Acceptability of Healthcare Professionals to Get Vaccinated against COVID-19 Two Weeks before Initiation of National Vaccination

When the first vaccine arrived: An investigation of factors that influenced the intention of health care workers in the national health system of Greece to be vaccinated against the SARS COV-2 virus during the first trimester of vaccine arrival

BACKGROUND

COVID-19 vaccination started in Greece in the last days of December 2020. Health care workers (HCWs) of the public national health system (NHS) were on the frontline and they would be role models for all the citizens.

AIM

Investigation of the intention and hesitation of HCWs (doctors, nurses, and nursing assistants) of the NHS of Greece, regarding the vaccine against SARS COV-2 virus and the factors that affect them, during the first trimester of the availability of vaccines, in the country.

METHODS

A multicenter cross-sectional study was conducted in Greece among health professionals (n = 2484) of the NHS. Data were collected with the use of an online questionnaire through snowballing sampling.

RESULTS

Acceptance of a safe and effective COVID- 19 vaccines was higher among doctors (85.6%), followed by nurses (66.3%), and nursing assistants (64.1%). This study confirms pre-existing research on the interaction of gender, age, quality of personal information, educational level, training by the employer, and cognitive background regarding viruses and vaccines.

CONCLUSION

In conclusion, our study showed that once a vaccine was available, most HCWs were willing to be vaccinated. These findings could be used in the future to tailor communication and promotion campaigns, using anthropocentric strategies.

Prevalence and Factors Affecting Willingness to Accept or Refuse Vaccination against COVID-19 among Healthcare Professionals in Southern Tunisia

BACKGROUND

The COVID-19 pandemic continues to spread throughout the world causing serious morbidity and mortality. Health care professionals (HCP) are on the front line in the face of this pandemic and are identified as priorities for COVID-19 vaccination. This study aimed to estimate the acceptability rate of the COVID-19 vaccination among HCP and to identify their predisposing factors. Methods: This was a cross-sectional study using an anonymous self-administered questionnaire including a randomized sample of HCP in Southern Tunisia, on March-April 2021. Results: Among 300 participants, the COVID-19 vaccine acceptability rate was 65.3%. Factors independently associated with vaccine acceptability were age groups <30 years [Adjusted Odds Ratio (AOR)=4.36; p = 0.002)], urbanity of residence (AOR = 3.44; p = 0.027), medical professional category (AOR = 2.69; p = 0.023) and caring for coronavirus infected patients (AOR = 2.32; p = 0.047). Belief that COVID-19 vaccination is important to work safely as a health care provider (AOR = 3.26; p = 0.013), should be available for all HCP (AOR = 17.98; p = 0.004) and has been quickly developed before it has been thoroughly vetted and tested for efficacy and safety (AOR = 5.88; p < 0.01) were independently associated with willingness to accept vaccine. Planning to get a COVID-19 vaccine for the next years and recommending it to the family were independent predictive factors of accepting COVID-19 vaccine ((AOR = 6.88; p < 0.001) and (AOR = 25.03; p < 0.001), respectively).Conclusion: The acceptance rate of vaccination against COVID-19 among Tunisian HCP is still low in South Tunisian hospitals. Socio-demographic, cultural and professional factors predisposing to the vaccination willingness were highlighted. Combating the vaccine hesitancy of HCP through enhancing sensibilization campaigns is essential to promote vaccination in general population.

COVID-19 Vaccination Hesitancy among Healthcare Workers-A Review

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

Physicians' Perception About the Side Effects of COVID-19 Vaccine and Their Role in Vaccination Program

INTRODUCTION

The Coronavirus disease 2019 (COVID-19) caused many problems in the health sector. Effective and safe vaccines are the only tool to combat the COVID-19 disease. Researchers and regulatory agencies have made efforts to develop such vaccines and healthcare professionals were prioritized for the vaccination program as first-line care providers. Considering this prioritization, we aimed to assess the physicians' perceptions regarding the side effects of the COVID-19 vaccine.

METHODS

An interview-based study was conducted from May 5 May to November 5, 2021 (6 months) in a teaching hospital in the capital city of Islamabad, Pakistan.

RESULTS

Among the 200 physicians who agreed to participate in the interview, 74% were male. A total of 94% did not experience any side effects after receiving the COVID-19 vaccine, regardless of the type of vaccine; 6% experienced side effects. Furthermore, 90% of physicians were afraid of side effects due to the high number of vaccine doses.

CONCLUSION

Conclusively, physicians had a positive perception regarding the COVID-19 vaccine. Healthcare authorities and related departments must take precautions to ensure the effective and safe COVID-19 vaccine to change the perceptions of physicians who had a negative perception. This will not only reduce the reluctance among physicians regarding administering COVID-19 vaccine, but will also boost and facilitate the vaccination program for the general public as well.

Physicians' Perspective on Vaccine-Hesitancy at the Beginning of Israel's COVID-19 Vaccination Campaign and Public's Perceptions of Physicians' Knowledge When Recommending the Vaccine to Their Patients: A Cross-Sectional Study

Because public healthcare workers (HCWs) are at the forefront of the battle against COVID-19, they must be able to provide vaccination information to their patients and respond to their anxieties and concerns. This research objectives were to (1) examine physicians' perceptions of how they received information about the Pfizer COVID-19 vaccine, their attitudes toward hesitant colleagues, and their own knowledge and self-efficacy in communicating information to their patients, and (2) to examine the public's perceptions of physicians' knowledge when recommending the COVID-19 vaccine to their patients. At the beginning of the vaccination campaign, a survey examined the attitudes of physicians in the Israeli public healthcare system (n = 295) regarding the Pfizer vaccine. In addition, the attitudes of a representative sample (n = 500) of the Israeli adult population (age 18+) were examined through interviews. Most of the participating physicians (81%) reported they had already been vaccinated or intended to be vaccinated. When asked about their reasons for vaccine hesitancy, 27% cited concerns about long-term side effects and doubts about the vaccine's effectiveness in preventing contagion. They cited system pressure and departmental norms as explanations for their eventual compliance. Moreover, they saw the system as less tolerant of hesitant physicians, while they themselves tend to be more tolerant. The results of the survey of the public showed that mostly young people (under 44) who tend to be critical believe that physicians do not have sufficient knowledge to make recommendations about the COVID-19 vaccine. The findings indicate that the health system should employ complete transparency in conveying the advantages and disadvantages of the COVID-19 vaccine to physicians. The system should be more tolerant of physicians' worries and concerns and grant legitimacy to their reservations and misgivings. Moreover, medical studies should reinforce physicians' immunological knowledge regarding vaccinations so they can help their patients make informed decisions.

COVID-19 Vaccine Refusal among Nurses Worldwide: Review of Trends and Predictors

COVID-19 vaccination hesitancy has become a major concern around the world. Recent reports have also highlighted COVID-19 vaccination hesitancy in healthcare workers. Despite media reports and scientific publications, little is known about the extent and predictors of COVID-19 vaccination refusal among nurses. Thus, the purpose of this study was to assess COVID-19 vaccine refusal rates among nurses globally and to explore the reasons for refusal and factors associated with the uptake of the vaccines. A scoping review of the published literature was conducted, and a final pool of 51 studies (n = 41,098 nurses) from 36 countries was included in this review. The overall pooled prevalence rate of COVID-19 vaccine refusal among 41,098 nurses worldwide was 20.7% (95% CI = 16.5-27%). The rates of vaccination refusal were higher from March 2020-December 2020 compared to the rates from January 2021-May 2021. The major reasons for COVID-19 vaccine refusal were concerns about vaccine safety, side effects, and efficacy; misinformation and lack of knowledge; and mistrust in experts, authorities, or pharmaceutical companies. The major factors associated with acceptance of the vaccines were: male sex, older age, and flu vaccination history. Evidence-based strategies should be implemented in healthcare systems worldwide to increase the uptake of COVID-19 vaccines among nurses to ensure their safety and the safety of their patients and community members.

Systematic Review and Meta-Analysis of COVID-19 Vaccination Acceptance

INTRODUCTION

Vaccination is an essential intervention to curb the coronavirus disease 2019 (COVID-19) pandemic. This review aimed to estimate the pooled proportion of COVID-19 vaccine acceptance worldwide.

METHODS

A systematic search of the MEDLINE (PubMed) database using "COVID-19," "vaccine" and "acceptance" to obtain original research articles published between 2020 and July 2021. Only studies with full text and that were published in English were included. The Joanna Briggs Institute meta-analysis was used to assess the data quality. The meta-analysis was performed using generic inverse variance with a random-effects model using the Review Manager software.

RESULTS

A total of 172 studies across 50 countries worldwide were included. Subgroup analyses were performed with regard to vaccine acceptance, regions, population, gender, vaccine effectiveness, and survey time. The pooled proportion of COVID-19 vaccine acceptance was 61% (95% CI: 59, 64). It was higher in Southeast Asia, among healthcare workers, in males, for vaccines with 95% effectiveness, and during the first survey.

CONCLUSION

COVID-19 vaccine acceptance needs to be increased to achieve herd immunity to protect the population from the disease. It is crucial to enhance public awareness of COVID-19 vaccination and improve access to vaccines.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO 2021, identifier CRD42021268645.

Perceptions and Experiences of COVID-19 Vaccine Side-Effects Among Healthcare Workers in Southern Ethiopia: A Cross-Sectional Study

Background

We examined the perceptions of healthcare workers about the side-effects of COVID-19 vaccine and the types of side-effects they experienced in the post-vaccination period.

Methods

An institutional-based cross-sectional survey research design was used in which a semi-structured questionnaire was distributed to collect quantitative data from healthcare workers in Southern Ethiopia that were selected on the basis of a multi-stage cluster sampling technique. After inserting the completed cases into SPSS software, descriptive statistical techniques, such as frequencies, percentages, charts and inferential statistical tool, particularly binary logistic regression analysis, were used to analyze and present the data.

Results

Majority (43.6%) of respondents perceive that COVID-19 vaccine will have muscle pain around the injection site, followed by fever (39.9%), problems of blood clots (37.8%), headache (35.6%), fatigue (33.5%), and aching limbs (16%). And 63.6%) of them reported that they have experienced muscle pain around the injection site after receiving the COVID-19 vaccine, followed by fatigue (42%), headache (37.2%), fever (34.2%), redness around the injection site (21.6%), and swelling around the injection site (17.8%). Moreover, 25% reported that the fear of potential side-effects of COVID-19 vaccine inhibited them from taking the vaccine. Above all, it is found that respondents’ expectation of COVID-19 vaccine to have such serious side-effects is significantly associated to their educational status (OR = 0.229; P < 0.01; 95%C.I.: 0.080–0.651).

Conclusion

While the expectations of most of the healthcare workers regarding the side-effects of the vaccine are parallel to the normal reactions of the vaccine, a significant proportion of the study participants have reported that they perceive COVID-19 vaccine will have life-threatening side-effects. Such fears have also played a role in affecting vaccine uptake. Therefore, the Ministry of Health, and other concerned government bodies should create further awareness on COVID-19 vaccine and related safety issues.

Physicians' Experience with COVID-19 Vaccination: A Survey Study

BACKGROUND

COVID-19 vaccine hesitancy remains high in the general population and is the main determinant of low vaccination rates and of the fourth pandemic wave severity in Romania. Additional information is needed to raise awareness over vaccine efficiency and the safety profile.

OBJECTIVE

To assess self-reported experience related to COVID-19 vaccination in Romanian physicians.

DESIGN, SETTING, AND PARTICIPANTS

A cross-sectional, self-administered questionnaire-based survey, distributed online in the period 24 March to 24 May 2021. The survey included 30 cascade questions with skip logic filters. All physicians included filled in the questionnaire voluntarily and anonymously. Not all respondents filled in all questions. Main outcome and measure: Primary outcomes addressed were related to the COVID-19 vaccine safety profile.

RESULTS

407/467 (87.15%) of the respondents' physicians were fully vaccinated, mostly with the Pfizer-BioNTech (Comirnaty)-BNT162b2 vaccine, with the peak of immunization in January 2021, with almost four-fifths of the study participants. Regarding COVID-19, almost 20% physicians had the infection and one declared COVID-19 re-infection. A number of 48/420 (11.42%) and 47/419 (11.22%) of the vaccinated physicians did not report any side effects after the first or second vaccine dose. However, most of the side effects reported were minor. Only 50/360 (13.88%) physicians reported the vaccine side effects on the dedicated online national platform. Approximately 40% respondents checked the anti-spike SARS-CoV2 antibodies' titer after complete vaccination, of which two cases reported indeterminate levels. Lower anti-spike SARS-CoV2 antibodies' titer of 100-1000 times the laboratory limit was more frequent in naive physicians (36.95% versus 14.28%, p = 0.012), moderate titers were similar, while very high levels, more than 10,000 times laboratory limit, were more frequent in physicians with previous COVID-19 infection (2.17% versus 42.85%, p < 0.001).

CONCLUSIONS AND RELEVANCE

In this cross-sectional survey study on the COVID-19 vaccination among Romanian physicians, we describe a safety vaccination profile among Romanian physicians.

Self-Reported Adverse Events of COVID-19 Vaccines in Polish Healthcare Workers and Medical Students. Cross-Sectional Study and Pooled Analysis of CoVaST Project Results in Central Europe

BACKGROUND

Optimization of COVID-19 vaccination rate among healthcare personnel is of utmost priority to secure provision of uninterrupted care and to protect the most vulnerable patients. This study, as part of the global CoVaST project, aimed to assess the occurrence of short-term adverse events (SRAEs) of two most administered COVID-19 vaccines, mRNA-based (Pfizer-BioNTech and Moderna) and viral vector-based (AstraZeneca) in healthcare sector workers (HWs).

METHODS

A cross-sectional survey-based study was carried out for the first time among 317 Polish healthcare sector personnel and medical students using a validated and pre-tested questionnaire. The online questionnaire included 25 pre-tested, validated questions concerning demographic data, medical parameters, COVID-19-related anamneses, and local or systemic reactions (reactogenicity) associated with COVID-19 vaccination. Descriptive statistics, inferential tests and binary logistic regression were performed.

RESULTS

Out of the 247 participating HWs, 79.8% were females, and 77.5% received mRNA-based vaccines, while 24.5% received a viral vector-based vaccine. Cumulatively, 78.9% and 60.7% of the participants reported at least one local and one systemic SRAE respectively, following their COVID-19 first or second dose of vaccine. A wide array of SRAEs was observed, while pain at injection site (76.9%) was the most common local SRAE, and fatigue (46.2%), headache (37.7%), muscle pain (31.6%) were the most common systemic SRAEs. The vast proportion of local (35.2%) and systemic (44.8%) SRAEs subsided up to 1 day after inoculation with both types of vaccines. The mRNA-based vaccine versions seem to cause higher prevalence of local SRAEs, mainly pain within injection site (81.3% vs. 71.7%; p = 0.435), while the viral vector-based vaccine was linked with increased incidents of mild systemic side effects (76.7% vs. 55.3%; p = 0.004) after both doses. Pooled analysis revealed uniform results while comparing the prevalence of SRAEs in HWs as recipients in four central European countries (OR = 2.38; 95% CI = 2.03-2.79).

CONCLUSIONS

The study confirmed the safety of commonly administered vaccines against COVID-19, which were associated with mild, self-resolving adverse events. No major vaccine-related incidents were reported which would affect every day functioning, significantly. The younger age group (below 29 y.o.) were associated with an increased risk of adverse events generally. The results enhanced current data regarding COVID-19 vaccination active surveillance in selected occupational groups.

Changes in Behaviors and Attitudes in Response to COVID-19 Pandemic and Vaccination in Healthcare Workers and University Students in Italy

The objectives of the cross-sectional study were to measure how behaviors and attitudes about preventive measures toward COVID-19 changed over time among Italian vaccinated healthcare workers and university students, and the associated characteristics. The study was carried out between February and March 2021 in the city of Naples, Campania region, Southern Italy. The perceived personal risk of being infected by SARS-CoV-2 after the vaccination was significantly higher among males, in those having a higher perceived personal risk of being infected by SARS-CoV-2 before the vaccination, and in those who were more concerned about the efficacy of the vaccination. The fear of getting the disease as reason to have the COVID-19 vaccination was reported more frequently in younger participants, in those with at least one chronic medical condition, in those with a higher concern about the severity of COVID-19, in those with a higher level of trust in the information received, and in those who acquired information from scientific journals. Overall, 21.3% were willing to engage the three main public health measures (wearing a mask, careful hand washing, physical distancing) after receiving the second dose of the vaccination compared to the behavior before the pandemic began. This willingness was predicted by a higher level of trust in the information received and by a lower self-rated health status. Only 0.1% of participants were willing to engage all three measures after receiving the second dose of the vaccination compared to the behavior before receiving the first dose. These findings are useful in order to develop information strategies regarding vaccine safety and efficacy and the importance of public health measures against COVID-19.

Drivers of COVID-19 Vaccine Uptake amongst Healthcare Workers (HCWs) in Nigeria

This study applied a behavioral lens to understand drivers of COVID-19 vaccination uptake among healthcare workers (HCWs) in Nigeria. The study used data from an online survey of Nigerian HCWs ages 18 and older conducted in July 2021. Multivariate logistic regression analyses were conducted to examine predictors of getting two doses of a COVID-19 vaccine. One-third of HCWs in our sample reported that they had gotten two doses of a COVID-19 vaccine. Motivation and ability were powerful predictors of being fully vaccinated: HCWs with high motivation and high ability had a 15-times higher odds ratio of being fully vaccinated. However, only 27% of HCWs had high motivation and high ability. This was primarily because the ability to get vaccinated was quite low among HCWs: Only 32% of HCWs reported that it was very easy to get a COVID-19 vaccination. By comparison, motivation was relatively high: 69% of HCWs reported that a COVID-19 vaccine was very important for their health. Much of the recent literature coming out of Nigeria and other LMICs focuses on increasing motivation to get a COVID-19 vaccination. Our findings highlight the urgency of making it easier for HCWs to get COVID-19 vaccinations.

Attitudes, acceptance and hesitancy among the general population worldwide to receive the COVID-19 vaccines and their contributing factors: A systematic review

BACKGROUND

High rates of vaccination worldwide are required to establish a herd immunity and stop the current COVID-19 pandemic evolution. Vaccine hesitancy is a major barrier in achieving herd immunity across different populations. This study sought to conduct a systematic review of the current literature regarding attitudes and hesitancy to receiving COVID-19 vaccination worldwide.

METHODS

A systematic literature search of PubMed and Web of Science was performed on July 5th, 2021, using developed keywords. Inclusion criteria required the study to (1) be conducted in English; (2) investigate attitudes, hesitancy, and/or barriers to COVID-19 vaccine acceptability among a given population; (3) utilize validated measurement techniques; (4) have the full text paper available and be peer-reviewed prior to final publication.

FINDINGS

Following PRISMA guidelines, 209 studies were included. The Newcastle Ottawa (NOS) scale for cross-sectional studies was used to assess the quality of the studies.Overall, vaccine acceptance rates ranged considerably between countries and between different time points, with Arabian countries showing the highest hesitancy rates compared with other parts of the world.

INTERPRETATION

A variety of different factors contributed to increased hesitancy, including having negative perception of vaccine efficacy, safety, convenience, and price. Some of the consistent socio-demographic groups that were identified to be associated with increased hesitancy included: women, younger participants, and people who were less educated, had lower income, had no insurance, living in a rural area, and self-identified as a racial/ethnic minority.

Intention to Receive the Second Round of COVID-19 Vaccine Among Healthcare Workers in Eastern Ethiopia

Background

COVID-19 pandemic has remained one of the leading causes of death which claimed the lives of many well-trained and experienced healthcare professionals. Vaccination is the most effective way of controlling infectious diseases, while success is challenged by individuals and groups who choose to delay or refuse vaccines. The objective of the present study was to assess the intention of healthcare workers in Eastern Ethiopia to receive the second round of COVID-19 vaccine.

Methods

Institution-based cross-sectional survey research design was used to collect quantitative data from a representative sample of healthcare workers in Dire Dawa, Haramaya, and Harar towns of Eastern Ethiopia. The correctly filled questionnaires were selected and entered into SPSS software for further analysis, where frequency tables, percentages, mean, and multinomial logistic regression analysis were used in the process.

Results

The findings revealed that most (61.6%) of the research participants are willing to receive the second round of COVID-19 vaccine, and 10.3% reported that they have not decided yet. Moreover, the main reason for respondents’ lack of intention to receive the second round of COVID-19 vaccine is the belief that the first round of COVID-19 vaccine is sufficient to prevent infection (27.8%) followed by concern over the safety or side effects of the vaccine (26.6%). Above all, the healthcare workers’ intention of taking the second round of COVID-19 vaccine is significantly associated to having children (OR=0.362, P<0.05; 95% CI: 3.279–5465.189), previous interaction with someone infected by COVID-19 (OR=1.480, P<0.05; 95% CI: 3.949–0.055), the perception that COVID-19 causes a severe illness (OR=0.018, P<0.05, 95% CI: 13.489–196.391), and experience of receiving the first round of COVID-19 vaccine (OR=50431.104, P<0.01; 95% CI: 408.789–626.00).

Conclusion

The present study has shown that healthcare workers in Eastern Ethiopia have a good intention of receiving the second round of COVID-19 vaccine. Nevertheless, the findings have also made it clear that there are still issues to be addressed as far as both willingness to receive the second round of the vaccine and experience of taking the first round of the vaccine are concerned. It is, therefore, important that sufficient training should be given to the healthcare workers in the area in order to raise their level of awareness and enhance their willingness to receive the second round of the vaccine.