Acceptance and Factors Influencing Acceptance of COVID-19 Vaccine in a Romanian Population

Moral characteristics predicting COVID-19 vaccination

OBJECTIVE

The current study aims to assess, for the first time, whether vaccination is predicted by different behavioral and cognitive aspects of moral decision-making.

BACKGROUND

Studies linking moral factors to vaccination have largely examined whether vaccination decisions can be explained by individual differences in the endorsement of various principles and norms central to deontology-based arguments in vaccination ethics. However, these studies have overlooked whether individuals prioritize norms over other considerations when making decisions, such as maximizing consequences (utilitarianism).

METHOD

In a sample of 1492 participants, the current study assessed whether vaccination is explained by individual differences in three aspects of moral decision-making (consequence sensitivity, norm sensitivity, and action tendency), while also considering ethics position (idealism, relativism) and moral identity.

RESULTS

Supportive vaccination (vaccine uptake accompanied by a positive attitude toward vaccines) was associated with utilitarianism (increased consequence sensitivity) and increased tolerance to risks and harm toward others. Meanwhile, although those in the non-vaccinated group was associated with higher harm sensitivities, they neither supported nor received the COVID vaccines (when vaccines prevent harm from infection).

CONCLUSION

Pro-vaccination messages may be made more effective by addressing perceptions of harms associated with vaccines and infections, respectively.

Prevalence and factors of COVID-19 vaccine refusal among solid cancer patients in China: an application of the health belief model

Introduction

It is essential to protect cancer patients from contracting COVID-19 through vaccination. A majority of cancer patients are recommended by international health authorities to take up the vaccines. COVID-19 vaccine refusal among cancer patients during the pandemic period is under-researched. This study investigated factors of vaccine refusal based on the Health Belief Model (HBM).

Methods

A cross-sectional study was conducted among female breast cancer patients, male/female thyroid cancer patients, and gynecological cancer patients in Shantou, China from April to August 2022 (n = 1,115). Multinomial logistic regression analysis adjusted for socio-demographics was conducted to test factors of COVID-19. Adjusted odds ratios of the two models comparing vaccine refusal vs. "vaccine non-refusal" and vaccine refusal vs. ever-vaccination were derived and presented.

Results

Of all the participants, the prevalence of vaccine refusal, "vaccine non-refusal," and ever-vaccination was 25.9, 22.2, and 51.8%, respectively. In both multinomial logistic regression models, significant factors of vaccine refusal included socio-demographics (age, education level, employment status, monthly household income, cancer type, duration since cancer diagnosis, current treatment status) and some vaccine-related HBM (perceived benefits, perceived barriers, cue to action, and self-efficacy). Perceived severity of COVID-19 was significant only in the vaccine refusal vs. ever-vaccination model. In neither model, perceived susceptibility to contract COVID-19 was statistically significant.

Conclusion

About ¼ of the participants expressed vaccine refusal. Interventions are warranted. Future longitudinal studies are needed to verify this study's findings. Pilot interventions should also be launched to test effectiveness of interventions modifying the significant HBM factors found in this study.

Survey upon the Reasons of COVID-19 Vaccination Acceptance in Romania

Aim: The present study aims to observe the reasons for which the participants have chosen to uptake one of the COVID-19 vaccines approved in Romania. Thus, it will help us to determine whether the reasons are medical in nature, with the respondents’ scope to stay healthy, or if there are other motivations. High rates of vaccine acceptance are essential in the struggle against the COVID-19 pandemic, and trust indicators in other inoculations may be vital for the good management of the vaccination campaign. Methods: The research consisted in applying an online questionnaire in the period January–March 2022 during the fifth wave of COVID-19. The individuals in the target group had to comply with three conditions: they should be inoculated, at least 18 years of age and Romanian residents. The questionnaire was administered to 2297 people and structured to obtain socio-demographic data, determine confidence in mandatory and optional vaccines (rotavirus, hepatitis A, meningococcal vaccine, etc.) and extract the reasons why respondents chose to be vaccinated. Results: The data extracted from the questionnaire reveal a high rate of confidence of participants in the vaccines included in the national vaccination scheme (98.6%) and in the optional vaccines other than anti-COVID-19 (97.2%). Of the respondents, 23.4% had at least one positive test for COVID-19. Although the entire sample is vaccinated against the SARS-CoV-2 virus, the reasons behind the decision to vaccinate are not only medical in nature, thus, 18.3% were motivated by “protecting their own health/protection against the virus”, 17% due to “fear of the disease”, 8.8% for getting back to normal life and ending the pandemic and 8.5% due to government restrictions/vaccination certificate. Conclusions: In our study, we were able to validate the research hypothesis that the reasons for vaccine acceptance are multiple and not only medical (health protection, existing co-morbidities, etc.) and to show that although vaccination has been accepted, some participants believe in conspiracy theories, including those that try to convince people of the harmfulness of the vaccine. In addition, by applying Pearson, Kendall and Spearman correlation tests, we observed that indicators showing high confidence in optional vaccines relate strongly with the decision to vaccinate against COVID-19.