Key Guidelines in Developing a Pre-Emptive COVID-19 Vaccination Uptake Promotion Strategy

Pediatric nurses' acceptance and attitudes toward COVID-19 vaccines for their children at Assiut University Children Hospital: A cross-sectional study

BACKGROUND

Children's vaccination mainly depends on their parents' decisions. Therefore, it is important to understand parents' acceptance and attitudes toward vaccinating their children against COVID-19.

AIM

The study aimed to assess the pediatric nurses' acceptance and attitudes toward COVID-19 vaccines for their children at Assiut University Children Hospital.

MATERIALS AND METHOD

A cross-sectional descriptive design was used on a convenience sample of 270 nurses who worked at Assiut University Children Hospital.

TOOLS

Tool one involved the demographic characteristics of pediatric nurses and their children. Tool two consisted of pediatric nurses' acceptance and attitudes toward COVID-19 vaccines for their children: RESULTS: The results indicated that 79.3% of pediatric nurses had higher acceptance of vaccines and immunization of their children. Results also revealed that 80.0% of pediatric nurses had positive attitudes toward vaccines and their children's immunizations.

CONCLUSION

It was concluded that most of pediatric nurses had high acceptance and positive attitudes toward vaccines and immunization of their children. Also, it was clarified that there was a positive statistically significant correlation between nurses' acceptance of vaccines and immunization of their children and their attitudes.

RECOMMENDATIONS

Continuing education and tailored intervention should be implemented to correct misinformation and negative conceptions about the safety of vaccines for children.

COVID-19 vaccination in low and middle-income countries: Creating a sustainable roadmap for promoting public health intervention

The Coronavirus Disease 2019 (COVID-19) pandemic is a global public health threat ravaging the health systems. In low and middle-income countries (LMICs), COVID-19 and several other challenges concurrently worsen the health outcome indicators. Interestingly, vaccines have been identified as the most reliable and cost-effective public health intervention, and the governments in LMICs have instituted an array of plans to ensure every eligible person gets vaccinated. However, there is still considerable apathy around the use of the available COVID-19 vaccines in LMICs which is impeding the fight against the COVID-19 pandemic. In this paper, we explore the multiple interrelated factors behind low COVID-19 vaccination coverage in LMICs. It is therefore recommended that the governments in LMICs embrace multicomponent and wide-ranging strategies. This should involve utilising community-based approaches such as community pharmacy-led vaccination to promote community access to COVID-19 vaccines and to revive trust in national health authorities by offering population-specific, target-driven, transparent, and timely communication to the community who they serve about the safety and efficacy of the COVID-19 vaccine. Communication strategies should be tailored to reflect diverse political orientations as this can enhance vaccine acceptance. Additionally, local political parties and representative should be engaged in broad alliances to facilitate community mobilisation and support for vaccination campaigns. Also, relevant Nongovernmental Organisations and Community-based Organisations should institute programs at the grassroots that incorporate the gatekeepers to the community aimed at influencing population behaviour regarding COVID-19 vaccine hesitancy. Besides, the public health department in the ministry of health in LMICs should create more awareness, through social and mass media, particularly in the rural, semi-urban, and slum communities about the pivotal role of vaccination. Thus, we opined that these strategies will help LMICs achieve the COVID-19 vaccination target and further reposition the healthcare systems, and promote other public health interventions now and in the future.

Respecting Conversational Norms Improves Reception of Expert Messages Among Unvaccinated Individuals

The association of medical experts with politically left-leaning cities and states early in the COVID-19 pandemic may have exacerbated vaccine hesitancy in right-leaning states of the US. Criticism from outside experts violates rules of communication between social groups (i.e. an intergroup sensitivity effect), leading to rejection of messages promoting vaccine safety and efficacy. In two studies, we document the effects of shared geographical group membership for medical expert messages promoting vaccination. We also found evidence that satisfying conversational norms against intergroup criticism reduces message rejection. Specifically, an invitation from ingroup political elites for a doctor to speak reduced the negative effects of unshared group identity.

"Implementation of intensified COVID-19 vaccination optimization (ICVOPT) campaigns strategy in complex humanitarian emergency settings and hard-to-reach areas; a case of South Sudan"

INTRODUCTION

The COVID-19 pandemic is still a public health concern in South Sudan having caused suffering since the first case of COVID-19 was introduced on 28th February 2020. COVAX vaccines have since been introduced using a number of strategies including fixed site, temporary mobile, hit and run in flooded and conflict affected areas. We aim to describe the 2 ICVOPT campaigns that were conducted to improve the uptake and document lessons learnt during the initial rollout of the COVID-19 vaccination programin South Sudan between February 2022 and June 2022 each lasting for 7-days.

METHODOLOGY

We conducted an operational cross-sectional descriptive epidemiological study of a series of the intensified COVID-19 vaccination Optimization (ICVOPT) campaigns from February 2022 to June 2022. Before the campaign, a bottom up micro-planning was conducted, validated by the County Health Departments (CHDs) and national MOH team. Each of the 2 campaigns lasted for 7 days targeting 30% of the eligible unvaccinated target population who were18 years and above. Each team consisted of 2 vaccinators, 2 recorders and 1 mobilizer. The teams employed both fixed site, temporary mobile, hit and run in flooded and conflict affected areas. The number of teams were calculated based on the daily workload per day (80 persons per team/day) for the duration of the campaigns.

RESULTS

A total of 444,030 individuals were vaccinated with primary series COVID-19 vaccine (J&J) out of the targeted 635,030 persons. This represented 69.9% of target population in the selected 28 counties and 10 states of South Sudan in 7 days' ICVOPT campaigns. More eligible persons were reached in 7 days campaigns than the 9 months of rollout of the COVID-19 vaccine prior to ICVOPT campaigns using the fixed site strategy at the health facility posts.

CONCLUSION

Intensified COVID-19 vaccination Optimization (ICVOPT) campaigns were vital and fast in scaling up vaccination coverages as compared to the fixed site vaccination strategies (2022 progress report on the Global Action Plan for Healthy Lives and Well-being for All Stronger collaboration for an equitable and resilient recovery towards the health-related Sustainable Development Goals, incentivizing collaboration, 2022) in complex humanitarian emergency settings and hard-to-reach areas of South Sudan.

Randomised experimental evaluation of a social media campaign to promote COVID-19 vaccination in Nigeria

Background

The coronavirus disease 2019 (COVID-19) pandemic has challenged public health and behaviour change programmes, and has led to the development of innovative interventions and research. In low -and middle-income countries (LMICs) such as Nigeria, new strategies to promote vaccination, increase pro-vaccination social norms, and reduce vaccine hesitancy have been deployed through social media campaigns and evaluated using digital media platforms.

Methods

We conducted two randomised experimental evaluations of social media content designed to promote COVID-19 vaccination and to complement research on a nationwide vaccination promotion campaign in Nigeria run in 2022. We conducted two studies in March and August 2022 among Nigerians drawn from 31 states that had not been targeted in the aforementioned nationwide campaign. We randomised the participants to either receive the pro-vaccination social media campaign or not and collected data at pre- and post-test time points to evaluate psychosocial predictors of vaccination and vaccination outcomes following the Theory of Change based on Diffusion of Innovations; the Social Norms Theory, and the Motivation, Opportunity, Ability (MOA) framework. Data were collected through a novel intervention delivery and data collection platform through social media.

Results

We found that pro-vaccination social norms and vaccination rates increased, while vaccine hesitancy decreased among participants randomised to the social media intervention study arm.

Conclusions

Social media campaigns are a promising approach to increasing vaccination at scale in LMICs, while social norms are an important factor in promoting vaccination, which is consistent with the Social Norms Theory. This study demonstrates the capability and potential of new social media-based data collection techniques. We describe implications for future vaccination campaigns and identify future research priorities in this area.

Registration

Pan African Clinical Trial Registry: PACTR202310811597445.

Presidents and vaccines: head of state inoculation as a tool for vaccine promotion

Introduction

Vaccine hesitancy, an important threat to global health, has increased since the onset of the COVID-19 pandemic. The public vaccination of high-profile figures, such as heads of state, has been touted as a potential tool for increasing vaccine acceptance among the general population. However, systematic information on such role modelling is lacking and existing studies focus on a small number of high-income countries. We take advantage of the COVID-19 pandemic to fill this gap.

Methods

Through a systematic search of internet sources, we first document that most global leaders supported the vaccination campaign and actively communicated their vaccination status to the public. We then turn to a case study to provide experimental evidence on vaccine role modelling for a country in Africa - the region that is most lagging behind in achieving universal immunization coverage. We rely on a randomized survey experiment with 600 citizens in the Democratic Republic of Congo and take advantage of the fact that the Congolese President publicly received a COVID-19 vaccine during the survey period.

Results and discussion

Our findings demonstrate that the impact of political leader's role modelling is moderated by trust and depends on media outreach and access. When trust in leaders is lacking, or news on their actions is inaccessible, alternative ambassadors and effective communication methods become crucial in motivating and informing the public. This may be especially relevant in fragile states and remote regions.

Examination of Predicting Factors for COVID-19 Vaccination Behaviors of University Students Utilizing the Theory of Planned Behavior

PURPOSE

This study aimed to examine the predictive factors of COVID-19 vaccination behavior by evaluating the moderating effect of perceived behavioral control on the theory of planned behavior.

METHODS

Data were collected from August 6 to August 31, 2022 from 235 college students (aged 20~29 years) across 12 universities using a structured web-based survey. Statistical analyses were conducted using the SPSS and AMOS software.

RESULTS

Attitudes toward COVID-19 vaccination, subjective norms, and intention to be vaccinated significantly influenced COVID-19 vaccination behavior. Attitudes and subjective norms indirectly affected COVID-19 vaccination behavior through intention to vaccinate, whereas intention to vaccinate had a direct effect. The moderating effect of perceived behavioral control on the relationship between subjective norms and intention to vaccinate was significant.

CONCLUSION

Interventions that foster a positive attitude toward COVID-19 vaccination and bolster subjective norms and perceived behavioral control can boost the intention to be vaccinated and facilitate the uptake of COVID-19 vaccination.

Clinical characteristics of COVID-19 patients treated in emergency COVID-19 hospitals in Vietnam: Experience from Phutho province, Vietnam

Background: This study aimed to evaluate the clinical characteristics, patient's management approaches, and outcomes of the COVID-19 patients in Phu Tho Province, Vietnam. Methods: A retrospective, multicenter study of 2166 COVID-19 patients in 13 hospitals in Phutho Province, Vietnam. The subjects were divided into 3 groups based on vaccination status: unvaccinated group, 1st dose of vaccine group, 2nd dose of vaccine group. The clinical characteristics, management approaches, and outcomes were collected and compared between the 3 groups. Results: The hospitalization rate of the 3 groups decreased from the unvaccinated group, the 1st dose of vaccinated group, to the 2nd dose of vaccinated group, 42.61%; 30,24% and 27,15% respectively. The 19-40 years old group had the highest hospitalization rate (38,1%) together with the group that had not accepted the full COVID 19 vaccination dose (57,64%). The 2nd dose of vaccinated group had the lowest percentages of high temperature, cough, dyspnea, chest pain and sore throat. The unvaccinated group had the highest heart rate, respiratory rate and SpO2 compared to the two other groups. The percentage needing Immunomodulation and Anticoagulant Therapy was highest (6.8% and 1.4 % respectively) in the unvaccinated group. The percentage receiving Antiviral Therapy was highest (42,5%) in those who had received the 2nd dose of vaccine. Conclusions: COVID-19 vaccination improved the symptoms of the patients and should be accepted in all ages.

Pandemic fatigue, behavioral intention and predictors of COVID-19 vaccination among individuals living with HIV in Bench Sheko Zone, in Southern Ethiopia, application of TBP: a facility based cross sectional study

Introduction

People living with HIV often face inequalities and negative outcomes, which make them vulnerable. To protect this population and achieve herd immunity, it is crucial for COVID-19 vaccination efforts to prioritize and encourage vaccination among people living with HIV (PLWH). However, in Ethiopia, there is a lack of motivation in this regard. To tackle this issue, a study was conducted in the Bench Sheko Zone of Southwest Ethiopia. The study aimed to assess pandemic fatigue, behavioral intention to get vaccinated, and factors influencing COVID-19 vaccine acceptance among PLWH in that region.

Methods

A facility-based cross-sectional study was conducted among individuals living with HIV who were over 18 years old in Bench-Sheko Zone, located in Southwest Ethiopia. The study included a total of 590 participants from four ART healthcare facilities within the zone. The researchers utilized the Theory of Planned Behavior to examine the predictors of intention to use preconception care. Multiple linear regression analysis was employed to determine these predictors, with a p-value of less than 0.05 considered as indicative of a significant association. The final analysis of the study involved the use of linear regression analysis, and the measure of association was presented as the standardized B coefficient following a multivariable logistic regression analysis.

Result

In the conducted study, the response rate was an impressive 98%. The researchers aimed to investigate the behavioral intention toward the COVID-19 vaccine, which was found to be 55.7%. The average age of the participants in the study was 34.65 ± 6.67. The study was the assessment of pandemic fatigue, which had a mean value of 17.22 ± 5.28. During the multivariate linear regression analysis, four predictor variables were identified. Among these, three variables, namely subjective norm, pandemic fatigue, and age, positively influenced the behavioral intention toward the COVID-19 vaccine. Comprehending these factors can assist healthcare professionals and policymakers in formulating precise interventions and strategies aimed at enhancing the acceptance and adoption of vaccines.

Conclusion

The study indicates that individuals living with HIV have shown lower vaccine intention compared to previous research. The study identifies subjective norm, pandemic control measures, income, and age as predictors of individuals' intention to receive the COVID-19 vaccine.

Knowledge of and Self-Expressed Stigma for COVID-19 Vaccination among Pre-University Students in a College in South India: A Cross-Sectional Study

Background

Coronavirus disease 2019 (COVID-19) is a contagious infection characterized by severe acute respiratory syndrome (SARS-CoV-2). Safe and effective vaccines are game-changers in the global vision of marking an end to the challenges posed by the COVID-19 pandemic. However, vaccine hesitancy due to perceived stigma and misinformation is a grave cause of concern.

Objectives

To assess pre-university students' self-expressed stigma regarding COVID-19 vaccination and its association with their knowledge.

Materials and Methods

A cross-sectional study was adopted for this research. A structured questionnaire approach was used to gather data from 384 students purposively at the selected pre-university college. The structured questionnaire consisted of three sections that explored the socio-demographic characteristics of the study participants, knowledge of vaccination, and self-expressed stigma, respectively. A total of 384 respondents took part in the study.

Results

The study observes a low positive relationship (r = 0.25, P < 0.01) between knowledge and self-expressed stigma toward vaccination. Further, it was observed that participants from rural backgrounds had lower knowledge and self-expressed stigma scores than participants from urban settings. It is pertinent to note that participants with other sources of information had higher knowledge than those who used the internet, friends/peers, or newspapers. Both of the aforementioned findings are statistically significant.

Conclusion

The interventions should revive trust in national health authorities, structured awareness campaigns by government agencies, and media coverage about the safety and efficacy of vaccines. In addition, it is also important to support citizens in ensuring that they have access to the right information from authentic sources in times of crisis.

Improving COVID-19 vaccine uptake: a message co-design process for a national mHealth intervention in Colombia

BACKGROUND

COVID-19 vaccination is a global priority. Latin American countries have some of the highest COVID-19 death rates worldwide with vaccination hampered by a variety of reasons, including mis- and disinformation, vaccine hesitancy, and vaccine supply constraints. Addressing vaccine hesitancy through effective messages has been found to help increase vaccine uptake. Participatory processes could be used to co-design health messages for this purpose.

OBJECTIVE

This article describes the methodology used to co-design evidence-based audio messages to be deployed in a cohort of individuals through an interactive voice response (IVR) mobile phone survey intervention, aimed towards increasing vaccination uptake in an adult population in Colombia.

METHODS

Participants of the COVID-19 vaccination message co-design process included a sample of the general population of the country, representatives of the funder organisation, and research team members. The co-design process consisted of four phases: (1) formative quantitative and qualitative research, (2) message drafting based on the results of the formative research, (3) message content evaluation, and (4) evaluation of the voices to deliver the audio messages; and was informed by reflexive meetings.

RESULTS

Three categories of evidence-based audio messages were co-designed, each corresponding to an arm of the mHealth intervention: (1) factual messages, (2) narrative messages, and (3) mixed messages. An additional fourth arm with no message was proposed for control. The iterative co-design process ended with a total of 14 audio messages recorded to be deployed via the intervention.

CONCLUSIONS

Co-developing health messages in response to health emergencies is possible. Adopting more context-relevant, participatory, people-centred, and reflexive multidisciplinary approaches could help develop solutions that are more responsive to the needs of populations and public health priorities. Investing resources in message co-design is deemed to have a greater potential for influencing behaviours and improving health outcomes.

COVID-19 vaccine acceptance in three rural communes in Haiti: A cross-sectional study

Vaccines are the most effective mechanism for ending the COVID-19 pandemic. However, reluctance to accept vaccines has hindered the efforts of health authorities to combat the virus. In Haiti, as of July 2021, less than 1% of the country's population has been fully vaccinated in part due to vaccine hesitancy. Our goal was to assess Haitian attitudes toward COVID-19 vaccination and investigate the primary reasons for Moderna vaccine hesitancy. We conducted a cross-sectional survey across three rural Haitian communities, in September 2021. The research team used electronic tablets to collect quantitative data from 1,071 respondents, selected randomly across the communities. We report descriptive statistics and identify variables associated with vaccine acceptance using logistic regression built using a backward stepwise approach. Among 1,071 respondents, the overall acceptance rate was 27.0% (n = 285). The most common reason for vaccine hesitancy was "concern about side effects" (n = 484, 67.1%) followed by "concern about contracting COVID-19 from the vaccine" (n = 472, 65.4%). Three-quarters of respondents (n = 817) identified their healthcare workers as their most trustworthy source for information related to the vaccine. In the bivariate analysis, male gender (p = .06) and no history of drinking alcohol (p < .001) were significantly associated with being more likely to take the vaccine. In the final reduced model, only those with a history of drinking alcohol were significantly more likely to take the vaccine (aOR = 1.47 (1.23, 1.87) p < .001). The acceptance rate for the COVID-19 vaccine is low, and public health experts should design and strengthen vaccination campaigns to combat misinformation and public distrust.

Assessment of willingness and determinants to receive the COVID-19 vaccine among the general population of the Somali region, Eastern Ethiopia: a 2021 cross-sectional study

OBJECTIVE

This research aimed to assess COVID-19 vaccine acceptance and the factors influencing it among the population of the Somali region in Ethiopia through a cross-sectional COVID-19 survey.

DESIGN

Community-based cross-sectional study.

SETTING

The survey was conducted in eight selected districts of the Somali region in Ethiopia from 20 October 2021 to 30 October 2021.

PARTICIPANTS

Participants were chosen using simple random sampling and data analysis used Stata V.14. Both bivariable and multivariable binary logistic regression methods were applied, with variables having a p value below 0.2 considered for inclusion in the final model, where statistically significant factors were identified at p<0.5.

PRIMARY OUTCOME MEASURE

Willingness to take the vaccine.

RESULTS

A total of 1010 respondents participated in this study. The proportion of people's willingness to take the vaccine was 65% (95% CI 62 to 68). When you believe moderately or highly that getting a COVID-19 vaccine will protect others (AOR=6.2, 95% CI 1.43 to 26.6) and (AOR=7.2, 95% CI 1.7 to 29.7), then you will protect others as well. Whereas, a desire to get vaccinated little, moderately and highly (AOR=4.3, 95% CI 1.77 to 10.4), (AOR=20, 95% CI 8.5 to 47) and (AOR=147, 95% CI 55 to 392), respectively, was significantly associated with willingness to take the vaccine. Moreover having close family and friends who want them to get a COVID-19 vaccine (AOR=2, 95% CI 1.2 to 3.57) and religious leaders or community leaders (AOR=1.8, 95% CI 1 to 3.1) were significant factors in the multivariable logistic regression model.

CONCLUSION

This study found that COVID-19 vaccine acceptance was low in the Somali region. Factors positively linked to one's willingness to get vaccinated included the belief that it protects others, personal desire for vaccination and support from family, friends, community and religious leaders.

Extracting factors associated with vaccination from Twitter data and mapping to behavioral models

Social media platform, particularly Twitter, is a rich data source that allows monitoring of public opinions and attitudes toward vaccines.Established behavioral models like the 5C psychological antecedents model and the Health Belief Model (HBM) provide a well-structured framework for analyzing shifts in vaccine-related behavior. This study examines if the extracted data from Twitter contains valuable insights regarding public attitudes toward vaccines and can be mapped to two behavioral models. This study focuses on the Arab population, and a search was carried out on Twitter using: ' تلقيحي OR تطعيم OR تطعيمات OR لقاح OR لقاحات' for two years from January 2020 to January 2022. Then, BERTopicmodeling was applied, and several topics were extracted. Finally, the topics were manually mapped to the factors of the 5C model and HBM. 1,068,466 unique users posted 3,368,258 vaccine-related tweets in Arabic. Topic modeling generated 25 topics, which were mapped to the 15 factors of the 5C model and HBM. Among the users, 32.87%were male, and 18.06% were female. A significant 55.77% of the users were from the MENA (Middle East and North Africa) region. Twitter users were more inclined to accept vaccines when they trusted vaccine safety and effectiveness, but vaccine hesitancy increased due to conspiracy theories and misinformation. The association of topics with these theoretical frameworks reveals the availability and diversity of Twitter data that can predict behavioral change toward vaccines. It allows the preparation of timely and effective interventions for vaccination programs compared to traditional methods.

Assessment of implicit COVID-19 attitudes using affective priming for pro-vaccine and vaccine-hesitant individuals

The COVID-19 pandemic has resulted in the introduction of pharmaceutical and non-pharmaceutical interventions such as precautionary behaviours. The current study used affective priming to evaluate COVID-19 attitudes in vaccine-hesitant and pro-vaccine participants. Explicitly, both groups rated their overall perception of risk associated with contracting COVID-19 significantly lower compared to their perception of necessary precautions and overall adherence to public health measures. Pro-vaccine participants rated their perception of necessary precautions higher compared to vaccine-hesitant participants. During baseline measures, both groups classified COVID-19 affiliated words as unpleasant. Affective priming was observed for congruent prime-target pleasant and unpleasant word pairs but was not observed for COVID-19 related word pairs. Differences between groups in the perception of necessary public health precautions points to different underlying pathways for reduced perceived risk and lack of affective priming. These results refine previous findings indicating that implicit attitudes towards COVID-19 can be measured using the affective priming paradigm.

Role of leadership and incentive-based programs in addressing vaccine hesitancy in India

The current study goes beyond the popular 5Cs model of vaccine hesitancy to explore perceived social norms, role of leadership and the role of incentive-based intervention for improving the likelihood of vaccination, in a population-representative sample of adults in India (N = 1129). We investigated differences in socio-demographic status, perceived descriptive norms like vaccine behaviours, beliefs, experience and perceived injunctive norms like community and political leadership within the context of the COVID-19 pandemic are related to vaccination. Further, we examined the role of incentive-based intervention as a potentially salient predictor of adults' vaccine uptake. The study is based on a cross-sectional survey conducted in July-November 2021, which included questions about impacts of pandemic collected by phone call interview from adults' beneficiaries of Government free food schemes, across 11 states in India. The data include 81 % vaccinated and 19 % vaccine hesitant participants, with a higher proportion of business or self-employed (53.1 %) as vaccine hesitant. We performed the t-test to assess the variation between vaccinated and vaccine hesitant adults, and Exploratory Factor Analysis to uncover the underlying dimension of vaccine hesitancy. Subsequently, Binary Logistic Regression model probed the factors associated with likelihood of vaccination uptake. In contrast to the prevailing evidence, results demonstrated community and political leadership has significant negative impact on vaccination (p-value < 0.06, 95 % CI, 0.57-1.01). Incentive-based intervention offer a vital leverage to enhance positive attitude towards vaccination (p-value < 0.05, 95 % CI, 1.01-1.80). The results thus broadly highlight the limited role of political and community leaders in leveraging their influence on vaccination, the role of timely, accurate information, applications of telemedicine as an important tool to provide healthcare and the need for optimal design of incentive-based vaccination programs recommended by trusted sources.

COVID-19 Vaccine Perspective Among University Lecturers and Students: A Qualitative Study of Pre Implementation of Vaccination

Background

The determinants of vaccine preferences and hesitancy varied by time and place.

Objective

The aim of this study was to assess the perspective of a COVID-19 vaccine among university-based groups.

Methodology

This qualitative research involved lecturers and students, and a selection of online focused group discussion was conducted based on the following criteria, including representatives of the health and non-health faculties, with at least 8 attendees in lecturer groups, and 8 participants in student groups.

Results

This study is described in 8 themes covering various issues about COVID-19 vaccine, such as views on COVID-19 vaccine, fake news, vaccine implementation by government.

Conclusion

The assessment of vaccine perspective shows that although awaited by some people, it also creates contradictions. This is due to the massive amount of information available regarding the vaccine descriptions. The role of the government as the main policy maker is to provide the right information and to make the right decisions about vaccines and vaccination implementation.

COVID-19 Vaccine Hesitancy: A Content Analysis of Nigerian YouTube Videos

Vaccination is key to developing herd immunity against COVID-19; however, the attitude of Nigerians towards being vaccinated stalled at the 70% vaccination target. This study engages Theory of Planned Behaviour to analyse the tone of Nigerian YouTube headlines/titles, and the tone of YouTube users' comments to examine the causes of COVID-19 vaccine hesitancy. YouTube videos uploaded between March 2021 and December 2022 were analysed using a content analytic approach. Results show 53.5% of the videos had a positive tone, while 40.5% were negative, and 6% neutral. Second, findings indicate most of the Nigerian YouTube users' comments were neutral (62.6%), while 32.4%, were negative, and 5% were positive. From the antivaccine themes, analysis shows the people's lack of trust in the government on vaccines (15.7%) and the presence of vaccine conspiracy theories mostly related to expressions of religion and biotechnology (46.08%) were the main causes of COVID-19 vaccine hesitancy in Nigeria. The study presents implications for theory and recommends ways for governments to develop better vaccination communication strategies.

COVID-19 Vaccine Knowledge and Attitude Among Healthcare Workers in Jeddah, Saudi Arabia

Background On March 11, 2020, the World Health Organization (WHO) proclaimed coronavirus disease 2019 (COVID-19) a pandemic. COVID-19 can result in asymptomatic infection, severe pneumonia, and death. In this study, healthcare workers in Jeddah, Saudi Arabia, were asked to reflect on their knowledge of and attitudes toward the COVID-19 vaccine. Methods Online anonymous polling of healthcare professionals in Jeddah, Saudi Arabia, was done. During the COVID-19 pandemic, the respondents' demographic information and knowledge of and attitudes toward the COVID-19 vaccine were gathered through a questionnaire. Both descriptive and inferential statistics were used to analyze the data. Results The knowledge of the responders for each vaccine is as follows: Pfizer-BioNTech, 96.1%; AstraZeneca-Oxford, 66.1%; Moderna, 56.9%; and Johnson & Johnson's Janssen, 18.2%. A small percentage of responders (5.7%) believe that COVID-19 vaccination may alter their DNA, while 70% believe it can prevent them from getting sick with COVID-19 infection. Half of the responders had a wrong opinion of COVID-19 vaccinations. Conclusion The findings imply that improving healthcare workers' knowledge of vaccines and changing attitudes toward vaccination may increase vaccine acceptability. This would involve addressing the respondents' concerns about vaccine side effects and their general mistrust of vaccine benefits.

Evaluation of the Global Health Security Index as a predictor of COVID-19 excess mortality standardised for under-reporting and age structure

BACKGROUND

Previous studies have observed that countries with the strongest levels of pandemic preparedness capacities experience the greatest levels of COVID-19 burden. However, these analyses have been limited by cross-country differentials in surveillance system quality and demographics. Here, we address limitations of previous comparisons by exploring country-level relationships between pandemic preparedness measures and comparative mortality ratios (CMRs), a form of indirect age standardisation, of excess COVID-19 mortality.

METHODS

We indirectly age standardised excess COVID-19 mortality, from the Institute for Health Metrics and Evaluation modelling database, by comparing observed total excess mortality to an expected age-specific COVID-19 mortality rate from a reference country to derive CMRs. We then linked CMRs with data on country-level measures of pandemic preparedness from the Global Health Security (GHS) Index. These data were used as input into multivariable linear regression analyses that included income as a covariate and adjusted for multiple comparisons. We conducted a sensitivity analysis using excess mortality estimates from WHO and The Economist.

RESULTS

The GHS Index was negatively associated with excess COVID-19 CMRs (table 2; β= -0.21, 95% CI= -0.35 to -0.08). Greater capacities related to prevention (β= -0.11, 95% CI= -0.22 to -0.00), detection (β= -0.09, 95% CI= -0.19 to -0.00), response (β = -0.19, 95% CI= -0.36 to -0.01), international commitments (β= -0.17, 95% CI= -0.33 to -0.01) and risk environments (β= -0.30, 95% CI= -0.46 to -0.15) were each associated with lower CMRs. Results were not replicated using excess mortality models that rely more heavily on reported COVID-19 deaths (eg, WHO and The Economist).

CONCLUSION

The first direct comparison of COVID-19 excess mortality rates across countries accounting for under-reporting and age structure confirms that greater levels of preparedness were associated with lower excess COVID-19 mortality. Additional research is needed to confirm these relationships as more robust national-level data on COVID-19 impact become available.

Unintended consequences of communicating rapid COVID-19 vaccine policy changes- a qualitative study of health policy communication in Ontario, Canada

BACKGROUND

The success of the COVID-19 vaccination roll-out depended on clear policy communication and guidance to promote and facilitate vaccine uptake. The rapidly evolving pandemic circumstances led to many vaccine policy amendments. The impact of changing policy on effective vaccine communication and its influence in terms of societal response to vaccine promotion are underexplored; this qualitative research addresses that gap within the extant literature.

METHODS

Policy communicators and community leaders from urban and rural Ontario participated in semi-structured interviews (N = 29) to explore their experiences of COVID-19 vaccine policy communication. Thematic analysis was used to produce representative themes.

RESULTS

Analysis showed rapidly changing policy was a barrier to smooth communication and COVID-19 vaccine roll-out. Continual amendments had unintended consequences, stimulating confusion, disrupting community outreach efforts and interrupting vaccine implementation. Policy changes were most disruptive to logistical planning and community engagement work, including community outreach, communicating eligibility criteria, and providing translated vaccine information to diverse communities.

CONCLUSIONS

Vaccine policy changes that allow for prioritized access can have the unintended consequence of limiting communities' access to information that supports decision making. Rapidly evolving circumstances require a balance between adjusting policy and maintaining simple, consistent public health messages that can readily be translated into action. Information access is a factor in health inequality that needs addressing alongside access to vaccines.

From Polio to COVID-19: Examining the Impact of Pandemics on Childhood Vaccination Programs

This review article aims to examine the impact of pandemics on childhood vaccination programs, specifically looking at the examples of polio and coronavirus disease 2019 (COVID-19). The article provides a comprehensive overview of the history of polio vaccination programs, including the challenges of eradicating the disease and the barriers to vaccine uptake. The article also looks at the global efforts to eradicate polio, such as the Global Polio Eradication Initiative, and the progress made in reducing the number of polio cases worldwide. The article reviews the impact of the COVID-19 pandemic on childhood vaccination programs and how the pandemic has disrupted routine vaccination services. Lockdowns and travel restrictions have contributed to this, which has reduced access to medical facilities and vaccine uptake. The article also explores how the prioritization of COVID-19 vaccines has led to a diversion of resources away from routine childhood immunization programs. The article highlights the need to address these challenges to prevent a resurgence of vaccine-preventable diseases. Furthermore, the article discusses the lessons learned from these pandemics, such as the importance of global collaboration, vaccine equity, addressing vaccine hesitancy, pandemic preparedness, and embracing technology. The article emphasizes the need to prioritize vaccine equity and ensure that vulnerable populations have access to vaccines. Additionally, the article stresses the importance of addressing vaccine hesitancy and providing effective communication and education about vaccines. The article also advocates for pandemic preparedness, emphasizing the need to invest in research and development of vaccines for emerging infectious diseases. Finally, the article suggests embracing technology as a means to improve vaccine accessibility and distribution.

Audience segmentation analysis of public intentions to get a COVID-19 vaccine in Australia

While previous studies provide broad categories of the public who intend to get a COVID-19 vaccine, few systematically segment and help understand and engage with distinct publics to improve COVID-19 vaccine uptake. Using data from a national sample of the Australian public (N = 1054) and using measures primarily based on the Theory of Planned Behaviour, a latent class analysis of 16 items was undertaken to identify COVID-19 audience segments for potential future message targeting. We found five different segments of COVID-19 vaccine intentions: vaccine enthusiasts (28%), supporters (26%), socials (20%), hesitant (15%) and sceptics (10%). These five audience segments also differ on demographic variables and their level of trust in mainstream media, scientists and health experts, social media and family and friends. Understanding the COVID-19 vaccine attitudinal and information-seeking characteristics of these sub-publics will help inform appropriate messaging campaigns.

Localizing COVID-19 Misinformation: A Case Study of Tracking Twitter Pandemic Narratives in Pennsylvania Using Computational Network Science

The recent COVID-19 outbreak has highlighted the importance of effective communication strategies to control the spread of the virus and debunk misinformation. By using accurate narratives, both online and offline, we can motivate communities to follow preventive measures and shape attitudes toward them. However, the abundance of misinformation stories can lead to vaccine hesitancy, obstructing the timely implementation of preventive measures, such as vaccination. Therefore, it is crucial to create appropriate and community-centered solutions based on regional data analysis to address mis/disinformation narratives and implement effective countermeasures specific to the particular geographic area.In this case study, we have attempted to create a research pipeline to analyze local narratives on social media, particularly Twitter, to identify misinformation spread locally, using the state of Pennsylvania as an example. Our proposed methodology pipeline identifies main communication trends and misinformation stories for the major cities and counties in southwestern PA, aiming to assist local health officials and public health specialists in instantly addressing pandemic communication issues, including misinformation narratives. Additionally, we investigated anti-vax actors' strategies in promoting harmful narratives. Our pipeline includes data collection, Twitter influencer analysis, Louvain clustering, BEND maneuver analysis, bot identification, and vaccine stance detection. Public health organizations and community-centered entities can implement this data-driven approach to health communication to inform their pandemic strategies.

Attitudes of University Students towards Mandatory COVID-19 Vaccination Policies: A Cross-Sectional Survey in Rome, Italy

Mandatory vaccination (MV) against COVID-19 is a contentious topic. In this study, we used logistic regression models to identify attitudes among Sapienza University students towards MV for COVID-19. We considered three different scenarios: mandatory COVID-19 vaccination (MCV) for healthcare workers (HCWs) (Model 1), for all people aged ≥ 12 years (Model 2), and for admission to schools and universities (Model 3). We collected 5287 questionnaires over a six-month period and divided these into three groups (September-October 2021, November-December 2021, and January-February 2022). MCV for HCWs was the most strongly supported policy (69.8% in favour), followed by MCV for admission to schools and universities (58.3%), and MCV for the general population (54.6%). In a multivariable analysis, the models showed both similarities and differences. There was no association of socio-demographic characteristics with the outcomes, apart from being enrolled in non-healthcare courses, which negatively affected Models 2 and 3. A greater COVID-19 risk perception was generally associated with a more positive attitude towards MCV, although heterogeneously across models. Vaccination status was a predictor of being in favour of MCV for HCWs, whereas being surveyed in November-February 2022 favoured MCV for admission to schools and universities. Attitudes towards MCV were variable across policies; thus, to avoid unintended consequences, these aspects should be carefully considered by policymakers.

Using Social Marketing to Promote COVID-19 Vaccination Uptake: A Case Study from the "AUBe Vaccinated" Campaign

The availability of and access to COVID-19 vaccines has been challenging in many low- and middle-income countries (LMICs), coupled with mistrust in public health organizations instigated by misinformation and disinformation diffused by traditional and social media. In the Spring of 2021, the American University of Beirut (AUB) in Lebanon spearheaded a nationwide vaccination drive with the ambitious goal of vaccinating its entire community by the beginning of the academic year 2021-2022, as the campus was due to be opened only to vaccinated individuals. This case study outlines the development, implementation, and evaluation of a social marketing campaign to encourage COVID-19 vaccinations among members of the AUB community, comprising students, faculty, staff, and dependents. Following French and Evans' 2020 guidelines, we implemented an evidence-based and co-designed strategy to maximize the availability and facilitate vaccine access. The campaign used a mix of methods to convince the segments of the population to receive their shots before accessing campus, resulting in a 98% uptake among the community segments within three months (July-September 2021). In this case study, we reflect on the experience and share suggestions for future research and applications that other higher education institutions could use to address similar problems.

Effects of Negative Attitudes towards Vaccination in General and Trust in Government on Uptake of a Booster Dose of COVID-19 Vaccine and the Moderating Role of Psychological Reactance: An Observational Prospective Cohort Study in Hong Kong

Uptake of a booster dose of COVID-19 vaccine is effective in preventing infection and severe consequences caused by COVID-19. The present study examined the effects of negative attitudes towards vaccination in general and trust in government on uptake of a COVID-19 booster dose, as well as the moderating role of psychological reactance to pro-vaccination messages in Hong Kong. An observational prospective cohort study using online survey was conducted among 264 adults. Findings showed that, after adjustment for significant background characteristics, negative attitudes towards vaccination in general negatively predicted uptake of a booster dose, and trust in government positively predicted uptake of a booster dose. In addition, the association between negative attitudes towards vaccination in general and uptake of a booster dose was weaker among those who reported a higher level of psychological reactance. The present study highlighted the importance of improving attitudes towards vaccination in general especially among those who are not experiencing psychological reactance, and building trust in government. This study also suggested that interventions aimed at improving attitudes towards vaccination in general should seek to avoid psychological reactance, and special attention should be given to people who are experiencing psychological reactance to pro-vaccination messages.

Development and Evaluation of an Index to Measure the Ability to Get Vaccinated for COVID-19

The COVID-19 pandemic has been an historic challenge to public health, and to behavior change programs. There have been challenges in promoting vaccination in LMICs, including Nigeria. One important hypothesis deserving consideration is the ability to obtain vaccination as a potential barrier to vaccination uptake. The MOA (motivation, opportunity, and ability) framework, as illustrated by multiple theories such as COM-B, EAST, and the Fogg model, is a primary theoretical basis for the evaluation of this ability as a factor in vaccination uptake. There is little research on measuring the ability to get vaccinated in LMICs, including on the role of all of the MOA framework. The aim of this study was to develop and evaluate an ability factors index measured through social media-based data collected in Nigeria in late 2021 and early 2022. We present findings from an online survey of 8574 Nigerians and highlight new social media-based data collection techniques in this research. This study found that a new ability factors index comprising 12 items was associated with vaccine uptake independent of measures capturing other components of the MOA framework. This index may serve as a valuable research instrument for future studies. We conclude that a person's perceived ability to get vaccinated, measured by a newly validated index, is related to vaccination uptake and hesitancy, and that more research should be conducted in this area.

Promoting COVID-19 Vaccine Acceptance through Community Engagement: An Ethnographic Study in Ghana

Introduction. To successfully manage COVID-19 and to meet the target of vaccinating 22.9 million people in Ghana, the government has adopted community engagement as one of the strategies. Yet, the Volta Region continues to record the lowest rate of vaccine acceptance in Ghana. This study explored how government institutions engaged communities on COVID-19 vaccine preparedness and acceptance in two administrative municipalities in Ghana. Methods. This qualitative study employed face-to-face in-depth interviews among thirty-six respondents comprising of government officials and community leaders and ten focus group discussions among 87 people made up of men and women most of whom were natives and some migrants in two administrative municipalities in Ghana. Data were collected from June to September 2021. Audio interviews were transcribed and uploaded to Nvivo 12 to support triangulation, coding, and thematic analysis. Ethical approval was obtained from the requisite authority, and all COVID-19 restrictions were observed. Results. Government institutions focused on informing communities of vaccines and vaccination with little input from the communities. The Ghana Health Service carried out the most extensive engagement because they had more decentralized institutions. Successful engagement activities resulted in vaccine acceptance among some community members. Challenges in community engagement included insufficient logistics and myths and misconceptions about vaccines, which accounted for some community members’ lack of trust in vaccines, resulting in their unwillingness to vaccinate. Government officials used innovative approaches such as comparing the safety of COVID-19 vaccines to vaccines designed for children under the age of five years to deal with misinformation. Conclusion. Government needs to provide more resources to institutions that are mandated to carry out engagement activities to enable them carry out their tasks. It is further recommended that government institutions should intensify community engagement in distant communities to support the country to meet the target.

Enjeux actuels et pistes de solution pour améliorer les couvertures vaccinales antigrippales dans les milieux ruraux

INTRODUCTION

Despite the positive impact of vaccination on health, influenza vaccination rates worldwide remain low for certain population groups. In Quebec, vaccination rates among populations with chronic diseases remain below what is expected by public health. Since this situation is also noticeable in rural areas, it is necessary to reflect on the current issues associated with low vaccination rates in the rural population.

PURPOSE OF RESEARCH

The purpose of this commentary is to explore the importance of obtaining a multifactorial understanding of the problem raised in order to propose possible solutions to increase influenza vaccination rates among people living in rural areas.

The Role of Trust in COVID-19 Vaccine Acceptance: Considerations from a Systematic Review

The goal of this research was to provide an overview of the role of trust in determining COVID-19 vaccine acceptance. Trust proved to be a key issue in all the strategic phases of the pandemic, a decisive element for the success of the worldwide vaccination campaign. By introducing a comprehensive systematic review of the state-of-the-art (N = 43), we intend to shed light on the various forms of trust that have been considered and how these relate to citizens’ vaccine acceptance. The analysis shows that trust has been used extensively, with particular reference to the COVID-19 vaccine, governments, manufacturers, healthcare systems, and science. A more in-depth analysis has also allowed us to evaluate the role that these factors have had and the social phenomena in which they have been decisive. Most notably, we proved that, in the different contributions, trust in the COVID-19 vaccine has a strong correlation with vaccine acceptance (R = 0.78, p < 0.01). Overall, vaccine acceptance emerges as a complex phenomenon that needs to be understood through the strictly interlaced relations of trust in the various factors coming into play. Besides clarifying what happened in previous years, the considerations included in this work also represent an important and useful interpretative framework to help public institutions and the healthcare system in the future.

The attitudes of healthcare professionals in Turkey toward the coronavirus vaccine

AIM

To identify healthcare professionals' attitudes toward the coronavirus vaccine.

BACKGROUND

Controlling the coronavirus pandemic depends on achieving a high level of herd immunity. Accordingly, it is very important that healthcare professionals become role models by displaying positive attitudes toward vaccination.

METHODS

This cross-sectional study was conducted between March and April 2021 with a total of 309 healthcare professionals. Data were collected via an online surveys using an "Introductory Information Form" and "Attitudes Towards the COVID-19 Vaccine Scale." One-way variance analysis and Bonferroni correction were used for the comparison of nonnormally distributed quantitative variables between more than two groups. The Kruskal-Wallis test and Dunn-Bonferroni test were used to compare non-normally distributed quantitative variables between more than two groups. Pearson correlation analysis was performed to evaluate the relationships between the quantitative variables.

RESULTS

Regarding the healthcare professionals' attitudes towards the COVID-19 vaccine, the average score of positive attitudes was 3.52 ± 0.87, and the average score of negative attitudes was 3.39 ± 0.68. A statistically significant weak relationship was found between the ages of the participants and the average score of their positive attitudes towards the COVID-19 vaccine. The negative attitude score of the individuals who wanted to get the coronavirus vaccine was significantly higher than those who were undecided or did not want to get the vaccine.

CONCLUSIONS

Healthcare professionals completely agreed with the opinion "I would persuade everyone around me to get the coronavirus vaccine," and completely disagreed with the opinion "I believe that they will inject microchips to people with the coronavirus vaccine." Healthcare professionals have positive attitudes toward the COVID-19 vaccine. COVID-19-vaccinated participants' positive and negative attitude scores were found higher than those who were not vaccinated.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Supportive social activities should be organized in the public sense so that healthcare professionals act as a role model by displaying positive attitudes toward vaccination.

Perception and willingness to accept COVID-19 Vaccines: A cross-sectional survey of the general population of Sokoto State, Nigeria

The number of confirmed cases of COVID-19 globally is well over 400 million, however, the number of cases is showing a downward trend especially in developed countries largely as a result of effective vaccination against COVID-19. In developing countries, vaccination coverage is still very low as a result of vaccine hesitancy, which could be attributed to misconceptions about COVID-19 itself and its newly developed vaccines. This study assessed COVID-19 vaccine acceptance and perception amongst the adult population in Sokoto state, Nigeria. A cross-sectional study was conducted in Sokoto state among 854 respondents selected via a multi-stage sampling technique. Data was collected electronically using a set of structured questionnaire and analysis was done using IBM SPSS version 25. Respondents' perception was assessed using a 5-point Likert scale ranging from strongly disagree (1) to strongly agree (5). Respondents having a score of 3 and below were graded as having poor perception and those having scores above 3 were graded as having good perception. Respondents' ages ranged from 17 to 76 years, with a mean of 34.8±12.07; more than half [474(53.7%)] of the respondents were males, 667(75.5%) were married and 539(61.0%) had formal education. The majority [839(95.0%)] of the respondents had a good perception of COVID -19 vaccine; 49.9% agreed enough research would be required on the safety of the vaccine. The majority, (72.4%) expressed their willingness to accept the COVID- 19 vaccine (male 38.4% vs. female 34.0%); 410(47.4%) said they can spend more than one hour to get the vaccine. Significant predictors of willingness to accept COVID 19 vaccine include age (p = 0.006; aOR = 0.223; 95% CI = 0.077-0.645), education (p<0.001; aOR = 1.720; 95% CI = 1.274-2.321) and perception of COVID 19 vaccine (p<0.001; aOR = 0.020; 95% CI = 0.009-0.044). The majority of the respondents had a good perception of COVID- 19 vaccine and more than two-thirds were willing to be vaccinated with the vaccine. Government should make the vaccine available for vaccination since a significant proportion of the respondents expressed their willingness to accept the vaccine.

What predicts people's belief in COVID-19 misinformation? A retrospective study using a nationwide online survey among adults residing in the United States

BACKGROUND

Tackling infodemics with flooding misinformation is key to managing the COVID-19 pandemic. Yet only a few studies have attempted to understand the characteristics of the people who believe in misinformation.

METHODS

Data was used from an online survey that was administered in April 2020 to 6518 English-speaking adult participants in the United States. We created binary variables to represent four misinformation categories related to COVID-19: general COVID-19-related, vaccine/anti-vaccine, COVID-19 as an act of bioterrorism, and mode of transmission. Using binary logistic regression and the LASSO regularization, we then identified the important predictors of belief in each type of misinformation. Nested vector bootstrapping approach was used to estimate the standard error of the LASSO coefficients.

RESULTS

About 30% of our sample reported believing in at least one type of COVID-19-related misinformation. Belief in one type of misinformation was not strongly associated with belief in other types. We also identified 58 demographic and socioeconomic factors that predicted people's susceptibility to at least one type of COVID-19 misinformation. Different groups, characterized by distinct sets of predictors, were susceptible to different types of misinformation. There were 25 predictors for general COVID-19 misinformation, 42 for COVID-19 vaccine, 36 for COVID-19 as an act of bioterrorism, and 27 for mode of COVID-transmission.

CONCLUSION

Our findings confirm the existence of groups with unique characteristics that believe in different types of COVID-19 misinformation. Findings are readily applicable by policymakers to inform careful targeting of misinformation mitigation strategies.

Integrated Multicultural Media Campaign to Increase COVID-19 Education and Vaccination Among Californians, 2021

Despite the availability of safe, effective COVID-19 vaccines, many remain unvaccinated or partially vaccinated. In 2021, the California Department of Public Health launched a California-wide integrated multicultural vaccine media campaign. The campaign was evaluated in two waves through online surveys with adults (n = 1594; n = 1575). Campaign exposure was associated with looking for vaccine information, visiting a state vaccine Web site, and becoming fully vaccinated during the campaign. Higher campaign exposure was associated with greater odds of vaccine engagement. (Am J Public Health. 2022;112(10):1389-1393. https://doi.org/10.2105/AJPH.2022.306974).

Determinants of COVID-19 Vaccine Hesitancy During the Pandemic: A Cross-Sectional Survey in the Canton of Vaud, Switzerland

Objectives: COVID-19 vaccine hesitancy is a major obstacle in the fight against the pandemic. This study aimed to identify the local determinants of vaccine hesitancy in the context of COVID-19 to better inform future immunization campaigns. Methods: The study, conducted in February 2021, included 1,189 randomly selected inhabitants of the canton of Vaud, Switzerland. Online questionnaires investigated determinants of the intention to vaccinate. Previously validated scores (Cronbach's alphas >0.70) were applied to our data for inclusion in the ordinal logistic regression model. Results: Individuals were more likely to vaccinate if they were 40 years or older, wealthy, reported a high educational attainment, or reported comorbidities. Doubts regarding vaccine safety and efficacy, mistrust in authorities and a propensity for natural immunity were identified as the main local hindrances to the COVID-19 vaccination. Conclusion: Outreach to people at risk of severe COVID-19 is particularly relevant in the pandemic context to help mitigate vaccine hesitancy in the canton of Vaud, and should take into consideration the level of education. Further investigation is needed to better understand reasons for mistrust in authorities.

vACcine COnfidence amongst those living with alleRgy during the COVID pandemic (ACCORD): a scoping review protocol

Background

Reports of allergic reactions to the COVID-19 vaccines have been documented, which may also contribute to hesitancy. Despite the low likelihood that the COVID-19 vaccine will trigger an allergic reaction, we and others have reported that families with allergy remain vaccine hesitant due to concerns of COVID-19-vaccine-triggered anaphylaxis.

Objective

To present our scoping review protocol, that will inform a forthcoming living scoping review in which we will investigate the peer-reviewed and grey literature on COVID-19 vaccine hesitancy and allergic disease and/or allergic reactions following a COVID-19 vaccine.

Methods

Informed by Arksey and O’Malley framework for methodological review, we have developed a search strategy with content and methodological experts, and which has undergone Peer Review of Electronic Search Strategies review. A search of four scientific databases, as well as gray literature, will be performed without restriction to articles by type of COVID-19 vaccine, or country of study, and will include publications in the ten languages our team can handle. Bi-monthly search alerts based on the search strategy will be generated.

Results

The first search will result in a stand alone peer reviewed scoping review. Bi-monthly updates will be posted on a pre-print server. Depending on the volume of literature, these updates will be synthesized and submitted for peer-review at 6 and/or 12 months.

Conclusion

COVID-19 vaccine hesitancy amongst individuals with allergy persists, despite very low risk of serious adverse reactions. Our living scoping review, which includes multiple forms of knowledge translation, will be a rigorous way to address hesitancy.

Knowledge, attitude and perception of medical students on COVID-19 vaccines: A study carried out in a Nigerian University

Objective

Vaccine development, distribution, and immunization of large populations have been identified as vital mitigation strategies for curbing the spread of COVID-19. However, vaccine hesitancy is a major barrier to this. The knowledge and perception of COVID-19 vaccines can improve vaccine acceptance. The purpose of this study was to assess medical students' knowledge, attitude, and perception of COVID-19 vaccines.

Methods

This study was a cross-sectional web-based survey conducted among undergraduate students from the faculties of Basic medical sciences and Clinical sciences, University of Uyo, Akwa Ibom State, Nigeria. The students' knowledge was ranked as excellent (>70%), good (50-69%) and poor (<50%) while perception was categorized into positive (>50%), and negative (<50%). The difference in knowledge based on demographics was analyzed using the Independent sample t-test. The association between demographics, and students' perception was carried out using the Chi-square and Fisher's Exact tests. Analyses were conducted using SPSS software version 25.

Results

A total of 233 students consented to participate in the study out of which 51.1% were female. Forty-eight students (20.6%) had good knowledge while 41.2% of the participants accepted to take the COVID-19 vaccine. Positive perception was reported among 51.1% (119) of the students.

Conclusion

There was poor knowledge and positive perception among majority of the students. Educational intervention in form of training should be done to improve medical students' knowledge and perception toward COVID-19 vaccination.

Trust in Science as a Possible Mediator between Different Antecedents and COVID-19 Booster Vaccination Intention: An Integration of Health Belief Model (HBM) and Theory of Planned Behavior (TPB)

As the literature highlights, many health behavior theories try to explain both social and psychological variables influencing an individual’s health behavior. This study integrates insights relative to the antecedents of getting vaccinated from health behavior theories, particularly including the health belief model (HBM), the theory of planned behavior (TPB), and the different socio-demographic factors. Furthermore, we considered the possible mechanism of impact of distrust in science on individuals’ hesitance and resistance to taking up SARS-CoV-2 vaccination in subjects living in Italy. A correlational study of 1095 subjects enrolled when the national vaccination campaign for the third dose was launched. A questionnaire was used to measure: Italian Risk Perception; subjective norm; trust in science, trust in the vaccine; fear of COVID-19; fear of the vaccine; perceived knowledge about SARS-CoV-2; booster vaccination intention. Principal results show that: (i) the positive relationship provided by HBM theory between perceptions of SARS-CoV-2 risk (vulnerability and severity) and intention to have the vaccine, through fear of COVID-19; (ii) the positive relationship between subjective norms and both trust in science and vaccination intention; (iii) that trust in science plays a crucial role in predicting vaccination intention. Finally, the results provided indications about a positive relationship between subjective norms and fear of COVID-19, and a full mediation role of trust in science in the relationships between determinants of both TPA and HBM, fear of COVID-19, and vaccination intention. In conclusion, an individual’s intention (not) to get vaccinated requires the consideration of a plethora of socio-psychological factors. However, overall, trust in science appears to be a key determinant of vaccination intention. Additional strategies promoting healthy behavior are needed.

Impact of the COVID-19 pandemic on family carers in the community: A scoping review

The COVID-19 pandemic has led to the closure or reduction in support services for family carers, resulting in increased social isolation and stress for this population. The current scoping review aimed to identify the impact of COVID-19 upon carers and support provided for them during the pandemic. Four online databases (CINAHL, Medline, PsycINFO and PubMed) were systematically searched on 16th December 2020 and updated on 16th July 2021 for articles written in English and published after January 2020, focused on the carer and the impact of COVID-19. Google scholar and reference lists of relevant papers were checked, and key authors were contacted for further relevant information. The database searches identified 976 citations, which resulted in 670 unique articles following the removal of duplicates. Title and abstract screening identified 63 articles for full-text review, 11 of which were subsequently excluded, leaving 52 articles which were subject to inductive thematic analysis. Four key themes were identified. Whilst a number of issues were identified that were exacerbated by the pandemic, others directly resulting from it were revealed. Few studies discussed support measures for carers and only one trial evaluated an intervention. This review identifies the impact of COVID-19 on carers, but there is a dearth of evidence to inform appropriate tailored support. Governments need to identify carers as a priority group in social care reform and commission co-produced, evidence and experience informed pathways to reinstate support services, potentially modelled on pandemic plans following the example currently being considered for the paid healthcare workforce.

Listening to Voices from African American Communities in the Southern States about COVID-19 Vaccine Information and Communication: A Qualitative Study

The high uptake of COVID-19 vaccines is one of the most promising measures to control the pandemic. However, some African American (AA) communities exhibit vaccination hesitancy due to mis- or disinformation. It is important to understand the challenges in accessing reliable COVID-19 vaccine information and to develop feasible health communication interventions based on voices from AA communities. We conducted 2 focus group discussions (FGDs) among 18 community stakeholders recruited from 3 counties in South Carolina on 8 October and 29 October 2021. The FGDs were conducted online via Zoom meetings. The FGD data were managed and thematically analyzed using NVivo 12. Participants worked primarily in colleges, churches, and health agencies. We found that the challenges of accessing reliable vaccine information in AA communities primarily included structural barriers, information barriers, and a lack of trust. Community stakeholders recommended recruiting trusted messengers, using social events to reach target populations, and conducting health communication campaigns through open dialogue among stakeholders. Health communication interventions directed at COVID-19 vaccine uptake should be grounded in ongoing community engagement, trust-building activities, and transparent communication about vaccine development. Tailoring health communication interventions to different groups may help reduce misinformation spread and thus promote vaccination in AA communities in the southern states.

COVID-19 vaccines uptake: Public knowledge, awareness, perception and acceptance among adult Africans

Introduction

The willingness of Africa’s population to patronise the COVID-19 vaccines is critical to the efficiency of national immunisation programmes. This study surveys the views of adult African inhabitants toward vaccination and the possibility of participating or not participating in governments’ efforts to get citizens vaccinated.

Method

A cross-sectional online survey of adult Africans was undertaken from December 2020 to March 2021. Responses were anonymised. The Pearson Chi-square test was performed to determine whether or not there were any variations in knowledge, awareness, perception and acceptance of the COVID-19 vaccines among the participants. Binomial logistic regression was used to evaluate the factors associated with willingness to accept the COVID-19 vaccines and participate in immunisation programmes.

Results

The results indicate that COVID-19 vaccines are more likely to be used by adult Africans over the age of 18 who are largely technologically savvy (55 percent) if the vaccine is made broadly available. A total of 33 percent of those who responded said they were unlikely to receive the vaccine, with another 15 percent stating they were undecided. Aside from that, we found that vaccine hesitancy was closely associated with socio-demographic characteristics such as age, gender, education and source of information. We also found that there were widespread conspiracies and myths about the COVID-19 vaccines.

Conclusion

More than one-third of African adults who participated in the survey indicated they would not receive the COVID-19 vaccine, with majority of them expressing skepticisms about the vaccine’s efficacy. It is possible that many of the people who would not be vaccinated would have an impact on the implementation of a COVID-19 immunisation programme that is meant for all of society. Majority of the respondents were unwilling to pay for the COVID-19 vaccines when made available. An awareness campaign should be focused on promoting the benefits of vaccination at the individual and population levels, as well as on taking preemptive actions to debunk misconceptions about the vaccines before they become further widespread.

Evaluation of the Real-World Effectiveness of Vaccines against COVID-19 at a Local Level: Protocol for a Test-Negative Case-Control Study

Vaccines against COVID-19 approved for use in the EU/EEA have been shown to be highly effective against wild-type SARS-CoV-2. However, their effectiveness against new variants may be reduced. This study aims to evaluate the effectiveness of vaccines against COVID-19 in the prevention of symptomatic and severe disease, during pre- and post-omicron phases. Individuals who sought treatment at the emergency department of a Portuguese hospital with COVID-19-like disease and were tested for SARS-CoV-2 are the subjects of the study. Patients who received a positive result are considered cases, while those with negative results are the controls. The test-negative case–control method is one of the study designs recommended by WHO to estimate the effectiveness of vaccines against COVID-19. The main advantage of this design is that it controls for the healthcare seeking bias, commonly present in traditional cohort and case–control designs. This study may have broad implications for understanding the real-world performance of the COVID-19 vaccines at the local level, which may play a key role in promoting adherence to vaccination. Moreover, this study may contribute to inform decisions regarding booster doses and variant-specific vaccine formulations leading to the control of this and future pandemics.

Health Information Sources Influencing Health Literacy in Different Social Contexts across Age Groups in Northern Thailand Citizens

Health literacy is an essential social determinant of health and has been associated with positive health outcomes. While many sources of health information are widely available, people of different ages also have diverse social contexts and preferences for health information sources. This study aimed to identify health information sources and socio-demographics influencing health literacy in different social contexts across age groups: 15–29 years (young), 30–59 years (middle-age), and ≥60 years (elderly). We obtained secondary data from a cross-sectional study in northern Thailand from March to August 2019. Multivariate linear regression with age group subgroup analysis was used to determine factors associated with general health literacy by the Thai version of the health literacy questionnaire. Receiving health information from physicians was significantly associated with higher general health literacy in young (β 6.45, 95%CI 0.44–12.45; p = 0.035) and elderly (β 5.18, 95%CI 1.84–8.52; p = 0.002) groups, while receiving health information from health volunteers was significantly associated with a higher general health literacy in the middle-aged (β 2.89, 95%CI 0.38–5.39; p = 0.024) group. Although younger participants showed more frequent access to health information via the media than the other age groups, there were no media sources significantly linked with their general health literacy. Health information from physicians is a vital source of health information.

COVID-19 Vaccination Hesitancy: A Review of the Literature and Recommendations

Vaccines are important to improve immunity against pathogens and diseases. The current COVID-19 disease is rapidly evolving and spreading among people; therefore, it is important to utilize a proper vaccination strategy against it. Currently, many approved vaccines are available and accessible; however, there is a reported hesitancy against taking them among the public and even the health care workers. Mainly, this is attributed to the fear of the possible side effects and complications. Moreover, inaccurate knowledge disseminated through the media/social media especially by those who lack proper expertise adds confusion and more fear that affects the vaccination decision. For such reasons, it is essential to find strategies to increase the acceptability of vaccines and to enhance confidence in the vaccination process. This should be accompanied by sufficient efforts and proper clinical studies to confirm the value and the safety of the vaccines. Those strategies are important to avoid the further spread of the COVID-19 disease and to abort the pandemic worldwide, especially when considering the likely approach towards a COVID-19 booster vaccination program, in which booster vaccines are re-taken along intervals to adequately contain the rapidly evolving nature of the virus. This review article highlights the factors influencing the acceptability of the COVID-19 vaccination and enrollment in clinical trials among the public and some specific populations. Furthermore, it summarizes the suggested strategies and recommendations that can improve the attitudes towards COVID-19 vaccination programs.

What Is the Support for Conspiracy Beliefs About COVID-19 Vaccines in Latin America? A Prospective Exploratory Study in 13 Countries

Conspiracy theories about COVID-19 began to emerge immediately after the first news about the disease and threaten to prolong the negative impact of the COVID-19 pandemic by limiting people's willingness of receiving a life-saving vaccine. In this context, this study aimed to explore the variation of conspiracy beliefs regarding COVID-19 and the vaccine against it in 5779 people living in 13 Latin American countries (Argentina, Bolivia, Chile, Colombia, Cuba, Ecuador, El Salvador, Guatemala, Mexico, Paraguay, Peru, Uruguay and Venezuela) according to sociodemographic variables such as gender, age, educational level and source of information about COVID-19. The study was conducted during the COVID-19 pandemic between September 15 and October 25, 2021. The Spanish-language COVID-19 Vaccine Conspiracy Beliefs Scale (ECCV-COVID) and a sociodemographic survey were used. The results indicate that, in most countries, women, people with a lower educational level and those who receive information about the vaccine and COVID-19 from family/friends are more supportive of conspiracy ideas regarding the COVID-19 vaccine. In the case of age, the results vary by country. The analysis of the responses to each of the questions of the ECCV-COVID reveals that, in general, the countries evaluated are mostly in some degree of disagreement or indecision regarding conspiratorial beliefs about COVID-19 vaccines. The findings could help open further study which could support prevention and treatment efforts during the COVID-19 pandemic.

The Psychological Experience of COVID-19 Vaccination and Its Impact on the Willingness to Receive Booster Vaccines among the Chinese Population: Evidence from a National Cross-Sectional Study

The purpose of this study was to assess the psychological experience of COVID-19 basic vaccination, the willingness to receive booster vaccines, and to determine their relationships among Chinese people. Between 6 August 2021 and 9 August 2021, a research firm performed a national cross-sectional online survey among Chinese individuals (aged over 18), using the snowball sampling approach, with 26,755 participants. Factor analysis and binary logistic regression were used to evaluate the existing associations. The overall COVID-19 vaccination psychological experience score of the participants was 25.83 (25.78~25.89; scores ranged from 7–35). A total of 93.83% (95%CI = 93.54~94.12) of respondents indicated a willingness to receive booster vaccines. After classifying psychological experiences associated with COVID-19 vaccination into positive and negative experiences and adjusting for confounding factors, for the former, the willingness to receive booster vaccines for participants with the highest scores of 13–15 was 3.933 times higher (OR = 3.933, 95%CI = 3.176~4.871) than participants who obtained scores of 3–9, and for the latter, the willingness to receive booster vaccines for participants with the highest scores of 19–20 was 8.871 times higher (OR = 8.871, 95%CI = 6.240~12.612) than participants who obtained scores of 4–13. Our study suggests that a good psychological experience with vaccination is positively associated with an increased willingness to receive booster vaccines.

COVID-19 vaccines: awareness, attitude and acceptance among undergraduate University students

Background

The myths and conspiracy theories on the COVID-19 vaccine cause people to be hesitant and maleficent towards the vaccine.

Objectives

To assess COVID-19 vaccine-related awareness, attitude and acceptance and to assess reasons for refusing the vaccine among undergraduate Jimma University Institute of Health students.

Methods

A cross-sectional study was conducted among 387 undergraduate students of Jimma University Institute of Health. Self-administered questionnaires were used to collect the data and summarized by descriptive statistics. A multivariable regression model was used to assess predictable variables for good awareness and positive attitude. A p value of < 0.05 was used to declare the statistical association.

Results

Only 41% of the students had a good awareness of the COVID-19 vaccine, and more than half, 224 (57.9%) of them had a positive attitude towards the COVID-19 vaccine. Age [(AOR: 95% CI) 1.18 (1.03, 1.35)] and having good awareness [(AOR: 95% CI) 2.39 (1.55, 3.68)] were associated with positive attitude of students towards the COVID-19 vaccine. However, only 27.1% of the students were willing to take the vaccine for COVID-19. Afraid of long term effects (49.1%), not being convinced of the safety standards (38.8%), lack of information about the vaccine (37.2%), and too short time for development (39.9%) was common reasons for refusing the COVID-19 vaccine.

Conclusions

According to the present study, the majority of the participants had a positive attitude towards COVID-19 vaccine. However, only less than half of the participants had a good awareness of the vaccine. In addition, the acceptability of the vaccine is low. Afraid of long term effects, not being convinced of the safety profile, lack of information about the vaccine, and the time used for the development were the common reasons for refusing the vaccine. Therefore, all stakeholders are advised to increase awareness, positive attitude, and acceptance of the vaccine.

Potential Influencers of COVID-19 Vaccine Acceptance Among Adults Living in the United States Who Have Accepted or Plan to Accept the Vaccine: An Online Survey

Purpose

The purpose of this study was to 1) determine the demographic differences between adults who have accepted, or plan to accept, the COVID-19 vaccine and those who will not accept the COVID-19 vaccine and 2) describe the potential influencers in deciding to accept the COVID-19 vaccine among adults living in the United States who have accepted or plan to accept the vaccine.

Design

A cross-sectional design utilizing an online survey was deployed using social media and a crowdsourcing platform.

Setting

United States.

Subjects

One thousand three hundred ninety-five (1395) adults completed the survey. The majority were white, male, between the ages of 25 and 45, and with representation from 50 states and Puerto Rico.

Measures

A two-branched survey was used to assess demographic information, vaccination intention, and 19 potential influencers of COVID-19 vaccine acceptance.

Analysis

Analysis included descriptive statistics and Chi-square tests to determine differences between groups.

Results

A higher proportion of male (P < .001), married (P < .001), and college-educated (P < .001) participants reported acceptance of the vaccine. The factors with the highest mean score of reported level of influence were duty to protect the vulnerable and contribution to move society back to a sense of normalcy.

Conclusion

Understanding the potential influencers of vaccine acceptance may provide insight into strategies that could increase vaccination uptake.