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Pereira da Silva A, Castaneda LR, Cavalcante de Oliveira AP, Fronteira I, Craveiro I, Maia LS, Chança R, Boniol M, Ferrinho P, Dal Poz MR. COVID-19 Vaccination Acceptance and Hesitancy in Healthcare Workers and the General Population: A Systematic Review and Policy Recommendations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:1134. [PMID: 39338017 PMCID: PMC11430955 DOI: 10.3390/ijerph21091134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 07/10/2024] [Accepted: 07/16/2024] [Indexed: 09/30/2024]
Abstract
INTRODUCTION The COVID-19 pandemic challenged the scientific community to find and develop a vaccine to fight the disease. However, problems with achieving high vaccine coverage have emerged, even among high-risk groups such as healthcare workers (HCWs). OBJECTIVE The objective of this study is to examine factors that influence HCW's and the general population's adherence to COVID-19 vaccination and national policies to vaccinate HCWs and other target groups. METHODS This study implemented a systematic review. The eligibility criterion for inclusion was being a HCW, target population for COVID-19 vaccination, or general population. Vaccination was the target intervention, and the COVID-19 pandemic was the context. We selected publications published between 1 January 2020 and 31 March 2022. Qualitative synthesis used a meta-aggregation approach. RESULTS Nineteen articles were included in the review, with study samples varying from 48 to 5708 participants. Most of the evidence came from cross-sectional and qualitative studies. The main findings were related to vaccine hesitancy rather than acceptance. Factors associated with HCW vaccine hesitancy included subjective feelings such as safety concerns, rapid vaccine development, and insufficient testing. Countries have adopted few public policies to address this problem, and the main concern is whether to enforce vaccination and the extent to which measures are legal. CONCLUSION The quality of the evidence base remains weak. Skepticism, mistrust, and hesitancy toward vaccination are global issues that can jeopardize vaccination coverage.
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Affiliation(s)
- Alessandra Pereira da Silva
- Instituto Nacional do Câncer, Rua Marquês de Pombal 125, 12° andar Centro, Rio de Janeiro 20230-240, RJ, Brazil;
| | - Luciana Ribeiro Castaneda
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rua São Francisco Xavier, 524-7° andar, Blocos D e E–Maracanã, Rio de Janeiro 20550-013, RJ, Brazil; (L.R.C.); (A.P.C.d.O.); (L.S.M.); (M.R.D.P.)
| | - Ana Paula Cavalcante de Oliveira
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rua São Francisco Xavier, 524-7° andar, Blocos D e E–Maracanã, Rio de Janeiro 20550-013, RJ, Brazil; (L.R.C.); (A.P.C.d.O.); (L.S.M.); (M.R.D.P.)
| | - Inês Fronteira
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa, Rua da Junqueira 100, 1349-008 Lisboa, Portugal; (I.F.); (I.C.); (P.F.)
| | - Isabel Craveiro
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa, Rua da Junqueira 100, 1349-008 Lisboa, Portugal; (I.F.); (I.C.); (P.F.)
| | - Leila Senna Maia
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rua São Francisco Xavier, 524-7° andar, Blocos D e E–Maracanã, Rio de Janeiro 20550-013, RJ, Brazil; (L.R.C.); (A.P.C.d.O.); (L.S.M.); (M.R.D.P.)
| | - Raphael Chança
- Instituto Nacional do Câncer, Rua Marquês de Pombal 125, 12° andar Centro, Rio de Janeiro 20230-240, RJ, Brazil;
| | - Mathieu Boniol
- Health Workforce Department, World Health Organization, Av. Appia 20, 1202 Geneva, Switzerland;
| | - Paulo Ferrinho
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa, Rua da Junqueira 100, 1349-008 Lisboa, Portugal; (I.F.); (I.C.); (P.F.)
| | - Mario Roberto Dal Poz
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rua São Francisco Xavier, 524-7° andar, Blocos D e E–Maracanã, Rio de Janeiro 20550-013, RJ, Brazil; (L.R.C.); (A.P.C.d.O.); (L.S.M.); (M.R.D.P.)
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Batmunkh B, Otgonbayar D, Shaarii S, Khaidav N, Shagdarsuren OE, Boldbaatar G, Danzan NE, Dashtseren M, Unurjargal T, Dashtseren I, Dagvasumberel M, Jagdagsuren D, Bayandorj O, Biziya B, Surenjid S, Togoo K, Bat-Erdene A, Narmandakh Z, Choijilsuren G, Batmunkh U, Soodoi C, Boldbaatar EA, Byambatsogt G, Byambaa O, Deleg Z, Enebish G, Chuluunbaatar B, Zulmunkh G, Tsolmon B, Gunchin B, Chimeddorj B, Dambadarjaa D, Sandag T. RBD-specific antibody response after two doses of different SARS-CoV-2 vaccines during the mass vaccination campaign in Mongolia. PLoS One 2023; 18:e0295167. [PMID: 38064430 PMCID: PMC10707641 DOI: 10.1371/journal.pone.0295167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 11/16/2023] [Indexed: 12/18/2023] Open
Abstract
The SARS-CoV-2 vaccination campaign began in February 2021 and achieved a high rate of 62.7% of the total population fully vaccinated by August 16, 2021, in Mongolia. We aimed to assess the initial protective antibody production after two doses of a variety of types of SARS-CoV-2 vaccines in the Mongolian pre-vaccine antibody-naïve adult population. This prospective study was conducted from March-April to July-August of 2021. All participants received one of the four government-proposed COVID-19 vaccines including Pfizer/BioNTech (BNT162b2), AstraZeneca (ChAdOx1-S), Sinopharm (BBIBP-CorV), and Sputnik V (Gam-COVID-Vac). Before receiving the first shot, anti-SARS-CoV-2 S-RBD human IgG titers were measured in all participants (n = 1833), and titers were measured 21-28 days after the second shot in a subset of participants (n = 831). We found an overall average protective antibody response of 84.8% (705 of 831 vaccinated) in 21-28 days after two doses of the four types of COVID-19 vaccines. Seropositivity and titer of protective antibodies produced after two shots of vaccine were associated with the vaccine types, age, and residence of vaccinees. Seropositivity rate varied significantly between vaccine types, 80.0% (28 of 35) for AstraZeneca ChAdOx1-S; 97.0% (193 of 199) for Pfizer BNT162b2; 80.7% (474 of 587) for Sinopharm BBIBP-CorV, and 100.0% (10 of 10) for Sputnik V Gam-COVID-Vac, respectively. Immunocompromised vaccinees with increased risk for developing severe COVID-19 disease had received the Pfizer vaccine and demonstrated a high rate of seropositivity. A high geometric mean titer (GMT) was found in vaccinees who received BNT162b2, while vaccinees who received ChAdOx1-S, Sputnik V, and BBIBP-CorV showed a lower GMT. In summary, we observed first stages of the immunization campaign against COVID-19 in Mongolia have been completed successfully, with a high immunogenicity level achieved among the population with an increased risk for developing severe illness.
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Affiliation(s)
- Burenjargal Batmunkh
- School of Biomedicine, Mongolian National University of Medical Sciences, Sainshand, Mongolia
| | - Dashpagma Otgonbayar
- National Center for Communicable Diseases of Mongolia, Ulaanbata, Mongolia
- School of Public Health, Mongolian National University of Medical Sciences, Sainshand, Mongolia
| | - Shatar Shaarii
- School of Public Health, Mongolian National University of Medical Sciences, Sainshand, Mongolia
| | - Nansalmaa Khaidav
- School of Public Health, Mongolian National University of Medical Sciences, Sainshand, Mongolia
| | - Oyu-Erdene Shagdarsuren
- School of Public Health, Mongolian National University of Medical Sciences, Sainshand, Mongolia
| | - Gantuya Boldbaatar
- School of Medicine, Mongolian National University of Medical Sciences, Sainshand, Mongolia
| | - Nandin-Erdene Danzan
- School of Medicine, Mongolian National University of Medical Sciences, Sainshand, Mongolia
| | | | - Tsolmon Unurjargal
- School of Medicine, Mongolian National University of Medical Sciences, Sainshand, Mongolia
| | - Ichinnorov Dashtseren
- School of Medicine, Mongolian National University of Medical Sciences, Sainshand, Mongolia
| | | | | | | | - Baasanjargal Biziya
- School of Biomedicine, Mongolian National University of Medical Sciences, Sainshand, Mongolia
| | - Seesregdorj Surenjid
- International School of Mongolian Medicine, Mongolian National University of Medical Sciences, Sainshand, Mongolia
| | - Khongorzul Togoo
- School of Biomedicine, Mongolian National University of Medical Sciences, Sainshand, Mongolia
| | - Ariunzaya Bat-Erdene
- School of Biomedicine, Mongolian National University of Medical Sciences, Sainshand, Mongolia
| | - Zolmunkh Narmandakh
- School of Biomedicine, Mongolian National University of Medical Sciences, Sainshand, Mongolia
| | - Gansukh Choijilsuren
- School of Biomedicine, Mongolian National University of Medical Sciences, Sainshand, Mongolia
| | - Ulziisaikhan Batmunkh
- School of Biomedicine, Mongolian National University of Medical Sciences, Sainshand, Mongolia
| | - Chimidtseren Soodoi
- School of Biomedicine, Mongolian National University of Medical Sciences, Sainshand, Mongolia
| | - Enkh-Amar Boldbaatar
- School of Biomedicine, Mongolian National University of Medical Sciences, Sainshand, Mongolia
| | - Ganbaatar Byambatsogt
- School of Nursing, Mongolian National University of Medical Sciences, Sainshand, Mongolia
| | - Otgonjargal Byambaa
- School of Biomedicine, Mongolian National University of Medical Sciences, Sainshand, Mongolia
| | - Zolzaya Deleg
- School of Biomedicine, Mongolian National University of Medical Sciences, Sainshand, Mongolia
| | - Gerelmaa Enebish
- School of Biomedicine, Mongolian National University of Medical Sciences, Sainshand, Mongolia
| | - Bazardari Chuluunbaatar
- Mongolia-Japan Hospital, Mongolian National University of Medical Sciences, Sainshand, Mongolia
| | - Gereltsetseg Zulmunkh
- Mongolia-Japan Hospital, Mongolian National University of Medical Sciences, Sainshand, Mongolia
| | | | - Batbaatar Gunchin
- School of Biomedicine, Mongolian National University of Medical Sciences, Sainshand, Mongolia
| | - Battogtokh Chimeddorj
- School of Biomedicine, Mongolian National University of Medical Sciences, Sainshand, Mongolia
| | - Davaalkham Dambadarjaa
- School of Public Health, Mongolian National University of Medical Sciences, Sainshand, Mongolia
| | - Tsogtsaikhan Sandag
- School of Biomedicine, Mongolian National University of Medical Sciences, Sainshand, Mongolia
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Zoumpoulis G, Deligiorgi P, Lamprinos D, Georgakopoulos P, Oikonomou E, Siasos G, Rachiotis G, Damaskos C, Papagiannis D, Papavassiliou KA, Patoulis G, Patsourakos F, Benetou V, Riza E, Orfanos P, Lagiou P, Marinos G. Attitudes and Practices Related to COVID-19 Vaccination with the Second Booster Dose among Members of Athens Medical Association: Results from a Cross-Sectional Study. Vaccines (Basel) 2023; 11:1480. [PMID: 37766156 PMCID: PMC10534426 DOI: 10.3390/vaccines11091480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 08/29/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND There are limited data on the attitudes and acceptance of the second booster (fourth dose) of the COVID-19 vaccination among physicians. METHODS A cross-sectional, questionnaire-based, online study was conducted among members of the Athens Medical Association (A.M.A.) who were invited to participate anonymously over the period from January to March 2023. RESULTS From the 1224 members who participated in the survey, 53.9% did not receive the fourth dose of the COVID-19 vaccine. The main reasons for no vaccination were the lack of obligation to receive the fourth dose, the history of three doses of the COVID-19 vaccine and the lack of sufficient information about the effectiveness of the fourth dose. Over half of the three-dose-vaccinated participants were willing to receive the fourth dose in the near future. Interestingly, the vaccination coverage among participants who had been informed about the fourth dose through scientific sources was low. CONCLUSIONS The low vaccination coverage with the fourth dose reported in this study can lead to broad and serious consequences, such as increase in COVID-19 infections, reduction of available healthcare staff and increased caseloads of COVID-19 in hospitals. Furthermore, hesitant physicians will adversely influence the vaccination uptake among the general population due to their key role in informing and recommending the vaccine. The healthcare system administration should acknowledge and address physician's concerns through effective communication and better support.
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Affiliation(s)
| | | | | | | | - Evangelos Oikonomou
- First Department of Cardiology, Hippokration General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Third Department of Cardiology, Thoracic Diseases General Hospital Sotiria, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Gerasimos Siasos
- First Department of Cardiology, Hippokration General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Third Department of Cardiology, Thoracic Diseases General Hospital Sotiria, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Georgios Rachiotis
- Department of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41500 Larissa, Greece
| | - Christos Damaskos
- Renal Transplantation Unit, Laiko General Hospital, 11527 Athens, Greece
- N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Dimitrios Papagiannis
- Public Health & Vaccines Laboratory, Department of Nursing, School of Health Science, University of Thessaly, 38221 Volos, Greece
| | - Kostas A Papavassiliou
- First Department of Respiratory Medicine, "Sotiria" Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | | | | | - Vasiliki Benetou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Elena Riza
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Philippos Orfanos
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Pagona Lagiou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Georgios Marinos
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece
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Viskupič F, Wiltse DL. Partisan self-identification predicts attitudes of South Dakota nurses toward COVID-19 vaccine mandate for healthcare workers. HEALTH POLICY AND TECHNOLOGY 2023; 12:100777. [PMID: 37389329 PMCID: PMC10290765 DOI: 10.1016/j.hlpt.2023.100777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
Objectives Nurses are at greater risk of infection from COVID-19. However, mistrust of the vaccine exists even among this group. In the United States, the government implemented a vaccine mandate for health care workers to increase vaccination rates. This study investigated the drivers of nurses' attitudes toward the mandate. Methods We fielded a survey to study the attitudes of nurses toward COVID-19 vaccine mandate for HCWs. We contacted nurses in South Dakota, United States, based on the information from the South Dakota Board of Nursing. The survey was open in June and July 2022. We conducted a multivariate regression analysis to identify the factors that predict attitudes toward this regulation. Results We received 1,084 responses. Results of regression analysis showed statistically significant relationships between partisan self-identification, evangelical identity, gender, and COVID-19 vaccination status and support for COVID-19 vaccine mandate for healthcare workers. Age, time with patients, positive COIVD-19 test in the last year, education, and nurse classification variables were not statistically significant. Conclusions The same factors that drive people's attitudes toward COVID-19 mitigation policies also explain nurses' attitudes toward a vaccine mandate for healthcare workers. The politicization of the COVID-19 pandemic is present also among nurses. Health care officials should be mindful of the influence of these biases as they evaluate the vaccine mandate and develop new regulations.
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Affiliation(s)
- Filip Viskupič
- School of American and Global Studies, South Dakota State University, United States of America
| | - David L Wiltse
- School of American and Global Studies, South Dakota State University, United States of America
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Politis M, Sotiriou S, Doxani C, Stefanidis I, Zintzaras E, Rachiotis G. Healthcare Workers' Attitudes towards Mandatory COVID-19 Vaccination: A Systematic Review and Meta-Analysis. Vaccines (Basel) 2023; 11:vaccines11040880. [PMID: 37112791 PMCID: PMC10142794 DOI: 10.3390/vaccines11040880] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/13/2023] [Accepted: 04/17/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND COVID-19 vaccine mandates are considered a controversial public health policy both in public debate and among healthcare workers (HCWs). Thus, the objective of this systematic review is to give a deep insight into HCWs' views and attitudes towards COVID-19 vaccination mandates amid the ongoing COVID-19 pandemic. METHODS A systematic literature search of five databases (PubMed, Scopus, Embase, CINAHL, and Web of Science) was conducted between July 2022 and November 2022. Original quantitative studies that addressed the attitudes of HCWs regarding COVID-19 vaccine mandates were considered eligible for this systematic review. All the included studies (n = 57) were critically appraised and assessed for risk of systematic bias. Meta-analyses were performed, providing a pooled estimate of HCWs' acceptance towards COVID-19 vaccine mandates for: 1. HCWs and 2. the general population. RESULTS In total, 64% (95% CI: 55%, 72%) of HCWs favored COVID-19 vaccine mandates for HCWs, while 50% (95% CI: 38%, 61%) supported mandating COVID-19 vaccines for the general population. CONCLUSIONS Our findings indicate that mandatory vaccination against COVID-19 is a highly controversial issue among HCWs. The present study provides stakeholders and policy makers with useful evidence related to the compulsory or non-compulsory nature of COVID-19 vaccinations for HCWs and the general population. Other: The protocol used in this review is registered on PROSPERO with the ID number: CRD42022350275.
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Affiliation(s)
- Marios Politis
- Department of Biomathematics, School of Medicine, University of Thessaly, 41222 Larissa, Greece
| | - Sotiris Sotiriou
- Department of Pathology, Faculty of Medicine, Aristotle University, 54124 Thessaloniki, Greece
| | - Chrysoula Doxani
- Department of Biomathematics, School of Medicine, University of Thessaly, 41222 Larissa, Greece
| | - Ioannis Stefanidis
- Department of Nephrology, School of Medicine, University of Thessaly, 41110 Larissa, Greece
| | - Elias Zintzaras
- Department of Biomathematics, School of Medicine, University of Thessaly, 41222 Larissa, Greece
- Center for Clinical Evidence Synthesis, Tufts University School of Medicine, Boston, MA 02111, USA
- The Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA 02111, USA
| | - Georgios Rachiotis
- Department of Hygiene and Epidemiology, School of Medicine, University of Thessaly, 41110 Larissa, Greece
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Chimeddorj B, Bailie CR, Mandakh U, Price DJ, Bayartsogt B, Meagher N, Altanbayar O, Magvan B, Deleg Z, Gantumur A, Byambaa O, Nyamdavaa E, Enkhtugs K, Munkhbayar U, Bayanjargal B, Badamsambuu T, Dashtseren M, Amartuvshin T, Narmandakh Z, Togoo K, Boldbaatar EA, Bat-Erdene A, Chimeddorj U, Nyamdavaa K, Tsevegmid E, Batjargal O, Enebish O, Enebish G, Batchuluun B, Zulmunkh G, Byambatsogt G, Enebish T, Le LV, Bergeri I, McVernon J, Erkhembayar R. SARS-CoV-2 seroepidemiology in Mongolia, 2020-2021: a longitudinal national study. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2023; 36:100760. [PMID: 37360871 PMCID: PMC10084888 DOI: 10.1016/j.lanwpc.2023.100760] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 03/03/2023] [Accepted: 03/21/2023] [Indexed: 06/28/2023]
Abstract
Background The COVID-19 pandemic has global impacts but is relatively understudied in developing countries. Mongolia, a lower-middle-income country, instituted strict control measures in early 2020 and avoided widespread transmission until vaccines became available in February, 2021. Mongolia achieved its 60% vaccination coverage goal by July 2021. We investigated the distribution and determinants of SARS-CoV-2 seroprevalence in Mongolia over 2020 and 2021. Methods We performed a longitudinal seroepidemiologic study aligned with WHO's Unity Studies protocols. We collected data from a panel of 5000 individuals in four rounds between October 2020 and December 2021. We selected participants through local health centres across Mongolia by age-stratified multi-stage cluster sampling. We tested serum for the presence of total antibodies against SARS-CoV-2 receptor-binding domain, and levels of anti-SARS-CoV-2 spike IgG and neutralising antibodies. We linked participant data with national mortality, COVID-19 case, and vaccination registries. We estimated population seroprevalence and vaccine uptake, as well as unvaccinated population prior-infection prevalence. Findings At the final round in late 2021, 82% (n = 4088) of participants completed follow-up. Estimated seroprevalence increased from 1.5% (95% CI: 1.2-2.0), to 82.3% (95% CI: 79.5-84.8) between late-2020 and late-2021. At the final round an estimated 62.4% (95% CI: 60.2-64.5) of the population were vaccinated, and of the unvaccinated population 64.5% (95% CI: 59.7-69.0) had been infected. Cumulative case ascertainment in the unvaccinated was 22.8% (95% CI: 19.1%-26.9%) and the overall infection-fatality ratio was 0.100% (95% CI: 0.088-0.124). Health workers had higher odds for being COVID-19 confirmed cases at all rounds. Males (1.72 (95% CI: 1.33-2.22)) and adults aged 20 and above (12.70 (95% CI: 8.14-20.26)) had higher odds for seroconverting by mid-2021. Among the seropositive, 87.1% (95% CI: 82.3%-90.8%) had SARS-CoV-2 neutralising antibodies by late 2021. Interpretation Our study enabled tracking of SARS-CoV-2 serological markers in the Mongolian population over one year. We found low SARS-CoV-2 seroprevalence in 2020 and early 2021, with seropositivity increasing over a 3-month interval in 2021 due to vaccine roll out and rapid infection of most of the unvaccinated population. Despite high seroprevalence in Mongolia amongst both vaccinated and unvaccinated individuals by end-2021, the SARS-CoV-2 Omicron immune escape variant caused a substantial epidemic. Funding World Health Organization, WHO UNITY Studies initiative, with funding by the COVID-19 Solidarity Response Fund and the German Federal Ministry of Health (BMG) COVID-19 Research and development. The Ministry of Health, Mongolia partially funded this study.
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Affiliation(s)
- Battogtokh Chimeddorj
- Department of Microbiology and Infection Prevention Control, School of Biomedicine, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
- Institute of Biomedical Sciences, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Christopher R. Bailie
- Department of Infectious Diseases, Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Australia
| | - Undram Mandakh
- Department of Family Medicine, School of Medicine, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - David J. Price
- Department of Infectious Diseases, Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Australia
- Centre for Epidemiology & Biostatistics, Melbourne School of Population & Global Health, The University of Melbourne, Melbourne, Australia
| | - Batzorig Bayartsogt
- Department of Epidemiology and Biostatistics, School of Public Health, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Niamh Meagher
- Department of Infectious Diseases, Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Australia
| | - Oyunbaatar Altanbayar
- Department of Microbiology and Infection Prevention Control, School of Biomedicine, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Battur Magvan
- Department of Microbiology and Infection Prevention Control, School of Biomedicine, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Zolzaya Deleg
- Department of Microbiology and Infection Prevention Control, School of Biomedicine, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Anuujin Gantumur
- Department of Microbiology and Infection Prevention Control, School of Biomedicine, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Otgonjargal Byambaa
- Department of Microbiology and Infection Prevention Control, School of Biomedicine, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Enkhgerel Nyamdavaa
- Department of Microbiology and Infection Prevention Control, School of Biomedicine, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Khangai Enkhtugs
- Department of Family Medicine, School of Medicine, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Usukhbayar Munkhbayar
- Department of Family Medicine, School of Medicine, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Batkhuu Bayanjargal
- Department of Family Medicine, School of Medicine, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Tuyajargal Badamsambuu
- Department of Family Medicine, School of Medicine, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Myagmartseren Dashtseren
- Department of Family Medicine, School of Medicine, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Tsolmontuya Amartuvshin
- Department of Family Medicine, School of Medicine, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Zolmunkh Narmandakh
- Department of Immunology, School of Biomedicine, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Khongorzul Togoo
- Department of Immunology, School of Biomedicine, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Enkh-Amar Boldbaatar
- Department of Immunology, School of Biomedicine, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Ariunzaya Bat-Erdene
- Department of Immunology, School of Biomedicine, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | | | | | | | - Ochbadrakh Batjargal
- Department of Molecular Biology and Genetics, School of Biomedicine, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | | | - Gerelmaa Enebish
- Department of Microbiology and Infection Prevention Control, School of Biomedicine, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Batzaya Batchuluun
- Central Clinical Laboratory, Mongolia Japan Hospital, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Gereltsetseg Zulmunkh
- Central Clinical Laboratory, Mongolia Japan Hospital, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Ganbaatar Byambatsogt
- Department of Biochemistry, School of Biomedicine, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Temuulen Enebish
- Regional Office for the Western Pacific, World Health Organization, Manila, Philippines
| | - Linh-Vi Le
- Regional Office for the Western Pacific, World Health Organization, Manila, Philippines
| | | | - Jodie McVernon
- Department of Infectious Diseases, Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Australia
- Victorian Infectious Diseases Reference Laboratory at the Peter Doherty Institute for Infection and Immunity, Royal Melbourne Hospital, Australia
| | - Ryenchindorj Erkhembayar
- Department of International Cyber Education, Graduate School, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
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Casey SM, Burrowes SAB, Hall T, Dobbins S, Ma M, Bano R, Yarrington C, Schechter-Perkins EM, Garofalo C, Drainoni ML, Perkins RB, Pierre-Joseph N. Healthcare workers' attitudes on mandates, incentives, and strategies to improve COVID-19 vaccine uptake: A mixed methods study. Hum Vaccin Immunother 2022; 18:2144048. [PMID: 36411988 PMCID: PMC9746602 DOI: 10.1080/21645515.2022.2144048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 10/19/2022] [Accepted: 10/29/2022] [Indexed: 11/23/2022] Open
Abstract
Healthcare workers are a trusted health information source and are uniquely positioned to reduce the burden of the COVID-19 pandemic. The purpose of this sequential exploratory mixed methods study was to understand attitudes of healthcare workers working in Massachusetts during the COVID-19 pandemic regarding strategies to improve COVID-19 vaccine utilization, including vaccine mandates and incentives. Fifty-two individuals completed one-on-one interviews between April 22nd and September 7th, 2021. The survey was developed based on findings from the interviews; 209 individuals completed the online survey between February 17th and March 23rd, 2022. Both the interview and survey asked about attitudes toward COVID-19 vaccine and booster mandates, incentives, and strategies to improve vaccination rates. Most participants were female (79%-interview, 81%-survey), Caucasian (56%, 73%), and worked as physicians (37%, 34%) or nurses (10%, 18%). Overall, nuanced attitudes regarding vaccine and booster mandates were expressed; many supported mandates to protect their patients' health, others emphasized personal autonomy, while some were against mandates if job termination was the consequence of declining vaccines. Similarly, views regarding vaccine incentives differed; some considered incentives helpful, yet many viewed them as coercive. Strategies believed to be most effective to encourage vaccination included improving accessibility to vaccination sites, addressing misinformation, discussing vaccine safety, tailored community outreach via trusted messengers, and one-on-one conversations between patients and healthcare workers. Healthcare workers' experiences with strategies to improve utilization of COVID-19 vaccines and boosters have implications for public health policies. Generally, efforts to improve access and education were viewed more favorably than incentives and mandates.
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Affiliation(s)
- Sharon M. Casey
- Department of Obstetrics and Gynecology, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Shana A. B. Burrowes
- Section of Infectious Diseases, Department of Medicine, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Taylor Hall
- Graduate of Medical Sciences, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Sidney Dobbins
- Epidemiology and Statistics, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Mengyu Ma
- Epidemiology and Statistics, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Ruqiyya Bano
- Epidemiology and Statistics, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Christina Yarrington
- Department of Obstetrics and Gynecology, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Elissa M. Schechter-Perkins
- Department of Emergency Medicine, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Christopher Garofalo
- Department of Family Medicine and Department of Obstetrics and Gynecology, Sturdy Memorial Hospital, Attleboro, Massachusetts, USA
- Family Medicine Associates of South Attleboro, South Attleboro, Massachusetts, USA
| | - Mari-Lynn Drainoni
- Section of Infectious Diseases, Department of Medicine, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts, USA
- Department of Health Law Policy & Management, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Rebecca B. Perkins
- Department of Obstetrics and Gynecology, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Natalie Pierre-Joseph
- Department of Pediatrics, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts, USA
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Iliyasu Z, Garba RM, Aliyu MA, Gajida AU, Amole TG, Umar AA, Abdullahi HM, Tsiga-Ahmed FI, Kwaku AA, Kowalski MS, Salihu HM, Aliyu MH. "I Would Rather Take the Vaccine Than Undergo Weekly Testing": Correlates of Health Workers' Support for COVID-19 Vaccine Mandates. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13937. [PMID: 36360818 PMCID: PMC9658226 DOI: 10.3390/ijerph192113937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 10/21/2022] [Accepted: 10/21/2022] [Indexed: 06/16/2023]
Abstract
This study examined the support for vaccine mandates and uptake among clinical and non-clinical staff at a tertiary hospital in northern Nigeria, focusing on variation of survey responses based on job position, socio-demographic characteristics, and perceived risk of infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Using an explanatory, sequential, mixed-methods design and deploying a pragmatic paradigm, 370 healthcare workers were administered structured questionnaires. This was followed by in-depth interviews with a sub-sample of respondents to further clarify the responses regarding support for the coronavirus disease 2019 (COVID-19) vaccine mandate. Findings demonstrated that less than one-half of respondents supported the COVID-19 mandate, and only one in three had received the recommended COVID-19 vaccine doses. Support for the vaccine mandate and vaccine uptake were predicted by profession, work experience, number of children, health status, and risk perception. Support for the vaccine mandate was ascribed to ethical and professional duty, whereas opposition was associated with respect for autonomy and human rights. This study documents the need to enhance support for vaccine mandates and uptake among healthcare workers through sustainable strategies, as Nigeria's healthcare workers are considered a source of trust and role models for the rest of society.
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Affiliation(s)
- Zubairu Iliyasu
- Department of Community Medicine, Bayero University, Kano PMB 3011, Nigeria
| | - Rayyan M. Garba
- Department of Community Medicine, Bayero University, Kano PMB 3011, Nigeria
| | - Mansur A. Aliyu
- Department of Community Medicine, Bayero University, Kano PMB 3011, Nigeria
| | - Auwalu U. Gajida
- Department of Community Medicine, Bayero University, Kano PMB 3011, Nigeria
| | - Taiwo G. Amole
- Department of Community Medicine, Bayero University, Kano PMB 3011, Nigeria
| | - Amina A. Umar
- Department of Community Medicine, Bayero University, Kano PMB 3011, Nigeria
| | | | | | - Aminatu A. Kwaku
- Department of Community Medicine, Bayero University, Kano PMB 3011, Nigeria
| | - Meira S. Kowalski
- Medicine, Health, and Society Program, Vanderbilt University, Nashville, TN 37240, USA
| | - Hamisu M. Salihu
- Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Muktar H. Aliyu
- Department of Health Policy, Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Nashville, TN 37203, USA
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9
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Attwell K, Roberts L, Blyth CC, Carlson SJ. Western Australian health care workers' views on mandatory COVID-19 vaccination for the workplace. HEALTH POLICY AND TECHNOLOGY 2022; 11:100657. [PMID: 35910408 PMCID: PMC9314263 DOI: 10.1016/j.hlpt.2022.100657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Background Health care workers (HCWs) are at an increased risk of catching and spreading Coronavirus Disease 2019 (COVID-19) compared with the general community, putting health systems at risk. Several jurisdictions globally have mandated or are looking to mandate COVID-19 vaccines for this cohort, but little is known about the acceptability of this measure, especially in different contexts, and there is little qualitative data to explore nuance, depth, and the reasons behind HCWs’ opinions. Methods In-depth semi-structured qualitative interviews were undertaken with 39 HCWs in Western Australia (WA) between February-August 2021, ascertaining their views on the prospective introduction and implementation of mandates for COVID-19 vaccines. Data were thematically analysed using NVivo 20. Results There was broad support for COVID-19 vaccine mandates for HCWs amongst our participants, but also different views about what such a mandate would mean (redeployment versus termination) and how it would impact the rest of the workforce. One vaccine hesitant participant said that mandates would be their prompt to get vaccinated. Other participants invoked an informal code whereby HCWs have an obligation to be seen to support vaccination and to protect public health more broadly. However, they also raised concerns about implementation and procedural and policy fairness. Conclusion Policymakers should consider how to mobilise the informal code of health promotion and public health support if introducing mandates. They should also consider whether HCWs will bring the same attitudes and approaches to mandates for additional vaccine doses.
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Affiliation(s)
- Katie Attwell
- School of Social Sciences, University of Western Australia, 35 Stirling Highway, Crawley WA 6009, Australia.,Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth Children's Hospital, Nedlands, WA 6009, Australia
| | - Leah Roberts
- School of Social Sciences, University of Western Australia, 35 Stirling Highway, Crawley WA 6009, Australia
| | - Christopher C Blyth
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth Children's Hospital, Nedlands, WA 6009, Australia
| | - Samantha J Carlson
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth Children's Hospital, Nedlands, WA 6009, Australia
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Giannakou K, Kyprianidou M, Christofi M, Kalatzis A, Fakonti G. Mandatory COVID-19 Vaccination for Healthcare Professionals and Its Association With General Vaccination Knowledge: A Nationwide Cross-Sectional Survey in Cyprus. Front Public Health 2022; 10:897526. [PMID: 35646772 PMCID: PMC9130732 DOI: 10.3389/fpubh.2022.897526] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 04/05/2022] [Indexed: 12/15/2022] Open
Abstract
COVID-19 compulsory vaccination for healthcare professionals (HCPs) is a sensitive and controversial topic, with different support rates worldwide. Previous studies in Cyprus identified a low COVID-19 vaccination acceptance among HCPs, however, no studies have investigated their perceptions toward mandatory COVID-19 vaccination. This is the first study to investigate the attitudes of HCPs toward mandatory COVID-19 vaccination and its association with general vaccination knowledge. A cross-sectional study was conducted, using an online self-administered, anonymous questionnaire to collect data on sociodemographic and health-related characteristics, trust and satisfaction with the healthcare system, utilization of preventive healthcare services, COVID-19 vaccination information, vaccination knowledge, and attitudes among HCPs toward mandatory COVID-19 vaccination. A total of 504 HCPs participated in the survey, with 34% being in favor of mandatory COVID-19 vaccination. A sufficient vaccination knowledge score was identified among the HCPs, with higher scores being associated with mandatory vaccination support (p < 0.001). As age increases by one year, the odds of supporting mandatory vaccination increase by 1.03 units (95% CI: 1.01-1.06). In addition, as the general vaccination knowledge score increases by one unit, the odds of supporting mandatory COVID-19 vaccination increase by 1.55 units (95% CI: 1.33-1.81). Our findings show that about two-thirds of the HCPs in Cyprus were opposed to a mandatory COVID-19 vaccination policy. Older age and general vaccination knowledge were found to be the strongest predictors of mandatory vaccination support. To avoid unforeseen outcomes, mandatory vaccination policies should be implemented with caution and consultation.
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Affiliation(s)
- Konstantinos Giannakou
- Department of Health Sciences, School of Sciences, European University Cyprus, Nicosia, Cyprus
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