Declared Intention (Not) to Be Vaccinated against COVID-19, and Actual Behavior—The Longitudinal Study in the Polish Sample

COVID-19 Vaccine Acceptance in Pregnant Women in the United States: A Systematic Review and Meta-Analysis

Purpose: Pregnant women are vulnerable to Coronavirus Disease 2019 (COVID-19) complications, yet may hesitate to get vaccinated. It is important to identify racial/ethnic and other individual characteristics associated with COVID-19 vaccine acceptance in the United States during pregnancy. Methods: We searched PubMed, Embase, and Web of Science for articles published through January 2023 for keywords/terms related to immunization, COVID-19, and pregnancy, and performed a systematic review and meta-analysis to examine characteristics associated with vaccine acceptance. Results: Of 1,592 articles, 23 met inclusion criteria (focused on pregnant women in the United States, and their willingness or hesitation to vaccinate). Twenty-two of the studies examined receipt of ≥1 COVID-19 vaccine dose and/or intention to vaccinate, while one examined vaccine hesitancy. Vaccine acceptance rates ranged from 7% to 78.3%. Meta-analyses demonstrated that compared with Whites, Hispanics (odds ratios [OR] 0.72; 95% confidence interval [CI] 0.58-0.91) and Blacks (OR 0.44; 95% CI 0.30-0.63) had less COVID-19 vaccine acceptance, while Asians (OR 1.78; 95% CI 1.10-2.88) had greater vaccine acceptance. College graduation or more (OR 3.25; 95% CI 2.53-4.17), receipt or intention to receive the influenza vaccine (OR 3.46; 95% CI 2.22-5.41), and at least part-time employment (OR 2.12; 95% CI 1.66-2.72) were significantly associated with vaccine acceptance. Conclusions: COVID-19 vaccine nonacceptance in pregnant women is associated with Hispanic ethnicity and Black race, while acceptance is associated with Asian race, college education or more, at least part-time employment, and acceptance of the influenza vaccine. Future COVID-19 vaccination campaigns can target identified subgroups of pregnant women who are less likely to accept vaccination.

Why some people do not get vaccinated against COVID-19: Social-cognitive determinants of vaccination behavior

It is puzzling that a sizeable percentage of people refuse to get vaccinated against COVID-19. This study aimed to examine social psychological factors influencing their vaccine hesitancy. This longitudinal study traced a cohort of 2663 individuals in 25 countries from the time before COVID-19 vaccines became available (March 2020) to July 2021, when vaccination was widely available. Multilevel logistic regressions were used to examine determinants of actual COVID-19 vaccination behavior by July 2021, with country-level intercept as random effect. Of the 2663 participants, 2186 (82.1%) had been vaccinated by July 2021. Participants' attitude toward COVID-19 vaccines was the strongest predictor of both vaccination intention and subsequent vaccination behavior (p < .001). Perceived risk of getting infected and perceived personal disturbance of infection were also associated with higher likelihood of getting vaccinated (p < .001). However, religiosity, right-wing political orientation, conspiracy beliefs, and low trust in government regarding COVID-19 were negative predictors of vaccination intention and behavior (p < .05). Our findings highlight the importance of attitude toward COVID-19 vaccines and also suggest that certain life-long held convictions that predate the pandemic make people distrustful of their government and likely to accept conspiracy beliefs and therefore less likely to adopt the vaccination behavior.

Implications for COVID-19 vaccine uptake: A systematic review

BACKGROUND

Globally, increasing coronavirus disease (COVID-19) vaccination coverage remains a major public health concern in the face of high rates of COVID-19 hesitancy among the general population. We must understand the impact of the determinants of COVID-19 vaccine uptake when designing national vaccination programmes. We aimed to synthesise nationwide evidence regarding COVID-19 infodemics and the demographic, psychological, and social predictors of COVID-19 vaccination uptake.

METHODS

We systematically searched seven databases between July 2021 and March 2022 to retrieve relevant articles published since COVID-19 was first reported on 31 December 2019 in Wuhan, China. Of the 12,502 peer-reviewed articles retrieved from the databases, 57 met the selection criteria and were included in this systematic review. We explored COVID-19 vaccine uptake determinants before and after the first COVID-19 vaccine roll-out by the Food and Drug Authority (FDA).

RESULTS

Increased COVID-19 vaccine uptake rates were associated with decreased hesitancy. Concerns about COVID-19 vaccine safety, negative side effects, rapid development of the COVID-19 vaccine, and uncertainty about vaccine effectiveness were associated with reluctance to be vaccinated. After the US FDA approval of COVID-19 vaccines, phobia of medical procedures such as vaccine injection and inadequate information about vaccines were the main determinants of COVID-19 vaccine hesitancy.

CONCLUSION

Addressing effectiveness and safety concerns regarding COVID-19 vaccines, as well as providing adequate information about vaccines and the impacts of pandemics, should be considered before implementation of any vaccination programme. Reassuring people about the safety of medical vaccination and using alternative procedures such as needle-free vaccination may help further increase vaccination uptake.

Declared Intention to Vaccinate against COVID-19 and Actual Vaccination-The Role of Trust in Science, Conspiratorial Thinking and Religiosity

AIMS

The study aims to investigate how trust in science, conspiratorial thinking, and religiosity affected people's declared willingness to vaccinate against COVID-19 at the onset of the vaccination program in Poland, their actual vaccination, and the consistency between intention and vaccination.

METHODS

In a longitudinal design, a representative sample of 918 members of the Polish general population was polled at the beginning of the vaccination program (February 2021) and polled again after 6 months of mass vaccination (August 2021). We measured the willingness to vaccinate, actual vaccination after 6 months, and individual variables-trust in science, conspiratorial thinking and religiosity.

RESULTS

The actual vaccination rate was higher than the declared intent, especially in the initially undecided and unwilling groups. Higher Trust in science and lower Conspiratorial Thinking were associated with declared intent to vaccinate and actual vaccination, while Religiosity was not clearly associated with vaccination.

CONCLUSIONS

Declared willingness to vaccinate is not an effective indicator of actual vaccination. Trust in science and Conspiratorial thinking are important factors associated with vaccine hesitancy. There may be a possibility to influence those unwilling to vaccinate and that are undecided to eventually get vaccinated.

Changes in COVID-19 Vaccine Intent Among a Diverse Population of Older Adults, June 2021-February 2022

Introduction COVID-19 vaccination rates remain suboptimal in the United States. Clinicians and policymakers need to better understand how likely vaccine-hesitant individuals are to ultimately accept vaccination and what is associated with such changes. This study's aims were to 1) describe changes between vaccine intentions and actual uptake from June 2021 through February 2022, and 2) identify modifiable factors associated with vaccine uptake among those with initial hesitancy. Methods This cohort study included a stratified random sample of adults aged 65 years and older in an integrated health care system. The survey, conducted June through August 2021, elicited intent and perceptions regarding COVID-19 vaccination. Subsequent vaccine uptake through February 2022 was analyzed using electronic health records. Results Of 1195 individuals surveyed, 66% responded; 213 reported not yet having received a COVID-19 vaccine and were further analyzed. At baseline, most individuals said they would definitely not (42%) or probably not (5%) get the COVID-19 vaccine or were not sure (26%). During follow-up, 61 individuals (29%) were vaccinated, including 19% of those who initially said they would definitely not be vaccinated. Among vaccine-hesitant individuals, the rate of vaccination was highest for those who initially considered COVID-19 less dangerous than the vaccine (46%) or named short-term side effects (36%) as their most important concern. Conclusions COVID-19 vaccine intent among older adults was malleable during the pandemic's second year, even among those who initially said they would definitely not be vaccinated. Vaccine uptake could be enhanced by increasing awareness of COVID-19 risks and by addressing vaccine side effects.

Strengthened belief in vaccine effectiveness predicted increased COVID-19 vaccination intention and behaviour: Results from a nationally representative longitudinal survey of U.S. adults from July 2020 to April/May 2021

Vaccine hesitancy remains a major barrier to ending the COVID-19 pandemic in the United States (U.S.) and an important target for communication interventions. Using longitudinal survey data, we examined whether baseline levels and changes in beliefs about the COVID-19 vaccines predicted change in vaccination intention/behaviour. Repeated measures were collected from a nationally representative sample of U.S. adults (n = 665) in July 2020 and April/June 2021. Linear regressions associated change in COVID-19 vaccination intention/behaviour with changes in beliefs about the COVID-19 vaccines’ safety, effectiveness in protecting others from infection, and effectiveness in protecting oneself from infection. Changes in beliefs from T1 to T2 were significantly associated with change in vaccination outcomes for all belief types (safety B = 0.39, SE = 0.07; effectiveness for self B = 0.38, SE = 0.09; effectiveness for others B = 0.43, SE = 0.07). Cross-lagged models suggested a reciprocal causal relationship between pro-vaccine beliefs and vaccination intention/behaviour: Intention to get vaccinated at T1 predicted strengthened safety and effectiveness beliefs at T2. T1 effectiveness beliefs predicted T2 vaccination intention/behaviour, though T1 safety beliefs did not. Communication interventions highlighting the protective benefits of COVID-19 vaccines may be particularly successful in reducing vaccine hesitancy.

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

COVID-19 vaccination has been recognized as one of the most effective ways to overcome the current SARS-CoV-2 pandemic. However, the success of this effort relies on national vaccination programmes. In May 2021, we surveyed 1552 people from Romania to determine acceptance rates and factors influencing acceptance of a COVID-19 vaccine. Of these, 39.2% of participants reported that they were vaccinated and 25.6% desired vaccination; nonetheless, 29.5% expressed opposition to vaccination. Concerning vaccination refusal, the top justification given by respondents is that the vaccine is insufficiently safe and there is a risk of serious side effects (84.4%). A higher rate of vaccination refusal was observed among female gender, younger age, and lower educational level. Refusal was also associated with unemployment, being in a relationship, and having a decrease in income during the pandemic. People who are constantly informed by specialized medical staff have a statistically significant higher vaccination rate, while people who choose to get information from friends, family, and co-workers have the strongest intention of avoiding the vaccine. Current levels of vaccine are insufficient to achieve herd immunity of 67%. It is mandatory to understand the aspects that define and establish confidence and to craft nationwide interventions appropriately.

Do Optimists Like Vaccines? The Effect of Perceived Vaccine Novelty and Beliefs in the World’s Positivity and Orderliness on the Attitudes toward COVID-19 Vaccinations—The Case of European Young Adults

The public debate over COVID-19 vaccinations tends to focus on vaccine-related arguments, such as their effectiveness and safety. However, the characteristics of a person’s worldview, such as beliefs about the world’s positivity and orderliness, may also shape attitudes toward COVID-19 vaccinations. These relationships were investigated using schema incongruity theory. The degree of the vaccine’s incongruence with the world’s order schema existing in people’s minds was represented by perceived vaccine novelty. Accordingly, the results of an online survey among European young adults (N = 435) indicate that perceived vaccine novelty negatively affects behavioral outcomes (vaccination intent, willingness to pay for vaccinations, and vaccination advocacy). Moreover, there occurred a negative interaction effect of positivity and orderliness beliefs on behavioral outcomes. Specifically, an effect of positivity was more positive when people perceived the world as less ordered. Furthermore, this interaction effect was more negative when perceived vaccine novelty was higher. A mediating role of perceived vaccine effectiveness was demonstrated for the above relationships. The results extend the existing literature on people’s worldviews into the domain of vaccine attitudes, and provide new insights on the role of perceived vaccine novelty. For vaccination policymakers and marketers, the paper suggests how to promote vaccinations with consideration of orderliness/positivity beliefs and vaccine novelty perception.