Pre-Vaccination Stress, Post-Vaccination Adverse Reactions, and Attitudes towards Vaccination after Receiving the COVID-19 Vaccine among Health Care Workers

How stressful was the COVID-19 vaccination procedure? Comparison between mass vaccination centers and general practices

Negative past experiences with vaccines or unfamiliar environments can be sources of stress during the COVID-19 vaccination procedure. We examined whether the perceived stressfulness of the vaccination procedure differ between mass vaccination centers and general practitioner (GP) practices. A survey was distributed (07/2021-10/2021) among newly vaccinated individuals in ten GP practices (n = 364) and two vaccine centers (n = 474). Stress was low at all sites. The perceived stressfulness of the procedure was higher among younger participants and those in GP practices, and increased with longer waiting time at the site. Stress decreased with better comprehensibility of the procedure and higher satisfaction with patient education. Participants who expressed greater concern about the health risks of COVID-19 vaccines perceived the vaccination procedure as more stressful. Our findings indicate opportunities for improvements in future vaccination campaigns and highlight the important role of healthcare providers in mitigating stress by addressing individual concerns.

Risk and protection factors of mental stress among medical staff in the third year of the COVID-19 pandemic

Background

The COVID-19 pandemic placed an extraordinary burden on health care workers (HCW), who are reported to suffer from great mental stress. The current study investigates the mental health of HCW in the later phases of the pandemic.

Methods

HCW completed the following questionnaires online (06/2021-02/2022, N=159): demographics (age, gender, profession, ward), Impact of Event Scale (IES-R, posttraumatic stress), State Trait Anxiety Inventory (STAI-S, state anxiety), stress-coping questionnaire (SVF-78), and bespoke corona-specific stress and protective-factor questions (5 items each). We used factor analysis to test scale properties and regression-type methods (t-tests, ANOVA, multiple regression) for hypothesis tests and effect-size estimation.

Results/discussion

Mental stress in HCW is influenced by similar factors as described for earlier phases. However, differences to earlier phases were found in ward affiliation which is no longer a variable of concern for explaining differences in mental health of HCW. Further, even if nurses are the occupational group with the highest mental stress as in prior research, detailed analysis shows that medical specialists with close proximity to patients with a high-level of responsibility are the most burdened sub-group. Unlike nurses, they suffer from high levels of anxiety in addition to high levels of post-traumatic and COVID-specific stress. Analyses showed further that COVID-specific stress is the strongest predictor of mental stress, wherein COVID-specific stress factors remain the same as reported in literature on the early pandemic phases. HCW showed to use still more positive than negative coping strategies. Negative strategies increased as expected mental stress, whereas positive strategies alleviated only anxiety. Additionally, we found that doctors benefited from many protective factors while nurses had access to fewer protective factors like earlier waves.

Conclusion

Data show that HCW still suffer from mental stress in the third year of the pandemic. HCW of all hospital wards may be affected by mental stress and need attention and protective measures. Medical specialists are the most burdened subgroup. Detailed analyses show that properties other than occupation, gender, or ward affiliation are more appropriate to evaluate mental stress of HCW. The findings have implications for developing specialized protection strategies for the post-pandemic phase and future pandemics.

Sex differences in the relationship between post-vaccination adverse reactions, decision regret, and WTP for the booster dose of COVID-19 vaccine in Taizhou, China

This study investigated sex differences in the relationship between post-vaccination adverse reactions, decision regret, and willingness to pay (WTP) for the booster dose of COVID-19 vaccines. This research carried out an online cross-sectional investigation among healthcare workers (HCWs) in Taizhou, China. In total, 1,054 respondents (165 males and 889 females) have received two-dose COVID-19 vaccination. We performed descriptive analysis, chi-square test, and mediation analysis on the exported data. In this study, 67 (40.6%) males and 429 (48.3%) females had WTP for the booster dose. Our study presented that decision regret mediated the effect of adverse reactions after vaccination on WTP for the booster dose in both male and female groups. In males, decision regret played a completely mediating role, while in females, it acted as a partial mediator. Sex differences in the relationship between post-vaccination side effects, decision regret, and WTP for the third dose were demonstrated in a sample of healthcare workers.

Are We Facing a Tsunami of Vaccine Hesitancy or Outdated Pandemic Policy in Times of Omicron? Analyzing Changes of COVID-19 Vaccination Trends in Poland

In this study, we analyzed Polish COVID-19 vaccination data until January 2023 from the European Centre for Disease Prevention and Control to understand individual decision making during the milder Omicron wave. Our findings show a general decline in subsequent vaccine uptake. As the number of government-provided doses increased, completion rates among certain low-risk groups dropped to less than 1%. Elderly individuals, especially those aged 70–79, showed greater adherence but also exhibited decreased interest in subsequent boosters. Healthcare workers exhibited a dramatic shift in their attitude, disregarding the recommended schedule. The overwhelming majority opted out of receiving the second boosters, while the remaining individuals adjusted their timing based on infection trends or the availability of updated boosters. Two factors positively influenced vaccination decisions: societal influence and the availability of updated boosters. Lower-risk individuals were more likely to postpone vaccination until updated boosters were available. Our findings highlight that while Polish policy aligns with international guidelines, it fails to garner significant adherence from the Polish population. Previous studies have shown that vaccinating low-risk groups resulted in more sick days due to adverse events following immunization than the days gained by preventing infection. Consequently, we advocate for the official abandonment of this policy, as its practical abandonment has already taken place, and persisting in pretending otherwise only serves to erode public trust. Therefore, we propose a shift toward treating COVID-19-like influenza with vaccination for vulnerable individuals and those who have close contact with them before the season.

Are We Facing a Tsunami of Vaccine Hesitancy or Outdated Pandemic Policy in Times of Omicron? Analyzing Changes of COVID-19 Vaccination Trends in Poland

In this study, we analyzed Polish COVID-19 vaccination data until January 2023 from the European Centre for Disease Prevention and Control to understand individual decision making during the milder Omicron wave. Our findings show a general decline in subsequent vaccine uptake. As the number of government-provided doses increased, completion rates among certain low-risk groups dropped to less than 1%. Elderly individuals, especially those aged 70-79, showed greater adherence but also exhibited decreased interest in subsequent boosters. Healthcare workers exhibited a dramatic shift in their attitude, disregarding the recommended schedule. The overwhelming majority opted out of receiving the second boosters, while the remaining individuals adjusted their timing based on infection trends or the availability of updated boosters. Two factors positively influenced vaccination decisions: societal influence and the availability of updated boosters. Lower-risk individuals were more likely to postpone vaccination until updated boosters were available. Our findings highlight that while Polish policy aligns with international guidelines, it fails to garner significant adherence from the Polish population. Previous studies have shown that vaccinating low-risk groups resulted in more sick days due to adverse events following immunization than the days gained by preventing infection. Consequently, we advocate for the official abandonment of this policy, as its practical abandonment has already taken place, and persisting in pretending otherwise only serves to erode public trust. Therefore, we propose a shift toward treating COVID-19-like influenza with vaccination for vulnerable individuals and those who have close contact with them before the season.

Healthcare Workers' Attitudes towards Mandatory COVID-19 Vaccination: A Systematic Review and Meta-Analysis

BACKGROUND

COVID-19 vaccine mandates are considered a controversial public health policy both in public debate and among healthcare workers (HCWs). Thus, the objective of this systematic review is to give a deep insight into HCWs' views and attitudes towards COVID-19 vaccination mandates amid the ongoing COVID-19 pandemic.

METHODS

A systematic literature search of five databases (PubMed, Scopus, Embase, CINAHL, and Web of Science) was conducted between July 2022 and November 2022. Original quantitative studies that addressed the attitudes of HCWs regarding COVID-19 vaccine mandates were considered eligible for this systematic review. All the included studies (n = 57) were critically appraised and assessed for risk of systematic bias. Meta-analyses were performed, providing a pooled estimate of HCWs' acceptance towards COVID-19 vaccine mandates for: 1. HCWs and 2. the general population.

RESULTS

In total, 64% (95% CI: 55%, 72%) of HCWs favored COVID-19 vaccine mandates for HCWs, while 50% (95% CI: 38%, 61%) supported mandating COVID-19 vaccines for the general population.

CONCLUSIONS

Our findings indicate that mandatory vaccination against COVID-19 is a highly controversial issue among HCWs. The present study provides stakeholders and policy makers with useful evidence related to the compulsory or non-compulsory nature of COVID-19 vaccinations for HCWs and the general population. Other: The protocol used in this review is registered on PROSPERO with the ID number: CRD42022350275.

Post-vaccination adverse reactions, decision regret, and willingness to pay for the booster dose of COVID-19 vaccine among healthcare workers: A mediation analysis

This study aimed to explore the relationship between post-vaccination adverse reactions, decision regret, and willingness to pay (WTP) for the booster dose. An online survey was conducted in Taizhou, China. Questionnaires were completed by 1,085 healthcare workers (HCWs) and 1,054 (97.1%) have received two doses of the COVID-19 vaccine. Mediation analysis method was adopted. Our study presented that post-vaccination adverse reactions in HCWs could decrease their WTP for the booster dose. Of note, HCWs experienced adverse reactions after vaccination would more likely regret their previous vaccination decisions, which, in turn, further reduced their WTP for a booster shot. Decision regret mediated the relationship between adverse post-vaccination reactions and WTP for the booster dose. The findings implied inextricable relationships among post-vaccination adverse reactions, decision regret, and WTP of the booster dose. It suggested that these post-vaccination adverse reactions should be further incorporated into vaccine campaigns to improve vaccine intention and potentially increase willingness to pay for booster doses of COVID-19 vaccine.

Uptake of COVID-19 booster shot among healthcare workers: A mediation analysis approach

Since the thrust of previous research investigations has been on people's willingness to get immunized against the COVID-19 infection, the underpinning principle of compliance has received very little attention. Addressing the possible drivers and mechanisms influencing vaccine acceptance may provide significant insights for limiting the pandemic. In response, we intend to investigate the influence of decision regret and the consequences of post-vaccination adverse effects on the inclination to undertake booster shots. An electronic survey that was self-administered was conducted in Rawalpindi, Pakistan. The questionnaire was completed by 1,369 participants, with a response rate of 41%. 1,343 of them (98.10%) had received both doses of the COVID-19 vaccination. Besides, the present research has also adopted a mediation model. Our findings demonstrate that unfavorable vaccination responses in healthcare workers significantly affect their likelihood of receiving booster shots. Interestingly, healthcare workers who had adverse experiences after being immunized were more prone to regret their prior immunization decisions, which in response affected their decision to get a booster shot. The motivation to receive the booster dosage and adverse post-vaccination responses were mediated by decision regret. The outcomes suggested indissociable connections between unfavorable vaccination responses, decision regret, and the likelihood of receiving a booster shot. To strengthen immunization acceptance intent and enhance the likelihood of receiving COVID-19 booster shots, it is recommended that awareness of these post-vaccination adverse events be extensively integrated into immunization awareness programs and policy measures supporting booster doses.

COVID-19-Related Predictors of Fear and Attitude to Vaccination Displayed by Polish Students

Vaccines are one of the most important achievements of modern medicine in maintaining the health of the population. The prolonged pandemic and subsequent lockdowns meant that the new COVID-19 vaccine was regarded by scientists and society as the way to end the pandemic and return to normal life. The purpose of this study was to analyze the factors responsible for the feeling of fear due to COVID-19 infection and the attitudes of medical students towards vaccination against COVID-19. A cross-sectional study was conducted online among medical students using standardized questionnaires: the Fear of COVID-19 scale and the Vaccination Attitude Examination scale. According to the results obtained, the respondents had a low level of fear of COVID-19 and the majority had positive attitudes towards vaccination against COVID-19. Regression analysis showed that the main predictors of fear of the pandemic and attitudes towards vaccination were age, sex, field of study, and sources of knowledge about vaccines. The analysis of factors related to the discussed issues can be the basis to formulate educational and preventive programs, to shape positive attitudes of future health sector employees toward the issue of preventive vaccination, as well as for the development of strategies to promote vaccination against COVID-19.

Evaluation of Prevalence of Side-Effects Associated with Booster Dose of mRNA-Based COVID-19 Vaccine Among Healthcare Workers in Eastern Province, Saudi Arabia: A Descriptive Cross-Sectional Study

Background

The purpose of this study was to examine the mild and moderate side-effects experienced by the healthcare workers (HCWs) in the Eastern Province of Saudi Arabia after receiving the booster dose of the Pfizer-BioNTech/BNT162b2 COVID-19 vaccine.

Methods

We directed a descriptive cross-sectional study among adults living in the Eastern Province of Saudi Arabia. A survey link was distributed through WhatsApp, SMS, or e-mail to HCWs. Participants' general and demographic information were also collected, as well as information about any local and systemic side-effects reported following vaccination.

Results

The results of this study showed that 81.84% (401/490) of the HCWs who contributed to this study reported the minimum COVID-19 post-vaccination side-effect. Body pain (89%) and pain at the site of injection (88.73%) were the most frequent frequently reported side-effects, followed by headache (28.68%), joint or bone pain (27.18%), muscle pain (26.43%), nausea or vomiting (21.2%), fever (18.95%), skin rashes (10.22%). History of chronic diseases had a 0.44-fold increased risk of side-effects compared to no history of chronic diseases HCWs (adjusted odds ratio (aOR) = 0.44; 95% CI = 0.224, 0.880), and significant association of occupation with side-effects was also 1.61-fold increased risk compared to nonmedical ((aOR) = 1.61; 95% CI = 1.037, 2.513).

Conclusion

According to this study, the Pfizer-BioNTech/BNT162b2 COVID-19 vaccine was safe when given to Saudi Arabian HCWs. All reported side-effects were mild to moderate. The outcomes indicated that most participants had body pain and pain at the site of injection and fatigue is among the least reported side-effect post-booster dose. Healthcare was highly connected with more reporting of side-effects.

COVID-19 Vaccination in China: Adverse Effects and Its Impact on Health Care Working Decisions on Booster Dose

Although many research studies have concentrated on people’s willingness to take the COVID-19 vaccine, little attention has been paid to the underlying mechanism of consent. An understanding of potential factors and mechanisms that affect the willingness to receive a vaccination can contribute information critical for containing the pandemic. This study explored the effects of post-vaccination adverse reactions on the willingness to take the booster dose and the role of decision regret. A self-administered online survey was carried out in Taizhou, China. Questionnaires were completed by 1085 healthcare workers (HCWs), 1054 (97.1%) of whom had completed two doses of the COVID-19 vaccine. Mediation analysis methodology was applied in this study. Our study showed that post-vaccination adverse reactions in HCWs could decrease their willingness to take the booster dose. Of note, HCWs who experienced adverse reactions after vaccination would be more likely to regret their previous vaccination decisions, which, in turn, further reduced their willingness to receive a booster shot. Decision regret mediated the relationship between adverse post-vaccination reactions and a willingness to take the booster dose. The findings implied inextricable relationships among post-vaccination adverse reactions, decision regret, and willingness to take the booster dose. It is suggested that notice of these post-vaccination adverse reactions should be further incorporated into vaccine communication campaigns and policy interventions advocating booster doses to improve vaccine uptake intent and increase the willingness to receive booster doses of a COVID-19 vaccine.

A Retrospective Cross-Sectional Study on the Risk of Getting Sick with COVID-19, the Course of the Disease, and the Impact of the National Vaccination Program against SARS-CoV-2 on Vaccination among Health Professionals in Poland

Six months after starting the National Vaccination Program against COVID-19, a cross-sectional retrospective study was conducted among 1200 salaried and non-salaried healthcare workers (HCWs) in Poland. Its aim was to assess factors including the risk of exposure to COVID-19, experiences with COVID-19, the trust in different sources of knowledge about the pandemic and SARS-CoV-2 vaccines, and the government campaign on vaccination as predictors of vaccination acceptance. The strongest awareness of a high risk of work-associated infection was demonstrated by doctors (D) (72.6%) and nurses and midwives (N) (64.8%); however, almost half of the medical students (MS) and nursing and midwifery students (NS) did not identify as a risk group. Out of several dozen variables related to sociodemographic characteristics and personal experience of COVID-19, only occupation, previous COVID-19 infection, and high stress seemed to significantly influence vaccination acceptance. Interestingly, only 6.7% of respondents admitted that the government campaign impacted their decision to vaccinate. This result is not surprising considering that the vast majority of respondents (87.8%) learned about vaccinations from sources such as academic lectures (29.9%), health professionals (29.0%), or the internet (28.9%). Those who gained information about vaccination from traditional media (radio, television, and daily press), a popular platform of the government campaign, had a lower propensity to vaccinate (OR = 0.16, p < 0.001). Additionally, almost twice as many considered the information provided in the campaign to be unreliable. Our findings, from this retrospective study, do not confirm that the government campaign was effective for healthcare professionals. Therefore, in this group, other forms of vaccination incentives should be sought. However, the vaccinated respondents were significantly more likely to support compulsory vaccination against COVID-19 among health professionals.