Cognitive and Cultural Factors That Affect General Vaccination and COVID-19 Vaccination Attitudes

Factors influencing COVID-19 vaccine uptake among Latinos: A cross-sectional study

Vaccination against COVID-19 can prevent severe illness and reduce hospitalizations and deaths. Understanding and addressing determinants contributing to vaccine uptake among high-risk groups, such as Latinos, are pivotal in ensuring equitable vaccine distribution, promoting health equity, and fostering community engagement to bridge the gap in vaccine acceptance and ultimately enhance public health. This study aimed to examine factors influencing vaccine uptake among Latinos. We conducted a cross-sectional study using an online platform (n = 242). The survey was administered using a multimodal approach. Strategies for recruitment included community outreach, social media, and targeting community networks serving Latinos. Descriptive statistics, chi-square, and multivariable analysis were performed. Overall, 81.4% of respondents had received at least one dose of the COVID-19 vaccine, with 77.0% recommending it and 70.6% believing it to be safe, 66.7% believing in its efficacy, 62.3% able to find trustful information in Spanish or Portuguese, and almost 40% who relied on health organizations as their primary resource for COVID-19 vaccine information. Factors significantly associated with vaccine uptake included higher education level (p<0.001), English level (p = 0.023), living in an urban area (p = 0.048), having insurance (p<0.001), and having a healthcare provider (p = 0.007). Furthermore, belief in vaccine safety and efficacy, trust in public health authorities, concerns about COVID-19, the ability to determine true/false vaccine information during the pandemic, and the availability of trustworthy information in Spanish/Portuguese had statistically significant associations (p<0.05) with COVID-19 vaccine uptake. COVID-19 vaccine uptake differed based on sociodemographic and other modifiable factors. Our findings emphasize the importance of implementing targeted interventions and culturally sensitive communication strategies to improve vaccination uptake among the Latino community in the United States.

The nurse's role in a patient-centered approach for reducing COVID-19 vaccine hesitancy during pregnancy: An American Academy of Nursing consensus paper

The evidence shows that COVID-19 vaccines can reduce the risks of poor pregnancy outcomes. Yet, reluctance to vaccinate remains high in pregnant populations. In this paper, we take a precision health and patient-centered approach to vaccine hesitancy. We adopted the society-to-cells vaccine hesitancy framework to identify society, community, family, individual, and physiologic factors contributing to COVID-19 vaccine hesitancy in pregnancy. Nurses are particularly well-suited to impact the factors associated with vaccine hesitancy. Because of their proximity to the patient, nurses are positioned to provide individualized, timely health information, and clinical guidelines to assist patients with decision-making related to vaccinations. Recommendations are provided to bolster nurses' engagement in precision health and patient-centered models of care to mitigate COVID-19 vaccine hesitancy in pregnancy.

COVID-19 Vaccine Confidence Mediates the Relationship between Health Literacy and Vaccination in a Diverse Sample of Urban Adults

We sought to analyze the relationship between health literacy, confidence in COVID-19 vaccines, and self-reported vaccination. We hypothesized that the relationship between health literacy and vaccination would be mediated by vaccine confidence. We recruited (N = 271) English- and Spanish-speaking adults in Boston and Chicago from September 2018 to September 2021. We performed a probit mediation analysis to determine if confidence in COVID-19 vaccines and health literacy predicted self-reported vaccination. We hypothesized that the relationship between health literacy and vaccination would be mediated by vaccine confidence. Participants were on average 50 years old, 65% female, 40% non-Hispanic Black, 25% Hispanic, and 30% non-Hispanic White; 231 (85%) reported at least one COVID-19 vaccination. A higher mean vaccine confidence score (t = -7.9, p < 0.001) and higher health literacy (t = -2.2, p = 0.03) were associated with vaccination, but only vaccine confidence predicted vaccination in a multivariate model. Vaccine confidence mediated the relationship between health literacy and COVID-19 vaccination (mediated effects: 0.04; 95% CI [0.02, 0.08]). We found that using a simple tool to measure vaccine confidence identified people who declined or delayed COVID-19 vaccination in a diverse sample of adults with varying levels of health literacy. Simple short survey tools can be useful to identify people who may benefit from vaccine promotion efforts and evidence-based communication strategies.

Trust in Physicians in the Context of HPV Vaccination of Children from the Perspective of Social Exchange Theory: A Representative Study of Polish Parents

The vaccination of children against human papillomavirus (HPV) effectively prevents HPV infection and HPV-related cancers in women and men. However, HPV vaccination programs are met with vaccine hesitancy, which varies between countries. The coverage in Poland is low, although introducing nationally funded HPV vaccination for girls aged 12-13 in mid-2023 may increase it. The uptake of the HPV vaccine in adolescents is highly affected by parental decisions, which in turn can be influenced by interactions with the physician. The present representative study aimed to analyze the acceptance of the HPV vaccine among Polish parents (n = 360) and the level of trust in HPV vaccination in the pediatrician/general practitioner who takes care of their children aged 9-15 years. The data were gathered in September 2022 using computer-assisted telephone interviews. Most surveyed parents reported trusting their child's physician regarding vaccine recommendations (89.2%) and vaccinated their child with all or most of the vaccines recommended by a national vaccination guideline (94.7%). However, 13.3% declared themselves as moderate or strong vaccine opponents, a group characterized by high (83.4%) distrust in physicians. There was no difference in the awareness of HPV in groups varying in trusting the physicians, but parents who trusted them were more frequently aware of the HPV vaccine. Parental willingness to vaccinate their child against HPV was highly differentiated by the level of trust in the child's physician. The results highlight that trust in physicians is a critical factor shaping decisions for children's vaccination, stressing a continuous need to improve strategies to communicate with patients.

Promoting RAPID Vaccine Science Education at the Onset of the COVID-19 Pandemic

At the onset of the 2019 coronavirus disease (COVID-19) pandemic, it was clear that we needed to support public education on the science of vaccines. This project was born of that need and led to the development of comprehensive educational materials that addressed the process of science, severe acute respiratory syndrome coronavirus 2 biology, vaccine development, and science communication and outreach. Called the "Online Vaccine Science Resources for COVID-19 Education," the materials generated were designed to be implemented by educators and community groups in various contexts. They took the form of four modules and general audience informational videos available on a YouTube channel. Each module was assembled as a toolkit with instructional videos, assessments, discussion questions, assignments, synthesis activities, and guides for constructing infographics and dual poster (science and general public audience) presentations. The materials were piloted and tested in various educational settings, including 2-year and 4-year colleges. Data gathered from surveys of faculty and student participants suggested that exposure to the materials promoted student trust in vaccination and the scientific process of vaccine development, and increased the likelihood of their getting a freely available vaccine. Assessment data indicated that the materials were successful in helping students achieve the learning objectives for the modules. Our results underscored the continued need for science education strategies that address the critical problem of vaccine hesitancy as we continue to emerge from the COVID-19 pandemic.

Socioeconomic Inequalities in COVID-19 Vaccine Hesitancy and Uptake in Greece and Cyprus during the Pandemic

Despite the rigorous investigation of the phenomenon of vaccine hesitancy and refusal during the COVID-19 pandemic, the socioeconomic determinants of this phenomenon remain poorly investigated on a global scale. Following proportional quota sampling, we conducted a population-based cross-sectional study. We recruited participants on-site and online from different settings, regions, and socioeconomic strata in two Eastern Mediterranean populations, Greece and Cyprus. Our approach provided a nationwide sample (n = 576) approaching the adult population structure of the two countries, with a slight underrepresentation of men and older people. Our results indicate clear socioeconomic differences in vaccine hesitancy and vaccination coverage, consistent with wider social inequalities in health. In particular, we reveal a clear socioeconomic gradient characterized by lower vaccine hesitancy and higher vaccination coverage, with increasing educational attainment and income. Additionally, participants residing in semi-urban areas show higher vaccine hesitancy and have lower vaccination coverage than those residing in urban and rural areas. Our results could inform Public Health approaches aiming to tackle the alarming phenomenon of vaccine hesitancy by enabling the targeting of population groups who are particularly vaccine-hesitant, rendering such approaches more targeted and effective while at the same time reducing inequalities in the control and prevention of infectious diseases.