Attitudes toward Vaccination against COVID-19 in Poland. A Longitudinal Study Performed before and Two Months after the Commencement of the Population Vaccination Programme in Poland

COVID-19 vaccination reluctance across Europe: Lessons for the future

BACKGROUND

Vaccine reluctance is both a complex and context-specific issue and is the result of many complicating factors that need to be addressed more systematically. In Europe, several country-based ad-hoc studies have been carried out on COVID-19 vaccines/vaccination and vaccine reluctance but a comprehensive overview covering all 27 European Union (EU27) countries is lacking. Such study can help understand vaccine reluctance in the overall EU as well as examine differences between individual countries.

METHODS

This study relies on data from Flash Eurobarometer 505, covering all 27 European Union member states; the sample size is N=26,641. It takes a fuzzy clustering approach to construct typologies of attitudes towards COVID-19 vaccination, and subsequently develops an "Index of Attitudes" (IA) which accounts for individual positioning of EU citizens. The data analysis is based on grade of membership (GoM) model which is a reliable statistical tool to tackle heterogeneous populations.

RESULTS

The output of GoM model unveiled a hierarchical fuzzy 3-partition corresponding to three clearly identified typologies of feelings towards COVID-19 vaccination: Typology 1 entails favourable feelings while moderate-favourable feelings describe the Typology 2. Finally, Tipology 3 encompasses the scepticism towards COVID-19 vaccines. The IA, which quantifies the sentiment of European citizens towards COVID-19 vaccination in a 0-1 scale, reveals that although EU27 citizens overall are not against COVID-19 vaccination (index mean =0.44) some, mostly in eastern countries, deviate from this prevailing trend.

CONCLUSION

Distrust in the safety and efficacy of all kinds of vaccines, as well as a generalised distrust in European and national institutions, are associated with the reluctance in relation towards COVID-19 vaccination. However, this reluctance varies across countries. The outcomes of our study not only inform national government and health care agents but also help define communication strategies to reach the most reluctant citizens. The segmentation it provides makes it easier to customise campaigns that raise awareness of the consequences of not being vaccinated, particularly as new SARS-CoV-2 variants emerge.

The landscape of the COVID-19 pandemic in Poland emerging from epidemiological and genomic data

The COVID-19 pandemic has profoundly affected all aspects of our lives. Through real-time monitoring and rapid vaccine implementation, we succeeded in suppressing the spread of the disease and mitigating its consequences. Finally, conclusions can be summarized and drawn. Here, we use the example of Poland, which was seriously affected by the pandemic. Compared to other countries, Poland has not achieved impressive results in either testing or vaccination, which may explain its high mortality (case fatality rate, CFR 1.94%). Through retrospective analysis of data collected by the COVID-19 Data Portal Poland, we found significant regional differences in the number of tests performed, number of cases detected, number of COVID-19-related deaths, and vaccination rates. The Masovian, Greater Poland, and Pomeranian voivodeships, the country's leaders in vaccination, reported high case numbers but low death rates. In contrast, the voivodeships in the eastern and southern parts of Poland (Subcarpathian, Podlaskie, Lublin, Opole), which documented low vaccination levels and low case numbers, had higher COVID-19-related mortality rates. The strong negative correlation between the CFR and the percentage of the population that was vaccinated in Poland supports the validity of vaccination. To gain insight into virus evolution, we sequenced more than 500 genomes and analyzed nearly 80 thousand SARS-CoV-2 genome sequences deposited in GISAID by Polish diagnostic centers. We showed that the SARS-CoV-2 variant distribution over time in Poland reflected that in Europe. Haplotype network analysis allowed us to follow the virus transmission routes and identify potential superspreaders in each pandemic wave.

Determinants of COVID-19 vaccination intention in Central and Eastern Europe: A cross-sectional study in Poland, Romania, and Slovenia

BACKGROUND

Identifying predictors of vaccination intention is critical to developing appropriate programs and campaigns targeting groups reluctant to be vaccinated. This study aimed to identify the determinants of vaccination intention at the beginning of the COVID-19 pandemic in three Central and Eastern European (CEE) countries: Poland, Romania, and Slovenia.

METHODS

In this cross-sectional study, a sample of unvaccinated 1723 Poles, Romanians, and Slovenians completed an online survey (April 2021). Questions included measures of vaccination intention, attitudes towards vaccines, conspiracy mindset, preference for a type of vaccine, and trust in information sources.

RESULTS

The results showed that mistrust of vaccine benefits and concerns about commercial profiteering negatively predicted vaccination intention. Conversely, trust in information from medical professionals and scientists, official sources, and traditional media was positively related to vaccination intention, while trust in digital media was negatively related to vaccination intention. In addition, preference for mRNA vaccine type was a positive significant predictor of vaccination intention. The differences between countries are discussed.

CONCLUSIONS

The study results deliver suggestions for developing appropriate vaccine uptake programs and campaigns that should consider presenting the positive outcomes of vaccines via official sources and traditional media based on scientific evidence and medical professionals' knowledge.

Utility of the Theory of Planned Behaviour for predicting parents' intentions to vaccinate their children against COVID-19

Vaccination is a crucial form of primary prevention, and it is important to understand the factors that influence parents' decisions to vaccinate their children. The current study examines the utility of the Theory of Planned Behaviour (TPB) and anticipated affect for explaining parents' intentions to vaccinate their children against COVID-19. Parents (N = 843) living in the United States completed an online survey. The TPB variables explained 65% of the variability in parents' intentions. In addition to all three of the TPB antecedents predicting vaccine intentions, both anticipated regret of not vaccinating and anticipated positive emotions of vaccinating were associated with parent intentions. Contrary to predictions, subjective norms were a stronger predictor of intentions when perceived behavioural control was lower compared to higher. These findings help further our understanding of parent-for-child vaccine decisions in the context of novel health threats and inform intervention efforts aimed at encouraging this behaviour.

Testing an extended theory of planned behaviour in predicting Covid-19 vaccination intention over the course of the pandemic: A three-wave repeated cross-sectional study

Background

Mass vaccination against Covid-19 has been recognised as the most effective strategy for overcoming the pandemic emergency and remains crucial in the ongoing efforts to mitigate the impact of the virus. The present study aimed to test the efficacy of an extended Theory of Planned Behaviour (TPB) model in predicting vaccination intention in three different phases of the pandemic. Understanding how psychological drivers of vaccine acceptance may have changed throughout the pandemic is essential for informing public health strategies and addressing vaccine hesitancy, even in the current post-pandemic context.

Methods

Using a repeated cross-sectional survey, we tested the hypothesised extended TPB model (intention, attitude, subjective norms, perceived behavioural control, anticipated affective reactions, risk perception, trust in science, trust in institutions and religiosity) across three independent samples: before (T1: November-December 2020; N = 657), during (T2: March-May 2021; N = 818), and after (T3: February-March 2022; N = 605) the start of the vaccination campaign in Italy.

Results

Results indicated significant differences between the time points in all investigated variables, pointing to a general trend of improvement in vaccine acceptability levels at T2 compared to T1, and a worsening at T3 compared to the other two time points. Interestingly, net of these differences, a multi-group Structural Equation Modeling analysis supported the invariance, across time, of the structural relationships examined within the extended TPB.

Conclusion

Findings demonstrated the efficacy of the TPB in predicting Covid-19 vaccination intention at different stages of the pandemic, suggesting that the model, in its extended version, represents a valuable framework for designing interventions aimed at promoting vaccine acceptance.

Willingness to vaccinate among adults, and factors associated with vaccine acceptance of COVID-19 vaccines in a nationwide study in Poland between March 2021 and April 2022

Introduction

Despite the availability, safety and effectiveness of COVID-19 vaccines, Poland remains one of the six countries of the European Union with the lowest cumulative uptake of the vaccine's primary course in the general population. This study examined willingness to vaccinate and the associated factors in samples of unvaccinated and vaccinated adults between March 2021 and April 2022.

Methods

Data were collected using OBSER-CO, a nationwide, repeated cross-sectional study, conducted at four different time points (rounds). Data on willingness to vaccinate among the unvaccinated (at all rounds) and willingness to receive another dose in the vaccinated (at 2 rounds-after booster introduction), reasons for reluctance, sociodemographic, health, and behavioral factors were collected using a uniform questionnaire via computer-assisted telephone interviewing. In each round, more than 20,000 respondents were interviewed. To assess associations between factors and willingness to vaccinate, separate multivariable logistic regression models were fitted for each factor at each round and adjusted for confounders.

Results

Between rounds 1 and 4 (March 2021-April 2022), in the unvaccinated, willingness to vaccinate declined from 73 to 12%, whereas in the vaccinated, willingness to receive another dose declined from 90 to 53%. The highest magnitude of decline between subsequent rounds occurred during the Omicron wave. Overall, concerns about side effects, effectiveness, and vaccine adverse effects were common but decreased over time. Age, gender, employment, place of residence, COVID-19 diagnosis or exposure, hospitalization, and participation in social activities were among the factors associated with willingness. However, associations changed over rounds highlighting the influence of different pandemic waves and variants.

Conclusion

We observed a declining and multifactorial willingness to vaccinate in Poland, with vaccine attitudes dynamically changing across subsequent rounds. To address vaccine concerns, sustained health communication about COVID-19 vaccines is essential, especially after the emergence of new variants.

Psychological factors associated with vaccination hesitancy: an observational study of patients hospitalized for COVID-19 in a later phase of the pandemic in Italy

Introduction

Vaccination against SARS-CoV-2 has been used to reduce the severity of COVID-19 disease and the incidence of new cases. However, a significant proportion of people have shown vaccination hesitancy.

Methods

This study explored psychological factors related to vaccination hesitancy in a sample of Italian COVID-19 patients (N = 54), hospitalized during 2021, after vaccines had been made available and while the vaccination campaign was on-going. Consecutive patients, aged 18 or older, admitted to the hospital with a diagnosis of COVID-19 were assessed with a set of standardized measures.

Results

In our sample, 48.1% was not vaccinated and 7.4% died within 6months after hospitalization, with a preponderance of deaths among non-vaccinated patients. Non-vaccinated participants had higher resilience scores at the CD-RISC-10 scale than vaccinated ones (33.6 ± 5.50 vs 28.6 ± 6.61; t40.2=+ 2.94, p = 0.005). No statistically significant differences were found between the two groups for any other measures.

Discussion

Higher levels of resilience among non-vaccinated patients may reflect greater identity worth and self-esteem, in turn resulting in a decrease in vaccination likelihood. This finding may have important public health implications, as it indicates that specific psychological aspects, such as resilience, may result in vaccination hesitancy, with implications for hospitalization rates, and thus healthcare costs, as well as loss of lives.

COVID-19 Vaccine Hesitancy among the General Population: A Cross-Sectional Study

Hesitancy about receiving vaccines has been deemed a global danger to public health by WHO. The sociocultural backgrounds of the people have an impact on vaccine acceptance. The purpose of this study was to examine the effect of sociodemographic factors on COVID-19 vaccination hesitancy as well as to identify the factors that contributed to COVID-19 vaccine hesitancy.

METHODS

A cross-sectional study was carried out to determine the primary variables causing COVID-19 vaccination hesitancy among residents of Pune. The general population was sampled through simple random sampling. The minimum sample size was determined to be 1246. The questionnaire inquired about the individuals' sociodemographic information, vaccination status, and reasons for vaccine hesitancy.

RESULTS

In total, there were 5381 subjects, 1669 of whom were unvaccinated and 3712 of whom were partially vaccinated. Fear of adverse effects (51.71%), fear of losing a few days of work (43.02%), and inability to secure a vaccine slot online (33.01%) were the most frequently cited reasons. An older population (>60 years, p = 0.004), males (p = 0.032), those who were literate (p = 0.011), those of lower middle socioeconomic status (p = 0.001), and smokers were significantly associated with fear and mistrust of the COVID-19 vaccine, while mistrust of the vaccine was greatest among individuals from the upper and lower middle classes (p = 0.001).

CONCLUSION

Vaccine hesitancy due to concerns about the side effects and long-term complications was prevalent among the elderly, males, those from the lower middle class, and smokers. This study emphasizes the importance of communicating effectively about the vaccine's efficacy, its distribution, and vaccination sites.

Before and After: Attitude and Adverse Effects Induced by the First and Second Doses of mRNA BNT162b2 Vaccine among Healthcare Professionals in the First Weeks after Their Introduction in Poland

BACKGROUND

In the last days of December 2020, the SARS-CoV-2 virus vaccine BNT162b2 (Comirnaty, Pfizer-BioNTech) was introduced, for the first time, for wide use in Poland. According to the vaccination schedule, healthcare workers were the first to receive the vaccine. The aim of this study was to analyse the attitudes of those who were determined to be vaccinated, with particular reference to their concerns, attitudes towards vaccination advocacy and sources of knowledge on vaccination, as well as the incidence of adverse reactions.

METHODS

The study had a three-stage design. Respondents completed a self-administered questionnaire before receiving the 1st and 2nd vaccine doses and 2 weeks after receiving the 2nd dose. A total of 2247 responses were obtained (1340 responses in the first stage, 769 in the second and 138 in the third).

RESULTS

The main source of knowledge on vaccination was the Internet (32%; n = 428). Of the respondents, 6% (n = 86) reported anxiety before the 1st dose of the vaccine, which increased to 20% (n = 157) before the 2nd dose. A declaration of willingness to promote vaccination among their families was made by 87% (n = 1165). Among adverse reactions after the 1st dose of the vaccine, respondents most frequently observed pain at the injection site (n = 584; 71%), fatigue (n = 126; 16%) and malaise (n = 86; 11%). The mean duration of symptoms was 2.38 days (SD 1.88). After the 2nd dose of vaccine, similar adverse reactions-pain at the injection site (n = 103; 75%), fatigue (n = 28; 20%), malaise (n = 22; 16%)-predominated among respondents. Those who declared having had a SARS-CoV-2 virus infection (p = 0.00484) and with a history of adverse vaccination reactions (p = 0.00374) were statistically more likely to observe adverse symptoms after vaccination.

CONCLUSIONS

Adverse postvaccinal reactions are relatively common after Comirnaty vaccination but are usually mild and transient in nature. It is in the interest of public health to increase the knowledge of vaccine safety.

The Importance of Resilience and Level of Anxiety in the Process of Making a Decision about SARS-CoV-2 Vaccination

People's opinions on immunization are diverse. Despite the constant improvement of vaccine formulas, the number of people reluctant to immunize is not decreasing. The purpose of our study is to assess the psychological determinants of immunization reluctance in depth. We measured levels of anxiety (death-related and general), fear of COVID-19, self-esteem and resilience among 342 adults. We found that the level of COVID-19 related fear is higher among the vaccinated population, despite general anxiety levels being lower. Surprisingly we didn't find significant differences in resilience and self-esteem levels. Findings are concurrent with previous research-COVID-19 related fear level is higher among vaccinated people. Resilience and self-esteem are defined as stable, trait-like constructs, and thus may not manifest higher levels in very specific pandemic situations, although they may lower the levels of general anxiety.

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.

Breastfeeding Women's Attitudes About the SARS-COV-2 Vaccine in Spain

BACKGROUND

Severe Acute Respiratory Syndrome Coronavirus 2 has spread globally, causing the coronavirus disease 2019 (COVID-19) pandemic. To control the pandemic and to achieve herd immunity, four vaccines have obtained market authorization in Europe. Researchers have reported that the sequence of administration of the vaccines depends on the risk of exposure to COVID-19 and age, recommending the vaccine to pregnant and breastfeeding women.

RESEARCH AIM

To examine the knowledge, willingness and attitudes of breastfeeding women in Spain regarding the possibility of receiving the COVID-19 vaccine.

METHODS

An observational descriptive cross-sectional study in two tertiary-level hospitals from Valencia was conducted. Breastfeeding women (N = 301) were recruited by non-probability sampling of consecutive cases. Questionnaires were collected in June 2021.

RESULTS

More than one in every two participants would accept a COVID-19 vaccine, and the percentage rose in participants who were older, more educated, or worked in high-risk jobs. Their main source of information was the Internet, and midwives were the professionals who most recommended vaccination. Participants who would not accept vaccination during lactation reported reasons linked to lack of information regarding vaccination in their condition and how it might affect newborns.

CONCLUSION

It is of primary concern for healthcare professionals to foster a greater understanding by providing updated information regarding the need, safety, and efficacy of the vaccine for both lactating mothers and their newborns.

The Influence of Preventive Activities on Stress Perception among Dentistry Students in the Period of the COVID-19 Pandemic

BACKGROUND

The COVID-19 pandemic resulted in the strengthening of the earlier stressors and the appearance of new pandemic-related stressors. Many students of dentistry fit the profile of a group who are particularly susceptible to stress related to the pandemic. Thus, it was necessary to implement preventive activities, reducing their stress perception. This was understood as a means of significantly influencing the student's well-being, thus improving the quality of education. Therefore, the aim of the study was to assess the impacts of implemented preventive activities on stress perception among students of dentistry during the pandemic, as well as their influence on this assessment of the selected students' personal experiences regarding the pandemic.

METHODS

The study was performed one year after the outbreak of the pandemic on students of dentistry at Jagiellonian University Medical College, Krakow, Poland. It consisted of the completion of a self-designed, voluntary, anonymous, online questionnaire. The respondent's task was to assess the influences of implemented preventive activities on stress perception using a five-point scale. The activities were divided into external (national, global) and internal (institutional). The material was statistically analysed for all students, including pre-clinical and clinical groups. Additionally, the impact of the selected students' personal experiences regarding the COVID-19 pandemic on the assessment was studied.

RESULTS

All preventive activities (in total) significantly reduced stress perception (p ≤ 0.001), but the intensity of their impacts (mean rank) was different. The most highly assessed activities were all external preventive activities, with the greatest intensity belonging to the prospect of receiving vaccination against SARS-CoV-2. The remaining external activities were the prospect of developing an effective COVID-19 treatment and the increase in knowledge about SARS-CoV-2. The internal activities were assessed and ascribed lower positions, with the exception of the theoretical classes held online. This activity was placed slightly lower than the highest-rated activity, the prospect of receiving vaccination.

CONCLUSIONS

The studied preventive activities reduced stress perception with different levels of intensity. The highest-ranked activities were external activities. One exception was the theoretical classes held online, an internal activity. Due to the lower impact of the internal activities and the ability to modify them by the educators, there is a need to strengthen their effectiveness. The possibility of monitoring and tailoring some preventive activities to the students' needs was the practical aspect of the conducted study. Students' personal experiences related to the COVID-19 pandemic influenced their assessment of the preventive activities, in some cases significantly.

Healthcare Workers and Nonhealthcare Workers Pro-Vaccination Attitude and Its Associated Factors towards COVID-19 Vaccine Globally: A Systematic Review and Meta-Analysis

Introduction

Coronavirus disease 2019 (COVID-19) pandemic has not been managed and controlled globally. The aim of this systematic review and meta-analysis were to determine the global pro-vaccination attitude and associated factors towards COVID-19 vaccine among healthcare workers (HCWs) and nonhealthcare workers (non-HCWs).

Methods

Different databases such as PubMed, Scopus, EMBASE, and Google Scholar were used. Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) 2020 flowchart diagram and PRISMA checklist were used for study screening, selection, and inclusion into this systematic review and meta-analysis. Newcastle-Ottawa Scale (NOS) quality assessment criteria for cross-sectional studies were used to assess the included articles.

Results

A total of 51 studies were included into this systematic review and meta-analysis. The meta-analysis revealed that the global pooled prevalence of pro-vaccination attitude towards COVID-19 vaccine among both HCWs and non-HCWs was 61.30% (95%CI: 56.12, 66.47, I 2 = 99.8%: p=0.000). Subgroup analysis showed that the global pooled prevalence of pro-vaccination attitude towards COVID-19 vaccine was the lowest (59.77%, 95%CI (51.56, 67.98); I 2 = 99.6%, p=0.000) among the HCWs participants and the highest (62.53%, 95%CI (55.39, 69.67); I 2 = 99.8%, p=0.000) among the non-HCWs participants and the lowest (54.31%, 95%CI (43, 65.63); I 2 = 99.5%, p=0.000) for sample size <700 and the highest (66.49%, 95%CI (60.01, 72.98); I 2 = 99.8%, p=0.000) for sample size >700; the lowest (60.70%, 95%CI (54.08, 67.44); I 2 = 93.0%, p=0.000) for studies published in 2020 year and the highest (61.31%, 95%CI (55.93, 66.70); I 2 = 99.8%, p=0.000) for the studies published after 2020 years. From this systematic review, factors significantly associated with pro-vaccination attitude towards COVID-19 vaccine among HCWs were such as age, gender, race, work experience, home location, having no fear of injections, being a non-smoker, profession, presence of chronic illnesses, allergies, confidence in pharmaceutical companies, history of taking influenza vaccine, vaccine recommendation, perceived risk of new vaccines, perceived utility of vaccine, receiving a seasonal flu vaccination in the last 5 years, working in a private hospital, a high perceived pandemic risk index, low vaccine harm index, high pro-socialness index, being in close contact with a high-risk group, knowledge about the virus, confidence in and expectations about personal protective equipment, and behaviors. The level of positive attitude towards COVID-19 vaccine among non-HCWs ranged from 21.40% to 91.99%. Factors associated with the attitude towards COVID-19 vaccine among non-HCWs were such as age, gender, educational level, occupation, marital status, residency, income, ethnicity, risk for severe course of COVID-19, direct contact with COVID-19 at work, being a health profession, being vaccinated against seasonal flu, perceived benefits, cues to actions, having previous history of vaccination, fear of passing on the disease to relatives, and the year of medical study, studying health-related courses, COVID-19 concern, adherence level to social distancing guidelines, history of chronic disease, being pregnant, perceived vaccine safety, having more information about vaccine effectiveness, mandatory vaccination, being recommended to be vaccinated, lack of confidence in the healthcare system to control epidemic, and belief in COVID-19 vaccines protection from COVID-19 infection.

Conclusion

This meta-analysis revealed that the global estimated pooled prevalence of pro-vaccination attitude towards COVID-19 vaccine among both HCWs and non-HCWs was unsatisfactory. Globally, there is a need for a call for action to cease the crisis of this pandemic.

Sociodemographic and Psychological Variables and Concerns Related to COVID-19 Vaccination among Polish Citizens

The aim of this study performed during the fourth wave of the pandemic was to analyse differences in sociodemographic and psychological variables between those who cite concerns regarding COVID-19 vaccination and those who do not, as well as the differences between those whose concerns stem from a negative evaluation of vaccines and those whose concerns are based on a positive evaluation of vaccines. The study included 417 participants aged 18 to 76 years (M = 34, SD = 13.9). Among the respondents, 89% were female. A survey questionnaire on sociodemographic variables and standardized research tools were used: mood (UMACL), emotions (PANAS), satisfaction with life (SWLS), optimism (LOT-R), and coping with stress (CISS). The results of the study indicate that the elderly and working people are concerned about inadequate vaccination of the population, whereas students are concerned about the pressure of compulsory vaccination. People who are concerned about inadequate vaccination of population are more likely to experience concerns about various stressors. Our results do not indicate a relationship between psychological variables and vaccination-related concerns. The results obtained may be the basis for the identification of target groups in order to adapt social campaigns promoting vaccination against COVID-19 in Poland.

COVID-19 Vaccination and Ukrainian Refugees in Poland during Russian-Ukrainian War-Narrative Review

The outbreak of the Russian–Ukrainian war contributed to the largest migration movement in the 21st century. As a result, over 3 million refugees, mainly women, children and the elderly, arrived in Poland in a short space of time. Despite the ongoing war, it is important to remember that the COVID-19 pandemic is still present in the world, and before the outbreak of the war, Ukraine was struggling with its fifth wave. Furthermore, Ukraine has one of the lowest vaccination rates in Europe, not exceeding 40%. It is, therefore, reasonable to suspect that the vast majority of migrants have not been vaccinated. This situation may pose a significant epidemiological risk. Therefore, it is necessary to implement appropriate steps to determine the vaccination status of refugees and to supplement the vaccination with both the core and booster doses. In response to these needs, the government of Poland, like many other countries, has made it possible to provide free COVID-19 vaccination to persons fleeing war. In the face of massive migration, the overriding priority should be to ensure adequate medical care for refugees, including free COVID-19 vaccinations. However, it seems that the lack of willingness to vaccinate among Ukrainians is also replicated on migration. It seems reasonable that appropriate steps should be taken to increase awareness and confidence in vaccination, which may ultimately translate into increased vaccination uptake. Analyzing previous experiences, it is advisable to consider that the first step should be to promote vaccination and remind refugees of the possibility of free COVID-19 vaccination. Additionally, refugees should be encouraged to be vaccinated during every contact with health care workers.

Perceptions and experiences of COVID-19 vaccines’ side effects among healthcare workers at an Egyptian University Hospital: a cross-sectional study

Background

A safe and effective vaccine is the ultimate key to mitigating the COVID-19 pandemic. Vaccine acceptance is influenced by various factors, including perceptions about the vaccine’s safety and side effects. The side effects vary depending on the type of the vaccine, but they are mainly mild, local, temporary, and self-limiting.

Methods

A cross-sectional study was carried out at Tanta University Hospitals, including 1246 healthcare workers who received either the first or the second dose of the COVID-19 vaccine, selected via a systematic random sampling technique using a self-administered structured validated questionnaire for data collection from November 2021 to January 2022. Qualitative data were presented as frequencies and percentages and analyzed using Chi-square and Fisher’s exact tests.

Results

The prevalence of one or more side effects was 91.3%. Among participants, about two-thirds believed in vaccine safety and its necessity (65.4% and 63.6%, respectively). Significantly more participants (46.9%) were concerned about AstraZeneca thrombotic complications than other vaccine types. The top five side effects reported by participants were injection site pain (64.8%), sense of fatigue (57.1%), headache (49.9%), muscle pain (48.7%), and fever (46.5). Most of the side effects were significantly higher among participants vaccinated with AstraZeneca. Side effects impacted work capacity of 23.4%, which was significantly higher among participants who received AstraZeneca (33.6%).

Conclusion

Participants had a good level of belief in vaccination safety and necessity. Healthcare workers who got the AstraZeneca vaccination reported more adverse effects than other vaccines. Injection site pain, fatigue, headache, muscle pains, and fever were the most frequently reported side effects. More research on vaccination safety is needed to understand the long-term adverse effects of vaccinations better, improve the public trust, and accelerate vaccine adoption.

Determinants of the Hesitancy toward COVID-19 Vaccination in Eastern European Countries and the Relationship with Health and Vaccine Literacy: A Literature Review

Herd immunity is necessary to control the coronavirus disease 2019 (COVID-19) pandemic. However, a low proportion of vaccinated people and low levels of vaccine acceptance have been noted in Eastern Europe. Our paper aimed to review the central attitudes associated with the hesitancy toward COVID-19 vaccination specific to Eastern European countries. The main Eastern European determinants of COVID-19 vaccine acceptance identified from the included studies are: public confidence in the vaccines’ safety and efficacy, vaccine literacy, and public trust in the government and the medical system. Each of these determinants is discussed along with possible improvement measures. Variables specific to Eastern Europe that predict the willingness to vaccinate have also been highlighted. The specific attitudes and their context as identified by our review should be incorporated into local public health programs, with the ultimate goal of reducing viral spreading, mutation emergence, and COVID-19 morbidity and mortality both within the borders of Eastern Europe and beyond.

The Relationship between Attitudes and Satisfaction Concerning the COVID-19 Vaccine and Vaccine Boosters in Urban Bangkok, Thailand: A Cross-Sectional Study

Background: COVID-19 vaccine hesitancy is a global concern. Many individuals are concerned about the potential side-effects of the COVID-19 vaccine and vaccine boosters. The purpose of this study was to assess attitudes and satisfaction concerning COVID-19 vaccines and vaccine boosters in the population in Bangkok, Thailand. Methods: A cross-sectional online survey measuring COVID-19 vaccine attitudes and satisfaction was distributed from September to December 2021. Multiple linear regression was used to explore associations between demographic variables and questionnaire results. Spearman’s correlation analysis was used to examine associations between attitude and satisfaction scores. Results: A total of 780 questionnaire responses were obtained. The largest groups of participants reported having obtained a first vaccination dose via viral vaccine (52.8%), a second vaccination booster via viral vaccine (49.5%), and a third vaccination booster via mRNA vaccine (28.8%). Multiple linear regression revealed a lower association between vaccine attitude scores and having earned less than a bachelor’s degree (β −0.109; 95% CI −2.541, −0.451) and infection risk without self-isolating (β −0.154; 95% CI −4.152, −0.670) compared with attaining a bachelor’s degree or higher and never having being at risk of infection, respectively. Higher vaccine satisfaction scores were more closely associated with being married than being single (β 0.074; 95% CI −0.073, 3.022), whereas lower vaccine satisfaction scores were less closely associated with non-healthcare workers (β −0.143; 95% CI −4.698, −0.831) and infection risk without self-isolating (β −0.132; 95% CI −6.034, −0.502) compared with non-healthcare workers and never being at risk of infection. There was weak but significant positive correlation between attitude and satisfaction scores (r = 0.338, p-value < 0.001). Hence, a gradual decline in protection following vaccination and the positive effects of a booster dose after primary vaccination have made the decision to administer booster doses. Conclusion: The results suggest that policymakers need to develop more effective strategies to raise awareness about the importance of vaccination.

Attitude of Health Care Workers and Medical Students towards Vaccination against COVID-19

The role of medical personnel in promoting vaccination and pro-health attitudes seems to be of key importance for protection against COVID-19. The aim of the study was to assess the attitudes of health care workers and students of medical faculties towards preventive vaccinations against COVID-19. A cross-sectional online self-administered survey was conducted among 497 people. The questions concerned attitudes towards vaccination as well as concerns about the side effects of the vaccine and contracting COVID-19. A positive attitude to vaccination was observed in 82% of the respondents. More than 54% respondents were concerned about side effects after COVID-19 vaccination. Medical students under 26 years had a more positive attitude towards COVID-19 vaccination, twice as high as among health care workers OR (95%Cl): 2.20 (1.03–4.66) vs. 4.06 (2.54–6.48), respectively. Students were more concerned than nurses about adverse effects of COVID-19 vaccine 3.8 (3.2–4.1) vs. 3.0 (2.7–3.5) and contracting the virus (1.7 (1.2–2.5) vs. 1.2 (1.0–2.0). Medical students had a more positive attitude toward vaccination than nursing students 4.2 (3.9–4.3) vs. 3.7 (3.3–4.3). In conclusion, predictors of positive attitudes toward vaccination were medical student status and young age.

Subjective health status: an easily available, independent, robust and significant predictive factor at the prometaphase of vaccination programs for the vaccination behavior of Chinese adults

BACKGROUND

The World Health Organization (WHO) proposed COVID-19 vaccination as an emergent and important method to end the COVID-19 pandemic. Since China started vaccination programs in December 2020, vaccination has spread to provinces and municipalities nationwide. Previous research has focused on people's vaccination willingness and its influencing factors but has not examined vaccination behavior. We examine the effectiveness of psychosocial factors in predicting vaccination behavior.

METHODS

A cross-sectional online survey was performed among Chinese adults on 8 May and 4 June 2021. The statistical analysis of the data included univariate analysis, receiver operator characteristics (ROC) analysis and ordinal multiclassification logistic regression model analysis.

RESULTS

Of the 1300 respondents, 761 (58.5%) were vaccinated. Univariate analysis showed that a high education level and good subjective health status were protective factors for vaccination behavior, while suffering from chronic diseases was a risk factor. ROC analysis showed that subjective health status (AUC = 0.625, 95% CI: 0.594-0.656, P < 0.001) was the best predictor of vaccination behavior. Logistic regression analysis with subjective health status as a dependent variable indicated that older age, female sex, depression, neurasthenia, obsession, hypochondriasis and chronic disease were significant risk factors, while positive coping tendencies were a significant protective factor.

CONCLUSION

Our study found a simple and effective marker, subjective health status, that can predict vaccination behavior. This finding can guide future epidemic prevention work.

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

The vaccines against COVID-19 are the best treatment for limiting the spread of the epidemic, and from an individual point of view, for avoiding getting sick. A cross-sectional retrospective survey was conducted from 15 May to 15 July 2021 among healthcare workers, including doctors, nurses, midwives, and students at the Medical University of Lodz (nursing, midwifery and medical students) in Poland. Data were obtained from 1080 participants. The aim of the study was to evaluate vaccination coverage against COVID-19 among healthcare workers (HCWs) in Poland, and to analyze their attitude towards the available vaccines, stress before taking, and side effects after administrating them, and motivation towards continuing vaccination in the future (if necessary). The survey also estimated the frequency and quality of adverse post-vaccination reactions after two doses of BioNTech/Pfizer and two doses of AstraZeneca vaccines. The present study revealed that the vaccination ratio after 6 months from the start of vaccination against COVID-19 in Poland among HCWs was very high at 91.2%. However, doctors and medical students were more likely to be vaccinated than nurses and midwives, and nursing and midwifery students (94.8%, 98.3% vs. 78.9% and 86.3%, respectively). The main reasons that HCWs reported receiving a vaccination were to protect the health of themselves and their families, while the main reasons for avoiding a vaccination were fear of side effects, doubts about effectiveness, and an expedited clinical trial process of vaccines. Furthermore, more than two-thirds of those vaccinated reported side effects after receiving at least one dose of the vaccine. Most of the side effects were short-term symptoms with only slight and moderate intensification. The univariate and multivariate logistic regressions showed that the type of vaccine used had a significant impact on the occurrence of adverse post-vaccination effects and the severity and duration of vaccination symptoms. In addition, chronic disease and fear of vaccination also had some influence. Despite this, most participants (more often older than younger participants; p < 0.001) were in favor of compulsory vaccination against COVID-19 for HCWs.

Assessment of Attitudes, Main Concerns and Sources of Knowledge Regarding COVID-19 Vaccination in Poland in the Unvaccinated Individuals-A Nationwide Survey

Vaccination is the most effective tool to combat the COVID-19 pandemic. However, it is ineffective without appropriate public acceptance. In Poland, 53% of the country's population is vaccinated, which puts us in the last position among the EU countries. Therefore, this study aims to assess the main concerns regarding vaccination in the unvaccinated population of Poland. The study was based on an original questionnaire that was distributed online. There were three phases of the study: Phase 1-before the preventive vaccination plan, Phase 2-2 months after implementation of the programme, Phase 3-after 4 months when the immunisation rate in Poland was 42%. A total of 4459 individuals participated in the study. As many as 1943 participants were excluded from the analysis due to lack of consent (30 subjects) or COVID-19 vaccination (1913 subjects). Out of the remaining 2516 unvaccinated individuals, 463 were participants in the first phase of the study, 1137 in the second phase of the study, and 916 in the third phase. As the preventive vaccination plan in Poland continued, concerns about vaccine adverse events, safety and efficacy were raised. The only lower concern was that about the vaccine transportation rules. Moreover, as the vaccination programme continued, there was an increase in the percentage of individuals declaring their full reluctance towards vaccination against COVID-19. Conclusions: The Internet is the main source of knowledge about the COVID-19 vaccination, so it should be focused on during vaccination campaigns. The public is primarily concerned about adverse events of vaccines and the lack of appropriate tests of the products used. Therefore, it is advisable to popularise the current state of knowledge and promote reliable information concerning the COVID-19 vaccination.

Approach of Pregnant Women from Poland and the Ukraine to COVID-19 Vaccination—The Role of Medical Consultation

There are many arguments for the safety and efficacy of COVID-19 vaccines in pregnancy. The aim of this study is to describe the level of vaccination acceptance, to find the factors that most influence the decision to vaccinate, and to describe the scale of changes in vaccination acceptance influenced by medical information on the safety, efficacy, and benefits of vaccination among pregnant women. A total of 300 patients completed the questionnaire, including 150 in Poland and 150 in the Ukraine. The level of vaccination acceptance was assessed before and after medical consultation. There were 53 (35.3%) patients with the intention to get vaccinated in Poland and 25 (16.7%) in the Ukraine. After consultation with a physician, this increased to 109 (72.6%) in Poland and 69 (46%) in the Ukraine. The main factors influencing the acceptance of vaccinations were the fear of harming the foetus (OR-0.119, CI-0.039–0.324 p < 0.001), complications in pregnancy (OR-0.073 CI-0.023–0.197 p < 0.001), and limitations in the vaccination programme (OR-0.026 CI-0.001–0.207 p < 0.001). Medical information about the safety, effectiveness and benefits of vaccinations among pregnant women, provided during a medical visit, may increase the acceptance of vaccinations by 105.6%, as among Polish patients, and by 176%, as among pregnant women from the Ukraine.

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.

Attitudes of Poles towards the COVID-19 Vaccine Booster Dose: An Online Survey in Poland

Introduction: COVID-19 vaccination has now become the most effective way to combat the pandemic, but there is a gradual decline in the protection that it offers over time. Therefore, the Food and Drug Administration (FDA) and EMA now recommend the use of the so-called booster dose, especially in at-risk groups. The purpose of the study was to assess the attitudes of Poles towards the recommendation to receive a booster dose of the COVID-19 vaccine and to evaluate the main reasons for refusing or delaying the decision. Material and methods: The study was based on a proprietary questionnaire distributed via the Internet. There were 1598 respondents, 54 of which did not consent to participate in the survey and/or did not complete the vaccination against SARS-CoV-2. As a result, 1528 surveys were included in the final analysis. The vast majority of the respondents, namely 1275 (83.4%), were female, and 772 (50.5%) were residents of cities with a population of over 250,000. Results: Out of all respondents, 38 (2.5%) had already received the COVID-19 vaccine booster dose and 1031 (67.4%) would like to receive it as soon as possible. Forty-five (2.9%) respondents reported that they were completely unwilling to take the booster dose. The occurrence of adverse events after primary vaccination were reported by 79.9% of the survey participants. The most common reasons why the respondents refused to be vaccinated are lack of confidence in the effectiveness of the booster dose and the occurrence of adverse events in them or their loved ones. Age, gender, residence, or relationship status were not shown to affect attitudes towards the expansion of the basic vaccination schedule. Conclusions: One in three respondents plans to delay or refrain from taking the COVID-19 vaccine booster dose. The main reason for refusal to be vaccinated is the belief that the previous vaccination provides sufficient protection.

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.

COVID-19 Vaccination in Patients with Pulmonary Arterial Hypertension and Chronic Thromboembolic Pulmonary Hypertension: Safety Profile and Reasons for Opting against Vaccination

The incidence of COVID-19 infection in patients with pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) is similar to that in the general population, but the mortality rate is much higher. COVID-19 vaccination is strongly recommended for PAH/CTEPH patients. The aim of our cross-sectional study was to identify reasons why PAH/CTEPH patients refused vaccination against COVID-19. Moreover, we assessed the safety profile of approved COVID-19 vaccines in PAH/CTEPH patients. We examined 261 patients (164 PAH patients and 97CTEPH patients) with a median age of 60 (18–92) years, 62% of which were female. Sixty-one patients (23%) refused to be vaccinated. The main reason for unwillingness to be vaccinated was anxiety about adverse events (AEs, 61%). Age and fear of COVID-19 in the univariate analysis and age ≥60 years in the multivariate regression analysis were factors that impacted willingness to be vaccinated (OR = 2.5; p = 0.005). AEs were reported in 61% of vaccinated patients after the first dose and in 40.5% after the second dose (p = 0.01). The most common reported AEs were pain at the injection site (54.5%), fever (22%), fatigue (21%), myalgia (10.5%), and headache (10%). A lower percentage of AEs was reported in older patients (OR = 0.3; p = 0.001). The COVID-19 vaccines are safe for PAH/CTEPH patients. The results obtained in this study may encourage patients of these rare but severe cardio-pulmonary diseases to get vaccinated against COVID-19.

Self-Reported Adverse Events of COVID-19 Vaccines in Polish Healthcare Workers and Medical Students. Cross-Sectional Study and Pooled Analysis of CoVaST Project Results in Central Europe

BACKGROUND

Optimization of COVID-19 vaccination rate among healthcare personnel is of utmost priority to secure provision of uninterrupted care and to protect the most vulnerable patients. This study, as part of the global CoVaST project, aimed to assess the occurrence of short-term adverse events (SRAEs) of two most administered COVID-19 vaccines, mRNA-based (Pfizer-BioNTech and Moderna) and viral vector-based (AstraZeneca) in healthcare sector workers (HWs).

METHODS

A cross-sectional survey-based study was carried out for the first time among 317 Polish healthcare sector personnel and medical students using a validated and pre-tested questionnaire. The online questionnaire included 25 pre-tested, validated questions concerning demographic data, medical parameters, COVID-19-related anamneses, and local or systemic reactions (reactogenicity) associated with COVID-19 vaccination. Descriptive statistics, inferential tests and binary logistic regression were performed.

RESULTS

Out of the 247 participating HWs, 79.8% were females, and 77.5% received mRNA-based vaccines, while 24.5% received a viral vector-based vaccine. Cumulatively, 78.9% and 60.7% of the participants reported at least one local and one systemic SRAE respectively, following their COVID-19 first or second dose of vaccine. A wide array of SRAEs was observed, while pain at injection site (76.9%) was the most common local SRAE, and fatigue (46.2%), headache (37.7%), muscle pain (31.6%) were the most common systemic SRAEs. The vast proportion of local (35.2%) and systemic (44.8%) SRAEs subsided up to 1 day after inoculation with both types of vaccines. The mRNA-based vaccine versions seem to cause higher prevalence of local SRAEs, mainly pain within injection site (81.3% vs. 71.7%; p = 0.435), while the viral vector-based vaccine was linked with increased incidents of mild systemic side effects (76.7% vs. 55.3%; p = 0.004) after both doses. Pooled analysis revealed uniform results while comparing the prevalence of SRAEs in HWs as recipients in four central European countries (OR = 2.38; 95% CI = 2.03-2.79).

CONCLUSIONS

The study confirmed the safety of commonly administered vaccines against COVID-19, which were associated with mild, self-resolving adverse events. No major vaccine-related incidents were reported which would affect every day functioning, significantly. The younger age group (below 29 y.o.) were associated with an increased risk of adverse events generally. The results enhanced current data regarding COVID-19 vaccination active surveillance in selected occupational groups.

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.

Attitudes of Parents with Regard to Vaccination of Children against COVID-19 in Poland. A Nationwide Online Survey

Within a few months, the scientific world achieved a great success, developing effective and safe vaccines against COVID-19. Many countries with full access to vaccines have introduced recommendations for the vaccination of not only people who are at risk of developing severe COVID-19, i.e., the elderly and chronically ill, but all members of society, including children aged 12 and above as the currently registered preparations can be used above the said age. However, the use of COVID-19 vaccines in children arouses strong emotions, with their sense being frequently questioned. The aim of the paper was to assess the attitudes of Polish parents with regard to vaccinations against COVID-19 administered to their children. The study was conducted with the use of the authors' original questionnaire, which was distributed online. The questionnaire was completed 4732 times, and 4432 surveys were qualified for the final analysis. The vast majority of the respondents were women (77.6%), people aged 36-44 (40.3%), with higher education (86.2%) and people living in the city with more than 250,000 inhabitants (48%). The mean age of the study group was 37.5 ± 6.61 years. Out of the studied group, 28.2% of parents are healthcare professionals. The study was conducted prior to the EMA's decision that permitted the use of BNT162b2 in children. Results: The vast majority of the respondents were mothers, who showed significantly more favorable attitudes toward the vaccinations than fathers. Forty-four percent of parents want to vaccinate their children as soon as possible, while every fourth parent does not want to vaccinate their child at all. Main concerns about the vaccines include concerns that the preparation has not been adequately tested and that it is ineffective, as well as the lack of information concerning potential complications in the future. The main sources of information on childhood vaccinations are the media, including the Internet and television. Vaccination of the pediatric population against COVID-19 raises many emotions and doubts in parents and it is also debated by experts. The decision to vaccinate should rest on child's parents. Both the individual benefits of protection against COVID-19 and the population benefits of pandemic control must be considered. There is a need for ongoing monitoring of the safety of administering COVID-19 vaccinations in children, as well as for evaluating their effectiveness and benefits in reducing individual risk of severe course of COVID-19 and complications after this disease, and for evaluating the population benefits of vaccines in children.

The Role of Attitudes, Norms, and Efficacy on Shifting COVID-19 Vaccine Intentions: A Longitudinal Study of COVID-19 Vaccination Intentions in New Zealand

While public intentions to get a COVID-19 vaccine have been shifting around the world, few studies track factors that help us understand and improve COVID-19 vaccine uptake. This study focuses on identifying changing public intentions to get a COVID-19 vaccine in New Zealand, a country that has been largely successful in containing the pandemic but risks new outbreaks as less than 20% of the population is fully vaccinated by August 2021. Data on COVID-19 intentions were collected just after the vaccine approval and rollout targeting old-age groups in February 2021 and then before the general public rollout in May 2021 (n = 650, 60% reinterview response rate). Results show that intention to get a COVID-19 vaccine increased in three months and was the highest in the last one year. Consistent with the Theory of Planned Behaviour, attitudes and efficacy beliefs were significantly associated with COVID-19 vaccine intentions, in the cross-sectional as well as longitudinal analyses. Findings highlight the persisting influence of attitudes, efficacy beliefs, and past intentions on future decision-making process to get a COVID-19 vaccine. Future research opportunities to understand vaccine intentions and improve public vaccine uptake are highlighted.

Attitudes, acceptance and hesitancy among the general population worldwide to receive the COVID-19 vaccines and their contributing factors: A systematic review

BACKGROUND

High rates of vaccination worldwide are required to establish a herd immunity and stop the current COVID-19 pandemic evolution. Vaccine hesitancy is a major barrier in achieving herd immunity across different populations. This study sought to conduct a systematic review of the current literature regarding attitudes and hesitancy to receiving COVID-19 vaccination worldwide.

METHODS

A systematic literature search of PubMed and Web of Science was performed on July 5th, 2021, using developed keywords. Inclusion criteria required the study to (1) be conducted in English; (2) investigate attitudes, hesitancy, and/or barriers to COVID-19 vaccine acceptability among a given population; (3) utilize validated measurement techniques; (4) have the full text paper available and be peer-reviewed prior to final publication.

FINDINGS

Following PRISMA guidelines, 209 studies were included. The Newcastle Ottawa (NOS) scale for cross-sectional studies was used to assess the quality of the studies.Overall, vaccine acceptance rates ranged considerably between countries and between different time points, with Arabian countries showing the highest hesitancy rates compared with other parts of the world.

INTERPRETATION

A variety of different factors contributed to increased hesitancy, including having negative perception of vaccine efficacy, safety, convenience, and price. Some of the consistent socio-demographic groups that were identified to be associated with increased hesitancy included: women, younger participants, and people who were less educated, had lower income, had no insurance, living in a rural area, and self-identified as a racial/ethnic minority.

Patients' Habits and the Role of Pharmacists and Telemedicine as Elements of a Modern Health Care System during the COVID-19 Pandemic

Aims/Introduction: The Polish government introduced the epidemic on 20 March 2020, after The World Health Organization (WHO) announced the new coronavirus disease (COVID-19) in January 2020. Patients’ access to specialist clinics and family medicine clinics was limited. In this situation, pharmacists were likely the first option for patient’s health information. On 18 March 2020, the National Health Fund issued modifications that increased the accessibility to primary health care such as telemedicine. The development of e-health in Poland during the COVID-19 pandemic included the implementation of electronic medical records (EDM), telemedicine development, e-prescription, and e-referrals implementation. We investigated this emergency’s effect on patients’ health habits, access to healthcare, and attitude to vaccination. Materials and methods: An anonymous study in the form of an electronic and paper questionnaire was conducted in March 2021 among 926 pharmacies patients in Poland. The content of the questionnaire included access to medical care, performing preventive examinations, implementation of e-prescriptions, patient satisfaction with telepathing, pharmaceutical care, and COVID-19 vaccination. Results: During the COVID-19 pandemic, 456 (49.2%) patients experienced worse access to a doctor. On the other hand, 483 (52.2%) patients did not perform preventive examinations during the COVID-19 pandemic. Almost half of the patients (45.4% (n = 420)) were not satisfied with the teleconsultation visit to the doctor. A total of 90% (n = 833) of the respondents do not need help in making an appointment with a doctor and buying medications prescribed by a doctor in the form of an e-prescription. In the absence of access to medical consultation, 38.2% (n = 354) of respondents choose the Internet as a source of medical advice. However, in the absence of contact with a doctor, 229 persons (24.7%) who took part in the survey consulted a pharmacist. In addition, 239 persons (25.8%) used pharmacist advice more often during the COVID-19 pandemic than before its outbreak on 12 March 2020. Moreover, 457 (49.4%) respondents are satisfied with the advice provided by pharmacists, and even 439 patients of pharmacies (47.4%) expect an increase in the scope of pharmaceutical care in the future, including medical advice provided by pharmacists. Most of the respondents, 45.6% (n = 422), want to be vaccinated in a hospital or clinic, but at the same time, for a slightly smaller number of people, 44.6% (n = 413), it has no meaning where they are will be vaccinated against COVID-19. Conclusions: Telemedicine is appreciated by patients but also has some limitations. The COVID-19 pandemic is the chance for telemedicine to transform from implementations to a routine healthcare system structure. However, some patients still need face-to-face contact with the doctor or pharmacist. Pharmacists are essential contributors to public health and play an essential role during the COVID-19 pandemic. Integration of pharmaceutical care with public health care and strong growth in the professional group of pharmacists may have optimized patient care.

Factors Associated with a Lack of Willingness to Vaccinate against COVID-19 in Poland: A 2021 Nationwide Cross-Sectional Survey

We aimed to assess the factors associated with a lack of willingness to vaccinate against COVID-19 among adults in Poland three months after the introduction of mass vaccination against COVID-19 in Poland. This cross-sectional study was carried out between 8 and 18 April 2021 on a representative nationwide sample of 1131 inhabitants of Poland aged 18 and over. Almost one-third of adult inhabitants of Poland (30%; 95%CI: 27.4–32.7%) declared a lack of willingness to vaccinate against COVID-19. Females had higher odds of refusing COVID-19 vaccination compared with males (OR = 1.68; 95%CI: 1.25–2.27). The lack of higher education was significantly (p < 0.001) associated with greater odds of refusing the COVID-19 vaccination. Participants living in rural areas compared with those living in the largest cities (over 500,000 inhabitants) had three times higher odds of refusing the COVID-19 vaccination (OR = 3.20; 95%CI: 1.71–6.01). Respondents who declared willingness to vote for one of the right-wing political parties publicly supporting the anti-vaccination movement in Poland had eight times higher odds (OR = 8.01; 95%CI: 3.65–17.60) of refusing the COVID-19 vaccination compared with other groups. Moreover, those who had three children or more, respondents who declared passivity towards participating in religious practices as well as active internet users had significantly higher odds of refusing the COVID-19 vaccination.

Profiles of vaccine hesitancy: The relation between personal experience with vaccines, attitude towards mandatory vaccination, and support for anti-vaccine arguments among vaccine hesitant individuals

This paper investigates the susceptibility to anti-vaccine rhetoric in the vaccine-hesitant population. Based on the literature on attitudes and attitude change it was assumed that susceptibility to anti-vaccine arguments may be related to personal experience with vaccination and to the strength of vaccine hesitant attitudes. The first aim of the study was to investigate the relation between personal experience with post-vaccination side effects and acceptance of select categories of anti-vaccine arguments. The second aim was to compare whether vaccination deniers and the vaccine-ambiguous group differ in their susceptibility to these arguments. The online survey was run in Poland on a final sample of 492 vaccine hesitant respondents. Results indicate that individuals who declared a negative experience with vaccination were persuaded by all types of anti-vaccine arguments. Moreover, pre-existing anti-vaccine skepticism may cause individuals to interpret negative symptoms as consequences of vaccines, further reinforcing the negative attitude. Additionally, it appeared that the vaccine-ambiguous believe in serious negative side effects of vaccination and ulterior motives of pharmaceutical companies, but do not believe that vaccines are ineffective. However, the opinion profile for vaccine deniers indicates that it may be a generalized stance, rather than a set of individual issues concerning different perceived negative aspects of vaccination.

Mapping of the Covid-19 Vaccine Uptake Determinants From Mining Twitter Data

Opinion polls on vaccine uptake clearly show that Covid-19 vaccine hesitancy is increasing worldwide. Thus, reaching herd immunity not only depends on the efficacy of the vaccine itself, but also on overcoming this hesitancy of uptake in the population. In this study, we revealed the determinants regarding vaccination directly from people's opinions on Twitter, based on the framework of the 6As taxonomy. Covid-19 vaccine acceptance depends mostly on the characteristics of new vaccines (i.e. their safety, side effects, effectiveness, etc.), and the national vaccination strategy (i.e. immunization schedules, quantities of vaccination points and their localization, etc.), which should focus on increasing citizens' awareness, among various other factors. The results of this study point to areas for potentially improving mass campaigns of Covid-19 immunization to increase vaccine uptake and its coverage and also provide insight into possible directions of future research.