baseline predisposing factors predicted COVID-19 vaccination uptake during the follow-up period, including asking whether their partners had COVID-19 symptoms [adjusted odds ratio (AOR): 1.17, 95% confidence interval (CI): 1.00-1.38], washing hands before and after sex (AOR: 1.23, 95% CI: 1.03-1.46), sanitizing before and after sex (AOR: 1.17, 95% CI: 1.00-1.37), perceived higher risk of COVID-19 transmission through sexual behaviors (AOR: 1.28, 95% CI: 1.04-1.58), and panic about COVID-19 (AOR: 1.48, 95% CI: 1.16-1.89). Regarding enabling factors, receiving testing for sexually transmitted infections (STI) (AOR: 2.19, 95% CI: 1.25-3.85) and other prevention measures for human immunodeficiency virus (HIV)/STI (AOR: 2.61, 95% CI: 1.56-4.37) 6 months prior to the baseline survey were associated with higher uptake of COVID-19 vaccination. Conclusion MSM's uptake rate of COVID-19 vaccination was comparable to that of the general population in Shenzhen, China. This study offered an overview for us to identify tapping points that can encourage COVID-19 vaccination uptake among Chinese MSM.
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Affiliation(s)
- Kechun Zhang
- Longhua District Center for Disease Control and Prevention, Shenzhen, China
| | - Paul Shing-fong Chan
- Jockey Club (JC) School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Siyu Chen
- Jockey Club (JC) School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Yuan Fang
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - He Cao
- Longhua District Center for Disease Control and Prevention, Shenzhen, China
| | - Hongbiao Chen
- Longhua District Center for Disease Control and Prevention, Shenzhen, China
| | - Tian Hu
- Longhua District Center for Disease Control and Prevention, Shenzhen, China
| | - Yaqi Chen
- Longhua District Center for Disease Control and Prevention, Shenzhen, China
| | - Xiaofeng Zhou
- Longhua District Center for Disease Control and Prevention, Shenzhen, China
| | - Zixin Wang
- Jockey Club (JC) School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
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Swendeman D, Norwood P, Saleska J, Lewis K, Ramos W, SantaBarbara N, Sumstine S, Comulada WS, Jimenez S, Ocasio MA, Arnold EM, Nielsen-Saines K, Fernandez MI, Rotheram-Borus MJ. Vaccine Attitudes and COVID-19 Vaccine Intentions and Prevention Behaviors among Young People At-Risk for and Living with HIV in Los Angeles and New Orleans. Vaccines (Basel) 2022; 10:vaccines10030413. [PMID: 35335045 PMCID: PMC8954448 DOI: 10.3390/vaccines10030413] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 03/03/2022] [Accepted: 03/07/2022] [Indexed: 01/07/2023] Open
Abstract
Sexual and gender minority (SGM) and racial or ethnic minority youth at-risk for or living with HIV may have higher risk of SARS-CoV-2 infection. However, there are few data on vaccine hesitancy/acceptance and COVID-19 self-protective behaviors among this population. Youth aged 15-24 years (n = 440), predominantly African American and Latine (73%, n = 320) SGM, from Los Angeles and New Orleans reported their vaccine attitudes and COVID-19 and HIV preventive behaviors in October 2020. Latent class analyses categorized individuals into groups based on their vaccine attitudes and preventive behaviors. Relationships between these groups and other factors were analyzed using Fisher's exact tests, ANOVA, and logistic regression. Most youth had accepting vaccine attitudes (70.2%, n = 309), with 20.7% hesitant (n = 91), and 9.1% resistant (n = 40). SGM and African Americans were significantly less accepting than their cis-gender and heterosexual peers. About two-thirds (63.2%, n = 278) of the respondents reported consistent COVID-19 self-protective behaviors. Youth with pro-vaccine attitudes were most consistently self-protective; however, only 54.4% (n= 168/309) intended to take a COVID-19 vaccine. Homelessness history, race, and sexual orientation were associated with vaccine attitudes. Accepting vaccine attitudes and consistent COVID-19 self-protective behaviors were closely related. COVID-19 attitudes/behaviors were not associated with HIV risk and only loosely associated with SARS-CoV-2 vaccine intentions.
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Affiliation(s)
- Dallas Swendeman
- Center for Community Health, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024, USA; (P.N.); (J.S.); (K.L.); (W.R.); (S.S.); (W.S.C.); (S.J.); (M.J.R.-B.)
- Correspondence:
| | - Peter Norwood
- Center for Community Health, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024, USA; (P.N.); (J.S.); (K.L.); (W.R.); (S.S.); (W.S.C.); (S.J.); (M.J.R.-B.)
| | - Jessica Saleska
- Center for Community Health, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024, USA; (P.N.); (J.S.); (K.L.); (W.R.); (S.S.); (W.S.C.); (S.J.); (M.J.R.-B.)
| | - Katherine Lewis
- Center for Community Health, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024, USA; (P.N.); (J.S.); (K.L.); (W.R.); (S.S.); (W.S.C.); (S.J.); (M.J.R.-B.)
| | - Wilson Ramos
- Center for Community Health, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024, USA; (P.N.); (J.S.); (K.L.); (W.R.); (S.S.); (W.S.C.); (S.J.); (M.J.R.-B.)
| | | | - Stephanie Sumstine
- Center for Community Health, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024, USA; (P.N.); (J.S.); (K.L.); (W.R.); (S.S.); (W.S.C.); (S.J.); (M.J.R.-B.)
| | - Warren Scott Comulada
- Center for Community Health, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024, USA; (P.N.); (J.S.); (K.L.); (W.R.); (S.S.); (W.S.C.); (S.J.); (M.J.R.-B.)
| | - Sergio Jimenez
- Center for Community Health, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024, USA; (P.N.); (J.S.); (K.L.); (W.R.); (S.S.); (W.S.C.); (S.J.); (M.J.R.-B.)
| | - Manuel A. Ocasio
- Section of Adolescent Medicine, Department of Pediatrics, School of Medicine, Tulane University, New Orleans, LA 70112, USA;
| | - Elizabeth M. Arnold
- Department of Family and Community Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA;
| | - Karin Nielsen-Saines
- Department of Pediatrics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA;
| | - Maria Isabel Fernandez
- Department of Public Health, College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL 33328, USA;
| | - Mary Jane Rotheram-Borus
- Center for Community Health, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024, USA; (P.N.); (J.S.); (K.L.); (W.R.); (S.S.); (W.S.C.); (S.J.); (M.J.R.-B.)
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Khan MD. Access to COVID-19 vaccination for transgender community in Multan, Punjab, Pakistan. Health Care Women Int 2022:1-14. [PMID: 35147488 DOI: 10.1080/07399332.2022.2029864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Given the discrimination, harassment, and lack of adequate healthcare facilities, the transgender community members find it hard to access the COVID-19 vaccination. The COVID-19 pandemic has exacerbated the disparities in access to healthcare for the transgender community. In November 2020, on the topic of 'COVID-19 and Disaster Vulnerability in Pakistan: A Human Rights Based Analysis', a co-published report from the UNDP and Ministry of Human Rights Pakistan, reflected concerns on the challenges of access to healthcare for the transgender community in Pakistan. The report demanded the government to amplify its response to further protect the transgender community. In this paper, I aim at developing a theoretical framework for providing indiscriminate access to the COVID-19 vaccination for the transgender community as a part of right to health by reporting the first-hand knowledge about the challenges of access to vaccination facilities using qualitative research methods.
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Affiliation(s)
- Muhammad Danyal Khan
- Faculty of Commerce Law and Business Administration, Bahauddin Zakariya University, Multan, Pakistan
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