Confidence, Acceptance and Willingness to Pay for the COVID-19 Vaccine among Migrants in Shanghai, China: A Cross-Sectional Study

Defining drivers of under-immunization and vaccine hesitancy in refugee and migrant populations

BACKGROUND/OBJECTIVE

Some refugee and migrant populations globally showed lower uptake of COVID-19 vaccines and are also considered to be an under-immunized group for routine vaccinations. These communities may experience a range of barriers to vaccination systems, yet there is a need to better explore drivers of under-immunization and vaccine hesitancy in these mobile groups.

METHODS

We did a global rapid review to explore drivers of under-immunization and vaccine hesitancy to define strategies to strengthen both COVID-19 and routine vaccination uptake, searching MEDLINE, Embase, Global Health PsycINFO and grey literature. Qualitative data were analysed thematically to identify drivers of under-immunization and vaccine hesitancy, and then categorized using the 'Increasing Vaccination Model'.

RESULTS

Sixty-three papers were included, reporting data on diverse population groups, including refugees, asylum seekers, labour migrants and undocumented migrants in 22 countries. Drivers of under-immunization and vaccine hesitancy pertaining to a wide range of vaccines were covered, including COVID-19 (n = 27), human papillomavirus (13), measles or Measles-mumps-rubella (MMR) (3), influenza (3), tetanus (1) and vaccination in general. We found a range of factors driving under-immunization and hesitancy in refugee and migrant groups, including unique awareness and access factors that need to be better considered in policy and service delivery. Acceptability of vaccination was often deeply rooted in social and historical context and influenced by personal risk perception.

CONCLUSIONS

These findings hold direct relevance to current efforts to ensure high levels of global coverage for a range of vaccines and to ensure that marginalized refugee and migrant populations are included in the national vaccination plans of low-, middle- and high-income countries. We found a stark lack of research from low- and middle-income and humanitarian contexts on vaccination in mobile groups. This needs to be urgently rectified if we are to design and deliver effective programmes that ensure high coverage for COVID-19 and routine vaccinations.

Socio-ecological barriers to access COVID-19 vaccination among Burmese irregular migrant workers in Thailand

Thailand is a migration hub in ASEAN (Association of Southeast Asian Nations), with more than 3.9 million migrant workers, accounting for 10% of the country's workforce. The government of Thailand has moved from a pandemic to an endemic state of living with the SAR-CoV2 virus as a new normal since over half of the population has been vaccinated. There is, however, an estimated 1.3 million irregular migrant workers in Thailand who are not covered by Social Security Schemes (SSS) and are likely to have not been vaccinated. This study examines the socio-ecological barriers to accessing vaccination among Burmese irregular migrant workers in Thailand. Qualitative and quantitative data were collected from NGO (Non-Government Organizations) workers and Burmese irregular migrants through an online survey and in-depth interviews. The study reported that over 90% of Burmese irregular migrants were unvaccinated. The main reasons for the low vaccination rate include exclusion from the vaccine distribution program, high cost of the vaccine, perceived low quality of vaccine, language barriers, lack of vaccine information, private and public discrimination against migrants, fear of being detained and deported, and difficulties in finding time and transportation to go to vaccination centres. The Thai government should employ culturally competent interpreters to disseminate vaccine information and potential side effects to encourage vaccinations in order to prevent further casualties and curb the global health crisis. Moreover, it is imperative that the Thai government provide free vaccines to all immigrants regardless of their status and amnesty from deportation and detention during the vaccination period.

How urban versus rural residency relates to COVID-19 vaccine hesitancy: A large-scale national Chinese study

RATIONALE

Although urban-rural residency has been shown to influence individual COVID-19 vaccine hesitancy, the differences between urban and rural China have yet to be uncovered.

OBJECTIVE

This study aims to assess the current prevalence and factors associated with COVID-19 vaccine hesitancy in urban and rural areas and explore whether the rural versus urban residency is associated with COVID-19 vaccine hesitancy.

METHODS

A national, cross-sectional, online survey among Chinese urban and rural adults (≥18 years old) was conducted from 6th to August 9, 2021. A questionnaire was used to collect data on sociodemographic factors, perceptions of the COVID-19 pandemic and vaccination status. A multivariable logistic regression model was used to identify the factors that influence COVID-19 vaccine hesitancy. Propensity score matching (PSM) analysis was performed to explore the association between urban versus rural residency and COVID-19 vaccine hesitancy.

RESULTS

In total, 29,925 participants (80.56% urban participants) were recruited. Urban participants had a higher COVID-19 vaccine hesitancy than their rural counterparts (9.39% vs. 4.26%). After adjusting for potential confounders, we found that COVID-19 vaccine hesitancy among females was lower than that in males in both urban (aOR = 0.78, 95% CI [0.69-0.88]) and rural areas (aOR = 0.54, 95% CI [0.39-0.75]). The lack of trust towards vaccine producers was found to be associated with vaccine hesitancy among the urban participants (aOR = 2.76, 95% CI [2.22-3.43]). The rural floating population had a lower COVID-19 vaccine hesitancy than the rural permanent residents (aOR = 0.58, 95% CI [0.42-0.80]). PSM analysis revealed a 2.38% difference in COVID-19 vaccine hesitancy between urban and rural participants.

CONCLUSIONS

Urban participants were more hesitant to receive the COVID-19 vaccine than rural participants. Priority should be placed on boosting confidence in the healthcare system to reduce COVID-19 vaccine hesitancy among urban residents. Furthermore, we advocate for extra incentives and vaccination education for rural permanent residents.

COVID-19 vaccine uptake and vaccine hesitancy in rural-to-urban migrant workers at the first round of COVID-19 vaccination in China

BACKGROUND

Migration can be linked to the transmission of COVID-19. COVID-19 vaccine uptake and hesitancy among rural-to-urban migrant workers in China, the largest group of internal migrants in the world, has not been characterized.

OBJECTIVE

To investigate COVID-19 vaccine uptake and identify vaccine hesitancy-associated factors among rural-to-urban migrant workers in the first round of COVID-19 vaccination in China.

METHODS

A cross-sectional questionnaire-based survey was conducted, including 14,917 participants. Socio-demographics, COVID-19 vaccine uptake, vaccine hesitancy and its associated factors based on Vaccine Hesitancy Determinants Matrix (VHDM) were applied for the survey. Data were principally analyzed by logistic regression analysis.

RESULTS

The COVID-19 vaccine uptake and vaccine hesitancy rates were 7.1% and 57.7%, respectively. Vaccine hesitancy was strongly associated with VHDM, including individual factors (female, higher annual income and fewer medical knowledge), group factors (less family support, friend support and public opinion support), COVID-19 epidemic factors (lower fatality, infection and emotional distress) and vaccine factors (less vaccine necessity, vaccine safety, vaccine efficacy, vaccine importance and vaccine reliability).

CONCLUSION

The VHDM model has the potential utility in efforts to reduce COVID-19 vaccine hesitancy. Greater efforts should be put into addressing positive predictors associated with vaccine hesitancy.

The determinants of COVID-19 vaccine uptake among migrants from 109 countries residing in China: A cross-sectional study

Background

The present study aimed to investigate the prevalence of COVID-19 vaccine uptake among foreign migrants in China and to explore the determinants of their vaccine uptake behavior.

Methods

From June to October 2021, we used convenience and snowball sampling to recruit a sample of 764 participants from five cities in which the overwhelming majority of foreign migrants in China live. The chi-square (χ²) tests were used to examine vaccination distribution according to demographic characteristics. Multivariate logistic regression models visualized by forest plot were used to investigate the associations between significant determinants and vaccine uptake.

Results

Overall, the prevalence of vaccination rate was 72.9% [95% confidence interval (CI): 69.9-76.0%]. Migrants whose social participation was very active [adjusted odds ratio (AOR): 2.95, 95% CI: 1.36-6.50, P = 0.007] or had perceived COVID-19 progression prevention by the vaccine (AOR: 1.74, 95% CI: 1.01-3.02, P = 0.012) had higher odds of vaccination compared to those whose social participation was inactive or who did not have this perception. Migrants who perceived the vaccine uptake process as complex (AOR: 0.47, 95% CI: 0.27-0.80, P = 0.016) or were unsure of their physical suitability for the vaccine (AOR: 0.40, 95% CI: 0.24-0.68, P < 0.001) had lower odds of vaccination compared to those who did not have these perceptions. Furthermore, migrants from emerging and developing Asian countries (AOR: 2.32, 95% CI: 1.07-5.21, P = 0.04) and the Middle East and Central Asia (AOR: 2.19, 95% CI: 1.07-4.50, P = 0.03) had higher odds of vaccination than those from major advanced economies (G7) countries, while migrants from other advanced economic countries (OR: 0.27, 95% CI: 0.11-0.63, P = 0.003) had lower odds of vaccination than those from G7 countries.

Conclusion

It may be beneficial to promote vaccine uptake among migrants by ensuring effective community engagement, simplifying the appointment and uptake process, and advocating the benefits and target populations of the COVID-19 vaccine.

The Role of Trust in COVID-19 Vaccine Acceptance: Considerations from a Systematic Review

The goal of this research was to provide an overview of the role of trust in determining COVID-19 vaccine acceptance. Trust proved to be a key issue in all the strategic phases of the pandemic, a decisive element for the success of the worldwide vaccination campaign. By introducing a comprehensive systematic review of the state-of-the-art (N = 43), we intend to shed light on the various forms of trust that have been considered and how these relate to citizens’ vaccine acceptance. The analysis shows that trust has been used extensively, with particular reference to the COVID-19 vaccine, governments, manufacturers, healthcare systems, and science. A more in-depth analysis has also allowed us to evaluate the role that these factors have had and the social phenomena in which they have been decisive. Most notably, we proved that, in the different contributions, trust in the COVID-19 vaccine has a strong correlation with vaccine acceptance (R = 0.78, p < 0.01). Overall, vaccine acceptance emerges as a complex phenomenon that needs to be understood through the strictly interlaced relations of trust in the various factors coming into play. Besides clarifying what happened in previous years, the considerations included in this work also represent an important and useful interpretative framework to help public institutions and the healthcare system in the future.

Global COVID-19 vaccine acceptance rate: Systematic review and meta-analysis

Background

A vaccine against COVID-19 is a vital tool in managing the current pandemic. It is becoming evident that an effective vaccine would be required to control COVID-19. Effective use of vaccines is very important in controlling pandemics and paving the way for an acceptable exit strategy. Therefore, this systematic review and meta-analysis aims to determine the global COVID-19 acceptance rate that is necessary for better management of COVID-19 pandemic.

Methods

This review was conducted based on Preferred Reporting Items for Systematic Reviews and Meta-Analysis protocols and considered the studies conducted on acceptance and/or hesitancy of COVID-19 vaccine. Articles were searched using electronic databases including PubMed, Scopus, Web of Science, Embase, CINAHL, and Google Scholar. The quality of the study was assessed using the Joanna Briggs Institute (JBI) critical assessment tool to determine the relevance of each included article to the study.

Results

Of the 6,021 articles identified through the electronic database search, 68 articles were included in the systematic review and meta-analysis. The global pooled acceptance rate of the COVID-19 vaccine was found to be 64.9% [95% CI of 60.5 to 69.0%]. Based on the subgroup analysis of COVID-19 vaccine acceptance rate by the World Health Organization's region, the countries where the study was conducted, occupation, and survey period, the prevalence of COVID-19 vaccine acceptance rate was 60.8% [95% CI: 56.3, 65.2%], 61.9% [95% CI: 61.3, 62.4%], 81.6% [95% CI: 79.7, 83, 2%] and 64.5% [95% CI: 60.3, 68.5%], respectively.

Conclusions

This review revealed the variation in the level of COVID-19 vaccine acceptance rate across the world. The study found that the overall prevalence of COVID-19 vaccine acceptance was 64.9%. This finding indicated that even if the COVID-19 vaccine is developed, the issue of accepting or taking the developed vaccine and managing the pandemic may be difficult.

The main decision-making competence for willingness-to-pay towards COVID-19 vaccination: a family-based study in Taizhou, China

PURPOSE

This research aimed to explore individuals' willingness to pay (WTP) and studied the role of family decision makers in WTP for COVID-19 vaccines.

METHODS

A self-administered online questionnaire evaluating the willingness of community residents to pay for booster vaccination of COVID-19 vaccine was conducted among families in a community in Taizhou, China. The logistic regression model was performed to identify the factors associated with WTP for the COVID-19 vaccines, and all data were analysed by R software, version 4.1.0.

RESULTS

44.2% and 43.7% of 824 community residents were willing to pay for the first two doses and the booster dose of the COVID-19 vaccine, respectively. Decision-makers were more willing to pay for both the first two doses and the boost dose of the COVID-19 vaccines, with OR (95%CI) being 1.75 (1.25-2.47) and 1.89 (1.34-2.67), respectively. Besides, participants' WTP for COVID-19 vaccines were also associated with their occupation and monthly household income.

CONCLUSION

This study found that family decision-makers were more willing to pay for both the first two doses and the booster dose of COVID-19 vaccines in Taizhou, China. To improve the WTP for COVID-19 vaccines, public policy programs need to conduct a comprehensive cost-benefit analysis and focus on the role of family decision makers in vaccination.Key MessagesA study evaluating the willingness of community residents to pay for booster vaccination of COVID-19 vaccine was conducted among families in a community in Taizhou, China.Family decision-makers were more willing to pay for both the first two doses and the booster dose of COVID-19 vaccines.To improve the WTP for COVID-19 vaccines, public policy programs need to conduct a comprehensive cost-benefit analysis and focus on the role of family decision-makers in vaccination.

Willingness-to-pay for a booster dose of inactivated SARS-CoV-2 vaccine in Taizhou, China

This study was conducted to ascertain whether people in China would be willing to pay for an inactivated COVID-19 vaccine booster dose. An online survey estimating participants' willingness to pay (WTP) for a booster dose of COVID-19 vaccine was conducted in Taizhou, China. The participants received ane-mail or e-poster on WeChat. A total of 1576 subjects participated the survey. A total of 66.4% (1046/1576) of the respondents were willing to pay for a booster dose of COVID-19 vaccine for themselves. Using binary logistic regression analysis, the following factors were significantly related to a WTP for a booster dose of COVID-19 vaccine: 1) confidence in the safety of the COVID-19 vaccines (high vs. low, OR: 4.30, 95%CI: 1.61-11.43), 2) confidence in the preventive effectiveness of the COVID-19 vaccines against SARS-CoV-2 virus (moderate vs. little, OR: 1.76, 95%CI: 1.30-2.38; great vs. little, OR: 2.244, 95%CI: 1.62-3.12), and 3) COVID-19 vaccine hesitancy (unhesitant vs. very unhesitant, OR: 0.67, 95%CI: 0.45-1.02; hesitant vs. very unhesitant, OR: 0.29, 95%CI: 0.19-0.44; very hesitant vs. very unhesitant, OR: 0.09, 95%CI: 0.03-0.27). This study revealed that a moderate proportion of participants responded that they would be willing to pay for a booster dose of COVID-19 vaccine. These findings suggest the importance of a detailed assessment and a health education plan that better understands the population's risk perception as well as the potential health risks in China.

Willingness to pay for booster dose of COVID-19 vaccine among healthcare workers in Taizhou,China

PURPOSE

We explored the willingness to pay for booster dose of COVID-19 vaccine among health-care workers in Taizhou, China.

METHODS

A population-based self-administered online questionnaire evaluating the willingness of health-care workers to pay for booster vaccination of COVID-19 vaccine was conducted in Taizhou, China. Of the 1102 health-care workers received the invitation, 1072 (97.3%) had received twice vaccination of COVID-19 vaccine.

RESULTS

There were 1569 (53.1%) out of 1072 health-care workers not willing to pay for thebooster dose of COVID-19 vaccines, 348 (32.5%) were willing to pay less than 100CHY for the booster dose of COVID-19 vaccines, only 155 (14.5%) were willing to pay more than 100 CHY. The factors related to willingness to pay for booster dose of COVID-19 vaccines were education level (c² = 9.42, P = .01) or whether they had adverse effect to COVID-19 vaccines (c² = 11.87, P < .01) .

CONCLUSION

This study found that about half of health-care workers were willing to pay for booster dose of inactivated SARS-CoV-2 vaccines in Taizhou, China, most of them are willing to pay less than 100 CHY. Health-care workers' willingness to pay for booster dose of COVID-19 vaccines were related to sex, education level, whether they had adverse effect to COVID-19 vaccines.

COVID-19 Vaccine Acceptance and Its Determinants among Myanmar Migrant Workers in Southern Thailand

Success in eradicating COVID-19 will rely on the rate of vaccination adoption worldwide. Vaccine acceptance among vulnerable groups is critical for preventing the spread of COVID-19 and decreasing unnecessary deaths. The purpose of this study was to report on the willingness to obtain COVID-19 immunization and the factors related to its acceptance among Myanmar migrant workers in southern Thailand. This cross-sectional study consisted of 301 samples collected between October and November 2021 and analyzed using multiple logistic regression. Thirty-nine percent of workers intended to receive the COVID-19 vaccine within a year. The following factors were associated with obtaining the COVID-19 vaccine: a high level of perception of COVID-19 (AOR = 5.43), income less than or equal to 10,000 baht/month (AOR = 6.98), financial status at a sufficient level (AOR = 7.79), wearing a face mask in the previous month almost all the time (AOR =4.26), maintaining 1-2 m of distance from anyone in the last month (AOR =2.51), and measuring temperature in the previous month (AOR = 5.24). High reluctance to accept the COVID-19 vaccine among Myanmar migrant workers can influence efforts to eliminate COVID-19. Collaboration with all stakeholders is critical to helping Myanmar workers understand COVID-19, social measures, and preventive beliefs to increase vaccine uptake.

Willingness to pay for and willingness to vaccinate with the COVID-19 vaccine booster dose in China

Objective: The present study aims to assess the willingness to pay (WTP) for and willingness to vaccinate (WTV) with the Coronavirus (COVID-19) vaccine booster dose in China when the pandemic is under adequate control and the majority of the population is vaccinated. This study is also to identify significant factors associated with the WTP.

Methods: This was a cross-sectional study on adults with no past or present COVID-19 infection. An online questionnaire was distributed to collect data on vaccination status, quarantine experience, and factors related to health beliefs on vaccination. The WTV was assessed through the vaccination preference. The WTP was examined by payment scale (PS) and iterative bidding game (IBG) administered in random order. Three IBG algorithms with different starting-price were presented randomly. The average WTP of PS and IBG were analyzed as primary outcomes using univariate and multivariate analyses. Multivariate ordered logistic regression was performed to identify significant factors for the WTP.

Results: The survey recruited 543 participants with a mean age of 32 years and 57.80% being female. The WTV rate was 86.74%, while 94.66% of participants completed full-schedule or enhanced vaccination. The mean WTP was CNY 149 (±CNY 197) and the median WTP was CNY 80. Regarding significant factors for the WTP, urban residents were 57% more likely (95% CI: 1.11-2.22) to pay for a high-priced vaccine than rural residents. Respondents who completed full-schedule vaccination were 46% more likely (95% CI: 1.03–2.07) to pay for a high-priced vaccine than those who completed enhanced vaccination. Respondents with a low household income of CNY 40k or lower were 62% less likely (95% CI: 0.21–0.66) to pay for a high-priced vaccine than those with a middle household income of CNY 110k–210k. Other significant factors associated with the WTP included the perceived benefit of vaccination and peer environmental pressure in the health belief model.

Conclusion: The WTV with the COVID-19 vaccine booster dose was high in China. The WTP was influenced by the place of residence, vaccination status, household income, perceived benefit of vaccination, and environmental peer pressure. Study findings can inform policymakers to better design vaccination programs and financial schemes involving out-of-pocket payments.

Psychological determinants of COVID-19 vaccine acceptance among urban slum dwellers of Bangladesh

Introduction

Coronavirus disease 2019 (COVID-19) vaccination has emerged as a promising approach to counter the harmful impacts of the pandemic. Understanding the psychological components that may impact an individual's attitude toward COVID-19 vaccination is crucial for generating evidence-based ways to minimize vaccine hesitancy. This study determined the psychological antecedents regarding vaccine acceptance among urban slum people of Bangladesh.

Methods

From 5 July to 5 August 5, 2021, a face-to-face survey was conducted in the urban slum of two large cities in Bangladesh. The questionnaire considered socio-demographics, health-related characteristics, psychological determinants, sources of information, and conspiracy beliefs regarding COVID-19. The 5C sub-scales were used to assess psychological antecedents. Five stepwise binary logistic regression models evaluated significant predictors for confidence, complacency, calculation, constraints, and collective responsibility. Multinomial logistic regression was used to determine the relationship between psychological antecedents and vaccine acceptability.

Results

The study revealed that the slum residents with a high level of confident (89.94%), complacent (72.73%), having constraints (82.31%), calculative (84.80%), and responsible (93.30%) showed a higher vaccine acceptance rate. Higher vaccine acceptance was related to the believer in natural-made origin (85.96%) and those who rejected anti-vaccination (88.44%). The information acquired from newspapers differed significantly (p < 0.05), though TV or radio was the most common primary information source about COVID-19 vaccines (74.75%). The regression result revealed that marital status, education, family income, and perceived health condition were significantly associated with the 5C domains. Two psychological antecedents including complacency (OR = 3.97; p < 0.001) and collective responsibility (OR = 0.23; p < 0.001) were significantly associated with vaccine acceptance.

Conclusions

Different predictors significantly affect psychological antecedents related to COVID-19 vaccine uptake. Therefore, considering the factors, targeted actions based on the findings may help to lower vaccine reluctance and boost vaccination rates.

Willingness to pay for COVID-19 vaccines in Jordan: Applying the health belief model

BACKGROUND

To date, there is no effective treatment for COVID-19. Vaccines are effective and safe strategies to control the pandemic.

OBJECTIVE

To measure consumers' maximum willingness to pay (WTP) for COVID-19 vaccines in Jordan and to identify the predictors of WTP.

METHOD

An online survey was used to collect data related to sociodemographic factors and constructs from the Health Belief Model (HBM). The contingent valuation method using the payment card approach was used, whereby the respondents were asked to choose their maximum WTP value from a range of 5-200 Jordanian Dinar (JOD). The maximum WTP values were then categorized into several groups, and an ordered logistic model was used to generate adjusted odds ratios and estimate the significant predictors of maximum WTP.

RESULTS

A total of 3116 respondents completed the survey. More than half of the sample were not willing to pay out of pocket for the vaccine (57%). Among the respondents who were willing to pay any amount above zero, the mean maximum WTP was 28.1 JOD (39.63 USD), and the median WTP was 20 JOD (28.21 USD). The significant predictors of higher WTP values were being of younger age, higher income, being a healthcare provider, having one or more chronic diseases, previous history of receiving the seasonal influenza vaccine, having a family member/friend who has died from the COVID-19, lower perceived risk of the vaccine, higher perceived benefits of the vaccine, and having been recommended to get the vaccine.

CONCLUSION

It is recommended to continue providing the vaccine free of charge to increase its uptake. Educational campaigns should focus on refuting myths related to the vaccine and promoting the benefits of receiving the vaccine in slowing the spread of the pandemic, and improving the economy. Healthcare providers' recommendations have the potential to increase WTP for the vaccine.

The Association of Social Emotions, Perceived Efficiency, Transparency of the Government, Concerns about COVID-19, and Confidence in Fighting the Pandemic under the Week-Long Lockdown in Shenzhen, China

The outbreak and spread of the COVID-19 pandemic have had a far-reaching impact. The present study investigated the factors primarily affecting the execution of the control measures, including social emotions, concerns about the pandemic, perceived efficiency, transparency of the government in publishing the pandemic-related information, and confidence in fighting the pandemic. Specifically, we examined the differences in these factors across four areas (i.e., lockdown area, control area, prevention area, and safe area) according to different COVID control measures under the week-long lockdown in Shenzhen. We found that social emotions, concerns about the pandemic, perceived efficiency of the government, and confidence in fighting the pandemic were more negative in the lockdown area than that in other areas. More importantly, after controlling for areas and education level of participants, the emotion of optimism, concerns about the COVID-19 pandemic, perceived efficiency, and perceived transparency of the government in releasing COVID-19 relevant information positively predicted confidence in fighting the pandemic, while anger negatively predicted confidence in fighting the pandemic. Therefore, the government and communities could make efforts at effective communication and find innovative approaches to make individuals (especially in the lockdown area) maintain social connections, reduce negative emotions, and enhance confidence in combating the pandemic.

Attitudes towards coronavirus (COVID-19) vaccine and sources of information across diverse ethnic groups in the UK: a qualitative study from June to October 2020

OBJECTIVES

Across diverse ethnic groups in the UK, explore attitudes and intentions towards COVID-19 vaccination and sources of COVID-19 information.

DESIGN

Remote qualitative interviews and focus groups (FGs) conducted June-October 2020 before UK COVID-19 vaccine approval. Data were transcribed and analysed through inductive thematic analysis and mapped to the Theoretical Domains Framework.

SETTING

England and Wales.

PARTICIPANTS

100 participants from 19 self-identified ethnic groups.

RESULTS

Mistrust and doubt were reported across ethnic groups. Many participants shared concerns about perceived lack of information about COVID-19 vaccine safety and efficacy. There were differences within each ethnic group, with factors such as occupation and perceived health status influencing intention to accept a vaccine once made available. Across ethnic groups, participants believed that public contact occupations, older adults and vulnerable groups should be prioritised for vaccination. Perceived risk, social influences, occupation, age, comorbidities and engagement with healthcare influenced participants' intentions to accept vaccination once available. All Jewish FG participants intended to accept, while all Traveller FG participants indicated they probably would not.Facilitators to COVID-19 vaccine uptake across ethnic groups included: desire to return to normality and protect health and well-being; perceived higher risk of infection; evidence of vaccine safety and efficacy; vaccine availability and accessibility.COVID-19 information sources were influenced by social factors and included: friends and family; media and news outlets; research literature; and culture and religion. Participants across most different ethnic groups were concerned about misinformation or had negative attitudes towards the media.

CONCLUSIONS

During vaccination rollout, including boosters, commissioners and providers should provide accurate information, authentic community outreach and use appropriate channels to disseminate information and counter misinformation. Adopting a context-specific approach to vaccine resources, interventions and policies and empowering communities has potential to increase trust in the programme.

Health-Related Rumor Control through Social Collaboration Models: Lessons from Cases in China during the COVID-19 Pandemic

Widely spread health-related rumors may mislead the public, escalate social panic, compromise government credibility, and threaten public health. Social collaboration models that maximize the functions and advantages of various agents of socialization can be a promising way to control health-related rumors. Existing research on health-related rumors, however, is limited in studying how various agents collaborate with each other to debunk rumors. This study utilizes content analysis to code the text data of health-related rumor cases in China during the COVID-19 pandemic. The study found that socialized rumor-debunking models could be divided into the following five categories: the government-led model, the media-led model, the scientific community-led model, the rumor-debunking platform-led model, and the multi-agent collaborative model. In addition, since rumors in public health crises often involve different objects, rumor refutation requires various information sources; therefore, different rumor-debunking models apply. This study verifies the value of socialized collaborative rumor debunking, advocates and encourages the participation of multiple agents of socialization and provides guidance for establishing a collaborative rumor-debunking model, thereby promoting efficient rumor-debunking methods and improving the healthcare of society.

Acceptance and willingness to purchase a hypothetical COVID-19 vaccine in a region under Shariah law: A cross-sectional study in Aceh, Indonesia

Vaccines are urgently needed to control the coronavirus disease 2019 (COVID-19) pandemic. The aim of this study was to determine the acceptance of and willingness to purchase a hypothetical COVID-19 vaccine in the general population of Aceh, a holistic Shariah law implementation province in Indonesia. An online cross-sectional study was conducted using a quota sampling technique between 1 to 24 September 2021. To determine hypothetical vaccine acceptance, respondents were asked if they were willing to accept vaccines with combinations of either 50% or 95% effectiveness and either 5% or 20% risk of adverse effects. Willingness to purchase was assessed by asking whether the participants would pay for such vaccines at certain price points. Logistic regression analysis was used to assess the associated determinants. Out of 377 respondents included in the final analysis, 86.5% were willing to accept a COVID-19 vaccine with 95% effectiveness and 5% adverse effects. The acceptance rate dropped to 45.1% if the risk of adverse effects was 20%. Vaccines with 50% effectiveness and 5% adverse effects were acceptable to 42.2% but the acceptance went down to 17.2% if the risk of adverse effects increased to 20%. Multivariate analysis found that men were twice as likely to accept a vaccine with 95% effectiveness and 5% adverse effects compared to females (aOR: 2.01; 95% CI 1.05-3.86). We found that 156/377 (41.3%) of respondents were willing to purchase a COVID-19 vaccine and of these participants 71.1% were willing to pay between Indonesian Rupiah (IDR) 50,000-150,000 (US$ 3.33-10.00). In conclusion, the acceptance rate of a hypothetical COVID-19 vaccine varied based on effectiveness and the risk of adverse effects.

COVID-19 vaccine acceptance and its determinants: A cross-sectional study among the socioeconomically disadvantaged communities living in Delhi, India

Background

Vaccination against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is the most desired solution to combat COVID-19. We examined the willingness to accept the vaccine and reasons for vaccine hesitancy, and identified some factors associated with the vaccine hesitancy among the socio-economically disadvantaged urban population from Delhi, India.

Methods

We conducted a cross-sectional survey of a randomly selected sample of 1539 households from 31 urban clusters. Data on socio-demographics, health beliefs, and willingness to accept the SARS-CoV-2 vaccine were collected through a face-to-face interviewer-administered, pre-tested questionnaire from an adult member. Vaccine acceptance/hesitancy was analysed by various socio-demographic and health belief variables. Multinomial regressions were carried out to identify the factors associated with the vaccine hesitancy.

Results

Overall, 64.9% (95% CI: 62.5 to 67.3) of the respondents would accept the vaccine, 17.4% (95% CI: 15.6 to 19.4) were undecided, and 17.7% (95% CI: 15.8 to 19.7) would not accept the vaccine. The reasons for not accepting the vaccine were: belief that they had immunity (12.9%), the corona was a hoax (11.8%), the vaccine was not necessary (7.4%), and did not want to disturb the natural bodily systems by the vaccine (5.6%). The undecided group mainly would like to wait and see (37.7%), decide when the vaccine become available (11.6%), will take if everyone in their community takes (10.4%). Multinomial logistic regression identified older age, low perceived susceptibility of contracting COVID-19, low perceived severity of COVID-19, low self-efficacy to protect against COVID-19, and unawareness and non-use of Arogyasetu App as significant predictors of vaccine hesitancy.

Conclusions

Two-thirds of Delhi's low-income groups would accept the vaccine against SARS-CoV-2. Vaccine hesitancy was associated with older age, low perceived susceptibility, low perceived severity, and low self-efficacy to protect themselves from COVID-19. Hence, efforts are needed to address these issues and vaccine concerns to increase the vaccine uptake.

Efficacy information influences intention to take COVID-19 vaccine

OBJECTIVES

A successful response to the COVID-19 pandemic requires achieving high levels of vaccine uptake. We tested whether directly contrasting the high efficacy of COVID-19 vaccines with the lower efficacy of the annual flu vaccine would increase intentions to take a COVID-19 vaccine.

DESIGN

A pre-registered online study of 481 participants compared four information conditions: (1) no information; (2) COVID-19 Vaccine Information Only; and COVID-19 Vaccine Information combined with flu vaccine information suggesting either (3) 60% efficacy or (4) 40% efficacy; we measured COVID-19 and flu vaccine intentions along with several other vaccine-related variables.

METHODS

The Prolific platform was used to recruit 481 UK participants (64% female; aged between 18 and 85 years) who had been pre-screened to have intermediate levels of vaccine hesitancy. After reading a short text (~200 words) about COVID-19 vaccines, participants were asked about their vaccination intentions.

RESULTS

Providing information about the safety and efficacy of the new COVID-19 vaccines resulted in vaccination intentions that were, on average, 0.39 standard deviations (SDs) higher than those in the no information condition; providing the same COVID vaccine efficacy information in the context of information about flu vaccine efficacy resulted in a further significant increase in vaccination intentions that were 0.68 SD higher than those in the no information condition. This positive contrast effect for the COVID-19 vaccine was not associated with reduced flu vaccine intentions.

CONCLUSIONS

Vaccination intentions can be strengthened through a simple messaging intervention that utilizes context effects to increase perceived response efficacy.

Willingness to Receive a COVID-19 Vaccine and Associated Factors among Older Adults: A Cross-Sectional Survey in Shanghai, China

Background: Older individuals have a high risk of morbidity and mortality due to COVID-19, and one of the most effective ways to prevent COVID-19 is vaccination. Little is known about older people’s willingness to receive a COVID-19 vaccine. Therefore, the objective of this study was to assess the acceptance of and factors influencing the intention to receive a COVID-19 vaccination among older adults in Shanghai, China. Methods: A cross-sectional study was conducted among older adults (≥60 years old) in Shanghai. Face-to-face interviews with a questionnaire were conducted in community health service centers, recording several parameters: demographic information, health-related factors; perceived likelihood, severity, and burden of COVID-19; perceived safety, effectiveness, necessity, and benefit of the COVID-19 vaccine, as well as their trust in the vaccine delivery system and doctors; willingness to receive a COVID-19 vaccination. Bivariate analysis between several survey items and the willingness to receive a COVID-19 vaccination was conducted using a chi-square test. Logistic regression was used to assess to what degree each variable affected the willingness to receive a COVID-19 vaccination. Results: Of the 1067 participants, 90.91% (970/1067) confirmed that they were willing to receive a COVID-19 vaccination. The participants were more likely to be willing to be vaccinated if they were immigrants (OR = 1.988, 95%CI = 1.062−3.717), had an education level of junior high school (OR = 2.724, 95%CI = 1.000−7.423) or high school or above (OR = 3.993, 95%CI = 1.576−10.119), and had a monthly income of CNY 3000−5000 (OR = 32.770, 95%CI = 1.144−6.711) or CNY >5000 (OR = 2.309, 95%CI = 1.003−5.319). The participants were also more likely to be willing to be vaccinated if they had received a pneumonia vaccination previously (OR = 2.138, 95%CI = 1.016−4.500), perceived the safety of the COVID-19 vaccine (OR = 1.508, 95%CI = 1.073−2.119), perceived the necessity of the COVID-19 vaccine (OR = 2.604, 95%CI = 1.946−3.484), or trusted the suggestions of doctors (OR = 1.706, 95%CI = 1.115−2.618). The participants were less likely to be willing to be vaccinated if they were aged ≥76 years (OR = 0.498, 95%CI = 0.264−0.939), reported a physical health condition of bad or below (OR = 0.229, 95% CI = 0.095−0.549), or were worried about the adverse effects of a COVID-19 vaccination (OR = 0.503, 95%CI = 0.364−0.695). Conclusions: Under the free vaccination policy for COVID-19, older adults have a high intention to be vaccinated to prevent COVID-19 in Shanghai, China. Widely publicizing the safety and necessity of COVID-19 vaccination is necessary.

Individual Preferences for COVID-19 Vaccination under the China’s 2021 National Vaccination Policy: A Discrete Choice Experiment Study

(1) Background: Since China’s national vaccination policy announcement in January 2021, individual vaccination preferences related to vaccine characteristics, social relationships, sociodemographic characteristics and cognition remain opaque. This study aims to investigate vaccination preferences regarding these attributes, and to assess changes in individual vaccine preferences since the pre-2021 emergency vaccination phase. (2) Methods: The two-part questionnaire surveyed 849 individuals between May and June 2021 in Qingdao, China. The survey contained eight binary choice tasks that investigated preference trade-offs. Respondents’ sociodemographic characteristics, including age, sex, urban/rural residence, income, education and whether living with the young or old, were also collected. Conditional logit, mixed logit and latent class models were used to quantify preference utility and identify preference heterogeneity. (3) Results: Vaccine effectiveness, vaccine side effects, duration of protection and probability of infection all significantly affected vaccination utility. Preference heterogeneity based on individual social relationships and sociodemographic characteristics were also established. Marginal analysis showed that compared to the pre-2021 phase, individuals’ preferences had shifted towards vaccines with longer protection periods and better accessibility. (4) Conclusion: This study will inform the full rollout of China’s 2021 national vaccination program and provide valuable information for future vaccination policy design to meet resurgent COVID-19 risks.

Willingness and uptake of the COVID-19 testing and vaccination in urban China during the low-risk period: a cross-sectional study

BACKGROUND

Regular testing and vaccination are effective measures to mitigate the ongoing COVID-19 pandemic. Evidence on the willingness and uptake of the COVID-19 testing is scarce, and the willingness and uptake of vaccination may change as the pandemic evolves. This study aims to examine willingness and uptake of COVID-19 testing and vaccination during a low-risk period of the COVID-19 pandemic in urban China.

METHODS

A cross-sectional online survey was conducted among 2244 adults in urban China. Descriptive analyses were performed to compare the respondents' willingness and uptake of COVID-19 testing and vaccination. Multivariate logistic regressions were fitted to investigate factors associated with the willingness and uptake of the two measures.

RESULTS

In early 2021, about half (52.45%) of the respondents had received or scheduled a COVID-19 test at least once, and a majority (95.63%) of the respondents were willing to receive testing. About two-thirds (63.28%) of the respondents had received/scheduled or were willing to receive a COVID-19 vaccine. Willingness and uptake of COVID-19 testing were not associated with socio-demographic characteristics, except for occupation. Being of older age, migrants, having higher educational attainment and secure employment were associated with a higher uptake of COVID-19 vaccination among the surveyed respondents, while willingness to vaccinate was consistent across socio-demographic characteristics among those who had not been vaccinated.

CONCLUSIONS

By early 2021, Chinese adults expressed almost universal willingness of COVID-19 testing and over half of adults have been tested, while the willingness and uptake of COVID-19 vaccination were relatively low at the low-risk period of the COVID-19 pandemic. Maintaining willingness of COVID-19 vaccination is critical and necessary, especially when the pandemic evolved into a low-risk period.

Ethnic/racial minorities’ and migrants’ access to COVID-19 vaccines: A systematic review of barriers and facilitators

Background

There are widespread concerns that ethnic minorities and migrants may have inadequate access to COVID-19 vaccines. . Improving vaccine uptake among these vulnerable groups is important towards controlling the spread of COVID-19 and reducing unnecessary mortality. Here we perform a systematic review of ethnic minorities’ and migrants’ access to and acceptance of COVID-19 vaccines.

Methods

We searched PubMed and Web of Science databases for papers published between 1 January 2020 and 7 October 2021. Studies were included if they were peer-reviewed articles; written in English, included data or estimates of ethnic minorities’ or migrants’ access to vaccines; and employed either qualitative or quantitative methods. Of a total of 248 studies screened, 33 met these criteria and included in the final sample. Risk of bias in the included studies was assessed using Newcastle Ottawa Scale and Critical Appraisal Skills Program tools. We conducted a Synthesis Without Meta-analysis for quantitative studies and a Framework synthesis for qualitative studies.

Results

31 of the included studies were conducted in high-income countries, including in the US (n = 17 studies), UK (n = 10), Qatar (n = 2), Israel (n = 1) and France (n = 1). One study was in an upper middle-income country -China (n = 1) and another covered multiple countries (n = 1). 26 studies reported outcomes for ethnic minorities while 9 studies reported on migrants. Most of the studies were quantitative -cross sectional studies (n = 24) and ecological (n = 4). The remaining were qualitative (n = 4) and mixed methods (n = 1). There was consistent evidence of elevated levels of COVID-19 vaccine hesitancy among Black/Afro-Caribbean groups in the US and UK, while studies of Hispanic/Latino populations in the US and Asian populations in the UK provided mixed pictures, with levels higher, lower, or the same as their White counterparts. Asians in the US had the highest COVID-19 vaccine acceptance compared to other ethnic groups. There was higher vaccine acceptance among migrant groups in Qatar and China than in the general population. However, migrants to the UK experienced barriers to vaccine access, mainly attributed to language and communication issues. Lack of confidence, mainly due to mistrust of government and health systems coupled with poor communication were the main barriers to uptake among Black ethnic minorities and migrants.

Conclusions

Our study found that low confidence in COVID-19 vaccines among Black ethnic minorities driven by mistrust and safety concerns led to high vaccine hesitancy in this group. Such vaccine hesitancy rates constitute a major barrier to COVID-19 vaccine uptake among this ethnic minority. For migrants, convenience factors such as language barriers, fear of deportation and reduced physical access reduced access to COVID-19 vaccines. Building trust, reducing physical barriers and improving communication and transparency about vaccine development through healthcare workers, religious and community leaders can improve access and facilitate uptake of COVID-19 vaccines among ethnic minority and migrant communities.

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

INTRODUCTION

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

METHODS

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

RESULTS

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

CONCLUSION

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

SYSTEMATIC REVIEW REGISTRATION

PROSPERO 2021, identifier CRD42021268645.

Global COVID-19 Vaccine Acceptance: A Systematic Review of Associated Social and Behavioral Factors

COVID-19 vaccines have met varying levels of acceptance and hesitancy in different parts of the world, which has implications for eliminating the COVID-19 pandemic. The aim of this systematic review is to examine how and why the rates of COVID-19 vaccine acceptance and hesitancy differ across countries and continents. PubMed, Web of Science, IEEE Xplore and Science Direct were searched between 1 January 2020 and 31 July 2021 using keywords such as “COVID-19 vaccine acceptance”. 81 peer-reviewed publications were found to be eligible for review. The analysis shows that there are global variations in vaccine acceptance among different populations. The vaccine-acceptance rates were the highest amongst adults in Ecuador (97%), Malaysia (94.3%) and Indonesia (93.3%) and the lowest amongst adults in Lebanon (21.0%). The general healthcare workers (HCWs) in China (86.20%) and nurses in Italy (91.50%) had the highest acceptance rates, whereas HCWs in the Democratic Republic of Congo had the lowest acceptance (27.70%). A nonparametric one-way ANOVA showed that the differences in vaccine-acceptance rates were statistically significant (H (49) = 75.302, p = 0.009*) between the analyzed countries. However, the reasons behind vaccine hesitancy and acceptance were similar across the board. Low vaccine acceptance was associated with low levels of education and awareness, and inefficient government efforts and initiatives. Furthermore, poor influenza-vaccination history, as well as conspiracy theories relating to infertility and misinformation about the COVID-19 vaccine on social media also resulted in vaccine hesitancy. Strategies to address these concerns may increase global COVID-19 vaccine acceptance and accelerate our efforts to eliminate this pandemic.

Parental COVID-19 vaccine hesitancy: a cross-sectional survey in Italy

BACKGROUND

Understanding parents' hesitancy against COVID-19 vaccination for their children is useful.

METHODS

A self-administered online survey was conducted among 394 parents with at least one child aged 12-18 years in Italy.

RESULTS

The mean perceived risk that their child can be infected by the SARS-CoV-2, measured on a 10-point Likert-type scale, was 7.7 and it was higher if at least one parent/partner cohabitant have had COVID-19, in those who believed that COVID-19 is a serious illness, and in those who had not vaccinated their child. 82.1% respondents were willing to vaccinate their child and this was more likely among those who believed that this vaccine is useful and who did not need additional information. 12.4% were, according to the 5-item Parent Attitudes About Childhood Vaccines Survey (PACV-5) score, high-hesitant toward anti-COVID-19 vaccination. Respondents not graduated, those who did not believe that this vaccination was useful, those who did not get this vaccine, those who did not obtain information from physicians, and those who needed additional information were more likely to be high-hesitant.

CONCLUSIONS

Communication and public health interventions must be intensified to enhance the attitude and to help parents in deciding on COVID-19 vaccination of their children.

Testing strategies to contain COVID-19 in migrant worker dormitories

Introduction

COVID-19 transmission within overcrowded migrant worker dormitories is an ongoing global issue. Many countries have implemented extensive control measures to prevent the entire migrant worker population from becoming infected. Here, we explore case count outcomes when utilizing lockdown and testing under different testing measures and transmissibility settings.

Methods

We built a mathematical model which estimates transmission across 10 different blocks with 1000 individuals per block under different parameter combinations and testing conditions over the period of 1 month. We vary parameters including differences in block connectivity, underlying recovered proportions at the time of intervention, case importation rates and testing protocols using either PCR or rapid antigen testing.

Results

We estimate that a relatively transmissible environment with fortnightly PCR testing at a relatively low initial recovered proportion of 40%, low connectivity where 10% of contacts occurred outside of the infected individuals’ block and a high importation rate of 1100000 per day, results in an average of 39 (95%Interval: 9–121) new COVID-19 cases after one month of observation. Similar results were observed for weekly rapid antigen testing at 33 (9–95) cases.

Interpretation

Our findings support the need for either fortnightly PCR testing or weekly rapid antigen testing in high population density environments such as migrant worker dormitories. Repeated mass testing is highly effective, preventing localized site outbreaks and reducing the need for site wide lockdowns or other extensive social distancing measures within and outside of dormitories.

Predictors of COVID-19 Vaccine Confidence: Findings from Slums of Four Major Metro Cities of India

There are limited studies on COVID vaccine confidence at the household level in urban slums, which are at high risk of COVID-19 transmission due to overcrowding and poor living conditions. The objective was to understand the reasons influencing COVID-19 vaccine confidence, in terms of barriers and enablers faced by communities in urban slums and informal settlements in four major metro cities in India. A mixed method approach was adopted, where in field studies were conducted during April-May 2021. First, a survey of at least 50 subjects was conducted among residents of informal urban settlements who had not taken any dose of the COVID-19 vaccine in Mumbai, Bengaluru, Kolkata and Delhi; second, a short interview with five subjects who had taken at least one dose of the vaccine in each of the four cities to understand the factors that contributed to positive behaviour and, finally, an in-depth interview of at least 3 key informants in each city to ascertain the vaccination pattern in the communities. The reasons were grouped under contextual, individual/group and vaccine/vaccination specific issues. The most frequent reason (27.7%) was the uncertainty of getting the vaccine. The findings show the need for increasing effectiveness of awareness campaigns, accessibility and the convenience of vaccination, especially among vulnerable groups, to increase the uptake.

Knowledge about, attitude and acceptance towards, and predictors of intention to receive the COVID-19 vaccine among cancer patients in Eastern China: A cross-sectional survey

OBJECTIVE

The coronavirus disease 2019 (COVID-19) pandemic has had a serious impact on health all over the world. Cancer patient, whose immunity is often compromised, faces a huge challenge. Currently, some COVID-19 vaccines are being developed and applied on general population; however, whether cancer patients should take COVID-19 vaccine remains unknown. Our study aimed to explore the knowledge, attitude, acceptance, and predictors of intention to receive the COVID-19 vaccine among cancer patients in Eastern China.

METHODS

A cross-sectional study was conducted in Eastern China from June 17th to September 3rd, 2021. Patients were selected using a convenience sampling method. A self-report questionnaire was developed to assess knowledge about the COVID-19 vaccine, attitude towards the vaccine and acceptance of the vaccine; following a review of similar studies previously published in the scientific literature, multivariate logistic regression analysis was used to determine the predictors associated with COVID-19 vaccine acceptance.

RESULTS

A total of 2158 cancer patients were enrolled in this study. The rate of vaccine hesitancy was 24.05% (519/2158); further, among the participants of vaccine acceptance, 767 had taken COVID-19 vaccine (35.54%), and 872 were willing to get vaccinated (40.01%). A total of 24 variables including demographic characteristics, clinical status of cancer, impact of COVID-19 pandemic on study participants, patients' knowledge about the COVID-19 vaccine, and attitude towards the vaccine, had significant differences between the "vaccine hesitancy" population and "vaccine acceptance" population. Multivariate logistic regression analysis indicated that parameters including alcohol consumption (odds ratio [OR] = 1.849; 95% confidence interval [CI]: 1.375-2.488; P-reference [P-Ref] < 0.001 vs non-drinkers), income impacted by COVID-19 pandemic (OR = 1.930, 2.037 and 2.688 for mild, moderate, and severe impact, respectively; all P-Ref < 0.01 vs no impact), knowledge of how the vaccine was developed (OR = 1.616; 95% CI: 1.126-2.318; P-Ref = 0.009 vs unknown), believing in the safety of the vaccine (OR = 1.502; 95% CI: 1.024-2.203; P-Ref = 0.038 vs denying the safety of vaccine), willingness to pay for the vaccine (OR = 3.042; 95% CI: 2.376-3.894; P-Ref < 0.001 vs unwilling), and willingness to recommend families and friends to get vaccinated (OR = 2.744; 95% CI: 1.759-4.280; P-Ref < 0.001 vs do not recommend) were contributors to vaccine acceptance. While such as being retired (OR = 0.586; 95% CI: 0.438-0.784; P-Ref < 0.001 vs unemployed), undergoing multiple therapies of cancer (OR = 0.408; 95% CI: 0.221-0.753; P-Ref = 0.004 vs no ongoing treatment), and worrying that the vaccine might deteriorate the prognosis of cancer (OR = 0.393; 95% CI: 0.307-0.504; P-Ref < 0.001 vs might not) were contributors to vaccine hesitancy.

CONCLUSION

This study provided preliminary estimates of the rates of vaccine acceptance and vaccine hesitancy among cancer patients in Eastern China. The intention to receive the COVID-19 vaccine was impacted by factors such as patient occupation, alcohol consumption, and some parts of knowledge about and attitude towards COVID-19 vaccine. It is recommended to develop individualized vaccination plans that meet the healthcare needs of cancer patients.

On willingness to pay for Covid-19 vaccines: a case study from India

In this paper, using survey data from 1251 respondents from peri-urban parts in the Bhopal district of India, we estimated the willingness-to-pay (WTP) for hypothetical Covid-19 vaccines. We use open-ended questions along with the discrete choice contingent valuation method for two vaccines, one with full efficacy and the other with 70% efficacy. While no major evidence of vaccine hesitancy was observed, we found a WTP of about Rs. 141 ($1.9) for the former type vaccine and about Rs. 116 ($1.6) for the latter. From the contingent valuation method, we found about 71.9% were not willing to spend Rs. 200 ($2.7) or more for the fully effective vaccine, while this figure goes up to 77.8% for the one with 70% efficacy. Estimations from linear and probit regressions suggest that economic indicators were the most important predictors of WTP. Usage of public transport, the number of days that the respondent stepped out for work, and the presence of comorbid individuals in the household were positively associated with the WTP, while pandemic-induced income reduction was negatively correlated. The findings lend support toward the requirement of highly subsidized vaccines, and hence back the recent policy announcement toward the supply of free vaccines to all states.

The Impact of Public Health Events on COVID-19 Vaccine Hesitancy on Chinese Social Media: National Infoveillance Study

BACKGROUND

The ongoing COVID-19 pandemic has brought unprecedented challenges to every country worldwide. A call for global vaccination for COVID-19 plays a pivotal role in the fight against this virus. With the development of COVID-19 vaccines, public willingness to get vaccinated has become an important public health concern, considering the vaccine hesitancy observed worldwide. Social media is powerful in monitoring public attitudes and assess the dissemination, which would provide valuable information for policy makers.

OBJECTIVE

This study aimed to investigate the responses of vaccine positivity on social media when major public events (major outbreaks) or major adverse events related to vaccination (COVID-19 or other similar vaccines) were reported.

METHODS

A total of 340,783 vaccine-related posts were captured with the poster's information on Weibo, the largest social platform in China. After data cleaning, 156,223 posts were included in the subsequent analysis. Using pandas and SnowNLP Python libraries, posts were classified into 2 categories, positive and negative. After model training and sentiment analysis, the proportion of positive posts was computed to measure the public positivity toward the COVID-19 vaccine.

RESULTS

The positivity toward COVID-19 vaccines in China tends to fluctuate over time in the range of 45.7% to 77.0% and is intuitively correlated with public health events. In terms of gender, males were more positive (70.0% of the time) than females. In terms of region, when regional epidemics arose, not only the region with the epidemic and surrounding regions but also the whole country showed more positive attitudes to varying degrees. When the epidemic subsided temporarily, positivity decreased with varying degrees in each region.

CONCLUSIONS

In China, public positivity toward COVID-19 vaccines fluctuates over time and a regional epidemic or news on social media may cause significant variations in willingness to accept a vaccine. Furthermore, public attitudes toward COVID-19 vaccination vary from gender and region. It is crucial for policy makers to adjust their policies through the use of positive incentives with prompt responses to pandemic-related news to promote vaccination acceptance.

A National Survey to Assess the COVID-19 Vaccine-Related Conspiracy Beliefs, Acceptability, Preference, and Willingness to Pay among the General Population of Pakistan

The current study aims to assess the beliefs of the general public in Pakistan towards conspiracy theories, acceptance, willingness to pay, and preference for the COVID-19 vaccine. A cross-sectional study was conducted through an online self-administered questionnaire during January 2021. The Chi-square test or Fisher exact test was utilized for statistical data analysis. A total of 2158 respondents completed the questionnaire, among them 1192 (55.2%) were male with 23.87 (SD: ±6.23) years as mean age. The conspiracy beliefs circulating regarding the COVID-19 vaccine were believed by 9.3% to 28.4% of the study participants. Among them, 1040 (48.2%) agreed to vaccinate on its availability while 934 (43.3%) reported the Chinese vaccine as their preference. The conspiracy beliefs of the participants were significantly associated with acceptance of the COVID-19 vaccine. The existence of conspiracy beliefs and low vaccine acceptance among the general population is a serious threat to successful COVID-19 vaccination.

Predictors of Intention to Vaccinate against COVID-19 in the General Public in Hong Kong: Findings from a Population-Based, Cross-Sectional Survey

Vaccination is one of the most effective ways to stop the spread of COVID-19. Understanding factors associated with intention to receive COVID-19 vaccines is the key to a successful vaccination programme. This cross-sectional study explored the rate of vaccination intention and identified its predictors using the health belief model (HBM) in the general population in Hong Kong during the pandemic. Data were collected between December 2020 and January 2021 via telephone surveys. Hierarchical logistic regression analysis was used to identify factors associated with intention to receive COVID-19 vaccines. A total of 1255 adults (>18 years, 53% female) completed the telephone survey. Overall, 42% indicated an intention to vaccinate, 31.5% showed vaccine hesitancy, and 26.5% reported refusal to receive any COVID-19 vaccines. Individuals who were men, older in age, working, with past experiences of other pandemics, less concerned with the vaccine safety, with poorer knowledge about COVID-19, and having greater levels of perceived susceptibility, self-efficacy, cues to action, and acceptance of governmental preventive measures related to COVID-19 were significantly more likely to report an intention to vaccinate. The low intention among the Hong Kong population reflects the importance of developing effective vaccination promotion campaigns with the predictors identified in this study.