Comparisons of Motivation to Receive COVID-19 Vaccination and Related Factors between Frontline Physicians and Nurses and the Public in Taiwan: Applying the Extended Protection Motivation Theory

Factors Related to Caregivers' Intention to Vaccinate Their Elderly Family Members with Major Neurocognitive Disorders against COVID-19

Vaccination helps reduce the risk of coronavirus disease 2019 (COVID-19) infection in elderly individuals with major neurocognitive disorders (MNDs). However, some caregivers are hesitant to have their elderly family members with MNDs vaccinated against COVID-19. This study explored the factors influencing caregivers' intentions to vaccinate elderly family members with MNDs against COVID-19. A total of 232 caregivers of elderly family members with MNDs participated in this study. In this survey, data regarding COVID-19 vaccination acceptance, fear, side effects, family members' attitudes toward vaccination, mental health status, neuropsychiatric symptoms, and cognitive impairments were collected from the elderly participants with MNDs. The associations between these variables and the caregivers' intention to vaccinate their elderly family members with MNDs against COVID-19 were examined using a multivariable linear regression analysis model. The results revealed that caregivers' perceived familial support for vaccination, the perceived value of vaccination, and autonomy to vaccinate elder family members were positively correlated with caregivers' intention to vaccinate elderly family members with MNDs, whereas elderly family members' age was negatively correlated with caregiver intentions. This study demonstrated that caregiver factors (perceived familial support, value of vaccination, and autonomy) and elderly family members' age were correlated with caregiver intention. These factors should be considered in developing interventions to enhance caregivers' intentions to vaccinate their elderly family members with MNDs against COVID-19.

A Parent Version of the Motors of COVID-19 Vaccination Acceptance Scale for Assessing Parents' Motivation to Have Their Children Vaccinated

Parents' motivation to vaccinate their children against coronavirus disease 2019 (COVID-19) plays a crucial role in the uptake of COVID-19 vaccines among children. The Motors of COVID-19 Vaccination Acceptance Scale (MoVac-COVID19S) is a valuable tool for assessing individuals' vaccination-related attitudes and the factors influencing their decision to be vaccinated against COVID-19. This study adapted the MoVac-COVID19S to create a parent version (P-MoVac-COVID19S) and examined the psychometric soundness of two P-MoVac-COVID19S versions (a 9-item version (P-MoVac-COVID19S-9) and a 12-item version (P-MoVac-COVID19S-12)) for assessing parents' motivation to vaccinate their children. A total of 550 parents completed the P-MoVac-COVID19S and a questionnaire assessing the factors that impact parents' intention to allow their children to receive the COVID-19 vaccine using a vaccine acceptance scale. We enquired about the level of parental worry regarding the adverse effects of COVID-19 vaccines on children's health and the number of COVID-19 vaccine doses received by parents. The factor structures of the P-MoVac-COVID19S-9 and P-MoVac-COVID19S-12 were examined using confirmatory factor analysis. The internal consistency, test-retest reliability, and concurrent validity of the P-MoVac-COVID19S were also examined. The results revealed that the P-MoVac-COVID19S-12 has a four-factor structure, which aligns well with the theoretical framework of the cognitive model of empowerment; the P-MoVac-COVID19S-9 has a one-factor structure. Both the P-MoVac-COVID19S-9 and P-MoVac-COVID19S-12 had good internal consistency and test-retest reliability and acceptable concurrent validity. The results of this study demonstrated that the P-MoVac-COVID19S is a reliable and valid instrument for assessing parent's motivation to vaccinate their children against COVID-19.

Adverse reactions of different COVID-19 vaccines among healthcare professionals: A qualitative study in Mosul, Iraq

Background

COVID-19 disease was highly infectious causing a declaration of a global pandemic and the scientists believed that developing a safe and effective vaccine was the solution. Various vaccine candidates were announced by different health authorities. Many factors affect the acceptance of vaccines. This study aims to explore the perceptions, attitudes, and expectations of healthcare professionals (HCPs) toward COVID-19 vaccines.

Method

A qualitative study approach was conducted by using face-to-face semi-structured interviews with HCPs in Mosul city, Iraq.

Results

Twenty-five HCPs participated in the interviews. After qualitative analysis four main themes emerged: perception of vaccines; participants believed that vaccines were vital inventions, motivations to take the vaccine; most HCPs were motivated based on the scientific evidence regarding COVID-19 vaccines, expectations about the safety and efficacy of COVID-19 vaccines; participants had different opinions based on the type of the vaccine and the available data, side effects experienced; severe side effects were expected but only mild adverse reactions were experienced by the majority.

Conclusion

HCPs had good knowledge about COVID-19 vaccines which was not affected by rumors and misinformation. In contrast to their expectations, the experienced side effects of the first and the second doses were mild to moderate in severity. The majority of HCPs based their choice of the vaccine on the efficacy and safety profile of the available options.

Relationship of Societal Adaptation with Vaccine Worries among Healthcare Workers during the COVID-19 Pandemic: The Mediating Effects of Posttraumatic Stress Disorder

Vaccine hesitancy has become a major public health problem among healthcare workers (HCWs) in this coronavirus disease 2019 (COVID-19) pandemic. The aim of this study was to examine the relationship between societal adaptation and vaccine worries and the mediating effects of posttraumatic stress disorder (PTSD) indicators in HCWs. A total of 435 HCWs (327 women and 108 men) were recruited. Their levels of societal adaptation were evaluated using the Societal Influences Survey Questionnaire (SISQ). Their severity and frequency of PTSD symptoms were examined using the Disaster-Related Psychological Screening Test (DRPST). The severity of vaccine worries was assessed using the Vaccination Attitudes Examination (VAX) Scale. The relationships among societal adaptation, PTSD, and vaccine worries were examined using structural equation modeling. The severity of societal adaptation was positively associated with both the severity of PTSD and the severity of vaccine worries. In addition, the severity of PTSD indicators was positively associated with the severity of vaccine worries. These results demonstrated that the severity of societal adaptation was related to the severity of vaccine worries, either directly or indirectly. The indirect relationship was mediated by the severity of PTSD. Societal adaptation and PTSD should be taken into consideration by the community of professionals working on vaccine hesitancy. Early detection and intervention of PTSD should be the objectives for programs aiming to lower vaccine hesitancy among HCWs.

Short-sighted decision-making by those not vaccinated against COVID-19

Widespread vaccination is necessary to minimize or halt the effects of many infectious diseases, including COVID-19. Stagnating vaccine uptake can prolong pandemics, raising the question of how we might predict, prevent, and correct vaccine hesitancy and unwillingness. In a multinational sample (N = 4,452) recruited from 13 countries that varied in pandemic severity and vaccine uptake (July 2021), we examined whether short-sighted decision-making as exemplified by steep delay discounting-choosing smaller immediate rewards over larger delayed rewards-predicts COVID-19 vaccination status. Delay discounting was steeper in unvaccinated individuals and predicted vaccination status over and above demographics or mental health. The results suggest that delay discounting, a personal characteristic known to be modifiable through cognitive interventions, is a contributing cause of differences in vaccine compliance.

Factors associated with COVID-19 vaccination behaviour in Latvian population: cross-sectional study

Vaccination is the most effective way of limiting the spread of COVID-19. However, despite the proven effectiveness and safety of vaccines, there is resistance in society and the course of vaccination is slow. The aim of this study was to identify the factors associated with COVID-19 vaccination behaviour.

Methods: The data originate from a representative sample of Latvian residents (N  = 1017) taken in September 2021. The data were analysed using Chi-squared test, Mann–Whitney test, Spearman's rank correlation coefficient, Kruskal Wallis test, and Binary Logistic regression analysis.

Results: The results of the study reveal several factors that are associated with COVID-19 vaccination behaviour. These factors are a higher level of education, motivation for protecting oneself against illness, for promoting collective immunity, protecting relatives and other people from infection, as well as motivation for vaccination in order to keep a job or continue studies, and institutional trust. On the other hand, perceived social support from relatives is negatively associated with vaccination behaviour.

Conclusion: A higher level of education and confidence in evidence-based information on COVID-19, provided by official sources of information, is the key factor in deciding whether to protect oneself from serious illness or to make a choice to promote collective immunity and protect other people. The need for vaccination in order to continue working and/or learning is also an essential motive for vaccination. On the other hand, the belief that, if necessary, it is possible to receive support from relatives may be a delaying factor in the behaviour of vaccination.

Studying SARS-CoV-2 vaccine hesitancy among health professionals in Tunisia

Background

People's lives were seriously affected by the emergence and the spread of the COVID-19 disease. Several vaccines were developed in record time to overcome this pandemic. However, putting an end to this public health problem requires substantial vaccination coverage rate. This latter depends on the acceptance of these vaccines especially by health professionals; the leaders of the current war against COVID-19. In fact, they have a central role in promoting vaccination against the SARS-CoV-2. In the developed countries, hesitancy rates towards these vaccines among health professionals vary from 4.3% to 72%. In the developing countries, few studies focused on this issue.

Objective

To estimate the prevalence and the predictors of SARS-CoV-2 vaccine hesitancy among the Tunisian health professionals.

Methods

A cross-sectional study was led online between the 7th and the 21th of January 2021 among Tunisian health professionals. At least 460 participants were required. Snowball sampling method served to recruit participants. Data were collected using a pre-established and pre-tested questionnaire recorded in a free Google form. The link of the questionnaire was disseminated online to be self-administered anonymously to the participants. The generated online Google Sheet was uploaded and exported to SPSS software for analysis.

Results

Of the 546 responses, 493 were retained. The mean age of participants was 37.4 (± 9.5) years. Females represented 70.2% of participants. Social media represented the most frequently used source of information about COVID-19. The prevalence of SARS-CoV-2 vaccine hesitancy among participants was 51.9% (95% CI_: 47.5–56.3)). Female sex, working far from the capital and having concerns about the vaccines components predicted more hesitancy among participants. In contrast, the use of the national COVID-19 information website predicted less hesitancy among them.

Conclusions

The current Tunisian communication plan about COVID-19 vaccines must be reinforced. Social media represent a cost effective communication channel that can serve to reassure Tunisian health professionals regarding the safety of COVID-19 vaccines. Special interest should be paid to females, paramedical professionals and those working far from the capital.

Human Consciousness and Behavior towards Infectious Diseases and Vaccines 2.0: A Commentary from Special Issue Editors

The WHO has identified vaccine hesitancy as one of the 10 threats to global health [...]

Rapid response of a medical center upon the surge of COVID-19 epidemic in Taiwan

A surge of coronavirus disease (COVID-19) cases emerged in northern Taiwan in mid-May 2021. In spite of over one-year preparedness, the medical system in this area suffered from the crisis. Far Eastern Memorial Hospital (FEMH) responded quickly with decreased total hospitalization cases (about 50%) to free manpower and space. With simple construction work, the in-hospital service capacity increases from 11 negative-pressure ward (1 unit) and 2 negative-pressure ICU (1 unit) beds to over 130 ward (5 units) and 58 ICU beds (4 units) without negative-pressure design within 3 weeks. For a period of time, FEMH takes care of 10% of all intensive care services in Taiwan. The vaccination rate of workers reaches 90% since mid-May. The amount of testing performed during the period, including PCR and rapid tests, comprised of more than 20% of tests performed in New Taipei City. Two hotels for mild/asymptomatic COVID patients were handled by FEMH workers. By mid-July, about one-fifth of COVID-19 cases in New Taipei City received services from the FEMH system. With determined leadership and concerted efforts, combined interventions can increase the capacity of medical care within weeks and help society against the COVID-19 epidemic.

Corporal and Cognizant Barriers to Voting: the Impact of COVID-19 on the 2020 Election Season in St. Louis

In 2020, two key elections in St. Louis, Missouri, took place in the midst of the intertwined pandemics of COVID-19 and racialized violence. Local community leaders in St. Louis emphasized a need to mobilize voters, particularly in communities of color, to engage in the elections in August and November 2020 as a tool for advancing health and racial equity. COVID-19 created a new set of barriers to voting. This study documents two typologies of challenges that organizers faced in their efforts to mobilize voters and increase participation in the election. The first is corporal — the use of one’s physical body and the risk within. The second is cognizant — the regulatory proficiency needed to navigate the shifting rules of the voting process. In this study, semi-structured interviews were conducted with a purposive sample of twenty-eight mobilizers working within low-income, poverty-impacted neighborhoods in St. Louis City and St. Louis County, which disproportionately consist of residents of color. Findings suggest COVID-19 created additional unforeseen barriers to voting. Corporal: Local ordinances that mandated limited in person gatherings and social distancing were serious obstacles to traditional voter mobilization efforts and created trepidation about in-person voting for fear of being exposed to the virus. Cognizant: The state of Missouri in an effort to address some of the public health concerns created additional rules for absentee or mail-in voting for limited populations with a complicated set of rules that confused mobilizers and voters.

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.

Differences in Sources of Information, Risk Perception, and Cognitive Appraisals between People with Various Latent Classes of Motivation to Get Vaccinated against COVID-19 and Previous Seasonal Influenza Vaccination: Facebook Survey Study with Latent Profile Analysis in Taiwan

The present study aimed (1) to identify distinct latent classes of motivation to get vaccinated against coronavirus disease 2019 (COVID-19) and previous seasonal influenza vaccination among people in Taiwan and (2) to examine the roles of sources of information, risk perception, and cognitive appraisals of vaccination against COVID-19 in these classes. We recruited 1047 participants through a Facebook advertisement. The participants' motivation to get vaccinated against COVID-19, previous seasonal influenza vaccination, sources of information about COVID-19 vaccination, risk perception of COVID-19, and cognitive appraisals of vaccination against COVID-19 were determined. We examined the participants' motivation for COVID-19 vaccination and previous seasonal influenza vaccination through latent profile analysis. Four latent classes of motivation were identified: participants with high motivation for COVID-19 vaccination and high seasonal influenza vaccination, those with high motivation for COVID-19 vaccination but low seasonal influenza vaccination, those with low motivation for COVID-19 vaccination but high seasonal influenza vaccination, and those with low motivation for COVID-19 vaccination and low seasonal influenza vaccination. Compared with participants in the latent class of high motivation for COVID-19 vaccination and high seasonal influenza vaccination, those in the other three latent classes had lower levels of positive appraisals of COVID-19 vaccination; participants in the latent class of low motivation for COVID-19 vaccination and low seasonal influenza vaccination had lower risk perception of COVID-19 and were also less likely to obtain information about COVID-19 vaccination from the internet, friends, and family members. The various motivations and behaviors for vaccination, sources of information, risk perception, and cognitive appraisals of vaccination against COVID-19 should be considered in intervention programs aiming to increase people's motivation to get vaccinated against COVID-19.

Denial of Justification for Vaccination: Its Multiple Related Variables and Impacts on Intention to Get Vaccinated against COVID-19

The aims of the present study were (1) to identify the variables related to denying the justification for vaccination during the coronavirus disease 2019 (COVID-19) pandemic in Taiwan and (2) to examine the associations of such denial with perceived risk of COVID-19 and the extrinsic and intrinsic intentions to get vaccinated against COVID-19. We recruited 1047 participants by using a Facebook advertisement. We investigated whether the participants denied justification for vaccination as well as their sociodemographic characteristics, mental health status, sources of information about COVID-19 vaccination, perceived risk of COVID-19, and extrinsic and intrinsic intentions to get vaccinated against COVID-19. The results indicated that 20.0% of the participants denied justification for vaccination. Participants who were older, had an educational level below college, were not health care workers, were in poor general mental health state, or did not obtain information about COVID-19 vaccination from the Internet were more likely to deny justification for vaccination. Denial was negatively associated with both extrinsic and intrinsic intentions to get vaccinated against COVID-19 but not associated with the perceived risk of COVID-19. Multiple variables related to denying the justification for vaccination; the denial was negatively associated with the intention to get vaccinated against COVID-19.

Explicit and Intrinsic Intention to Receive COVID-19 Vaccination among Heterosexuals and Sexual Minorities in Taiwan

The present study compared the levels of explicit and intrinsic intention to receive COVID-19 vaccination among sexual minority and heterosexual individuals and examined the association of explicit and intrinsic intentions with sexual orientation. We enrolled 171 sexual minority and 876 heterosexual individuals through a Facebook advertisement. The participants' explicit and intrinsic intentions to receive COVID-19 vaccination and their risk perception of COVID-19 were measured. We discovered that sexual minority individuals had higher levels of explicit and intrinsic intention to receive vaccination relative to heterosexual individuals. Intrinsic intention was positively associated with explicit intention after the effects of demographic characteristics and risk perception of COVID-19 were controlled for. Sexual orientation did not moderate the association between explicit and intrinsic intentions. The present study determined the relationship between sexual orientation and intention to receive COVID-19 vaccination.

Differences in the Protection Motivation Theory Constructs between People with Various Latent Classes of Motivation for Vaccination and Preventive Behaviors against COVID-19 in Taiwan

The present study aimed to identify the distinct classes of motivations to get vaccinated and to adopt preventive behaviors against the coronavirus disease 2019 (COVID-19) among people in Taiwan and to examine the roles of Protection Motivation Theory (PMT) cognitive constructs in these unique classes of motivations to get vaccinated and to adopt preventive behaviors. We recruited 1047 participants by using a Facebook advertisement. Participants’ motivations to get vaccinated and to adopt preventive behaviors against COVID-19, PMT constructs of threat appraisal (perceived severity and perceived vulnerability), and PMT constructs of coping appraisal (self-efficacy, response efficacy, response cost, knowledge, and previous vaccination for seasonal influenza) were determined. We analyzed participants’ motivations to get vaccinated and to adopt preventive behaviors against COVID-19 by using latent profile analysis. The present study identified three latent classes, including the participants with high motivation for vaccination and preventive behaviors (the class of Both High), those with low motivation for vaccination and preventive behaviors (the class of Both Low), and those with high motivation for vaccination but low motivation for preventive behaviors (the class of High Vaccination but Low Preventive Behaviors). Compared with the participants in the class of Both High, participants in the class of Both Low had lower levels of perceived vulnerability, perceived severity, self-efficacy to have vaccination, response efficacy of vaccination, knowledge about vaccination, and previous vaccination for seasonal influenza; participants in the class of High Vaccination but Low Preventive Behaviors had lower levels of perceived vulnerability and perceived severity but higher levels of response cost of vaccination. We concluded that varieties of motivations, threat, and coping appraisals should be considered in intervention programs aiming to increase motivation to adopt recommended protective behaviors against COVID-19.