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Konstantinou P, Kyprianidou M, Christodoulou A, McHugh L, Constantinou M, Epiphaniou E, Vahey N, Nicolaou C, Middleton N, Karekla M, Kassianos AP. Behavioral, cognitive and emotional determinants of getting vaccinated for COVID-19 and the mediating role of institutional trust among young adults in Cyprus. BMC Public Health 2024; 24:2336. [PMID: 39198798 PMCID: PMC11351732 DOI: 10.1186/s12889-024-19859-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 08/22/2024] [Indexed: 09/01/2024] Open
Abstract
BACKGROUND Vaccination uptake is a complex behavior, influenced by numerous factors. Behavioral science theories are commonly used to explain the psychosocial determinants of an individual's health behavior. This study examined the behavioural, cognitive, and emotional determinants of COVID-19 vaccination intention based on well-established theoretical models: Acceptance and Commitment Therapy (ACT), Capability, Opportunity, Motivation, and Behaviour (COM-B) and the Health Belief Model (HBM). Additionally, it examined the mediating role of institutional trust in the relationship between determinants of these models and vaccination intentions. METHODS A cross-sectional study was conducted from January to May 2022, where university students in Cyprus completed an online survey. RESULTS A total of 484 university students completed the online survey, with 23.8% reporting being vaccinated with fewer than three vaccination doses and/or no intention to vaccinate further. Hierarchical logistic regression analysis showed that higher scores in institutional trust, perceived severity, motivation, physical and psychological capability were significantly associated with higher odds of intending to vaccinate. Higher psychological flexibility and not being infected with COVID-19 were also associated with higher odds of vaccination intention, but not in the final model when all determinants were included. Additionally, significant indirect effects of psychological and physical capability, motivation and perceived severity on vaccination intention were found to be mediated by institutional trust. CONCLUSIONS When tackling COVID-19 vaccination hesitancy, behavioural, cognitive, and emotional aspects should be considered. Stakeholders and policymakers are advised to implement targeted vaccination programs in young people while at the same time building trust and improving their capabilities and motivation towards getting vaccinated.
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Affiliation(s)
- Pinelopi Konstantinou
- Department of Psychology, University of Cyprus, Nicosia, Cyprus
- Department of Psychology, School of Sciences, University of Central Lancashire, Larnaca, Cyprus
| | - Maria Kyprianidou
- Department of Social and Behavioral Science, European University Cyprus, Nicosia, Cyprus
| | - Andria Christodoulou
- Department of Social and Behavioral Science, European University Cyprus, Nicosia, Cyprus
| | - Louise McHugh
- Department of Psychology, University College Dublin, Dublin, Ireland
| | | | - Eleni Epiphaniou
- Department of Social and Behavioral Science, European University Cyprus, Nicosia, Cyprus
| | - Nigel Vahey
- Department of Psychology, Technological University Dublin, Dublin, Ireland
| | - Christiana Nicolaou
- Department of Nursing, Cyprus University of Technology, Limassol, 3041, Cyprus
| | - Nicos Middleton
- Department of Nursing, Cyprus University of Technology, Limassol, 3041, Cyprus
| | - Maria Karekla
- Department of Psychology, University of Cyprus, Nicosia, Cyprus
| | - Angelos P Kassianos
- Department of Psychology, University of Cyprus, Nicosia, Cyprus.
- Department of Nursing, Cyprus University of Technology, Limassol, 3041, Cyprus.
- Department of Applied Health Research, UCL, London, UK.
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Roy DN, Ferdiousi N, Mohabbot Hossen M, Islam E, Shah Azam M. Global disparities in COVID-19 vaccine booster dose (VBD) acceptance and hesitancy: An updated narrative review. Vaccine X 2024; 18:100480. [PMID: 38585380 PMCID: PMC10997838 DOI: 10.1016/j.jvacx.2024.100480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 03/18/2024] [Accepted: 03/19/2024] [Indexed: 04/09/2024] Open
Abstract
The global deployment of COVID-19 vaccine booster dose (VBD) has been recognized as a promising therapeutic alliance to provide repeated immunity against the arrival of new variants. Despite scientific evidence supports the effectiveness of periodic doses, COVID-19 vaccine booster reluctance continues to thrive. This narrative review aimed to examine global COVID-19 vaccine booster dose (VBD) acceptance and summarize an up-to-date assessment of potential antecedents associated with VBD acceptance. A comprehensive search was performed in several reputable databases such as Medline (via PubMed), Scopus, Google scholar, and Web of Science from June 10th, 2023, to August 1st, 2023. All relevant descriptive and observational studies on COVID-19 VBD acceptance and hesitancy were included in this review. A total of fifty-eight (58) studies were included, with Asia representing the highest count with thirty-one (53%) studies, Europe with eleven (19 %), the United States with nine (16 %), and other regions (Africa and multi-ethnic) with seven (12 %). Worldwide, the pooled COVID-19 VBD acceptance rate was 77.09 % (95 % CI: 76.28-78.18), VBD willingness (n) = 164189, and the total sample (N) = 212,990. The highest and the lowest VBD acceptance rate was reported in Europe and American regions, respectively, 85.38 % (95 % CI: 85.02-85.73, (n) = 32,047, (N = 37,533) vs. 66.92 % (95 % CI: 66.56-67.4), (n) = 29335, (N) = 43,832. However, Asia and multi-ethnic areas reported moderately high VBD acceptance rate 79.13 % (95 % CI: 78.77-79.23, (n) = 93,994, (N) = 11,8779) and 72.16 % (95 % CI: 71.13-72.93, (n) = 9276, (N) = 12,853), respectively. The most common and key antecedents of COVID-19 VBD acceptance and hesitancy across the countries were "equal safety", "efficacy", "effectiveness", "post-vaccination side effects", "community protection" "family protection", "risk-benefit ratio", "booster necessity", "trust", and "variants control". Disparities in the uptake of COVID-19 VBD were observed globally, with the highest rates found in Europe, and the lowest rates in American regions. Multiple potential antecedents including safety, efficacy, and post-vaccination side effects were associated with VBD acceptance and hesitancy.
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Affiliation(s)
- Debendra Nath Roy
- Department of Pharmacy, Jashore University of Science and Technology, Jashore 7408, Bangladesh
- Institute of Education and Research, University of Rajshahi, Rajshahi 6205, Bangladesh
| | - Nowrin Ferdiousi
- Department of Pharmacy, Mawlana Bhasani Science and Technology University, Tangail 1902, Bangladesh
| | | | - Ekramul Islam
- Department of Pharmacy, University of Rajshahi, Rajshahi 6205, Bangladesh
| | - Md. Shah Azam
- Department of Marketing, University of Rajshahi, Rajshahi 6205, Bangladesh
- Office of the Viec-Chancellor, Rabindra University, Bangladesh
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Bouloukaki I, Christodoulakis A, Papageorgakopoulou S, Tsiligianni I. The Prevalence and Determinants of Hesitancy for Regular COVID-19 Vaccination among Primary Healthcare Patients with Asthma or COPD in Greece: A Cross-Sectional Study. Vaccines (Basel) 2024; 12:414. [PMID: 38675796 PMCID: PMC11054093 DOI: 10.3390/vaccines12040414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Revised: 04/09/2024] [Accepted: 04/12/2024] [Indexed: 04/28/2024] Open
Abstract
The emergence of novel coronavirus mutations and signs of the waning immunity provided by COVID-19 vaccines underscore the importance of regular vaccination. This study aimed to investigate the prevalence of regular COVID-19 vaccination hesitancy and the factors that influence it among patients with asthma or chronic obstructive pulmonary disease (COPD) who visited primary care centers. The cross-sectional study was conducted in six primary healthcare centers in Crete, Greece (October-December 2023). Participants completed a questionnaire, which included questions about socio-demographic characteristics, health status, previous COVID-19 booster vaccination, attitudes, and beliefs about COVID-19 vaccination. Multivariate logistic regression was used to identify the factors that influenced vaccine hesitancy. Of the 264 participants, 65% exhibited hesitancy towards COVID-19 booster vaccination. Female gender, middle age, lower educational attainment, depression diagnosis, concerns about vaccine side effects, lack of confidence in vaccine efficacy, and reliance on media information were positively associated to vaccine hesitancy. Conversely, those having a cardiovascular disease or type 2 diabetes, those generally adhering to the recommendations of the treating physician, and those having previously received the flu vaccine or more than three COVID-19 vaccine doses were positively associated with regular COVID-19 vaccinations. Consequently, our findings could help develop strategies that could potentially reduce regular vaccination hesitancy among patients with asthma or COPD.
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Affiliation(s)
- Izolde Bouloukaki
- Department of Social Medicine, School of Medicine, University of Crete, 71003 Heraklion, Greece; (A.C.); (S.P.); (I.T.)
| | - Antonios Christodoulakis
- Department of Social Medicine, School of Medicine, University of Crete, 71003 Heraklion, Greece; (A.C.); (S.P.); (I.T.)
- Department of Nursing, School of Health Sciences, Hellenic Mediterranean University, 71410 Heraklion, Greece
| | - Stavroula Papageorgakopoulou
- Department of Social Medicine, School of Medicine, University of Crete, 71003 Heraklion, Greece; (A.C.); (S.P.); (I.T.)
| | - Ioanna Tsiligianni
- Department of Social Medicine, School of Medicine, University of Crete, 71003 Heraklion, Greece; (A.C.); (S.P.); (I.T.)
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Khoo CMJ, Dea EZQ, Law LY, Wong SST, Ng KY, Bakhtiar A. Acceptability of COVID-19 booster vaccine in malaysia: a cross-sectional study. Sci Rep 2024; 14:8421. [PMID: 38600166 PMCID: PMC11006945 DOI: 10.1038/s41598-024-59195-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 04/08/2024] [Indexed: 04/12/2024] Open
Abstract
Despite the high efficacy and safety demonstrated in clinical trials, COVID-19 booster vaccination rates in Malaysia remain below 50% among the general public. This study explores the factors influencing public acceptance of the COVID-19 booster vaccine among the Malaysian population. The questionnaire included variables on sociodemographics, knowledge, and the Health Belief Model (HBM) constructs. Based on the Chi-squared test of contingencies, a t-test and multivariate logistic regression analysis on 411 collected responses, the findings revealed that older participants, individuals of Chinese ethnicity, and those with higher education levels and incomes were more willing to accept booster vaccinations. The analysis further identified perceived susceptibility, perceived severity and perceived barriers as significant predictors influencing booster vaccination acceptance rates. Healthcare policymakers may consider targeting interventions to diminish the obstacles associated with booster vaccinations. These intervention strategies include implementing health intervention programmes, such as public health awareness initiatives, to raise awareness of the risks and severity of COVID-19, ultimately encouraging higher uptake of booster vaccines.
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Affiliation(s)
- Cheryl Minn Jee Khoo
- School of Pharmacy, Monash University Malaysia, 47500, Bandar Sunway, Selangor, Malaysia
| | - Eve Zhi Qing Dea
- School of Pharmacy, Monash University Malaysia, 47500, Bandar Sunway, Selangor, Malaysia
| | - Li Yeow Law
- School of Pharmacy, Monash University Malaysia, 47500, Bandar Sunway, Selangor, Malaysia
| | - Sharon Siew Tong Wong
- School of Pharmacy, Monash University Malaysia, 47500, Bandar Sunway, Selangor, Malaysia
| | - Khuen Yen Ng
- School of Pharmacy, Monash University Malaysia, 47500, Bandar Sunway, Selangor, Malaysia
| | - Athirah Bakhtiar
- School of Pharmacy, Monash University Malaysia, 47500, Bandar Sunway, Selangor, Malaysia.
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Ghazy RM, Gebreal A, Saleeb MRA, Sallam M, El-Deen AESN, Sheriff SD, Tessema EA, Ahurwendeire S, Tsoeu N, Chamambala PC, Cibangu PB, Okeh DU, Traoré AS, Eshun G, Kengo NE, Kubuka AE, Awuah LB, Salah A, Aljohani M, Fadl N. Compulsory Vaccination Coverage in 12 Sub-Saharan African Countries Two Years Following the COVID-19 Pandemic. J Community Health 2024; 49:193-206. [PMID: 37646982 DOI: 10.1007/s10900-023-01261-1] [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] [Accepted: 07/13/2023] [Indexed: 09/01/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic is a global threat, challenging health services' provision and utilization. This study aimed to assess compulsory vaccination coverage in 12 Sub-Saharan African countries two years following the COVID-19 pandemic using the Health Belief Model. A cross-sectional survey was conducted from November 1 to December 15, 2022. Multivariate logistic regression was conducted to identify the determinants of vaccination coverage. Among the 5032 respondents, 73.1% reported that their children received compulsory vaccination. The lowest coverage was observed in Ghana (36.5%), while the highest was in Burkina Faso and Congo (92.0%). Factors associated with non-vaccination included older mothers (adjusted odds ratio (AOR) = 1.04, 95%CI: 1.03-1.05), lower mothers' education, older children (AOR = 0.76, 95%CI: 0.60-0.96), children with chronic illnesses (AOR = 0.55, 95%CI: 0.45-0.66), and difficult accessibility to healthcare facilities (AOR = 11.27, 95%CI: 9.48-13.44). Low perceived risk, in which non-vaccinated children were believed to be at no higher risk for infectious diseases and the disease severity would not worsen among non-vaccinated children, increased the likelihood of non-vaccination (AOR = 2.29, 95%CI: 1.75-2.99 and AOR = 2.12, 95%CI: 1.64-2.73, respectively). Perceiving vaccines as unnecessary, and needless for breastfed babies increased the probability of non-vaccination (AOR = 1.38, 95%CI: 1.10-1.73 and AOR = 1.69, 95%CI: 1.31-2.19, respectively). Higher odds of non-vaccination were found when the provision of vaccine information did not motivate parents to vaccinate their children (AOR = 4.29, 95%CI: 3.15-5.85). Conversely, believing that vaccines were safe for children decreased the odds of non-vaccination (AOR = 0.72, 95%CI: 0.58-0.88). Parental perceptions and concerns should be considered in interventions aiming to increase compulsory vaccine acceptance and coverage.
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Affiliation(s)
- Ramy Mohamed Ghazy
- Tropical Health Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | - Assem Gebreal
- Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | | | - Malik Sallam
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman, Jordan
- Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Amman, Jordan
| | - Ahmed El-Sayed Nour El-Deen
- Department of Physiology, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
- Department of Basic Medical and Dental Sciences, Faculty of Dentistry, Zarqa University, PO Box 2000, Zarqa, 13110, Jordan
| | | | | | - Salvias Ahurwendeire
- Department of Epidemiology and Biostatistics, Makerere University School of Public Health, Kampala, Uganda
| | | | | | - Patrick B Cibangu
- Health Officer, Les Ailes du Coeur NGO, Congo, Democratic Republic of Congo
| | - Debra Ukamaka Okeh
- Department of Community Medicine, Federal Medical Centre Umuahia, Abia, Nigeria
| | | | - Gilbert Eshun
- Seventh-Day Adventist Hospital, Agona-Asamang, Ghana
| | - Nathan Ezie Kengo
- Faculty of Medicine and Biomedical Sciences, University of Garoua, Garoua, Cameroun
| | - Amos Elisha Kubuka
- Saint Francis University College of health and allied Sciences, Ifakara, Morogoro, Tanzania
| | - Lydia Baffour Awuah
- Department of Health Promotion and Disability Studies, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Assia Salah
- Faculty of Medicine, Algiers University, Algiers, Algeria
| | - Moath Aljohani
- Department of Family and Community Medicine, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, Saudi Arabia
| | - Noha Fadl
- Family Health Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt.
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van Roekel C, Labuschagne L, Pijpers J, van Roon A, Smagge B, Ferreira JA, Hahné S, de Melker H. Factors associated with COVID-19 autumn 2022 booster uptake in the Netherlands among older adults aged ≥ 60 years and younger adults with chronic conditions. Vaccine 2024; 42:146-155. [PMID: 38101955 DOI: 10.1016/j.vaccine.2023.12.027] [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: 08/17/2023] [Revised: 11/21/2023] [Accepted: 12/05/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND A booster with bivalent COVID-19 vaccine was offered in the Netherlands in autumn, 2022. We aimed to investigate vaccine uptake during the autumn 2022 booster round among the population subgroups at risk for severe COVID-19 that were specifically targeted by this campaign: the medical risk group aged 18-59 years and individuals ≥ 60 years. We calculated booster uptake in both populations and analyzed determinants of booster uptake among those who had received at least one prior COVID-19 vaccination. METHODS Having had an autumn 2022 booster dose was defined as having received a COVID-19 vaccination between 19 September 2022 and 7 March 2023. The study population included individuals who received at least one previous COVID-19 vaccination. National registries of sociodemographic determinants and COVID-19 vaccination were linked by a unique person identifier. Voting proportions for political parties were included at neighborhood level. Determinants of COVID-19 vaccine autumn booster uptake were ranked by importance by random forest analyses. RESULTS Booster uptake was 68 % among those aged ≥ 60 and 30 % among those aged 18-59 years with a medical risk factor for severe disease. For both target groups the most important determinant for booster uptake was age (15 % in 18-29 years to 72 % in 80 + years). Voting proportions for progressive liberal political parties ranked second in the random forest analysis in both groups, with an increasing proportion of votes associated with higher uptake. In the 60 + group, household type ranked third, with highest vaccine uptake among married couples without children (72 %) and the lowest uptake among unmarried couples with children (47 %). In the medical risk group, migration status ranked third. Migrants with two parents born abroad had the lowest uptake (18 %), whereas migrants with both parents born in the Netherlands had the highest uptake (35 %). CONCLUSION The target group of people aged ≥ 60 years was much better reached than the target group of people with a medical risk aged 18-59 years. Uptake varied considerably among subgroups in both target groups. The findings of this study can be used in future vaccination strategies as well as for further research to better understand the drivers and barriers of vaccine uptake among the subgroups with notably low uptake.
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Affiliation(s)
- Caren van Roekel
- Epidemiology and Surveillance, National Institute for Public Health and the Environment, Bilthoven, the Netherlands.
| | - Lisanne Labuschagne
- Epidemiology and Surveillance, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Joyce Pijpers
- Epidemiology and Surveillance, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Annika van Roon
- Epidemiology and Surveillance, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Bente Smagge
- Epidemiology and Surveillance, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - José A Ferreira
- Statistics and Modelling, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Susan Hahné
- Epidemiology and Surveillance, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Hester de Melker
- Epidemiology and Surveillance, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
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Mubarak S, A'aqoulah A, AlGhawrie H, Albalas S, Innab N. Assessing the acceptability of COVID-19 vaccine and its booster dose. Immun Inflamm Dis 2023; 11:e950. [PMID: 37773710 PMCID: PMC10521373 DOI: 10.1002/iid3.950] [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: 01/18/2023] [Revised: 06/26/2023] [Accepted: 07/08/2023] [Indexed: 10/01/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Coronavirus disease of 2019 (COVID-19) vaccinations are essential to control the pandemic and prevent severe COVID-19 infections. This study aims to assess the acceptability of the COVID-19 vaccine and the factors that impact the intention to take the COVID-19 vaccine and its booster dose. METHODS A cross-sectional study was conducted in Saudi Arabia and Jordan. The study used a self-administered web-based survey (questionnaire) for data collection that was distributed via social media platforms from May 2022 to July 2022. RESULTS In this study, among 518 participants, 54.4% had already received two doses of the COVID-19 vaccine, and out of the participants who didn't receive the booster dose, 19.9% declared a definite willingness to receive it, while 42% had already taken a booster dose, which indicated good acceptance. After adjustment for significant background characteristics, a significant association between the country and receiving the COVID-19 vaccine, the intention to get the vaccine, and infection with COVID-19 were found, in addition to a significant association between the country and the participants' opinion that electronic applications helped them to follow their vaccine schedule were found (p < .001). Also, the results showed that participants' attitudes were significantly associated with educational level and age groups (p ≤ .001, p = .032, respectively). There was a significant association between the intention to receive the vaccine booster dose and the country (p < .001). The Saudi participants were willing to get the booster dose seven times more than the Jordanians, furthermore, there was a significant association between taking the vaccine booster dose in the country, as well as age group, working in the medical field, previous COVID-19 infection, and the intention to vaccinate the children (p < .001, p = .030, .031, .025, < .001, respectively). CONCLUSION Overall, our results emphasize a positive response and a positive attitude toward COVID-19 vaccination. In addition, define the groups to be targeted with effective communication regarding the COVID-19 vaccine and its booster dose.
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Affiliation(s)
- Sawsan Mubarak
- Infection Control Program, King Hussein Cancer Center, Amman, Jordan
| | - Ashraf A'aqoulah
- Department of Health Systems Management, College of Public Health and Health Informatics, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Hadeel AlGhawrie
- Infection Control Program, King Hussein Cancer Center, Amman, Jordan
| | - Samir Albalas
- Department of Health Services Administration, Faculty of Economics and Administrative Sciences, Yarmouk University, Irbid, Jordan
| | - Nisreen Innab
- Department of Computer Science and Information Systems, College of Applied Sciences, AlMaarefa University, Saudi Arabia
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Berríos H, López-Cepero A, Pérez CM, Cameron S, Pons Calvo AD, Colón-López V. COVID-19 Vaccine Booster Hesitancy among Hispanic Adults: A Cross-Sectional Study from the Puerto Rico Community Engagement Alliance against COVID-19 Disparities (PR-CEAL). Vaccines (Basel) 2023; 11:1426. [PMID: 37766103 PMCID: PMC10537643 DOI: 10.3390/vaccines11091426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 08/09/2023] [Accepted: 08/09/2023] [Indexed: 09/29/2023] Open
Abstract
Hispanic/Latino communities have suffered a disproportionate burden of the COVID-19 pandemic. Although Puerto Rico has one of the highest COVID-19 primary series vaccination rates nationwide, this estimate contrasts with the reported booster doses' low uptake. This study aimed to assess health belief correlates of COVID-19 vaccine booster uptake. Using a convenience sampling approach, the Puerto Rico-Community Engagement Alliance (PR-CEAL) conducted a cross-sectional study where 787 participants were recruited using online and in-person strategies between December 2021 and February 2022. Participants were adults 18 years or older, Spanish-speaking, and residents of Puerto Rico. The Health Belief Model was used to evaluate attitudes and beliefs. A total of 784 participants were used in this analysis. Adjusted Poisson regression models were used to estimate prevalence ratios (PR) and 95% confidence intervals (CI) of booster refusal. Overall, 22% of participants refused the vaccine booster or had not gotten it yet. Adjusted models showed that (i) participants who disagreed that getting the booster dose either made them feel less worried about COVID-19 or (ii) felt that the vaccine decreased their chances of getting COVID-19 presented higher booster-refusal prevalence ratios (PR = 4.20, 95% CI: 3.00, 5.90; PR = 3.70, 95% CI: 2.64, 5.18). Moreover, participants that (iii) reported having concerns for booster side effects [PR = 2.47; 95% CI = 1.73, 3.51], (iv) booster efficacy [PR = 2.50; 95% CI = 1.75, 3.58], and (v) booster safety [PR = 2.80; 95% CI = 1.96, 3.99] were significantly more likely to refuse the booster. In conclusion, booster vaccination refusal was associated with lower perceived vaccine benefits and greater barriers among adults in Puerto Rico. These results informed the development of PR-CEAL's targeted community outreach strategies and public health campaigns to increase booster vaccine uptake.
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Affiliation(s)
- Hérmilis Berríos
- Division of Cancer Control and Population Sciences, University of Puerto Rico Comprehensive Cancer Center, San Juan 00927, Puerto Rico; (H.B.); (S.C.); (A.D.P.C.)
| | - Andrea López-Cepero
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA;
| | - Cynthia M. Pérez
- Department of Biostatistics and Epidemiology, University of Puerto Rico Medical Sciences Campus, San Juan 00935, Puerto Rico;
| | - Stephanie Cameron
- Division of Cancer Control and Population Sciences, University of Puerto Rico Comprehensive Cancer Center, San Juan 00927, Puerto Rico; (H.B.); (S.C.); (A.D.P.C.)
| | - Adriana D. Pons Calvo
- Division of Cancer Control and Population Sciences, University of Puerto Rico Comprehensive Cancer Center, San Juan 00927, Puerto Rico; (H.B.); (S.C.); (A.D.P.C.)
| | - Vivian Colón-López
- Division of Cancer Control and Population Sciences, University of Puerto Rico Comprehensive Cancer Center, San Juan 00927, Puerto Rico; (H.B.); (S.C.); (A.D.P.C.)
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Salam M, Honein-AbouHaidar G. Determinants of influenza and COVID-19 vaccine intent or uptake in Lebanon: a scoping review of the literature. BMC Infect Dis 2023; 23:511. [PMID: 37544988 PMCID: PMC10404373 DOI: 10.1186/s12879-023-08478-4] [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: 02/27/2023] [Accepted: 07/21/2023] [Indexed: 08/08/2023] Open
Abstract
BACKGROUND Vaccination is essential to protect from influenza and recently from COVID-19, yet uptake in Lebanon is suboptimal. Several factors determine uptake including knowledge, attitude and policies. We conducted a scoping review of the literature to explore the determinants of influenza and COVID-19 vaccine intent or uptake in Lebanon. METHODS Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines, thirty one peer reviewed studies indexed in six databases Pub Med, EMBASE, Scopus, CINAHL, Medline, and the Cochrane Library were screened. Two students, a senior Librarian and an Associate Professor in nursing searched for eligible studies. The library search strategy followed a combination of three broad concepts (viral influenzas; vaccines; Lebanon). The search timeframe was up till December 31, 2022. Determinants of influenza and COVID-19 vaccine intent or uptake were categorized following the constructs of the Theory of Planned Behavior. RESULTS Nine studies investigated influenza vaccine intent or uptake among the public community, parents and healthcare workers. Twenty one studies investigated COVID-19 vaccine intent or uptake among the public community, older refugees, university students, patients with cancer, dentists, and social media users. One study investigated both types of vaccines. A conceptual model of the determinants of vaccine intent and uptake within the Lebanese context was developed. Various determinants included environmental factors, norms, knowledge, perceptions, attitudes, past experiences, behavioral control and hesitancy. CONCLUSIONS Research on vaccine intent and uptake in Lebanon is still in its infancy, while that of COVID-19 is on the rise. Multifaceted reasons behind the low vaccination rates were observed yet few attempts were made to target vulnerable groups. Further research studies are needed to target vulnerable groups.
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Affiliation(s)
- Mahmoud Salam
- Rafic Hariri School of Nursing, American University of Beirut, P.O. Box 11-0236, Beirut, 1107 2020, Lebanon
| | - Gladys Honein-AbouHaidar
- Rafic Hariri School of Nursing, American University of Beirut, P.O. Box 11-0236, Beirut, 1107 2020, Lebanon.
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Fadl N, Elbarazi I, Saleeb MRA, Youssef N, Shaaban R, Ghazy RM. Parental intention to vaccinate children against seasonal influenza in the Eastern Mediterranean region: A cross-sectional study using the health belief model. Hum Vaccin Immunother 2023; 19:2238513. [PMID: 37527814 PMCID: PMC10395193 DOI: 10.1080/21645515.2023.2238513] [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: 04/03/2023] [Revised: 07/05/2023] [Accepted: 07/12/2023] [Indexed: 08/03/2023] Open
Abstract
Seasonal influenza vaccine is the most effective strategy for reducing influenza incidence and severity. Parental decision-making regarding childhood vaccination is influenced by one's vaccine-related beliefs. A cross-sectional study was conducted to determine the role of the Health Belief Model (HBM) in predicting parental intention to vaccinate their children against influenza in the Eastern Mediterranean Region (EMR). An anonymous online survey was distributed to parents of children aged 6 months to 18 years in 14 EMR countries. Out of the 5964 participants, 28.2% intended to vaccinate their children against influenza. Urban residents (OR = 0.55, 95%CI: 0.35-0.85), decision-making regarding child's health by the father alone (OR = 0.43, 95%CI: 0.34-0.55) or the mother alone (OR = 0.78, 95%CI: 0.65-0.93), having a child with a chronic illness (OR = 0.45, 95%CI: 0.38-0.53), reporting high perceived severity, susceptibility, and benefits (OR = 0.35, 95%CI: 0.30-0.40), and cues to action (OR = 0.45, 95%CI: 0.39-0.51) were inversely associated with parental unwillingness to vaccinate their children against influenza. While parents with a higher number of children in the household (OR = 1.08, 95%CI:1.03-1.12) and higher perceived barriers (OR = 2.92, 95%CI: 2.56-3.34) showed an increased likelihood of unwillingness to vaccinate their children. Interventions targeting parental beliefs and perceptions are necessary to improve influenza vaccination acceptance and coverage among children.
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Affiliation(s)
- Noha Fadl
- Family Health Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | - Iffat Elbarazi
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, AlAin, Abu Dhabi, UAE
| | | | - Naglaa Youssef
- Department of Medical-Surgical Nursing, College of Nursing, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Ramy Shaaban
- Department of Instructional Technology and Learning Sciences, Utah State University, Logan, UT, USA
| | - Ramy Mohamed Ghazy
- Tropical Health Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt
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Tahoun MM, Ismail HM, Fiidow OA, Ashmawy R, Hammouda EA, Elbarazi I, Ghazy RM. Quality of life among the Arab population two years after COVID-19 pandemic. BMC Public Health 2023; 23:1268. [PMID: 37391817 PMCID: PMC10311886 DOI: 10.1186/s12889-023-16171-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 06/22/2023] [Indexed: 07/02/2023] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has resulted in severe consequences worldwide. Our study aims to assess the quality of life (QoL) domains and its determinants among the general population in Arab countries after two years of the COVID-19 pandemic. METHODS An anonymous online cross-sectional survey using the short version of World Health Organization QoL (WHOQOL-BREF) instrument was distributed among Arab adults in 15 Arab Countries. RESULTS A total of 2008 individuals completed the survey. Amongst them, 63.2% were 18-40 years and 63.2% were females, 26.4% had chronic disease, 39.7% confirmed having contracted COVID-19, and 31.5% had experienced the unfortunate loss of relatives due to COVID-19. The survey revealed that 42.7% reported good physical QoL, 28.6% were satisfied with psychological QoL, 32.9% had a sense of well-being in the social domain, and 14.3% had good QoL in the environmental domain. The predictors of physical domains were as follows: being a male (β = 4.23 [95%CI 2.71, 5.82]), being from low-middle income country (β = -3.79 [95%CI -5.92, -1.73]) or being from high-middle-income country (β = -2.95 [95%CI -4.93, -0.92]), having a a chronic disease (β = -9.02 [95%CI -10.62,-7.44]) having a primary/secondary education (β = -2.38 [95%CI -4.41, -0.054]), number of years of work experience ≥ 15 years (β = 3.25 [95%CI 0.83, 5.73]), income-per-capita [ranged from (β = 4.16 [95%CI -5.91, -2.40]) to (β = -11.10 [95CI%, -14.22, -8.11])], a previous COVID-19 infection (β = -2.98 [95%CI -4.41, -1.60]), and having relative died from COVID-19 (β = -1.56 [95%CI -3.01, -0.12]). The predictors of psychological domain were having a chronic disease (β = -3.15 [95%CI -4.52, -1.82]), a postgraduate education (β = 2.57 [95% CI 0.41, 4.82]), number of years of work experience ≥ 15 years (β = 3.19 [95%CI 1.14, 5.33]), income-per-capita [ranged from (β = -3.52 [95%CI -4.91, -1.92]) to (β = -10.31 [95%CI -13.22, -7.44])], and a previous COVID-19 infection (β = -1.65 [95%CI -2.83, -0.41]). The predictors of social domain were being a male (β = 2.78 [95%CI 0.93, 4.73]), being single, (β =-26.21 [-28.21, -24.32]), being from a low-income country (β = 5.85 [95%CI 2.62, 9.13]), or from a high-middle-income country (β = -3.57 [95%CI -6.10, -2.12]), having a chronic disease (β = -4.11 [95%CI -6.13, -1.11]), and income-per-capita [ranged from (β = -3.62 [95%CI -5.80, -1.41]) to (β = -11.17 [95%CI -15.41, -6.92])]. The predictors of environmental domain were being from a low-middle-income country (β = -4.14 [95%CI -6.90, -1.31), from a high-middle-income country (β = -12.46 [95%CI -14.61, -10.30]), or from a low-income-country (β = -4.14 [95%CI, -6.90, -1.32]), having a chronic disease (β = -3.66 [95%CI -5.30, -1.91]), having a primary/secondary education (β = -3.43 [95%CI -5.71, -1.13]), being not working (β = -2.88 [95%CI -5.61, -0.22]), income-per-capita [ranged from (β = -9.11 [95%CI -11.03, -7.21] to (β = -27.39 [95%CI -31.00, -23.84])], a previous COVID-19 infection (β = -1.67 [95%CI -3.22, -0.21]), and having a relative who died from COVID-19 (β = -1.60 [95%CI -3.12, -0.06]. CONCLUSION The study highlights the need for public health interventions to support the general population in the Arab countries and mitigate its impact on their QoL.
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Affiliation(s)
- Mohamed Mostafa Tahoun
- Department of Epidemiology, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | - Horeya M. Ismail
- High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | - Osman Abubakar Fiidow
- School of Public Health and Research, Mogadishu, Somali National University, Mogadishu, Somalia
| | - Rasha Ashmawy
- Department of Clinical Research, Maamora Chest Hospital, MoHP, Alexandria, Egypt
| | | | - Iffat Elbarazi
- Institute of Public Health, College of Medicine &Health Sciences, United Arab Emirates University, Al Ain, UAE
| | - Ramy Mohamed Ghazy
- Tropical Health Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt
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12
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Al-Taie A, Yilmaz ZK. Exploring the Intention and Hesitancy to Receive a Booster Dose of COVID-19 Vaccine among Patients with Comorbid Disease Conditions Using a Health Belief Model. VACUNAS 2023; 24:S1576-9887(23)00056-0. [PMID: 38620154 PMCID: PMC10308228 DOI: 10.1016/j.vacun.2023.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 06/12/2023] [Accepted: 06/20/2023] [Indexed: 04/17/2024]
Abstract
Despite the fact that the WHO recommends that adults over the age of 18 have to receive a booster dose of the COVID-19 vaccine. The willingness and intention to accept a booster dose of the COVID-19 vaccine remain major issues among the general population, particularly patients with comorbid disease conditions. The aim of this study was to assess the patterns regarding COVID-19 infection and vaccination, along with the intention and hesitancy to receive a booster dose of the COVID-19 vaccine among patients with comorbid disease conditions in Istanbul, Türkiye. Methods: This was a descriptive, cross-sectional study conducted among patients with comorbid disease conditions using a three-part, structured, validated questionnaire. Vaccine hesitancy from a booster dose of the COVID-19 vaccine was assessed using the Health Belief Model (HBM), based on a 5-point Likert-type scale. Results: The study enrolled 162 participants with a mean age of 57.2 ± 13.3 years. 97% of the respondents received the COVID-19 vaccine. Almost half of respondents (51.2%) reported receiving information about a booster dose of the COVID-19 vaccine. HBM among the participants with comorbidities showed a significant agreement regarding the perceived susceptibility (P < 0.0001), perceived severity (P < 0.0001) and perceived benefits (P < 0.0001) to receive a booster vaccine dose. There was a statistically significant correlation between the intention to receive a booster vaccine dose and education level (university education; P < 0.0001). Conclusion: A vast and significant majority of patients with chronic comorbid disease conditions who received the COVID-19 vaccine reported an intention to receive a booster dose.
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Affiliation(s)
- Anmar Al-Taie
- Clinical Pharmacy Department, Faculty of Pharmacy, Istinye University, Istanbul, Türkiye
| | - Zekiye K Yilmaz
- Clinical Pharmacy Department, Faculty of Pharmacy, Acıbadem Mehmet Ali Aydınlar University, Istanbul, Türkiye
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Ghazy RM, Sallam M, Abdullah FSA, Hussein M, Hussein MF. The Effect of Combining the COVID-19 Vaccine with the Seasonal Influenza Vaccine on Reducing COVID-19 Vaccine Rejection Among Libyans. J Epidemiol Glob Health 2023; 13:292-302. [PMID: 37171545 PMCID: PMC10176301 DOI: 10.1007/s44197-023-00107-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 04/21/2023] [Indexed: 05/13/2023] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) vaccine coverage remains low in Libya compared to other countries in the Eastern Mediterranean Region. This study aimed to evaluate the willingness of the general public in Libya to receive COVID-19 and seasonal influenza vaccines. Additionally, the study aimed to investigate the potential effect of combining the two vaccines to reduce COVID-19 vaccine rejection. METHODS An anonymous nationwide online cross-sectional survey was carried out from 1st September to 16th October 2022. Libyans aged 18 years or older were recruited using convenience and snowball sampling approaches. The participants were surveyed for sociodemographic information, health status, and vaccination attitude towards COVID-19 and seasonal influenza vaccines. RESULTS A total of 2484 participants formed the final study sample: 68.7% were females, 39.4% were aged 18-25 years, 50.4% were single, 32.5% had previous COVID-19 infection, and 47.2% experienced COVID-19 death among relatives. Three-fourths of the respondents showed COVID-19 vaccine rejection: 57.3% did not receive COVID-19 vaccination, 10.1% would not complete the primary vaccination series, and 7.8% refused booster doses. About 55.0% rejected seasonal influenza vaccination, while 1.9% reported influenza vaccine uptake and 21.2% were willing to get the influenza vaccine for the first time. Additionally, 18.8% had already received influenza vaccination in the last year and intended to get the vaccine this season, while 3.3% were unwilling to get influenza vaccination this year despite receiving it in the last influenza season. Age, sex, and occupation were significantly associated with COVID-19 and influenza vaccine rejection. Rejection of COVID-19 vaccination decreased if its combination with influenza vaccine as a single dose was suggested, with 28.2% of the COVID-19 vaccine rejector group accepting the combined vaccine as it would be safer (50.9%), needing fewer injections (24.0%), would be more effective (19.1%), and would be less expensive (3%). Approximately 73.0% of the COVID-19 vaccine rejector group refused this combination due to fear of side effects (48.7%), absence of published studies on this combination (29.8%), and considering this combination as useless (11.2%). CONCLUSION In Libya, the prevalence of COVID-19 vaccine rejection was high, while the rejection of seasonal influenza vaccination was relatively lower. If influenza and COVID-19 vaccines are administered simultaneously as a single injection, this may reduce the rejection of the COVID-19 vaccine due to better-perceived vaccine safety and efficacy besides being more convenient in terms of the number of injections and cost.
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Affiliation(s)
- Ramy Mohamed Ghazy
- Tropical Health Department, High Institute of Public Health, Alexandria University, Alexandria, 21561 Egypt
| | - Malik Sallam
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman, 11942 Jordan
- Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Amman, 11942 Jordan
- Department of Translational Medicine, Faculty of Medicine, Lund University, 22184 Malmö, Sweden
| | | | - Mai Hussein
- Clinical Research Administration, Alexandria Directorate of Health Affairs, Alexandria, Egypt
- Ministry of Health and Population, Cairo, Egypt
| | - Mohamed Fakhry Hussein
- Occupational Health and Industrial Medicine Department, High Institute of Public Health, Alexandria University, Alexandria, 21561 Egypt
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14
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Limbu YB, Gautam RK. How Well the Constructs of Health Belief Model Predict Vaccination Intention: A Systematic Review on COVID-19 Primary Series and Booster Vaccines. Vaccines (Basel) 2023; 11:vaccines11040816. [PMID: 37112728 PMCID: PMC10141697 DOI: 10.3390/vaccines11040816] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 04/02/2023] [Accepted: 04/04/2023] [Indexed: 04/29/2023] Open
Abstract
This systematic review synthesizes the findings of quantitative studies examining the relationships between Health Belief Model (HBM) constructs and COVID-19 vaccination intention. We searched PubMed, Medline, CINAHL, Web of Science, and Scopus using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and identified 109 eligible studies. The overall vaccination intention rate was 68.19%. Perceived benefits, perceived barriers, and cues to action were the three most frequently demonstrated predictors of vaccination intention for both primary series and booster vaccines. For booster doses, the influence of susceptibility slightly increased, but the impact of severity, self-efficacy, and cues to action on vaccination intention declined. The impact of susceptibility increased, but severity's effect declined sharply from 2020 to 2022. The influence of barriers slightly declined from 2020 to 2021, but it skyrocketed in 2022. Conversely, the role of self-efficacy dipped in 2022. Susceptibility, severity, and barriers were dominant predictors in Saudi Arabia, but self-efficacy and cues to action had weaker effects in the USA. Susceptibility and severity had a lower impact on students, especially in North America, and barriers had a lower impact on health care workers. However, cues to action and self-efficacy had a dominant influence among parents. The most prevalent modifying variables were age, gender, education, income, and occupation. The results show that HBM is useful in predicting vaccine intention.
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Affiliation(s)
- Yam B Limbu
- Feliciano School of Business, Montclair State University, 1 Normal Ave., Montclair, NJ 07043, USA
| | - Rajesh K Gautam
- Department of Anthropology, Dr. Harisingh Gour Central University, Sagar 470003, MP, India
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15
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Fadl N, Al Awaidy ST, Elshabrawy A, Makhlouf MSAH, Ibrahim SA, Abdel-Rahman S, Tookhy NA, Alsalmani A, Al-Saeedi M, Al-Sawalha I, El-Din MAA, Saad J, Ayoob Z, Rourou MK, Ali M, Tawati SM, Gadain YMA, Al-saidi SY, Hassan GA, Alsanafi M, Sandouk L, Youssef N, Alothman S, Yazbek S, Al-Ansi KS, Mehdad S, Adam MF, Gebreal A, Ghazy RM. Determinants of parental seasonal influenza vaccine hesitancy in the Eastern Mediterranean region: A cross-sectional study. Front Public Health 2023; 11:1132798. [PMID: 37056660 PMCID: PMC10086336 DOI: 10.3389/fpubh.2023.1132798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 03/07/2023] [Indexed: 03/30/2023] Open
Abstract
BackgroundSeasonal influenza vaccine can reduce the risk of influenza-associated hospitalizations and deaths among children. Given that parents are the primary decision makers, this study examined the parental attitude toward childhood influenza vaccine and identified determinants of vaccine hesitancy (VH) in the Eastern Mediterranean region (EMR).MethodsA cross-sectional study was conducted using an anonymous online survey in 14 EMR countries. Parents of children aged 6 months to 18 years were included. The Parent Attitude about Childhood Vaccines (PACV) was used to assess VH. Chi square test and independent t-test were used to test for association of qualitative and quantitative variables, respectively. A structural equations model (SEM) was used to identify direct and indirect determinants of parental VH.ResultsAlmost half of the parents were hesitant about vaccinating their children against influenza (50.8%). Parental VH was significantly higher among older mothers (37.06 ± 8.8 years, p = 0.006), rural residents (53.6%, p < 0.001), high-income countries residents (50.6%, p < 0.001), and mothers with higher educational levels (52.1%, p < 0.001). Parents of school-aged children (5–9 years) (55.6%, p < 0.001), children free from any comorbidities (52.5%, p < 0.001), children who did not receive routine vaccination at all (51.5%, p = 0.03), children who were not vaccinated against COVID-19 (54.3%, p < 0.001), in addition to parents who were not vaccinated against influenza (57.1%, p < 0.001) were significantly associated with increased likelihood of VH. Parents who were depending on healthcare provider as a source of information regarding vaccines were less likely to report VH (47.9%, p < 0.001), meanwhile those who used social media as their source of health information showed a significantly higher VH (57.2%, p < 0.001). The SEM suggested that mother’s age, residence, country income level, child gender, total number of children and source of information regarding vaccines had a direct effect on VH. Meanwhile, parents vaccinated against influenza, children completely or partially vaccinated with routine vaccines and children vaccinated against Coronavirus disease 2019 (COVID-19) had an indirect effect on VH.ConclusionA high proportion of included parents were hesitant to vaccinate their children against seasonal influenza. This attitude is due to many modifiable and non-modifiable factors that can be targeted to improve vaccination coverage.
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Affiliation(s)
- Noha Fadl
- Department of Family Health, High Institute of Public Health, Alexandria University, Alexandria, Egypt
- *Correspondence: Noha Fadl,
| | - Salah T. Al Awaidy
- Office of Health Affairs, Ministry of Health, Muscat, Oman
- Middle East, Eurasia and Africa Influenza Stakeholders Network (ME’NA-ISN), Cape Town, South Africa
| | - Abdelhamid Elshabrawy
- Faculty of Graduate Studies for Statistical Research, Cairo University, Cairo, Egypt
| | - Mona Sayed Aly Hassan Makhlouf
- Department of Pediatric, Al Galaa Teaching Hospital, General Organization for Teaching Hospitals and Institutes (GOTHI), Ministry of Health and Population, Cairo, Egypt
| | - Sarah Assem Ibrahim
- Faculty of Graduate Studies for Statistical Research, Cairo University, Cairo, Egypt
| | - Suzan Abdel-Rahman
- Faculty of Graduate Studies for Statistical Research, Cairo University, Cairo, Egypt
| | - Nazir Ahmad Tookhy
- Department of Paraclinic, Faculty of Veterinary Science, Herat University, Herat, Afghanistan
| | - Abdullah Alsalmani
- National Space Science and Technology Center, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Mays Al-Saeedi
- College of Pharmacy, Al Ain University, Al Ain, United Arab Emirates
| | - Ibrahim Al-Sawalha
- Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | | | | | - Zainab Ayoob
- Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | | | - Manahil Ali
- Karachi Medical and Dental College, Karachi, Pakistan
| | - Salha M. Tawati
- Department of Pharmaceutical Chemistry, Benghazi University, Benghazi, Libya
| | | | | | | | - Mariam Alsanafi
- Department of Pharmacy Practice, Faculty of Pharmacy, Kuwait University, Kuwait, Kuwait
| | - Leen Sandouk
- Faculty of Pharmacy, Arab International University, Daraa, Syria
| | - Naglaa Youssef
- Department of Medical-Surgical Nursing, College of Nursing, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Shaykhah Alothman
- Organ Transplant Pediatric Clinic, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Saja Yazbek
- Faculty of Public Health, Lebanese University, Beirut, Lebanon
| | | | - Slimane Mehdad
- Physiology and Physiopathology Research Team, Research Centre of Human Pathology Genomics, Faculty of Sciences, Mohammed V University in Rabat, Rabat, Morocco
| | | | - Assem Gebreal
- Alexandria Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Ramy Mohamed Ghazy
- Tropical Health Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt
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COVID-19 Vaccine Booster Hesitancy in Malaysia: A Web-Based Cross-Sectional Study. Vaccines (Basel) 2023; 11:vaccines11030638. [PMID: 36992222 DOI: 10.3390/vaccines11030638] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 03/06/2023] [Accepted: 03/08/2023] [Indexed: 03/18/2023] Open
Abstract
Vaccination is a key public health strategy that is known to be effective in mitigating the risk of infection and severe disease. However, in the context of the COVID-19 pandemic, the percentage (<50%) of Malaysians who have received a booster for the COVID-19 vaccine has remained stagnant over a year. This study aimed to determine the prevalence of and the factors associated with hesitancy toward the second dose of booster for the COVID-19 vaccine. A web-based cross-sectional study was conducted from August to November 2022. The Oxford Vaccine Hesitancy Scale was used to assess the hesitancy toward the second dose of booster for the COVID-19 vaccine. Simple and multiple factors logistic regressions were used to determine the predictors of hesitancy. A p-value less than 0.05 was considered to be statistically significant. Data from 798 respondents were included in the analysis. The prevalence of hesitancy toward the second booster of the COVID-19 vaccine was 26.7%. The predictors of second-booster hesitancy were older age (AOR = 1.040, 95 CI = 1.022, 1.058), having received the third dose (first booster) because of instruction by the government (AOR = 2.125, 95% CI = 1.380, 3.274), concern about serious long term side effects of the vaccine (AOR = 4.010, 95% CI = 2.218, 7.250), and opinions of close friends and immediate family members that the booster is harmful (AOR = 2.201, 95% CI = 1.280, 3.785). Conversely, factors that appear to reduce vaccine booster hesitancy were acceptance of the third dose due to the high number of cases and the increasing rate of infection (AOR = 0.548, 95% CI = 0.317, 0.947), the belief that the vaccine will decrease the risk of getting the infection (AOR = 0.491, 95% CI = 0.277, 0.870), and opinions of close friends and immediate family members that the booster is helpful (AOR = 0.479, 95% CI = 0.273, 0.840). In conclusion, more than one-fifth of Malaysians were hesitant to take the second booster of the COVID-19 vaccine. This suggests that appropriate steps that increase vaccine acceptance, taking into consideration the findings of the present study, are needed to address this issue and to foster more positive attitudes toward vaccination. The survey was available in three main languages but limited to people with internet access; hence, it would likely be biased toward younger adults and social media users and exclude those with limited or no internet access, in particular older people. Therefore, the results are not representative of the Malaysian population at large and caution should be exercised when interpreting the findings.
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Why Some People Are Hesitant to Receive COVID-19 Boosters: A Systematic Review. Trop Med Infect Dis 2023; 8:tropicalmed8030159. [PMID: 36977160 PMCID: PMC10054177 DOI: 10.3390/tropicalmed8030159] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 02/25/2023] [Accepted: 03/03/2023] [Indexed: 03/08/2023] Open
Abstract
As the COVID-19 pandemic continues and transitions to an endemic stage, booster vaccines will play an important role in personal and public health. However, convincing people to take boosters continues to be a key obstacle. This study systematically analyzed research that examined the predictors of COVID-19 booster vaccine hesitancy. A search of PubMed, Medline, CINAHL, Web of Science, and Scopus uncovered 42 eligible studies. Globally, the average COVID-19 booster vaccination hesitancy rate was 30.72%. Thirteen key factors influencing booster hesitancy emerged from the literature: demographics (gender, age, education, income, occupation, employment status, ethnicity, and marital status), geographical influences (country, region, and residency), adverse events, perceived benefit/efficacy, perceived susceptibility, perceived severity, prior history of COVID-19 infection, vaccination status, vaccination recommendations, health status, knowledge and information, skepticism/distrust/conspiracy theories, and vaccine type. Vaccine communication campaigns and interventions for COVID boosters should focus on factors influencing booster confidence, complacency, and convenience.
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Amponsah-Tabi S, Djokoto R, Opoku S, Senu E, Boakye DK, Azanu WK, Ankobea-Kokroe F, Owusu-Asubonteng G, Ansah RO, Owusu E, Ackah-Avoh E, Kwayie AA, Boateng EA, Azavil RP, Ennin F. Knowledge, attitude and acceptability of COVID-19 vaccine among residents in rural communities in Ghana: a multi-regional study. BMC Infect Dis 2023; 23:60. [PMID: 36721102 PMCID: PMC9887558 DOI: 10.1186/s12879-023-08029-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 01/24/2023] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND The Coronavirus Infectious Disease 2019 (COVID-19) pandemic has continuously affected human life with several devastating effects. Currently, there are effective vaccines to protect people from COVID-19 and the World Health Organization (WHO) has highlighted strategies to influence COVID-19 vaccine uptake in hard-to-reach communities in Ghana. However, prior studies on COVID-19 vaccine acceptability in Ghana are online surveys targeting the literates and those in urban areas, leaving residents in far-flung communities. We assessed knowledge, attitude and acceptability of COVID-19 vaccine among residents in rural communities in Ghana. METHODS This study was a community-based cross-sectional study and was conducted at three selected regions in Ghana (Northern, Ashanti and Western North) from May to November, 2021. This study included residents 15-81 years, living in the selected rural communities for more than 1 year. Study participants were recruited and questionnaires administered to collect data on knowledge, attitude and acceptance of the COVID-19 vaccine. Statistical analyses were performed using Statistical Package for Social Science (SPSS) version 26.0 and GraphPad Prism Version 8.0 software. RESULTS Of the 764 participants included in this study, more than half had inadequate knowledge (55.0%), poor attitudes (59.4%) and bad perception about COVID-19 vaccine (55.4%). The acceptability of COVID-19 vaccine in this study was 41.9%. The acceptability of COVID-19 vaccine in Ashanti, Northern and Western North regions were 32.5%, 26.2% and 29.6% respectively. In a multivariate logistic regression analysis, receiving recent or previous vaccine such as HBV vaccine [aOR = 1.57, 95% CI (1.23-3.29), p = 0.002], having good attitude towards COVID-19 vaccine [aOR = 61.47, 95% CI (29.55-127.86), p < 0.0001] and having good perception about the COVID-19 vaccine [aOR = 3.87, 95% CI (1.40-10.72), p < 0.0001] were independently associated with higher odds of accepting COVID-19 vaccine. CONCLUSION More than half of residents in Ghanaian rural communities have inadequate knowledge, poor attitudes and bad perception about COVID-19 vaccine. The acceptability of COVID-19 vaccine is generally low among rural residents in Ashanti, Northern and Western North regions of Ghana. Residents living in hard-to-reach communities must be educated about the benefits of COVID-19 vaccine to achieve effective vaccination program.
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Affiliation(s)
- Seth Amponsah-Tabi
- grid.415450.10000 0004 0466 0719Department of Obstetrics and Gynaecology, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Rex Djokoto
- grid.415450.10000 0004 0466 0719Department of Obstetrics and Gynaecology, Komfo Anokye Teaching Hospital, Kumasi, Ghana ,grid.9829.a0000000109466120Department of Obstetrics and Gynaecology, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Stephen Opoku
- grid.9829.a0000000109466120Department of Medical Diagnostics, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana ,grid.9829.a0000000109466120Department of Molecular Medicine, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Ebenezer Senu
- grid.9829.a0000000109466120Department of Molecular Medicine, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Derrick Kyei Boakye
- grid.9829.a0000000109466120Department of Medical Diagnostics, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Wisdom Klutse Azanu
- grid.449729.50000 0004 7707 5975Department of Obstetrics and Gynaecology, University of Health and Allied Sciences, Ho, Ghana
| | - Frank Ankobea-Kokroe
- grid.415450.10000 0004 0466 0719Department of Obstetrics and Gynaecology, Komfo Anokye Teaching Hospital, Kumasi, Ghana ,grid.9829.a0000000109466120Department of Obstetrics and Gynaecology, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Gerald Owusu-Asubonteng
- grid.415450.10000 0004 0466 0719Department of Obstetrics and Gynaecology, Komfo Anokye Teaching Hospital, Kumasi, Ghana ,grid.9829.a0000000109466120Department of Obstetrics and Gynaecology, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Richard Owusu Ansah
- grid.9829.a0000000109466120Department of Medical Diagnostics, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Emmanuel Owusu
- Laboratory Department, Nyaho Medical Center, Greater Accra Region, Accra, Ghana
| | - Emmanuel Ackah-Avoh
- Laboratory Department, Nyaho Medical Center, Greater Accra Region, Accra, Ghana
| | - Afia Agyapomaa Kwayie
- grid.9829.a0000000109466120Department of Medical Diagnostics, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Eric Appiah Boateng
- grid.9829.a0000000109466120Department of Medical Diagnostics, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Richard Pul Azavil
- grid.460777.50000 0004 0374 4427Laboratory Department, Tamale Teaching Hospital, Northern Region, Tamale, Ghana
| | - Frederick Ennin
- Laboratory Department, Bibiani Government Hospital, Western North Region, Bibiani, Ghana
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19
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Ghazy RM, Yazbek S, Gebreal A, Hussein M, Addai SA, Mensah E, Sarfo M, Kofi A, AL-Ahdal T, Eshun G. Monkeypox Vaccine Acceptance among Ghanaians: A Call for Action. Vaccines (Basel) 2023; 11:vaccines11020240. [PMID: 36851118 PMCID: PMC9959510 DOI: 10.3390/vaccines11020240] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/13/2023] [Accepted: 01/18/2023] [Indexed: 01/26/2023] Open
Abstract
Background: Ghana ranked 31st worldwide and 3rd in Africa in the number of confirmed cases worldwide. We aimed to assess the intention to receive the monkeypox (MPOX) vaccine and its associated psychological antecedents among the Ghanaian population. Methods: A cross-sectional online survey was conducted in Ghana from November to December 2022. Snowball sampling was used to recruit participants via social media platforms, such as WhatsApp, LinkedIn, Telegram, and Facebook. The validated 5C scale was used to assess five psychological factors that influence vaccination behavior and intent: confidence, complacency, constraints, calculation, and collective responsibility. Results: The study drew 605 participants; their mean age was 30.0 ± 6.8; 68.1% were single; 60.8 % were males, and 51.9% were living in Greater Accra (The capital and largest city of Ghana). About 53.9% of the studied Ghanaian population did not intend to receive the MPOX vaccination. Vaccine acceptance among non-healthcare workers (non-HCWs) was significantly lower than among HCWs (41.7 vs. 55.3, p < 0.001). The determinants of vaccine acceptance were male gender (AOR = 1.48, 95% CI, 1.00-2.18, p = 0.049), urban residence (AOR = 0.63, 95% CI, 0.41-0.96, p = 0.033), refusal of coronavirus 2019 vaccine (AOR = 0.29, 95% CI, 0.16-0.52, p < 0.001), confidence in vaccination ((AOR = 2.45, 95% CI, 1.93-3.15, and p < 0.001), and collective responsibility (AOR = 1.34, 95% CI, 1.02-1.75, p = 0.034)). Conclusions: The participants in this study did not show high levels of intention to accept the MPOX vaccination. Consequently, tailoring the efforts aiming to promote MPOX vaccination is needed especially among non-HCWs through increasing their confidence in vaccine effectiveness and safety and promoting the importance of self-vaccination to protect others.
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Affiliation(s)
- Ramy Mohamed Ghazy
- Tropical Health Department, High Institute of Public Health, Alexandria University, Alexandria 21561, Egypt
- Correspondence: (R.M.G.); (T.A.-A.)
| | - Saja Yazbek
- Faculty of Public Health, Lebanese University, Beirut 6573, Lebanon
| | - Assem Gebreal
- Alexandria Faculty of Medicine, Alexandria University, Alexandria 21568, Egypt
| | - Mai Hussein
- Clinical Research Administration, Alexandria Directorate of Health Affairs, Alexandria 21554, Egypt
- Ministry of Health and Population, Cairo 71529, Egypt
| | - Sylvia Agyeman Addai
- Department of Science & Department of Educational Administration and Management, University of Education, Winneba CE-119-9961, Ghana
- Business School, Datalink University, Tema GN-03-266605, Ghana
- Human Resource & Marketing Department, Central University, Miotso-Prampram GT-001-5571, Ghana
| | - Ernestina Mensah
- Department of Midwifery, Seventh Day Adventist Nursing and Midwifery Training College, Agona-Asamang P.O. Box GN 37, Ghana
| | - Michael Sarfo
- School of Human and Health Sciences, University of Huddersfield, Huddersfield HD1 3DH, UK
| | - Agyapong Kofi
- Manhyia Government Hospital, Kumasi AK-039-5028, Ghana
| | - Tareq AL-Ahdal
- Institute of Global Health (HIGH), Heidelberg University, Neuenheimer Feld 130/3, 69120 Heidelberg, Germany
- Correspondence: (R.M.G.); (T.A.-A.)
| | - Gilbert Eshun
- Seventh Day Adventist Hospital, Agona-Asamang AZ-0581-8540, Ghana
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20
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Sookaromdee P, Wiwanitkit V. Perceptions of COVID-19 Vaccination in Patients with Genitourinary Cancers: Correspondence. Cancer Invest 2023; 41:107-108. [PMID: 36398598 DOI: 10.1080/07357907.2022.2149773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
| | - Viroj Wiwanitkit
- Department of Pharmaceutical Sciences, University Centre for Research & Development, Chandigarh University Gharuan, Mohali, India
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21
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Elkhadry SW, Salem TAEH, Elshabrawy A, Goda SS, Bahwashy HAA, Youssef N, Hussein M, Ghazy RM. COVID-19 Vaccine Hesitancy among Parents of Children with Chronic Liver Diseases. Vaccines (Basel) 2022; 10:vaccines10122094. [PMID: 36560504 PMCID: PMC9783335 DOI: 10.3390/vaccines10122094] [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] [Received: 11/22/2022] [Revised: 12/01/2022] [Accepted: 12/05/2022] [Indexed: 12/13/2022] Open
Abstract
Children with chronic medical conditions are more susceptible to developing a serious negative outcome from corona virus disease 2019 (COVID-19) than healthy children. This study investigated the extent of COVID-19 vaccine hesitancy (VH) and its predictors in parents of children with chronic liver disease (CLD) in Egypt. Methods: A cross-sectional study was conducted at the National Liver Institute from September to October 2022, using a random sampling method. Data were collected using the validated Arabic version of parents’ attitudes about childhood vaccines (PACV) scale. Structural equation modeling (SEM) and discriminant analysis were used to identify direct and indirect determinants of VH. Results: Of the 173 participating parents, 81.5% hesitated to vaccinate their child. Relevant characteristics for hesitancy included being the mother of the child (88.2%), younger than 40 years (92.9%), illiterate (92%), unemployed (88.8%), without health insurance (87.8%), unvaccinated against COVID-19 (97.2%), refused to complete vaccinations (85.7%), and not having chronic disease (85.7%) (p < 0.05). Previous COVID-19 infection of children motivated vaccination (p < 0.0001). Median total PACV, attitude, and trust scores were significantly higher in the hesitant group than the vaccinated group (p = 0.023). SEM suggests that child age and family size have a direct effect, while education level, and income have indirect effects on parents’ hesitancy. The model showed acceptable goodness of fit (GFI = 0.994, CFI = 1, RMSEA < 0.0001). A 92.9% corrected classification of the discriminator VH variables was determined using the discriminant analysis model (safety and efficacy, attitude and trust, child age, and family size). Conclusions: Many socioeconomic factors significantly affect parents’ attitudes toward their child’s vaccination. Thus, increasing parents’ awareness of the importance of childhood vaccination, especially among this risky group, may enhance their decision-making ability regarding vaccinating their children.
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Affiliation(s)
- Sally Waheed Elkhadry
- Department of Epidemiology and Preventive Medicine, National Liver Institute, Menoufia University, Menoufia 32511, Egypt
- Correspondence: (S.W.E.); (R.M.G.); Tel.: +200-100-366-0120 (R.M.G.)
| | - Tahany Abd El Hameed Salem
- Department of Pediatric Hepatology, Gastroenterology, and Nutrition, National Liver Institute, Menoufia University, Menoufia 32511, Egypt
| | - Abdelhamid Elshabrawy
- Department of Bio Statistics and Demography, Faculty of Graduate Studies for Statistical Research, Cairo University, Cairo 12556, Egypt
| | - Shymaa Sami Goda
- Department of Pediatric Hepatology, Gastroenterology, and Nutrition, National Liver Institute, Menoufia University, Menoufia 32511, Egypt
| | - Howyda Ali Al Bahwashy
- Department of Pediatric Hepatology, Gastroenterology, and Nutrition, National Liver Institute, Menoufia University, Menoufia 32511, Egypt
| | - Naglaa Youssef
- Department of Medical-Surgical Nursing, College of Nursing, Princess Nourah bint Abdulrahman University, Riyadh 11671, Saudi Arabia
| | - Mai Hussein
- Alexandria Clinical Research Administration, Health Affairs Directorate, Ministry of Health and Population, Alexandria 21554, Egypt
| | - Ramy Mohamed Ghazy
- Tropical Health Department, High Institute of Public Health, Alexandria University, Alexandria 21561, Egypt
- Correspondence: (S.W.E.); (R.M.G.); Tel.: +200-100-366-0120 (R.M.G.)
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22
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Abdelmoneim SA, Sallam M, Hafez DM, Elrewany E, Mousli HM, Hammad EM, Elkhadry SW, Adam MF, Ghobashy AA, Naguib M, Nour El-Deen AES, Aji N, Ghazy RM. COVID-19 Vaccine Booster Dose Acceptance: Systematic Review and Meta-Analysis. Trop Med Infect Dis 2022; 7:298. [PMID: 36288039 PMCID: PMC9611447 DOI: 10.3390/tropicalmed7100298] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/03/2022] [Accepted: 10/04/2022] [Indexed: 11/17/2022] Open
Abstract
The World Health Organization (WHO) recommended coronavirus disease 2019 (COVID-19) booster dose vaccination after completing the primary vaccination series for individuals ≥18 years and most-at-risk populations. This study aimed to estimate the pooled proportion of COVID-19 vaccine booster dose uptake and intention to get the booster dose among general populations and healthcare workers (HCWs). We searched PsycINFO, Scopus, EBSCO, MEDLINE Central/PubMed, ProQuest, SciELO, SAGE, Web of Science, Google Scholar, and ScienceDirect according to PRISMA guidelines. From a total of 1079 screened records, 50 studies were extracted. Meta-analysis was conducted using 48 high-quality studies according to the Newcastle-Ottawa Scale quality assessment tool. Using the 48 included studies, the pooled proportion of COVID-19 vaccine booster dose acceptance among 198,831 subjects was 81% (95% confidence interval (CI): 75-85%, I2 = 100%). The actual uptake of the booster dose in eight studies involving 12,995 subjects was 31% (95% CI: 19-46%, I2 = 100%), while the intention to have the booster dose of the vaccine was 79% (95% CI: 72-85%, I2 = 100%). The acceptance of the booster dose of COVID-19 vaccines among HCWs was 66% (95% CI: 58-74%), I2 = 99%). Meta-regression revealed that previous COVID-19 infection was associated with a lower intention to have the booster dose. Conversely, previous COVID-19 infection was associated with a significantly higher level of booster dose actual uptake. The pooled booster dose acceptance in the WHO region of the Americas, which did not include any actual vaccination, was 77% (95% CI: 66-85%, I2 = 100%). The pooled acceptance of the booster dose in the Western Pacific was 89% (95% CI: 84-92%, I2 = 100), followed by the European region: 86% (95% CI: 81-90%, I2 = 99%), the Eastern Mediterranean region: 59% (95% CI: 46-71%, I2 = 99%), and the Southeast Asian region: 52% (95% CI: 43-61%, I2 = 95). Having chronic disease and trust in the vaccine effectiveness were the significant predictors of booster dose COVID-19 vaccine acceptance. The global acceptance rate of COVID-19 booster vaccine is high, but the rates vary by region. To achieve herd immunity for the disease, a high level of vaccination acceptance is required. Intensive vaccination campaigns and programs are still needed around the world to raise public awareness regarding the importance of accepting COVID-19 vaccines needed for proper control of the pandemic.
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Affiliation(s)
- Shaimaa Abdelaziz Abdelmoneim
- Clinical Research Administration, Alexandria Directorate of Health Affairs, Egyptian Ministry of Health and Population, Alexandria 21554, Egypt
| | - Malik Sallam
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman 11942, Jordan
- Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Amman 11942, Jordan
| | - Dina Mohamed Hafez
- Pharmacy Department, Alexandria University Students Hospital, Alexandria 5422023, Egypt
| | - Ehab Elrewany
- Tropical Health Department, High Institute of Public Health, Alexandria University, Alexandria 21561, Egypt
| | - Hesham Metwalli Mousli
- Continuous Quality Improvement & Patient Safety Department, Alexandria Urology Hospital, Alexandria 5442045, Egypt
| | | | - Sally Waheed Elkhadry
- Department of Epidemiology and Preventive Medicine, National Liver Institute, Menoufia University, Menoufia 32511, Egypt
| | | | | | - Manal Naguib
- Egyptian Ministry of Health and Population, Alexandria 21554, Egypt
| | | | - Narjiss Aji
- Faculty of Medicine and Pharmacy of Rabat, Mohammed V University, Rabat 10100, Morocco
| | - Ramy Mohamed Ghazy
- Tropical Health Department, High Institute of Public Health, Alexandria University, Alexandria 21561, Egypt
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