Motivation for COVID-19 Vaccination in Priority Occupational Groups: A Cross-Sectional Survey

Characteristics associated with SARS-CoV-2 testing, infection and vaccine uptake among essential non-healthcare workers in Montréal, 2021

Background

Essential non-healthcare workers experienced higher rates of SARS-CoV-2 infection compared to non-essential workers.

Objective

Identify characteristics associated with SARS-CoV-2 testing, infection and vaccine uptake among essential non-healthcare workers in Montréal, Québec.

Methods

Secondary, cross-sectional analysis of data collected from participants prospectively recruited in two observational studies (first study, Onsite Testing Study, January-March 2021; second study, Self-Testing Study, July-October 2021) of essential non-healthcare workers in 2021. Logistic regression with generalized linear mixed models was used to explore characteristics associated with our outcomes (previous SARS-CoV-2 testing, exposure and vaccination).

Results

Overall, 2,755 participants were included (first study, Onsite Testing Study, n=2,128; and second study, Self-Testing Study, n=627). A higher proportion of participants identified as male (n=1,601; 58%), non-White (n=1,527; 55%) and worked in the manufacturing/supplier sector (n=1,706; 62%). Relative to the first study, Onsite Testing Study, participants in the second study, Self-Testing Study, had higher odds (78% vs. 46%; aOR 4.1, 95% CI: 3.2-5.2) of previous SARS-CoV-2 testing and of testing positive prior to study enrolment (6.2% vs. 4.3%; aOR 1.7, 95% CI: 1.1-2.6). Individuals reporting recent SARS-CoV-2 exposure had higher odds of previous SARS-CoV-2 testing (aOR 4.0, 95% CI: 3.0-5.4), while older age (aOR 0.98, 95% CI: 0.98-0.99 per one-year increase) and being male (aOR 0.6, 95% CI: 0.5-0.7) were associated with lower odds of previous testing. Results were similar in stratified analyses. Participants from businesses with more than 50 employees had higher odds of having received a SARS-CoV-2 vaccine (91% vs. 80%; aOR 2.6, 95% CI: 1.4-4.8).

Conclusion

Consideration of individual and business characteristics associated with testing and vaccination programs for SARS-CoV-2 could improve equity, uptake and impact.

Increasing vaccine uptake among employees within the non-health related critical infrastructure sectors: A review

This review aimed to identify barriers to employee vaccination, motivators for vaccination, and vaccine uptake strategies within the critical infrastructure sectors. We focused on non-healthcare-related sectors, including food and agriculture, manufacturing, and education where employee vaccination is rarely mandated. We conducted a search for literature published from 2012 to 2022 from MEDLINE-PubMed, PsycINFO, and Web of Science Core Collection, which resulted in 22 studies that met the inclusion criteria. We found that 1) barriers to vaccination differ by infectious disease and population; 2) common motivators for vaccination were about protecting self, family, and community; and 3) common uptake strategies for influenza (which accounted for 83% of uptake strategies in reviewed studies) addressed convenience and confidence barriers such as vaccination cost and education. Our review highlights the need for employers, policymakers, and researchers to identify infectious disease and population-specific barriers to vaccination and implement strategies aimed at addressing the identified barriers.

“I Would Never Push a Vaccine on You”: A Qualitative Study of Social Norms and Pressure in Vaccine Behavior in the U.S

Previous researchers have established the influence of social norms on vaccine behavior. However, little work has been performed contextualizing individuals’ experience with these social factors and how they operate to persuade individuals’ acceptance or refusal of a vaccine. We aimed to determine the mechanisms of familial and societal pressure or expectations that contribute to COVID-19 vaccine decision-making. We conducted four focus groups and eleven individual interviews (total n = 32) with participants from across the U.S. of different vaccination statuses. We identified three emergent themes: (1) Altruistic reasoning was particularly prevalent among initially hesitant late adopters—the desire to protect loved ones and others constituted a dominant motive, more powerful than protecting oneself. Vaccination was also reckoned as part of a joint effort to return to normal life; hence, it invoked a sense of responsibility or “obligation”; (2) expectation often became pressure; although most vaccinated participants stated that they respected others’ choices, late adopters or unvaccinated participants perceived differently and felt rushed or “forced” into choosing, and many resented being “targeted” or “bullied”; (3) vaccination status became a new label, frequently dividing families, thus producing familial mandates, exclusions, or social stratifications. This caused sadness and feelings of isolation, along with the formation of a camaraderie among the excluded unvaccinated. A vaccine decision builds from the complexities of individuals’ experiences and cultures. The vaccinated were not free of hesitancy nor were the unvaccinated all anti-vaxxers. Vigorous vaccine promotion successfully converted some undecided individuals but also fostered distrust of government; alarmingly, the push to receive the COVID-19 vaccine further triggered doubts about established vaccines. Communication strategies need to be developed and implemented carefully so as not to ostracize the unvaccinated community and strengthen their resistance.

COVID-19 Vaccination Hesitancy among Healthcare Workers-A Review

The COVID-19 pandemic and its associated vaccine have highlighted vaccine hesitancy among healthcare workers (HCWs). Vaccine hesitancy among this group existed prior to the pandemic and particularly centered around influenza vaccination. Being a physician, having more advanced education, and previous vaccination habits are frequently associated with vaccine acceptance. The relationship between age and caring for patients on COVID-19 vaccination is unclear, with studies providing opposing results. Reasons for hesitancy include concerns about safety and efficacy, mistrust of government and institutions, waiting for more data, and feeling that personal rights are being infringed upon. Many of these reasons reflect previous attitudes about influenza vaccination as well as political beliefs and views of personal autonomy. Finally, several interventions to encourage vaccination have been studied, including education programs and non-monetary incentives with the most effective studies using a combination of methods.

Determinants of the Hesitancy toward COVID-19 Vaccination in Eastern European Countries and the Relationship with Health and Vaccine Literacy: A Literature Review

Herd immunity is necessary to control the coronavirus disease 2019 (COVID-19) pandemic. However, a low proportion of vaccinated people and low levels of vaccine acceptance have been noted in Eastern Europe. Our paper aimed to review the central attitudes associated with the hesitancy toward COVID-19 vaccination specific to Eastern European countries. The main Eastern European determinants of COVID-19 vaccine acceptance identified from the included studies are: public confidence in the vaccines’ safety and efficacy, vaccine literacy, and public trust in the government and the medical system. Each of these determinants is discussed along with possible improvement measures. Variables specific to Eastern Europe that predict the willingness to vaccinate have also been highlighted. The specific attitudes and their context as identified by our review should be incorporated into local public health programs, with the ultimate goal of reducing viral spreading, mutation emergence, and COVID-19 morbidity and mortality both within the borders of Eastern Europe and beyond.

COVID-19 Vaccination: An Exploratory Study of the Motivations and Concerns Detailed in the Medical Records of a Regional Australian Population

Understanding motivations and concerns surrounding COVID-19 vaccine uptake is important to reduce vaccine hesitancy and inform strategies to mitigate concerns and increase vaccine uptake. This study aimed to explore motivations and concerns associated with COVID-19 vaccination among adults seeking their first COVID-19 vaccine in a regional Australian community with low prevalence of COVID-19, who received a medical consult prior to vaccination. Medical records from consults were audited and the modified Framework Method was used to conduct qualitative content analysis of data, generating themes and overall core concepts related to motivations for COVID-19 vaccination and associated concerns. There were 102 people included in the study, 81% of whom were aged ≥60 years. Concerns surrounding COVID-19 vaccination included five core concepts: 1. Perceived vaccine risks, 2. Perceived vaccine performance, 3. Uncertainty, 4. Autonomy, and 5. Fairness in access; and a further five core concepts were generated from motivations to seek vaccination: 1. Protection, 2. Occupational or facility responsibility or requirement, 3. Trust in primary healthcare physician, 4. Autonomy, and 5. Civic duty. These motivating factors and concerns can be used to inform strategies and education to increase vaccine uptake in ongoing and future vaccine rollouts.

Supporting Tourism by Assessing the Predictors of COVID-19 Vaccination for Travel Reasons

The persistence of the SARS-CoV-2 virus imposed vaccination passports for traveling in most countries. We investigated psychological factors that predict the intention to vaccinate for travel. In a cross-sectional study, we examined how demographic variables, vaccination status, perceived risk of infection and severity of disease contracted at travel destination, safety and effectiveness of vaccines against contracting COVID-19 during travel, and conspiracy beliefs are related to intention to vaccinate for travel. Further analyses involved differences between vaccinated and unvaccinated individuals in a Romanian sample regarding conspiracy beliefs, attitudes about vaccines, and self-efficacy of controlling COVID-19 infection. Results showed that the intention to vaccinate for travel reasons is best predicted by vaccination status and perceptions of safety and efficacy of vaccines against COVID-19. Thus, vaccinated individuals believing that vaccines are safe and effective most probably will take another vaccine booster if it will allow them to travel. Positive relationships of the intention to vaccinate for travel reasons were found with age, vaccination status, conspiracy beliefs, perceptions of safety and effectiveness of vaccines, intention to travel, and a more cautious approach to travel. No significant relationships were found between perceptions of risk for self or for transmitting the disease to others, severity of disease, and the intention to vaccinate for travel. We also found significant differences between vaccinated and unvaccinated participants, as unvaccinated participants showed higher levels of conspiracy beliefs and less trust in the safety and efficacy of vaccines. We conclude that campaigns focused on promoting information on the safety and efficacy of vaccines is the most important direction for promoting vaccination in young travelers.