Vaccinated and Unvaccinated Risk Perceptions and Motivations for COVID-19 Preventive Measures Based on EPPM-A Polish Qualitative Pilot Study

COVID-19 Vaccination Effectiveness in the General Population of an Italian Province: Two Years of Follow-Up

We carried out a cohort study on the overall population of the province of Pescara, Italy, to assess the real-world effectiveness of SARS-CoV-2 vaccination against infection, severe, or lethal COVID-19, two years after the start of the vaccination campaign. We included all the resident or domiciled subjects, and extracted the official demographic, vaccination, COVID-19, hospital and co-pay exemption datasets from 1 January 2021, up to 15 February 2023. Cox proportional hazards analyses were adjusted for gender, age, diabetes, hypertension, COPD, major cardio- and cerebrovascular events, cancer, and kidney diseases. Throughout the follow-up (466 days on average), 186,676 subjects received greater than or equal to three vaccine doses (of ChAdOx1 nCoV-19, BNT162b2, mRNA-1273, NVX-CoV2373, or JNJ-78436735), 47,610 two doses, 11,452 one dose, and 44,989 none. Overall, 40.4% of subjects were infected with SARS-CoV-2. Of them, 2.74% had severe or lethal (1.30%) COVID-19. As compared to the unvaccinated, the individuals who received greater than or equal to one booster dose showed a ≥85% lower risk of severe or lethal COVID-19. A massive impact of vaccination was found among the elderly: 22.0% of the unvaccinated, infected individuals died, as opposed to less than 3% of those who received greater than or equal to three vaccine doses. No protection against infection was observed, although this finding was certainly influenced by the Italian restriction policies to control the pandemic. Importantly, during the Omicron predominance period, only the group who received at least a booster dose showed a reduced risk of COVID-19-related death.

Attitudes towards booster, testing and isolation, and their impact on COVID-19 response in winter 2022/2023 in France, Belgium, and Italy: a cross-sectional survey and modelling study

Background

European countries are focusing on testing, isolation, and boosting strategies to counter the 2022/2023 winter surge due to SARS-CoV-2 Omicron subvariants. However, widespread pandemic fatigue and limited compliance potentially undermine mitigation efforts.

Methods

To establish a baseline for interventions, we ran a multicountry survey to assess respondents’ willingness to receive booster vaccination and comply with testing and isolation mandates. Integrating survey and estimated immunity data in a branching process epidemic spreading model, we evaluated the effectiveness and costs of current protocols in France, Belgium, and Italy to manage the winter wave.

Findings

The vast majority of survey participants (N = 4594) was willing to adhere to testing (>91%) and rapid isolation (>88%) across the three countries. Pronounced differences emerged in the declared senior adherence to booster vaccination (73% in France, 94% in Belgium, 86% in Italy). Epidemic model results estimate that testing and isolation protocols would confer significant benefit in reducing transmission (17–24% reduction, from R = 1.6 to R = 1.3 in France and Belgium, to R = 1.2 in Italy) with declared adherence. Achieving a mitigating level similar to the French protocol, the Belgian protocol would require 35% fewer tests (from 1 test to 0.65 test per infected person) and avoid the long isolation periods of the Italian protocol (average of 6 days vs. 11). A cost barrier to test would significantly decrease adherence in France and Belgium, undermining protocols’ effectiveness.

Interpretation

Simpler mandates for isolation may increase awareness and actual compliance, reducing testing costs, without compromising mitigation. High booster vaccination uptake remains key for the control of the winter wave.

Funding

The 10.13039/501100000780European Commission, ANRS–Maladies Infectieuses Émergentes, the Agence Nationale de la Recherche, the Chaires Blaise Pascal Program of the Île-de-France region.

'COVID Is Coming, and I'm Bloody Scared': How Adults with Co-Morbidities' Threat Perceptions of COVID-19 Shape Their Vaccination Decisions

Adults with comorbidities have faced a high risk from COVID-19 infection. However, Western Australia experienced relatively few infections and deaths from 2020 until early 2022 compared with other OECD countries, as hard border policies allowed for wide-scale vaccination before mass infections began. This research investigated the thoughts, feelings, risk perceptions, and practices of Western Australian adults with comorbidities aged 18-60 years in regard to COVID-19 disease and COVID-19 vaccines. We conducted 14 in-depth qualitative interviews between January and April 2022, just as the disease was starting to circulate. We coded results inductively and deductively, combining the Extended Parallel Process Model (EPPM) and vaccine belief models. Non-hesitant participants believed COVID-19 vaccines were safe and effective at mitigating COVID-19's threat and subsequently got vaccinated. Vaccine hesitant participants were less convinced the disease was severe or that they were susceptible to it; they also did not consider the vaccines to be sufficiently safe. Yet, for some hesitant participants, the exogenous force of mandates prompted vaccination. This work is important to understand how people's thoughts and feelings about their comorbidities and risks from COVID-19 influence vaccine uptake and how mandatory policies can affect uptake in this cohort.

Barriers and Facilitators to COVID-19 Vaccine Uptake among Polish Patients: A Qualitative Interview Study

The decision to receive a COVID-19 vaccine is influenced by a variety of individual and contextual factors. However, there are very few studies that analyse individual vaccination decisions using a qualitative methodology. To close this gap, we conducted a qualitative interview study to examine the opinions and experiences with the vaccine among patients previously hospitalized due to COVID-19, including barriers and facilitators to vaccine uptake. An exploratory qualitative study, using semi-structured telephone interviews, was conducted among 22 patients admitted for COVID-19 in Poland in 2022. Opinions of patients previously hospitalized with COVID-19 on vaccination were varied. Barriers to COVID-19 vaccine uptake stemmed from concerns about vaccine safety, patients' religious beliefs, and negative stories. High disease severity and anxiety over personal and family health were important arguments in favour of receiving the COVID-19 vaccine. The study findings indicated the need for ongoing health education by healthcare staff as well as coordination and integration of multi-sectoral institutional measures regarding COVID-19 prevention strategies as well as increased public health initiatives on social media and engagement of community leaders for awareness about vaccines and vaccination. It is crucial to build trust in COVID-19 vaccinations among the general public by disseminating reliable information through trustworthy and credible sources. However, it ought to be emphasised that, regardless of the measures taken, some individuals will remain unconvinced about receiving a COVID-19 vaccine.