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Carpenter R, Carter-Templeton H, Phillips B, Vance B, Charnik A. Attitudes and beliefs of nurses who choose to not vaccinate for COVID 19 in West Virginia: A qualitative study. Appl Nurs Res 2024; 78:151825. [PMID: 39053994 DOI: 10.1016/j.apnr.2024.151825] [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: 12/26/2023] [Revised: 07/08/2024] [Accepted: 07/09/2024] [Indexed: 07/27/2024]
Abstract
PURPOSE The purpose of this study was to describe beliefs and attitudes that underpin vaccine confidence and hesitancy in nurses who chose not to vaccinate for COVID-19. The research question that guided this work was: What are the beliefs and attitudes of nurses who chose to not vaccinate for COVID-19? METHODS This study followed a focus group methodology to collect qualitative data from focused discussions to gather insights into the beliefs and attitudes of participants. Two focus groups consisting of 3 to 5 participants were conducted virtually. RESULTS Using open coding, six themes were generated. Based on descriptors provided by participants, two themes were focused on beliefs, and four were related to attitudes about the vaccine. Findings suggest that participants' beliefs and attitudes were strengthened during this time in the pandemic. This event further divided nurses included in this study from their peers who chose to vaccinate and their employers who mandated inoculation. CONCLUSIONS Understanding the perceptions of this sample has given insight into the thoughts and feelings of nurses who chose not to vaccinate against COVID-19. This is a perspective that is often absent from scientific literature. Knowledge gained from this study may assist in supporting strategies such as open communication, conflict resolution, and collaboration in an effort to mitigate the divide within the nursing workforce, which may ultimately contribute to nursing retention in clinical settings.
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Affiliation(s)
- Roger Carpenter
- West Virginia University School of Nursing, 64 Medical Center Drive, Morgantown, West Virginia 26506, United States of America.
| | - Heather Carter-Templeton
- West Virginia University School of Nursing, 64 Medical Center Drive, Morgantown, West Virginia 26506, United States of America.
| | - Brad Phillips
- West Virginia University School of Nursing, 64 Medical Center Drive, Morgantown, West Virginia 26506, United States of America.
| | - Billie Vance
- West Virginia University School of Nursing, 64 Medical Center Drive, Morgantown, West Virginia 26506, United States of America.
| | - Asa Charnik
- West Virginia University School of Nursing, 64 Medical Center Drive, Morgantown, West Virginia 26506, United States of America.
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Ayaz-Alkaya S, Erdal A, Kacar D, Kayan S, Ersoy T. Nurses' COVID-19-related fear and anxiety and their attitudes to the COVID-19 vaccine: A descriptive and correlational study. Int J Nurs Pract 2024; 30:e13212. [PMID: 37786940 DOI: 10.1111/ijn.13212] [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: 03/05/2023] [Revised: 09/07/2023] [Accepted: 09/17/2023] [Indexed: 10/04/2023]
Abstract
BACKGROUND The novel coronavirus disease 2019 has caused psychological distress such as anxiety and fear among nurses worldwide. Nurses are a creditable source of vaccine-related information and have a primary role in building confidence regarding vaccines. AIM The present study was designed to investigate the fear and anxiety of nurses regarding novel coronavirus disease 2019 (COVID-19) and their attitudes towards the COVID-19 vaccine. The predictors of fear, anxiety and attitudes towards the vaccine were also investigated. METHODS A descriptive and correlational design was used. The study was conducted in three public hospitals from different parts of the Turkey, and 405 nurses from the three hospitals were recruited by stratified sampling. RESULTS Anxiety and negative attitudes towards the vaccine were positively related to fear of COVID-19. Age and fear were also positively associated with anxiety related to COVID-19. Nurses who had received the vaccine and those who were fearful had a positive attitude towards the vaccine. CONCLUSION Psychosocial support programmes should be implemented to improve psychological resilience and coping strategies in nurses and organized education programmes are needed to increase positive attitudes towards vaccination.
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Affiliation(s)
| | - Aysun Erdal
- Faculty of Nursing, Gazi University, Ankara, Turkey
| | - Dilek Kacar
- Institute of Health Sciences, Department of Nursing, Gazi University, Ankara, Turkey
| | - Sultan Kayan
- Faculty of Health Science, Public Health Nursing Department, Bilecik Seyh Edebali University, Bilecik, Turkey
| | - Tuğçe Ersoy
- Institute of Health Sciences, Department of Nursing, Gazi University, Ankara, Turkey
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Pristov Z, Lobe B, Sočan M. Factors Influencing COVID-19 Vaccination among Primary Healthcare Nurses in the Pandemic and Post-Pandemic Period: Cross-Sectional Study. Vaccines (Basel) 2024; 12:602. [PMID: 38932331 PMCID: PMC11209193 DOI: 10.3390/vaccines12060602] [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: 04/22/2024] [Revised: 05/25/2024] [Accepted: 05/29/2024] [Indexed: 06/28/2024] Open
Abstract
The decision to vaccinate against COVID-19 is primarily a personal choice influenced by numerous factors. Vaccine acceptance and a positive attitude towards vaccination among nurses have an impact on patients' willingness to vaccinate. To assess COVID-19 vaccination coverage among primary healthcare nurses and to associate socio-demographic factors, comorbidity, self-rated health, and unhealthy lifestyle with the decision to be vaccinated, we conducted an online cross-sectional study from March to May 2023 using a self-administrated questionnaire. Probability sampling was used to select 32 health centers and nurses were invited via email. Among the 560 participants who completed survey, 78.3% and 50.8% received the primary two-dose course and at least one booster dose of COVID-19 vaccine, respectively. Primary care nurses who were ≥41 years of age, physically less active, and those who were overweight opted statistically significantly more often for the primary vaccination scheme (p = 0.00, 0.015 and 0.017, respectively). Education and the living environments of primary care nurses did not significantly influence the decision to receive two primary COVID-19 doses. Likewise, good self-rated health and comorbidity did not contribute significantly to the vaccination decision. Nurses that were vaccinated with booster doses were significantly more often overweight (p = 0.034) and ≥41 year of age (p = 0.000).
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Affiliation(s)
- Zorica Pristov
- Community Health Centre Ljubljana, 1000 Ljubljana, Slovenia;
| | - Bojana Lobe
- Faculty of Social Sciences, University of Ljubljana, 1000 Ljubljana, Slovenia;
| | - Maja Sočan
- National Institute of Public Health, 1000 Ljubljana, Slovenia
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Miles TT, Li SJ, Danzig T, Marrero M, Morales I, Babazadeh S. Assessment of Covid-19 vaccine confidence among healthcare personnel in the safety-net sector in the United States and Puerto Rico. BMC Health Serv Res 2024; 24:580. [PMID: 38702754 PMCID: PMC11069172 DOI: 10.1186/s12913-024-10996-z] [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: 03/02/2023] [Accepted: 04/16/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND This study aimed to assess COVID-19 vaccine confidence among healthcare personnel in the safety net sector of the United States and Puerto Rico. This study aimed to examine the extent to which increased knowledge and positive attitudes toward COVID-19 vaccine safety and efficacy were associated with healthcare workers' COVID-19 vaccination status and their recommendation of the vaccine to all patients. METHODS Online survey data were collected from health care workers working in Free and Charitable Clinics across the United States and Federally Qualified Health Centers in Puerto Rico. The survey consisted of 62 questions covering various demographic measures and constructs related to healthcare workers' vaccination status, beliefs, and recommendations for COVID-19 vaccination. Statistical analyses, including multivariate analysis, were conducted to identify the factors associated with the COVID-19 vaccine status and recommendations among healthcare personnel. RESULTS Among the 2273 respondents, 93% reported being vaccinated against COVID-19. The analysis revealed that respondents who believed that COVID-19 vaccines were efficacious and safe were three times more likely to be vaccinated and twice as likely to recommend them to all their patients. Respondents who believed they had received adequate information about COVID-19 vaccination were 10 times more likely to be vaccinated and four times more likely to recommend it to all their patients. CONCLUSIONS The study results indicate that healthcare workers' confidence in COVID-19 vaccines is closely tied to their level of knowledge, positive beliefs, and attitudes about vaccine safety and efficacy. The study emphasizes the significance of healthcare workers feeling well informed and confident in their knowledge to recommend the vaccine to their patients. These findings have important implications for the development of strategies to boost COVID-19 vaccine confidence among healthcare workers and increase vaccine uptake among patients.
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Biton L, Shvartsur R, Grinberg K, Kagan I, Linetsky I, Halperin O, Azab AN, Cohen O. Vaccinating without complete willingness against COVID-19: Personal and social aspects of Israeli nursing students and faculty members. Nurs Inq 2024; 31:e12601. [PMID: 37731259 DOI: 10.1111/nin.12601] [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: 04/19/2023] [Revised: 09/06/2023] [Accepted: 09/07/2023] [Indexed: 09/22/2023]
Abstract
Soon after the coronavirus disease 2019 (COVID-19) pandemic outbreak, it became clear that vaccination will be the most useful tool to combat the disease. Despite the apparent safety and efficacy of the developed anti-COVID-19 vaccines, relatively high percentages of the population worldwide refused to get vaccinated, including many health workers and health students. The present cross-sectional study examined the motives, attitudes, and personal characteristics of those who did not get vaccinated against COVID-19 or vaccinated without complete willingness among nursing students and nursing faculty members in Israel (n = 472). Results show that the vast majority of the study participants (97%) received at least one dose of the anti-COVID-19 vaccine. Nearly 37% of the participants indicated that they received the vaccine without complete willingness. As compared to faculty members, nursing students reported lower trust in the efficacy of the vaccine, perceived the COVID-19 pandemic as a health threat to a lesser extent, exhibited lower institutional and personal trust, and had higher levels of posttraumatic stress disorder symptoms. Non-Jewish participants were at risk of vaccinating without complete willingness. These findings underscore the need for developing evidence-based strategies to promote the safety and efficacy of the anti-COVID-19 vaccines in nursing schools.
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Affiliation(s)
- Linoy Biton
- Department of Nursing, Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Rachel Shvartsur
- Department of Nursing, School of Health Sciences, Ashkelon Academic College, Israel
| | - Keren Grinberg
- Department of Nursing Sciences, Faculty of Social and Community Sciences, Ruppin Academic Center, Emek-Hefer, Israel
| | - Ilya Kagan
- Department of Nursing, School of Health Sciences, Ashkelon Academic College, Israel
| | - Irena Linetsky
- Department of Nursing Sciences, Faculty of Social and Community Sciences, Ruppin Academic Center, Emek-Hefer, Israel
| | - Ofra Halperin
- Department of Nursing, Max Stern Academic College of Emek-Yezreel, Jezreel Valley, Israel
| | - Abed N Azab
- Department of Nursing, Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Department of Clinical Biochemistry and Pharmacology, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Odeya Cohen
- Department of Nursing, Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Butsing N, Maneesriwongul W, Visudtibhan PJ, Leelacharas S, Kittipimpanon K. COVID-19 Vaccine Acceptance and Hesitancy among Nurses in Thailand: Implications, Challenges, and Future Prospects for Attitudes and Vaccine Literacy. Vaccines (Basel) 2024; 12:142. [PMID: 38400126 PMCID: PMC10892553 DOI: 10.3390/vaccines12020142] [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: 12/03/2023] [Revised: 01/20/2024] [Accepted: 01/24/2024] [Indexed: 02/25/2024] Open
Abstract
Nurses are healthcare workers at high risk of contracting COVID-19 and are prioritized for COVID-19 vaccination. This study aimed to explore COVID-19 vaccine acceptance, vaccine literacy, and attitudes toward COVID-19 vaccines, and determine factors associated with COVID-19 vaccine acceptance among nurses in Thailand. A cross-sectional survey was conducted using online questionnaires between May and June 2021. A total of 510 nurses were recruited during the pandemic's third wave in Thailand. Data were analyzed using descriptive and inferential statistics. Ten percent (n = 51) of the participants were men, all of whom showed COVID-19 vaccine acceptance. Of the 459 female nurses, 94.8% (n = 435) accepted COVID-19 vaccination and 91.3% (n = 419) reported previous influenza vaccination. In multiple logistic regression models, previous influenza vaccination, interactive-critical vaccine literacy, and attitudes toward COVID-19 vaccines were significant predictors of COVID-19 vaccine acceptance among female nurses in Thailand. Those who had previously received influenza vaccination were more likely to accept COVID-19 vaccination. Higher scores for interactive-critical vaccine literacy and positive attitudes toward the COVID-19 vaccine increased the odds of accepting vaccination, while negative attitudes were associated with decreased vaccine acceptance. Vaccine literacy, together with attitudes toward the COVID-19 vaccine, had a strong positive effect on increasing vaccination acceptance and reducing vaccine hesitancy. The results suggest that policymakers should consider both attitudes and vaccine literacy when establishing prospective strategies for promoting vaccine acceptance among nurses beyond the COVID-19 pandemic.
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Affiliation(s)
| | - Wantana Maneesriwongul
- Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand; (N.B.); (P.J.V.); (S.L.); (K.K.)
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Aldakhlan HA, Khan AS, Alabdulbaqi D. Hesitancy Over the COVID-19 Vaccine Among Various Healthcare Workers: An International Narrative Review. Cureus 2024; 16:e53059. [PMID: 38410316 PMCID: PMC10896459 DOI: 10.7759/cureus.53059] [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] [Accepted: 01/26/2024] [Indexed: 02/28/2024] Open
Abstract
Healthcare workers (HCWs) are role models in their communities. If they receive the COVID-19 vaccine, many people are likely to follow and have the vaccine. If HCWs are hesitant or resistant to taking the vaccine, this may impede the efforts to implement the vaccine, reach herd immunity, and eliminate the pandemic. In this narrative review, we reviewed previous studies on hesitancy over COVID-19 vaccination among different healthcare professions and people in the medical field, such as primary HCWs, dentists, nurses, and medical students. We reviewed the common reasons and associated factors for hesitancy toward the COVID-19 vaccine among different healthcare professions. The following keywords were used in the database search: COVID-19 AND vaccine AND hesitancy AND healthcare workers. We searched for articles using the PubMed, Scopus, and Google Scholar databases. We found HCW professions with various rates of hesitancy, including primary healthcare center (PHC) workers (50%), medical students (45%), nurses (21%), and dentists (18%). Hesitancy toward booster doses was also found in HCWs who had taken primary doses (2.8% to 26%). Race and ethnicity also influenced hesitancy rates, with Black individuals being the most hesitant group. The most common reasons were concerns about the safety and adverse effects of the vaccine, insufficient information, and a lack of confidence in healthcare policies. Despite varying rates of HCW hesitancy after the vaccine's release, this hesitancy is expected to negatively affect efforts to achieve widespread vaccination. The recommendations to policymakers to address these concerns are raising the awareness of PHC doctors because they are the easiest to reach and are the first line for patient information, improving communication with the HCWs through all channels (e.g., webinars, e-mails, and social media), and inviting HCWs to online meetings or workshops with the healthcare policymakers so the policymakers can listen to their concerns and recommendations. Correctly addressing the issue of HCWs' vaccination hesitancy can support efforts to contain the pandemic.
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Affiliation(s)
| | - Abdul S Khan
- Familly Medicine, King Faisal University, Alhsa, SAU
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Tselebis A, Sikaras C, Milionis C, Sideri EP, Fytsilis K, Papageorgiou SM, Ilias I, Pachi A. A Moderated Mediation Model of the Influence of Cynical Distrust, Medical Mistrust, and Anger on Vaccination Hesitancy in Nursing Staff. Eur J Investig Health Psychol Educ 2023; 13:2373-2387. [PMID: 37998057 PMCID: PMC10669979 DOI: 10.3390/ejihpe13110167] [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: 09/15/2023] [Revised: 10/25/2023] [Accepted: 10/26/2023] [Indexed: 11/25/2023] Open
Abstract
During the pandemic, nurses experienced anger that stemmed from a sense of threat, frustration, or even a sense of injustice. The purpose of this study was to examine the relationship between vaccination hesitancy, anger, cynicism, and medical mistrust among nurses, as there are no relevant studies in the literature. This study was conducted online by completing self-report questionnaires. The Dimensions of Anger Reactions-5, the 8-item "Cynical Distrust" scale, and the Medical Mistrust Multiformat Scale were used. For vaccination hesitancy, two questions with a 5-point scale were used: one question examining hesitancy to get vaccinated with the COVID-19 vaccine, and another question examining hesitancy to get vaccinated with the influenza vaccine. In total, 387 nurses (66 men and 321 women) participated in this study. Nurses showed statistically greater hesitancy toward the COVID-19 vaccine compared to hesitancy toward the influenza vaccine. The variation in vaccine hesitancy was explained by the scores in the Medical Mistrust Multiformat Scale, the Dimensions of Anger Reactions, and the Cynical Distrust Scale. The Medical Mistrust Multiformat Scale mediated the relationship between the Cynical Distrust Scale and total vaccine hesitancy. The Dimensions of Anger Reactions Scale significantly moderated the indirect effect of the Cynical Distrust Scale on total vaccine hesitancy through the Medical Mistrust Multiformat Scale. In conclusion, it is highly likely that anger is involved in reported vaccine hesitancy both by activating schemas of distrust in others and by adopting anti-systemic views of mistrust in the medical system.
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Affiliation(s)
- Athanasios Tselebis
- Psychiatric Department, Sotiria Thoracic Diseases Hospital of Athens, 11527 Athens, Greece; (K.F.); (S.M.P.); (A.P.)
| | - Christos Sikaras
- Nursing Department, Sotiria Thoracic Diseases Hospital of Athens, 11527 Athens, Greece;
| | - Charalampos Milionis
- Department of Endocrinology, Diabetes and Metabolism, Elena Venizelou General and Maternity Hospital, 11521 Athens, Greece; (C.M.); (I.I.)
| | - Eleni Paraskevi Sideri
- Emergency Department of General Hospital of Athens Korgialeneio—Benakeio Hellenic Red Cross, 11526 Athens, Greece;
| | - Konstantinos Fytsilis
- Psychiatric Department, Sotiria Thoracic Diseases Hospital of Athens, 11527 Athens, Greece; (K.F.); (S.M.P.); (A.P.)
| | - Styliani Maria Papageorgiou
- Psychiatric Department, Sotiria Thoracic Diseases Hospital of Athens, 11527 Athens, Greece; (K.F.); (S.M.P.); (A.P.)
| | - Ioannis Ilias
- Department of Endocrinology, Diabetes and Metabolism, Elena Venizelou General and Maternity Hospital, 11521 Athens, Greece; (C.M.); (I.I.)
| | - Argyro Pachi
- Psychiatric Department, Sotiria Thoracic Diseases Hospital of Athens, 11527 Athens, Greece; (K.F.); (S.M.P.); (A.P.)
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Nabirova D, Horth R, Kassabekova L, Henderson A, Yesmagambetova A, Alaverdyan S, Nuorti JP, Smagul M. Factors associated with COVID-19 vaccine confidence among primary care providers in Kazakhstan, March-April 2021. Front Public Health 2023; 11:1245750. [PMID: 37744481 PMCID: PMC10517263 DOI: 10.3389/fpubh.2023.1245750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 08/21/2023] [Indexed: 09/26/2023] Open
Abstract
Introduction Vaccination is a critical public health intervention, and vaccine hesitancy is a major threat. Globally, confidence in COVID-19 vaccines has been low, and rates of routine immunizations decreased during the COVID-19 pandemic. Because healthcare providers are a trusted source of information on vaccination in Kazakhstan, it was vital to understand their knowledge, attitudes and practices (KAP) related to both routine and COVID-19 vaccines. Methods From March to April 2021, we conducted a cross-sectional study among the healthcare providers responsible for vaccination in 54 primary care facilities in three cities in Kazakhstan. All consenting providers anonymously completed structured online questionnaires at their place of work. A provider was classified as having COVID-19 vaccine confidence if they planned to get a COVID-19 vaccine, believed that COVID-19 vaccines are important to protect their community and either believed the vaccine was important to protect themselves or believed that getting a vaccine was safer than getting COVID-19. Statistical analysis included chi-square, Spearman's rank correlation coefficient, and Poisson regression. Results Of 1,461 providers, 30% had COVID-19 vaccine confidence, 40% did not, and 30% would refuse vaccination. Participants were mostly female (92%) and ≤ 35 years old (57%). Additionally, 65% were nurses, 25% were family physicians, and 10% were pediatricians. Adequate KAP for routine vaccines was low (22, 17, and 32%, respectively). Adequate knowledge was highest among pediatricians (42%) and family physicians (28%) and lowest among nurses (17%). Misconceptions about vaccines were high; 54% believed that influenza vaccines cause flu, and 57% believed that there is a scientifically proven association between vaccination and autism and multiple sclerosis. About half (45%) of the practitioners felt confident answering patient vaccine-related concerns. In adjusted models, COVID-19 vaccine confidence was positively associated with adequate knowledge of vaccines (prevalence ratio: 1.2, 95% confidence interval: 1.0-1.4) and adequate attitudes related to routine vaccines (3.1, 2.7-3.6). Conclusion Our study uncovers critical areas for interventions to improve KAP related to routine immunizations and COVID-19 vaccine confidence among providers in Kazakhstan. The complex relationship between KAP of routine vaccines and COVID-19 vaccine confidence underscores the importance of addressing vaccine hesitancy more broadly and not focusing solely on COVID-19.
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Affiliation(s)
- Dilyara Nabirova
- Division of Global Health Protection in Central Asia, United States Centers for Disease Control and Prevention, Almaty, Kazakhstan
- Central Asia Field Epidemiology Training Program, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
- Health Sciences Unit, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Roberta Horth
- Division of Global Health Protection in Central Asia, United States Centers for Disease Control and Prevention, Almaty, Kazakhstan
- Central Asia Field Epidemiology Training Program, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | - Lena Kassabekova
- Central Asia Field Epidemiology Training Program, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
- Scientific and Practical Center of Sanitary-Epidemiological Examination and Monitoring, Branch of the National Center for Public Health, Almaty, Kazakhstan
| | - Alden Henderson
- Division of Global Health Protection, United States Centers for Disease Control and Prevention, Atlanta, GA, United States
| | | | - Sevak Alaverdyan
- Manoogian Simone College of Business and Economics, American University of Armenia, Yerevan, Armenia
| | - J. Pekka Nuorti
- Health Sciences Unit, Faculty of Social Sciences, Tampere University, Tampere, Finland
- Infectious Diseases and Vaccinations Unit, Department of Health Security, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Manar Smagul
- Central Asia Field Epidemiology Training Program, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
- Scientific and Practical Center of Sanitary-Epidemiological Examination and Monitoring, Branch of the National Center for Public Health, Almaty, Kazakhstan
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Viskupič F, Wiltse DL. Partisan self-identification predicts attitudes of South Dakota nurses toward COVID-19 vaccine mandate for healthcare workers. HEALTH POLICY AND TECHNOLOGY 2023; 12:100777. [PMID: 37389329 PMCID: PMC10290765 DOI: 10.1016/j.hlpt.2023.100777] [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] [Indexed: 07/01/2023]
Abstract
Objectives Nurses are at greater risk of infection from COVID-19. However, mistrust of the vaccine exists even among this group. In the United States, the government implemented a vaccine mandate for health care workers to increase vaccination rates. This study investigated the drivers of nurses' attitudes toward the mandate. Methods We fielded a survey to study the attitudes of nurses toward COVID-19 vaccine mandate for HCWs. We contacted nurses in South Dakota, United States, based on the information from the South Dakota Board of Nursing. The survey was open in June and July 2022. We conducted a multivariate regression analysis to identify the factors that predict attitudes toward this regulation. Results We received 1,084 responses. Results of regression analysis showed statistically significant relationships between partisan self-identification, evangelical identity, gender, and COVID-19 vaccination status and support for COVID-19 vaccine mandate for healthcare workers. Age, time with patients, positive COIVD-19 test in the last year, education, and nurse classification variables were not statistically significant. Conclusions The same factors that drive people's attitudes toward COVID-19 mitigation policies also explain nurses' attitudes toward a vaccine mandate for healthcare workers. The politicization of the COVID-19 pandemic is present also among nurses. Health care officials should be mindful of the influence of these biases as they evaluate the vaccine mandate and develop new regulations.
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Affiliation(s)
- Filip Viskupič
- School of American and Global Studies, South Dakota State University, United States of America
| | - David L Wiltse
- School of American and Global Studies, South Dakota State University, United States of America
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Xie Z, Lau JTF, Liang Y, Ouyang Q, Chen J, Lin S, Yao K, Hu X, Lin H, Yu Y, Zeng D. Prevalence and factors of COVID-19 vaccine refusal among solid cancer patients in China: an application of the health belief model. Front Public Health 2023; 11:1236376. [PMID: 37601174 PMCID: PMC10435902 DOI: 10.3389/fpubh.2023.1236376] [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: 06/07/2023] [Accepted: 07/19/2023] [Indexed: 08/22/2023] Open
Abstract
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.
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Affiliation(s)
- Zhaomin Xie
- School of Public Health, Shantou University, Shantou, China
- Department of Medical Oncology, Cancer Hospital of Shantou University Medical College, Shantou, China
- Guangdong Provincial Key Laboratory for Breast Cancer Diagnosis and Treatment, Cancer Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Joseph Tak-Fai Lau
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
- Zhejiang Provincial Clinical Research Center for Mental Disorders, The Affiliated Wenzhou Kangning Hospital, Wenzhou Medical University, Wenzhou, China
- School of Public Health, Zhejiang University, Hangzhou, China
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Yuanke Liang
- Department of Thyroid and Breast Surgery, Clinical Research Center, The First Affiliated Hospital of Shantou University Medical College (SUMC), Shantou, China
| | | | - Junjia Chen
- Shantou University Medical College, Shantou, China
| | - Si Lin
- Shantou University Medical College, Shantou, China
| | - Kaitao Yao
- Shantou University Medical College, Shantou, China
| | - Xuanyin Hu
- Shantou University Medical College, Shantou, China
| | - Haoyu Lin
- Department of Thyroid and Breast Surgery, Clinical Research Center, The First Affiliated Hospital of Shantou University Medical College (SUMC), Shantou, China
| | - Yanqiu Yu
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, Shanghai, China
| | - De Zeng
- Department of Medical Oncology, Cancer Hospital of Shantou University Medical College, Shantou, China
- Guangdong Provincial Key Laboratory for Breast Cancer Diagnosis and Treatment, Cancer Hospital of Shantou University Medical College, Shantou, Guangdong, China
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12
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Picelli S, Danielis M, Zanotti R. Better to Be Unpaid than COVID-19 Vaccinated! A Qualitative Study on Italian Nurses Suspended from Work without Salary. Vaccines (Basel) 2023; 11:1239. [PMID: 37515054 PMCID: PMC10386292 DOI: 10.3390/vaccines11071239] [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: 05/15/2023] [Revised: 07/03/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023] Open
Abstract
In Italy, from April 2021, healthcare workers were required to receive the COVID-19 vaccine; if they refused it, an immediate unpaid suspension was implemented until they received the vaccine. Although there are numerous quantitative studies on the factors that influenced vaccine hesitancy during the COVID-19 pandemic, qualitative research on the causes of vaccine refusal is still missing. This research aimed to investigate the phenomenon of nurses who refused to receive COVID-19 vaccination despite being required to do so, as well as the reasons behind their refusal. Furthermore, the actions of those who abandoned this stance were explored. This was a qualitative study involving the methodological approach of grounded theory. Twenty-four nurses were interviewed virtually via Zoom from May to July 2022. Anti-vax behavior-as emerged from nurses' experiences-was based on seven themes: (1) job satisfaction, (2) the main sources of information on COVID-19, (3) the reasons for refusing the COVID-19 vaccine, (4) the attitudes of family members toward the COVID-19 vaccine, (5) previous experience with other vaccines, (6) firm opposition to the vaccine (unvaccinated nurses), (7) reluctant acceptance (vaccinated nurses). It was shown that it is imperative for health authorities to adopt timely, documented, transparent, and consistent communication when carrying out public health campaigns, especially for vaccination.
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Affiliation(s)
- Serena Picelli
- Laboratory of Studies and Evidence Based Nursing, Department of Medicine, University of Padua, 35131 Padova, Italy
| | - Matteo Danielis
- Laboratory of Studies and Evidence Based Nursing, Department of Medicine, University of Padua, 35131 Padova, Italy
| | - Renzo Zanotti
- Laboratory of Studies and Evidence Based Nursing, Department of Medicine, University of Padua, 35131 Padova, Italy
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13
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Kluczna A, Orzeł R, Bardowska A, Dzierżanowski T. The Degree of Acceptance of Cocoon Strategy of Vaccination against Influenza and COVID-19 in Palliative Home Care Professionals and Caregivers. Vaccines (Basel) 2023; 11:1235. [PMID: 37515049 PMCID: PMC10383800 DOI: 10.3390/vaccines11071235] [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: 06/13/2023] [Revised: 07/02/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023] Open
Abstract
Palliative care patients are an immunocompromised population, so the cocooning strategy of vaccinating those around them is a suitable protective strategy against infections. This is especially significant for infectious diseases such as influenza and COVID-19, which pose a challenge to the healthcare system. In order to improve the patient's quality of life, it is necessary to develop research-based, defined strategies. This questionnaire-based study was conducted to determine the level of knowledge about influenza and SARS-CoV-2 coronavirus vaccination among the factual caregivers and medical staff in the palliative care setting. The survey revealed that the sources of knowledge about vaccination varied and depended on one's role. Doctors and nurses used professional literature, while other medical professionals relied on the Internet, mass media, and information from family and friends. The study also showed that adherence to vaccination guidelines was not associated with COVID-19 incidence. The overall opinion on vaccination was positive, but the degree of acceptance varied by the role. Palliative care nurses and caregivers were the groups that were the least accepting of vaccination. To improve the acceptance of vaccinations, a remedial program based on professional education should be implemented using the sources declared by the respondents. It may help improve the quality of life for palliative care patients and prevent the spread of infectious diseases.
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Affiliation(s)
- Agnieszka Kluczna
- Department of Palliative Medicine, Institute of Sciences, University of Opole, 45-052 Opole, Poland
| | - Rafał Orzeł
- Laboratory of Palliative Medicine, Department of Social Medicine and Public Health, Medical University of Warsaw, 02-007 Warsaw, Poland
| | - Anna Bardowska
- Laboratory of Palliative Medicine, Department of Social Medicine and Public Health, Medical University of Warsaw, 02-007 Warsaw, Poland
| | - Tomasz Dzierżanowski
- Laboratory of Palliative Medicine, Department of Social Medicine and Public Health, Medical University of Warsaw, 02-007 Warsaw, Poland
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14
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Akintunde TY, Chen JK, Ibrahim E, Isangha SO, Sayibu M, Musa TH. Factors associated with COVID-19 vaccine uptake among foreign migrants in China. Heliyon 2023; 9:e17567. [PMID: 37533745 PMCID: PMC10292914 DOI: 10.1016/j.heliyon.2023.e17567] [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: 11/01/2022] [Revised: 06/14/2023] [Accepted: 06/21/2023] [Indexed: 08/04/2023] Open
Abstract
Background/Purpose The COVID-19 outbreak created unique policy challenges for vaccinating special groups like migrants. As part of sustainable development goals, the equitable distribution of the COVID-19 vaccine can contribute to ensuring health for all. This study examined COVID-19 vaccine uptake among foreign migrants in China based on sociodemographics, cultural beliefs, past vaccine behaviors, and psychosocial factors. Design An online cross-sectional survey was conducted among foreign migrants in mainland China via social media platforms from 21 November through 20 December 2021. Bivariate (unadjusted odd-ratio) and multivariate logistic regression analyses were performed to establish the correlates of COVID-19 vaccine uptake. Result Surveyed foreign migrants that are culture neutral (AOR: 2.5, CI: 95%, 1.02-5.90, p = 0.044), willing to pay for vaccination (AOR: 2.27, CI: 95%, 1.18-3.98, p = 0.012), believe in vaccine efficacy (AOR: 3.00, CI: 95%, 1.75-5.16, p < 0.000), have poor psychological health (AOR: 1.96, CI: 95%, 1.14-3.38, p = 0 0.014), and have higher perceived seriousness of COVID-19 (AOR: 2.12, CI: 95%, 1.26-3.57, p = 0.005) are more likely to receive COVID-19 vaccine. Those migrants with a history of declining vaccination (AOR: 0.34, CI: 95%, 0.18-0.65, p = 0.000) and middle-income earners $1701-3500 (AOR: 0.43, CI: 95%, 0.23-0.82, p = 0.010) are less likely to receive the COVID-19 vaccine. Conclusion This study brings a unique perspective to understanding vaccine behavior among international migrants in China. There is an urgent call from the World Health Organization and countries for complete vaccination and efforts to improve vaccine coverage. However, fewer studies have been conducted globally on the vaccination of migrant populations. The current study provides empirical information to increase the knowledge of the correlates of vaccine behavior among immigrants in countries around the globe. Future studies should conduct cross-country comparisons to understand the factors associated with increasing vaccination rates among immigrant populations to formulate a strong policy to increase vaccine coverage among immigrant populations across countries.
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Affiliation(s)
- Tosin Yinka Akintunde
- Department of Sociology, School of Public Administration, Hohai University, China
- Department of Social Work, Chinese University of Hong Kong, Hong Kong
| | - Ji-Kang Chen
- Department of Social Work, Chinese University of Hong Kong, Hong Kong
| | - Elhakim Ibrahim
- Department of Demography, College for Health, Community and Policy, The University of Texas, San Antonio, TX, United States
| | - Stanley Oloji Isangha
- Department of Social and Behavioral Sciences, College of Liberal Art and Social Sciences, City University of Hong Kong, Hong Kong
| | - Muhideen Sayibu
- Department of Sci-Tech Communication and Policy, University of Science and Technology of China, Anhui, Hefei, China
| | - Taha Hussein Musa
- Department of Epidemiology and Health Statistics, Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
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15
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Jun J, Tubbs Cooley H, O’Mathúna DP, Kim M, Pignatiello G, Fitzpatrick JJ, Tucker S. Individual and Work-Related Characteristics Associated with COVID-19 Vaccination Status among Ohio Nurses. Policy Polit Nurs Pract 2023; 24:81-90. [PMID: 36482714 PMCID: PMC9742733 DOI: 10.1177/15271544221141060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Uptake of the COVID-19 vaccine by nurses lags behind that of other health care professionals with minimal empirical evidence to understand this phenomenon. In this secondary analysis, we examined nurses' individual and work-related characteristics and their association with COVID-19 vaccination status. Alumni of three Ohio nursing colleges and members of a professional organization were invited to complete questionnaires from June through August 2021. Logistic regression models were used to evaluate associations between nurse characteristics and vaccination status. Among 844 respondents, 754 (80.30%) had received at least one dose of the vaccine. Older age, having a bachelor's degree or higher, and working in critical care were associated with vaccination. Providing direct care for COVID-19 patients in the last 7 days and a higher perception of one's work being affected by COVID-19 were significantly associated with being vaccinated, whereas prior COVID-19 infection was inversely associated with vaccination status. Our findings suggest that COVID-19 vaccine uptake among nurses is influenced by a host of factors related to virus knowledge, beliefs, and risk perceptions. Awareness of these factors can aid the development of interventions to increase nurses' acceptance of vaccines.
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Affiliation(s)
- Jin Jun
- College of Nursing, the Ohio State University, Columbus, OH, USA
| | | | | | - Minjin Kim
- College of Nursing, University of Cincinnati, Cincinnati, OH, USA
| | - Grant Pignatiello
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | - Joyce J. Fitzpatrick
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | - Sharon Tucker
- Fuld EBP Institute, College of Nursing, the Ohio State University, Columbus, OH, USA
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16
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McCready JL, Nichol B, Steen M, Unsworth J, Comparcini D, Tomietto M. Understanding the barriers and facilitators of vaccine hesitancy towards the COVID-19 vaccine in healthcare workers and healthcare students worldwide: An Umbrella Review. PLoS One 2023; 18:e0280439. [PMID: 37043505 PMCID: PMC10096263 DOI: 10.1371/journal.pone.0280439] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 12/31/2022] [Indexed: 04/13/2023] Open
Abstract
BACKGROUND Healthcare workers (HCWs) and healthcare students display high levels of vaccine hesitancy with impact on healthcare provision, patient safety, and health promotion. The factors related to vaccine hesitancy have been reported in several systematic reviews. However, this evidence needs to be synthesised, as interventions to reduce vaccination hesitancy in this population are needed. METHODS This Umbrella Review aimed to explore the barriers and facilitators of vaccine hesitancy toward the COVID-19 vaccine for HCWs and healthcare students. The review was performed and reported in accordance with Joanna Briggs Institutes guidelines and the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. A protocol was preregistered on PROSPERO (CRD42022327354). Eight databases were searched from November 2019 to 23rd May 2022 to identify any systematic reviews that explored factors associated with hesitancy towards the COVID-19 vaccine for HCWs or healthcare students. RESULTS A total of 31 studies were included in the review. The majority of studies (71%) were appraised as strong or moderate quality and there was a slight degree of overlap (<5%) of primary studies between the reviews. Vaccine hesitancy was more common among HCWs and healthcare students in specific occupational roles (e.g. nurses) than others (e.g. physicians). Frequent reasons for hesitancy were related to sociodemographic factors (gender, age, ethnicity), occupational factors (COVID-19 exposure, perceived risk, mandatory vaccination), health factors (vaccination history), vaccine-related factors (concerns about safety, efficacy, side-effects, rapid development, testing, approval and distribution of the vaccine), social factors (social pressure, altruism and collective responsibility), distrust factors (key social actors, pandemic management), information factors (inadequate information and sources, exposure to misinformation). CONCLUSION The results from this Umbrella Review have wide-reaching implications for the research area, healthcare systems and institutions and governments worldwide. Designing tailored strategies for specific occupational groups is pivotal to increasing vaccine uptake and securing a safe healthcare provision worldwide.
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Affiliation(s)
- Jemma Louise McCready
- Department of Social Work, Education and Community Wellbeing, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Bethany Nichol
- Department of Social Work, Education and Community Wellbeing, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Mary Steen
- Department of Nursing, Midwifery and Health, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - John Unsworth
- Department of Nursing, Midwifery and Health, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | | | - Marco Tomietto
- Department of Nursing, Midwifery and Health, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland
- University of Bari “Aldo Moro”, Bari, Italy
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17
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Ledda C, Rapisarda V, Maltezou HC. COVID-19 vaccination refusal and suspension of work among healthy healthcare personnel in Italy: A cross-sectional study of their knowledge and attitudes toward vaccinations. Vaccine X 2023; 13:100275. [PMID: 36819213 PMCID: PMC9918318 DOI: 10.1016/j.jvacx.2023.100275] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 01/26/2023] [Accepted: 02/09/2023] [Indexed: 02/12/2023] Open
Abstract
Despite the initial optimistic projections from various countries and the evidence that vaccination against coronavirus disease 2019 (COVID-19) reduces the associated hospitalization rates and mortality, vaccine hesitancy and refusal among healthcare personnel (HCP) became a major public health concern globally. The aim of this survey was to estimate the knowledge about the Italian Vaccination Plan for HCP and attitudes about occupational vaccinations for HCP among Italian HCP who refused COVID-19 vaccination and were suspended from work. A total of 52 HCP participated in the study. Nurses were the prevalent profession among vaccination refusers. About COVID-19, 24 (26.2%) of all responders have been involved in COVID-19 care and 21 (40.4%) had a history of COVID-19. None had received influenza and pneumococcus vaccination in the past. Knowledge of vaccinations recommended for HCP was high, ranging from 75% to 98% by vaccine. Instead, all HCP were against any mandatory vaccination policy for all HCP. Finally, most HCP questioned the expected benefits and safety of vaccines in general, raised issues of mistrust of information provided for authorities and of compliance with their HCP' vaccination recommendations. Our study indicates good knowledge of occupational vaccinations but strong anti-vaccination beliefs among Italian HCP who refused COVID-19 vaccination and were suspended from work.
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Affiliation(s)
- Caterina Ledda
- Occupational Medicine Unit, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
- Corresponding author.
| | - Venerando Rapisarda
- Occupational Medicine Unit, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
- Occupational Medicine Unit, “G. Rodolico-San Marco” University Hospital, Catania, Italy
| | - Helena C. Maltezou
- Directorate for Research, Studies and Documentation, National Public Health Organization, Athens, Greece
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18
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Afshari P, Alavi SM, Abedi P, Beheshtinasab M, Dashtpayma S, Amiri H. Exploring the underlying factors of COVID-19 vaccination hesitancy in Ahvaz, Iran: a comprehensive cross-sectional study. Clin Exp Vaccine Res 2023; 12:127-133. [PMID: 37214142 PMCID: PMC10193107 DOI: 10.7774/cevr.2023.12.2.127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 01/25/2023] [Accepted: 02/03/2023] [Indexed: 05/24/2023] Open
Abstract
Purpose Around 70% of the Iranian population had received two doses of coronavirus disease 2019 (COVID-19) vaccines by the end of 2021. In this study, we evaluated the reasons for vaccination refusal among people in Ahvaz, Iran. Materials and Methods In this cross-sectional study, 800 participants (400 vaccinated and 400 unvaccinated) were recruited. A demographic questionnaire was completed through interviews. The unvaccinated participants were asked about the reasons for their refusal. The Shapiro-Wilk test, independent t-test, chi-square test, and logistic regression were used for analyzing data. Results Older people were 1.018 times more likely to refrain from vaccination (95% confidence interval [CI], 1.001-1.039; p=043). People who were manual workers as well as those who were unemployed/housewives were 0.288 and 0.423 times less likely to receive vaccination, respectively. Those with high school education and married women were 0.319 and 0.280 times less likely to receive vaccination, respectively (95% CI, 198-0.515; p<0.001; 95% CI, 0.186-0.422; p<0.001). Participants who had hypertension or suffered from neurological disorders were more likely to receive the vaccination. Finally, people affected with severe COVID-19 infection were 3.157 times more likely to get vaccinated (95% CI, 1.672-5.961; p<0.001). Conclusion The results of this study showed that lower level of education and older age were contributed to reluctance for vaccination, while having chronic diseases or being already infected with severe COVID-19 infection were associated with more acceptance of vaccination.
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Affiliation(s)
- Poorandokht Afshari
- Midwifery Department, Reproductive Health Promotion Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Seyed Mohammad Alavi
- Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Parvin Abedi
- Midwifery Department, Menopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Maryam Beheshtinasab
- Midwifery Department, Reproductive Health Promotion Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Shohreh Dashtpayma
- Midwifery Department, Reproductive Health Promotion Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Homayon Amiri
- Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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19
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Cawley JF. The Antivaccination Movement and Vaccine Hesitancy. PHYSICIAN ASSISTANT CLINICS 2023. [DOI: 10.1016/j.cpha.2023.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
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20
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COVID-19 Vaccination Attitude and Behavior among Nurses at a West Texas Regional Hospital. Vaccines (Basel) 2023; 11:vaccines11020343. [PMID: 36851221 PMCID: PMC9967739 DOI: 10.3390/vaccines11020343] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 01/31/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023] Open
Abstract
Vaccinations against COVID-19 infection have become a contentious issue in the United States. Multiple segments of society, including healthcare workers, have expressed concerns regarding the need for vaccination and the safety of current vaccines. Many hospital-based nurses have helped care for patients with severe COVID-19 infections. An anonymous online survey was sent to the nursing staff at University Medical Center in Lubbock, TX, USA, through a hospital-based email system to determine vaccination status and attitudes towards the COVID-19 vaccine and other routine vaccines. Multivariable regression analysis was used to determine factors associated with vaccination. A total of 251 nurses responded to this survey; 211 nurses (83.7%) had received the vaccine. Almost all nurses (242, 96%) had received all childhood vaccinations, and 231 (91.7%) had received an influenza vaccination in the prior year. A minority of nurses (75, 29.8%) supported mandatory vaccination for healthcare workers. The reasons for declining vaccination included the possibility that diet and alternative medications provided better protection against COVID-19. This survey demonstrates that over 80% of nurses working in a hospital managing very sick patients with COVID-19 infection had been vaccinated. However, nurses who did not take the annual influenza vaccine and did not consider other protective measures useful (such as mask-wearing) were significantly less likely to vaccinate. Nurses can provide an important resource for conversations with the public and patients about vaccine initiatives.
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21
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Ghare F, Meckawy R, Moore M, Lomazzi M. Determinants of Acceptance of COVID-19 Vaccination in Healthcare and Public Health Professionals: A Review. Vaccines (Basel) 2023; 11:311. [PMID: 36851189 PMCID: PMC9961323 DOI: 10.3390/vaccines11020311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 01/23/2023] [Accepted: 01/25/2023] [Indexed: 02/02/2023] Open
Abstract
Vaccinations of healthcare workers (HCWs) aim to directly protect them from occupational diseases, and indirectly protect their patients and communities. However, studies increasingly highlight that HCWs can be vaccine hesitant. This review aims to analyze HCWs' and public health professionals' sentiments toward COVID-19 (Coronavirus Disease 2019) vaccination and determinants across different countries. A search strategy was conducted in PubMed using keywords such as "COVID-19", "sentiment/acceptance", "healthcare workers", "vaccine hesitancy", and "influenza". A total of 56 articles were selected for in-depth analyses. The highest COVID-19 vaccination uptake was found in an Italian study (98.9%), and the lowest in Cyprus (30%). Older age, male gender, the medical profession, higher education level, presence of comorbidities, and previous influenza vaccination were associated with vaccine acceptance. Factors for low acceptance were perceived side effects of the vaccine, perceived lack of effectiveness and efficacy, and lack of information and knowledge. Factors for acceptance were knowledge, confidence in the vaccine, government, and health authorities, and increased perception of fear and susceptibility. All studies focused on healthcare providers; no studies focusing on public health professionals' sentiments could be found, indicating a gap in research that needs to be addressed. Interventions must be implemented with vaccination campaigns to improve COVID-19 vaccine acceptance.
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Affiliation(s)
- Fathema Ghare
- World Federation of Public Health Associations (WFPHA), Institute of Global Health, University of Geneva, Campus Biotech—G6, Chemin des Mines 9, 1202 Geneva, Switzerland
| | - Rehab Meckawy
- World Federation of Public Health Associations (WFPHA), Institute of Global Health, University of Geneva, Campus Biotech—G6, Chemin des Mines 9, 1202 Geneva, Switzerland
- Public Health and Community Medicine Department, Alexandria Faculty of Medicine, Alexandria University, Champollion Street, Al Attarin, Alexandria 21321, Egypt
| | - Michael Moore
- World Federation of Public Health Associations (WFPHA), Institute of Global Health, University of Geneva, Campus Biotech—G6, Chemin des Mines 9, 1202 Geneva, Switzerland
| | - Marta Lomazzi
- World Federation of Public Health Associations (WFPHA), Institute of Global Health, University of Geneva, Campus Biotech—G6, Chemin des Mines 9, 1202 Geneva, Switzerland
- Institute of Global Health, University of Geneva, Campus Biotech—G6, Chemin des Mines 9, 1202 Geneva, Switzerland
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22
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Viskupič F, Wiltse DL. Drivers of COVID-19 booster uptake among nurses. Am J Infect Control 2022:S0196-6553(22)00815-X. [PMID: 36427700 PMCID: PMC9683517 DOI: 10.1016/j.ajic.2022.11.014] [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: 08/22/2022] [Revised: 11/15/2022] [Accepted: 11/16/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Nurses are at the forefront of efforts to contain COVID-19 and are thus at greater risk of infection from the virus than the general population. Unlike the initial vaccination, booster vaccinations are not always required, and some nurses have not received a booster shot. We investigate the predictors of booster uptake among nurses. METHODS We developed an original survey to study booster uptake among nurses. Using contact information from the South Dakota Board of Nursing, we contacted nurses in South Dakota in June and July of 2022. We conducted a multivariate logistic regression to analyze the data. RESULTS One thousand eighty-four nurses participated in our study. We found booster uptake among nurses was associated with their partisan self-identification (OR 0.40, 95% CI 0.31-0.52), age (OR 1.04, 95% CI 1.02-1.05), flu vaccination last season (OR 5.61, 95% CI 2.6-12.1), and positive COVID-19 test in last 12 months (OR 0.51, 95% CI 0.35-0.74). DISCUSSION/CONCLUSIONS Our results show that COVID-19 booster uptake has been politicized even among nurses. As public health officials continue devising interventions to increase booster uptake among healthcare workers, they should be mindful that they would be viewed through the partisan lens.
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Affiliation(s)
- Filip Viskupič
- Address correspondence to Filip Viskupič, PhD, 219 West Hall, South Dakota State University, Brookings, SD 57006
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23
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Lielsvagere-Endele S, Kolesnikova J, Puzanova E, Timofejeva S, Millere I. Motivators and barriers to COVID-19 vaccination of healthcare workers in Latvia. Front Psychol 2022; 13:903506. [PMID: 36275263 PMCID: PMC9580560 DOI: 10.3389/fpsyg.2022.903506] [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: 03/24/2022] [Accepted: 08/30/2022] [Indexed: 11/16/2022] Open
Abstract
This study aims to identify motivators and barriers regarding Coronavirus disease 2019 (COVID-19) vaccination among Latvian healthcare workers (HCWs). Data were collected from March to May 2021 using an online survey. Overall, 1,444 participants took part in the study. From this pool of respondents, 528 indicated motivating factors in favor of the COVID-19 vaccination (86.5% were women; aged between 20 and 75 years), while 198 mentioned barriers against the COVID-19 vaccination (92.9% were women; aged between 19 and 68 years). The thematic analysis was conducted on two open-ended questions. The main motivators reported for COVID-19 vaccination were belief in the effectiveness of the vaccine, benefits of easing COVID-19 restrictions, responsibility, and restriction or pressure in case of non-vaccination. The main barriers reported regarding the COVID-19 vaccination were concerns about the effectiveness and safety of vaccines, perceived health risks of vaccination, risk perception toward COVID-19, misinformation about COVID-19 vaccines, belief that vaccination is being imposed, and belief in the conspiracy theories surrounding COVID-19. The results of this study help identify the existing motivating and hindering factors for COVID-19 vaccination among HCWs in Latvia. These results can be used to promote vaccination in HCW, develop information campaigns, and alleviate concerns of HCW.
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Affiliation(s)
- Sintija Lielsvagere-Endele
- Psychology Laboratory, Faculty of Public Health and Social Welfare, Riga Stradins University, Riga, Latvia
| | - Jelena Kolesnikova
- Psychology Laboratory, Faculty of Public Health and Social Welfare, Riga Stradins University, Riga, Latvia
| | - Elina Puzanova
- Faculty of Public Health and Social Welfare, Riga Stradins University, Riga, Latvia
| | - Svetlana Timofejeva
- Faculty of Public Health and Social Welfare, Riga Stradins University, Riga, Latvia
| | - Inga Millere
- Faculty of Public Health and Social Welfare, Riga Stradins University, Riga, Latvia
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24
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Rossettini G, Peressutti V, Visintini E, Fontanini R, Caruzzo D, Longhini J, Palese A. Italian nurses' experiences of the COVID-19 pandemic through social media: A longitudinal mixed methods study of Internet posts. Digit Health 2022; 8:20552076221129082. [PMID: 36211800 PMCID: PMC9536097 DOI: 10.1177/20552076221129082] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 04/12/2022] [Indexed: 11/05/2022] Open
Abstract
Objective To examine the experience of Italian nurses posted on social media and discover changes, if any, over the waves. Methods A mixed methods study reported according to the Good Reporting of a Mixed Methods Study criteria. All narratives (texts, letters and interviews) posted by Italian nurses from February 2020 to May 2020 (first wave) and from October 2020 to May 2021 (second/third wave) on the five most famous Italian professional social media platforms. The data were analysed qualitatively (first wave) and then quantitatively (second/third wave). Results A total of 380 narratives (202,626 words, 2510 quotes) were posted in the first wave, and 161 (68,388 words, 835 quotes) in the second/third wave. In the first wave, the following five themes emerged: (a) ‘sharing what is happening within myself’ (891; 35.5%); (b) ‘experiencing unprecedented working conditions’ (749; 29.8%); (c) ‘failing to rehabilitate the image of nurses in society’ (376; 15%); (d) ‘experiencing a deep change’ (253; 10.1%) and (e) ‘do not abandon us’ (241; 9.6%). The same themes and subthemes also emerged in the second/third wave with some significant differences, indicating changes in the lived experience of nurses. Moreover, in the second/third wave, a new theme emerged: ‘experiencing the mixed emotions towards jabs’. Conclusions By analysing their posts, Italian nurses continue to face challenges during the COVID-19 pandemic, with changes in their lived experiences across the waves. Governments, nursing associations and health care organizations should consider these changes to design policies to prevent the further loss of nurses.
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Affiliation(s)
- Giacomo Rossettini
- Clinical PT, School of Physiotherapy, University of Verona, Verona, Italy
| | | | | | | | | | | | - Alvisa Palese
- Udine University, Udine, Italy,Jessica Longhini, Udine University, Viale Ungheria, 20, 33100, Udine, Italy.
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Garcia L, Firek A, Freund D, Massai D, Khurana D, Lee JE, Zamarripa S, Sasaninia B, Michaels K, Nightingale J, Gatto NM. Decisions to Choose COVID-19 Vaccination by Health Care Workers in a Southern California Safety Net Medical Center Vary by Sociodemographic Factors. Vaccines (Basel) 2022; 10:1247. [PMID: 36016135 PMCID: PMC9412623 DOI: 10.3390/vaccines10081247] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/28/2022] [Accepted: 07/30/2022] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Limited information exists regarding COVID-19 vaccine hesitancy among healthcare workers (HCWs). Our previous survey analyzed the reasons for HCWs' decisions to accept vaccination, suggesting that a "one-size fits all" approach may not suffice to increase vaccine uptake. METHODS Based on the vaccination acceptance group (acceptor, hesitant, refuser), we examined differences by sociodemographic factors (race/ethnicity, household income, education) from Likert Scale responses to fourteen influences affecting a decision to be vaccinated using the Kruskal-Wallis test and multinomial logistic regression with mutual adjustment for these sociodemographic factors, age, and sex. RESULTS Non-Hispanic White vaccine acceptors ranked lower confidence in preventing, withstanding, or treating COVID-19, while Non-Hispanic Blacks more highly regarded the motivation of a religious leader, colleague, or family member. Social media was ranked more influential among Non-Hispanic Asians. Acceptors with lower incomes ranked a job requirement influential; conversely, higher income vaccine hesitant HCWs highly rated this reason. More highly educated acceptors ranked being motivated by colleagues, family, and other HCWs higher. Adjustment weakened some but not all the differences between groups. CONCLUSIONS Sociodemographic factors affect HCWs' decisions to be vaccinated against COVID-19. Our findings may help develop more focused and tailored strategies to improve vaccination acceptance.
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Affiliation(s)
- Lauren Garcia
- School of Community and Global Health, Claremont Graduate University, 150 E 10th St, Claremont, CA 91711, USA; (L.G.); (D.F.); (D.M.)
| | - Anthony Firek
- Comparative Effectiveness and Clinical Outcomes Research Center, Riverside University Health System, 26520 Cactus Avenue, Moreno Valley, CA 92555, USA; (A.F.); (D.K.); (S.Z.); (B.S.); (K.M.); (J.N.)
| | - Deborah Freund
- School of Community and Global Health, Claremont Graduate University, 150 E 10th St, Claremont, CA 91711, USA; (L.G.); (D.F.); (D.M.)
- Department of Economic Sciences, Claremont Graduate University, 150 E 10th St, Claremont, CA 91711, USA;
| | - Donatella Massai
- School of Community and Global Health, Claremont Graduate University, 150 E 10th St, Claremont, CA 91711, USA; (L.G.); (D.F.); (D.M.)
| | - Dhruv Khurana
- Comparative Effectiveness and Clinical Outcomes Research Center, Riverside University Health System, 26520 Cactus Avenue, Moreno Valley, CA 92555, USA; (A.F.); (D.K.); (S.Z.); (B.S.); (K.M.); (J.N.)
- Division of Addiction Psychiatry, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, 10833 Le Conte Ave, Los Angeles, CA 90095, USA
| | - Jerusha E. Lee
- Department of Economic Sciences, Claremont Graduate University, 150 E 10th St, Claremont, CA 91711, USA;
| | - Susanna Zamarripa
- Comparative Effectiveness and Clinical Outcomes Research Center, Riverside University Health System, 26520 Cactus Avenue, Moreno Valley, CA 92555, USA; (A.F.); (D.K.); (S.Z.); (B.S.); (K.M.); (J.N.)
| | - Bijan Sasaninia
- Comparative Effectiveness and Clinical Outcomes Research Center, Riverside University Health System, 26520 Cactus Avenue, Moreno Valley, CA 92555, USA; (A.F.); (D.K.); (S.Z.); (B.S.); (K.M.); (J.N.)
| | - Kelsey Michaels
- Comparative Effectiveness and Clinical Outcomes Research Center, Riverside University Health System, 26520 Cactus Avenue, Moreno Valley, CA 92555, USA; (A.F.); (D.K.); (S.Z.); (B.S.); (K.M.); (J.N.)
| | - Judi Nightingale
- Comparative Effectiveness and Clinical Outcomes Research Center, Riverside University Health System, 26520 Cactus Avenue, Moreno Valley, CA 92555, USA; (A.F.); (D.K.); (S.Z.); (B.S.); (K.M.); (J.N.)
| | - Nicole M. Gatto
- Comparative Effectiveness and Clinical Outcomes Research Center, Riverside University Health System, 26520 Cactus Avenue, Moreno Valley, CA 92555, USA; (A.F.); (D.K.); (S.Z.); (B.S.); (K.M.); (J.N.)
- School of Public Health, Loma Linda University, 24951 Circle Dr, Loma Linda, CA 92354, USA
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 1975 Zonal Ave., Los Angeles, CA 90089, USA
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Elliott TR, Perrin PB, Powers MB, Jacobi KS, Warren AM. Predictors of Vaccine Hesitancy among Health Care Workers during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127123. [PMID: 35742372 PMCID: PMC9222587 DOI: 10.3390/ijerph19127123] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 06/01/2022] [Accepted: 06/08/2022] [Indexed: 02/04/2023]
Abstract
Most studies of COVID-19 vaccine hesitancy among health care workers (HCWs) have been descriptive, few have tested models to predict hesitancy, and none have examined the possible relationship between HCWs’ distress and vaccine hesitancy. This study examined predictors of COVID-19 vaccine hesitancy, including HCWs’ distress after taking into account HCW sex, doctoral-level status, race, age, and exposure to COVID-19. Further, it examined specific reasons HCWs endorsed for their hesitancy. 266 HCWs in the United States (U.S.). completed an online survey administered in January 2021, following the availability of the vaccine for HCWs in the U.S. The survey assessed demographics, depression, anxiety, COVID-19 vaccine hesitancy, and reasons for hesitancy. A comprehensive linear regression model explained 72.2% of the variance in COVID-19 vaccine hesitancy. HCWs were more hesitant if they did not know someone personally who had tested positive. Distress had no effect. The reasons most predicting vaccine hesitancy included safety, potential side effects, believing the risks from COVID-19 were lower than from the vaccine, not feeling at risk for getting COVID-19, and current pregnancy. Rather than rely on providing information about the COVID-19 vaccines to HCWs, strategies that address their concerns are required to promote vaccine acceptance. Contemporary issues of political polarization, misinformation and mistrust are likely to contribute to the concerns HCWs have about the COVID-19 vaccines.
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Affiliation(s)
- Timothy R. Elliott
- Department of Educational Psychology, Texas A&M University, College Station, TX 77843, USA;
- Correspondence:
| | - Paul B. Perrin
- Department of Psychology, Virginia Commonwealth University, Richmond, VA 23284, USA;
| | - Mark B. Powers
- Trauma Research Consortium, Baylor Scott & White Research Institute, Department of Trauma, Critical Care and Acute Care Surgery, Baylor University Medical Center, Dallas, TX 75246, USA; (M.B.P.); (A.M.W.)
| | - Katelin S. Jacobi
- Department of Educational Psychology, Texas A&M University, College Station, TX 77843, USA;
| | - Ann Marie Warren
- Trauma Research Consortium, Baylor Scott & White Research Institute, Department of Trauma, Critical Care and Acute Care Surgery, Baylor University Medical Center, Dallas, TX 75246, USA; (M.B.P.); (A.M.W.)
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