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Tang J, Wang Y, Lu W, Gao Z, Xu M, Wu L, Jin J. High SARS-CoV-2 infection rate in children unvaccinated with COVID-19 vaccine in Changzhou, China, shortly after lifting zero-COVID-19 policy in December 2022. BMC Infect Dis 2024; 24:560. [PMID: 38840046 PMCID: PMC11151613 DOI: 10.1186/s12879-024-09445-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Accepted: 05/29/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND China experienced an overwhelming COVID-19 pandemic from middle December 2022 to middle January 2023 after lifting the zero-COVID-19 policy on December 7, 2022. However, the infection rate was less studied. We aimed to investigate the SARS-CoV-2 infection rate in children shortly after discontinuation of the zero-COVID-19 policy. METHODS From February 20 to April 10, 2023, we included 393 children aged 8 months to less than 3 years who did not receive COVID-19 vaccination and 114 children aged 3 to 6 years who received inactivated COVID-19 vaccines based on the convenience sampling in this cross-sectional study. IgG and IgM antibodies against nucleocapsid (N) and subunit 1 of spike (S1) of SARS-CoV-2 (anti-N/S1) were measured with commercial kits (Shenzhen YHLO Biotech, China). RESULTS Of the 393 unvaccinated children (1.5 ± 0.6 years; 52.2% boys), 369 (93.9%) were anti-N/S1 IgG positive. Of the 114 vaccinated children (5.3 ± 0.9 years; 48.2% boys), 112 (98.2%) were anti-N/S1 IgG positive. None of the unvaccinated or vaccinated children was anti-N/S1 IgM positive. The median IgG antibody titers in vaccinated children (344.91 AU/mL) were significantly higher than that in unvaccinated children (42.80 AU/mL) (P < 0.0001). The positive rates and titers of anti-N/S1 IgG had no significant difference between boys and girls respectively. CONCLUSION Vast majority of children were infected with SARS-CoV-2 shortly after ending zero-COVID-19 policy in China. Whether these unvaccinated infected children should receive COVID-19 vaccine merits further investigation.
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Affiliation(s)
- Jie Tang
- Department of Obstetrics and Gynecology, Wujin Hospital Affiliated with Jiangsu University, Changzhou, Jiangsu, 213017, China.
- Department of Obstetrics and Gynecology, The Wujin Clinical College of Xuzhou Medical University, Changzhou, Jiangsu, 213017, China.
| | - Yong Wang
- Department of Clinical Laboratory, Wujin People's hospital, Changzhou, Jiangsu, 213017, China
| | - Weiqin Lu
- Department of Respiratory Diseases, Changzhou Hospital of Traditional Chinese Medicine, Changzhou, Jiangsu, 213003, China
| | - Zhihong Gao
- Department of Clinical Laboratory, Wujin People's hospital, Changzhou, Jiangsu, 213017, China
| | - Mingfeng Xu
- Department of Pediatrics, Wujin People's hospital, Changzhou, Jiangsu, 213017, China
| | - Lin Wu
- Department of Infection Management, Changzhou Hospital of Traditional Chinese Medicine, Changzhou, Jiangsu, 213003, China
| | - Jianhua Jin
- Department of Oncology, Wujin Hospital Affiliated with Jiangsu University, Changzhou, Jiangsu, 213017, China.
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Liu TL, Hsiao RC, Chou WJ, Yen CF. Prospective and Cross-Sectional Factors Predicting Caregiver Motivation to Vaccinate Children with Attention-Deficit/Hyperactivity Disorder against COVID-19: A Follow-Up Study. Vaccines (Basel) 2024; 12:450. [PMID: 38793701 PMCID: PMC11125857 DOI: 10.3390/vaccines12050450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Revised: 04/16/2024] [Accepted: 04/22/2024] [Indexed: 05/26/2024] Open
Abstract
Adolescents with attention-deficit/hyperactivity disorder (ADHD) have higher risks of contracting COVID-19 and worse outcomes compared with adolescents without ADHD. The most effective method of preventing infection is vaccination. This follow-up study explored the prospective and cross-sectional factors influencing caregiver willingness to vaccinate children with ADHD against COVID-19. Baseline data on caregiver demographics, affiliate stigma, parenting stress, emotional difficulties, beliefs regarding the causes of ADHD, and ADHD symptoms were collected prior to the outbreak of the COVID-19 pandemic in Taiwan. At follow-up, the study assessed caregiver willingness to vaccinate children with ADHD, the challenges caregivers faced in parenting during the pandemic, and ADHD symptoms. The results revealed that caregiver age at baseline was positively associated with a willingness to vaccinate children against COVID-19 at follow-up. By contrast, the belief that ADHD resulted from failures in parental discipline at baseline was negatively associated with caregiver willingness to vaccinate. Parenting challenges were also negatively associated with caregiver willingness to vaccinate. Therefore, the age of caregivers, beliefs about the causes of ADHD, and parenting challenges during the pandemic should be considered when developing interventions to enhance caregiver willingness to vaccinate children with ADHD.
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Affiliation(s)
- Tai-Ling Liu
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80754, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Ray C. Hsiao
- Department of Psychiatry, Seattle Children’s, Seattle, WA 98195, USA
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, WA 98105, USA
| | - Wen-Jiun Chou
- Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung 83341, Taiwan
- School of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
| | - Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80754, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- College of Professional Studies, National Pingtung University of Science and Technology, Pingtung 91201, Taiwan
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Kyakuwa N, Kimbugwe G, Nakanjako F, Kalute H, Mpooya S, Atuhairwe C, Perez L, Kikaire B. High uptake of COVID-19 vaccines among healthcare workers in urban Uganda. PLoS One 2024; 19:e0277072. [PMID: 38626070 PMCID: PMC11020364 DOI: 10.1371/journal.pone.0277072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 11/07/2023] [Indexed: 04/18/2024] Open
Abstract
OBJECTIVES The aim of the study was to describe the facilitators, barriers to and level of uptake of COVID-19 vaccines among healthcare workers in primary healthcare facilities in an urban setting in Uganda. MATERIALS AND METHODS We conducted a cross-sectional study among HCWs in private and public health facilities in Entebbe municipality between July 2021 and August 2021. Data was collected using a structured questionnaire that was shared, via an online link, to consented participants. Uptake of the vaccines among healthcare workers was analysed as proportions, and logistic regression was used to analyse barriers and facilitators to uptake of COVID-19 vaccines. RESULTS The study enrolled 360 participants, with 61.7% (n = 222) females. A total of 236 (65.6%) healthcare workers had received at least one dose of COVID-19 vaccine, with higher uptake among females 64% (n = 151). Age above 40 years (OR 2.16), working in a government healthcare facility (OR 3.12), participating in COVID-19 vaccine related activities (OR 4.62), and having tested for SARS-COV-2 (OR 3.05) increased the odds of having been vaccinated. Working in small roadside clinics reduced the odds of being vaccinated by almost 70%, while HCWs in government health services were 3.1 times more likely to have been vaccinated. History of having cared for a COVID-19 patient and having a positive SARS-COV-2 test result did not influence the uptake of the vaccines in the study population. CONCLUSION Vaccine uptake among HCWs was close to the World Health Organisation (WHO) recommended uptake of 70% by mid-2022.
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Affiliation(s)
| | | | | | - Hamza Kalute
- Uganda Virus Research Institute, Entebbe, Uganda
| | - Simon Mpooya
- Uganda Virus Research Institute, Entebbe, Uganda
| | | | | | - Bernard Kikaire
- Makerere University College of Health Sciences, Kampala, Uganda
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Manookian A, Nayeri ND, Dashti S, Shahmari M. Ethical Challenges to the Self-care of Nurses during the Covid-19 Pandemic. Nurs Ethics 2024; 31:161-175. [PMID: 37428123 DOI: 10.1177/09697330231180753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
BACKGROUND The emerging working conditions triggered by the COVID-19 pandemic have imposed numerous ethical challenges on the nurses, which, in turn, can negatively impact the nurses' physical and mental health, and thus their work performance through intensifying negative emotions and psychological pressures. AIM The purpose of this study was to highlight the nurses' perceptions of the ethical challenges that they faced regarding their self-care during the COVID-19 pandemic. RESEARCH DESIGN A qualitative, descriptive study with a content analysis approach. PARTICIPANTS AND RESEARCH CONTEXT The data were collected through semi-structured interviews with 19 nurses working in the COVID-19 wards of two university-affiliated hospitals. These nurses were selected using a purposive sampling method and the data were analyzed using a content analysis approach. ETHICAL CONSIDERATIONS The study was approved by the TUMS Research Council Ethics Committee under the code: IR.TUMS.VCR.REC.1399.594. In addition, it is based on the participants' informed consent and confidentiality. FINDINGS Two themes and five sub-themes were identified, including ethical conflicts (the conflict between self-care and comprehensive patient care, prioritization of life, and inadequate care) and inequalities (intra- and inter-professional inequalities). CONCLUSION The findings demonstrated that the nurses' care is a prerequisite for the patients' care. Considering that the ethical challenges faced by nurses are related to unacceptable working conditions, organizational support, and lack of access to facilities such as personal protective equipment, it seems essential to support nurses and provide adequate working conditions to provide patients with quality care.
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Affiliation(s)
- Arpi Manookian
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Nahid Dehghan Nayeri
- Professor of Nursing, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Seemin Dashti
- Health Education and Promotion Department, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Nursing, Ardabil Branch, Islamic Azad University, Ardabil, Irans
| | - Mehraban Shahmari
- Department of Medical-Surgical, School of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran and
- USERN CARE (TUMS) Office, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
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Zhou YH, Xu C, Tao Y, Gu M, Zhou G, Zhou W, Jin Y, Xie J, Xu B, Zhou W, Chen J, Shi W. Incidence of SARS-CoV-2 infection in children shortly after ending zero-COVID-19 policy in China on December 7, 2022: a cross-sectional, multicenter, seroepidemiological study. Front Public Health 2023; 11:1283158. [PMID: 38026391 PMCID: PMC10666904 DOI: 10.3389/fpubh.2023.1283158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 10/19/2023] [Indexed: 12/01/2023] Open
Abstract
Background China discontinued the zero-COVID-19 policy on December 7, 2022, and then COVID-19 surged mid-December 2022 through mid-January 2023. However, the actual incidence was unknown. This study aimed to estimate the incidence of SARS-CoV-2 infection in children shortly after ending the zero-COVID-19 policy. Methods This multicenter cross-sectional study included 1,065 children aged 8 months to 12 years from seven hospitals at six regions across Jiangsu province, based on the convenience sampling, from February 10 to March 10, 2023. Group I comprised 324 children aged 8 months-2 years without COVID-19 vaccination, group II consisted of 338 preschool children aged 3-5 years with varied vaccination history, and group III contained 403 primary school children aged 6-12 years with mostly vaccinated. The COVID-19 vaccines were composed of inactivated SARS-CoV-2. In addition, 96 children's sera collected in 2014 were included as negative controls. IgG and IgM antibodies against nucleocapsid (N) and subunit 1 of spike (S1) of SARS-CoV-2 (anti-N/S1) were measured with commercial kits (YHLO Biotech, Shenzhen, China). Results None of the 96 children (5.1 ± 3.5 years; 58.3% boys) in 2014 was positive for anti-N/S1 IgG or IgM. Of the 1,065 children (5.0 ± 3.5 years; 56.0% boys), 988 (92.8%) were anti-N/S1 IgG positive but none was anti-N/S1 IgM positive. The positive rate of anti-N/S1 IgG in Group I, II, and III was 90.4, 88.5, and 98.3%, respectively, with significantly higher in group III than in groups I and II (p < 0.0001). The median antibody titers in group III (381.61 AU/ml) were much higher than that in group I (38.34 AU/ml) and II (51.88 AU/ml; p < 0.0001). Conclusion More than 90% children experienced SARS-CoV-2 infection shortly after ending zero-COVID-19 policy in China, much higher than estimated infections by other studies. The widespread SARS-CoV-2 infection in unvaccinated children should be influential on the policy of COVID-19 vaccination in children in the future.
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Affiliation(s)
- Yi-Hua Zhou
- Departments of Laboratory Medicine and Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, and Jiangsu Key Laboratory for Molecular Medicine, Nanjing University, Nanjing, Jiangsu, China
| | - Chenyu Xu
- Department of Obstetrics and Gynecology, Zhenjiang Fourth People’s Hospital, Zhenjiang, Jiangsu, China
| | - Yue Tao
- Departments of Laboratory Medicine and Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, and Jiangsu Key Laboratory for Molecular Medicine, Nanjing University, Nanjing, Jiangsu, China
| | - Meng Gu
- Department of Clinical Laboratory, Affiliated Changzhou Children's Hospital of Nantong University, Changzhou Children's Hospital, Changzhou, Jiangsu, China
| | - Guiping Zhou
- Department of Clinical Laboratory, Yixing Second People’s Hospital, Yixing, Jiangsu, China
| | - Wei Zhou
- Department of Clinical Laboratory, The First People’s Hospital of Changzhou, Changzhou, Jiangsu, China
| | - Yue Jin
- Department of Clinical Laboratory, Huai'an Second People's Hospital and the Affiliated Huai'an Hospital of Xuzhou Medical University, Huai’an, Jiangsu, China
| | - Jun Xie
- Department of Clinical Laboratory, People's Hospital of Xuyi County, Xuyi, Jiangsu, China
| | - Biyun Xu
- Medical Statistics and Analysis Center, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
| | - Wensan Zhou
- Departments of Laboratory Medicine and Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, and Jiangsu Key Laboratory for Molecular Medicine, Nanjing University, Nanjing, Jiangsu, China
| | - Junhao Chen
- Departments of Laboratory Medicine and Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, and Jiangsu Key Laboratory for Molecular Medicine, Nanjing University, Nanjing, Jiangsu, China
| | - Weifeng Shi
- Department of Clinical Laboratory, The First People’s Hospital of Changzhou, Changzhou, Jiangsu, China
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Sujarwoto S, Maharani A. Is knowledge about COVID-19 associated with willingness to receive vaccine, vaccine uptake, and vaccine booster uptake in rural Malang, Indonesia? Front Public Health 2023; 11:1203550. [PMID: 37351094 PMCID: PMC10282756 DOI: 10.3389/fpubh.2023.1203550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 05/19/2023] [Indexed: 06/24/2023] Open
Abstract
Background Lack of knowledge regarding the coronavirus disease (COVID-19) and COVID-19 vaccines is a key barrier to COVID-19 vaccine uptake in low- and middle-income countries (LMICs). Aims To examine factors associated with knowledge about COVID-19 and the association between knowledge of COVID-19, willingness to receive a COVID-19 vaccine, and vaccine uptake in Malang, East Java, Indonesia. Method A cross-sectional study among individuals aged 15-99 years was conducted in Malang, Java Timur, Indonesia between November 2022 and January 2023. Of 10,050 potential respondents, 10,007 were able to complete the survey. The main independent variable was knowledge about COVID-19, which was assessed using a six-item questionnaire. The dependent variables were COVID-19 vaccine uptake and COVID-19 booster vaccine uptake. The mediating variable was respondent's willingness to receive a COVID-19 vaccine. Linear regression was used to examine factors associated with knowledge about COVID-19. Logistic regression was employed to examine the association of knowledge about COVID-19 with vaccine uptake. Generalized structural equation modeling (GSEM) was performed to examine whether willingness to receive a vaccine mediated the association between knowledge about COVID-19 and vaccination uptake. Findings The percentage of respondents who reported having received at least one dose of a COVID-19 vaccine was 94.8%, while the percentage of those who reported having received at least three doses was 88.5%. These numbers are higher than the national average for COVID-19 vaccine and booster vaccine uptake. Most respondents answered about four of six knowledge items correctly (M = 4.60, SD = 1.1). Among respondents who had not received a vaccine, 83.1% expressed willingness to receive a vaccine when it became available to them. Older, more educated, employed respondents, and those with higher economic status, demonstrated more accurate knowledge about COVID-19 than younger, less educated, unemployed respondents and those with lower economic status. Respondents who demonstrated more accurate knowledge about COVID-19 were more likely to have received a vaccine (OR = 1.528, 95% CI = 1.428-1.634) and a booster vaccine (OR = 1.260, 95% CI = 1.196-1.328). Willingness to receive a vaccine mediated the association between knowledge about COVID-19 and vaccine uptake (coef. = 0.426, 95% CI = 0.379-0.473). Implications Interventions and public health programs aiming to improve knowledge about COVID-19 can be implemented to improve individual willingness to receive COVID-19 vaccination and to improve COVID-19 vaccine uptake among the general population.
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Affiliation(s)
- Sujarwoto Sujarwoto
- Department of Public Administration, Faculty of Administrative Science, Brawijaya University, Malang, Indonesia
| | - Asri Maharani
- Department of Nursing, Faculty of Health and Education, Manchester Metropolitan University, Manchester, United Kingdom
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Galanis P, Vraka I, Katsiroumpa A, Siskou O, Konstantakopoulou O, Zogaki E, Kaitelidou D. Psychosocial Predictors of COVID-19 Vaccine Uptake among Pregnant Women: A Cross-Sectional Study in Greece. Vaccines (Basel) 2023; 11:269. [PMID: 36851147 PMCID: PMC9967309 DOI: 10.3390/vaccines11020269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 01/23/2023] [Accepted: 01/24/2023] [Indexed: 01/28/2023] Open
Abstract
An understanding of the factors associated with the COVID-19 vaccine uptake in pregnant women is paramount to persuade women to get vaccinated against COVID-19. We estimated the vaccination rate of pregnant women against COVID-19 and evaluated psychosocial factors associated with vaccine uptake among them. We conducted a cross-sectional study with a convenience sample. In particular, we investigated socio-demographic data of pregnant women (e.g., age, marital status, and educational level), COVID-19 related variables (e.g., previous COVID-19 diagnosis and worry about the side effects of COVID-19 vaccines), and stress due to COVID-19 (e.g., danger and contamination fears, fears about economic consequences, xenophobia, compulsive checking and reassurance seeking, and traumatic stress symptoms about COVID-19) as possible predictors of COVID-19 vaccine uptake. Among pregnant women, 58.6% had received a COVID-19 vaccine. The most important reasons that pregnant women were not vaccinated were doubts about the safety and effectiveness of the COVID-19 vaccines (31.4%), fear that COVID-19 vaccines could be harmful to the fetus (29.4%), and fear of adverse side effects of COVID-19 vaccines (29.4%). Increased danger and contamination fears, increased fears about economic consequences, and higher levels of trust in COVID-19 vaccines were related with vaccine uptake. On the other hand, increased compulsive checking and reassurance seeking and increased worry about the adverse side effects of COVID-19 vaccines reduced the likelihood of pregnant women being vaccinated. An understanding of the psychosocial factors associated with increased COVID-19 vaccine uptake in pregnant women could be helpful for policy makers and healthcare professionals in their efforts to persuade women to get vaccinated against COVID-19. There is a need for targeted educational campaigns to increase knowledge about COVID-19 vaccines and reduce vaccine hesitancy in pregnancy.
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Affiliation(s)
- Petros Galanis
- Clinical Epidemiology Laboratory, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Irene Vraka
- Department of Radiology, P. & A. Kyriakou Children’s Hospital, 11527 Athens, Greece
| | - Aglaia Katsiroumpa
- Clinical Epidemiology Laboratory, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Olga Siskou
- Department of Tourism Studies, University of Piraeus, 18534 Piraeus, Greece
| | - Olympia Konstantakopoulou
- Center for Health Services Management and Evaluation, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Eleftheria Zogaki
- Faculty of Midwifery, University of West Attica, West Attica, 12243 Aigaleo, Greece
| | - Daphne Kaitelidou
- Center for Health Services Management and Evaluation, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece
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Cheng Y, Shen P, Tao Y, Zhang W, Xu B, Bi Y, Han Z, Zhou YH. Reduced antibody response to COVID-19 vaccine composed of inactivated SARS-CoV-2 in diabetic individuals. Front Public Health 2022; 10:1025901. [PMID: 36568756 PMCID: PMC9773130 DOI: 10.3389/fpubh.2022.1025901] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 11/23/2022] [Indexed: 12/14/2022] Open
Abstract
Background Patients with type 2 diabetes mellitus (T2DM) are at increased risk for COVID-19 related morbidity and mortality. Antibody response to COVID-19 vaccine in T2DM patients is not very clear. The present work aims to evaluate the antibody response to the inactivated SARS-CoV-2 vaccine in this population. Methods Two groups of subjects with no history of SARS-CoV-2 infection were included: 63 T2DM patients and 56 non-T2DM controls. Each participant received two doses of inactivated COVID-19 vaccine. IgG antibodies against the nucleocapsid (N) and spike (S) proteins of SARS-CoV-2 (anti-N/S IgG) and receptor binding domain (RBD) proteins (anti-RBD IgG) were quantitatively evaluated by the electrochemiluminescence immunoassays, respectively. Results It was observed that the positive rates and titers of anti-N/S IgG and anti-RBD IgG in T2DM patients were significantly lower than those in controls, respectively (anti-N/S: 85.7 vs. 98.2%, P = 0.034; 25.48 vs. 33.58 AU/ml P = 0.011; anti-RBD: 85.7 vs. 96.4%, P = 0.044; 15.45 vs. 22.25 AU/ml, P = 0.019). Compared to non-T2DM subjects, T2DM patients with uncontrolled glycemia showed lower positive antibody rates and titers (anti-N/S IgG: 75% and 13.30 AU/ml; anti-RBD IgG: 75% and 11.91 AU/ml, respectively, all P < 0.05), while T2DM patients with controlled glycemia had similar positive antibody rates and titers (anti-N/S IgG: 94.3% and 33.65 AU/ml; and anti-RBD IgG: 94.3% and 19.82 AU/ml, respectively, all P > 0.05). Conclusion In the analysis performed, the data indicate that T2DM patients with uncontrolled glycemia showed a lower level of IgG antibodies compared to non-diabetic controls and individuals with controlled glycemia when immunized with the inactivated COVID-19 vaccine.
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Affiliation(s)
- Yandong Cheng
- Department of Endocrinology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Ping Shen
- Department of Laboratory Medicine, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Yue Tao
- Department of Laboratory Medicine, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Wenjun Zhang
- Department of Laboratory Medicine, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Biyun Xu
- Department of Biomedicine Statistics, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Yan Bi
- Department of Endocrinology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Zhen Han
- Department of Prevention and Health Care, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China,*Correspondence: Yi-Hua Zhou
| | - Yi-Hua Zhou
- Department of Laboratory Medicine, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China,Department of Infectious Diseases and Jiangsu Key Laboratory for Molecular Medicine, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China,Zhen Han
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Cheng Y, Li T, Zheng Y, Xu B, Bi Y, Hu Y, Zhou YH. Self-Reported adverse events among Chinese healthcare workers immunized with COVID-19 vaccines composed of inactivated SARS-CoV-2. Hum Vaccin Immunother 2022; 18:2064134. [PMID: 35452357 PMCID: PMC9897645 DOI: 10.1080/21645515.2022.2064134] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Mass vaccination is critical to control the pandemic of coronavirus disease 2019 (COVID-19). Fear of adverse events (AEs) after COVID-19 vaccination is a main factor associated with vaccination hesitancy. We aimed to analyze AEs in healthcare workers (HCWs) vaccinated with COVID-19 vaccines (Aikewei or CoronaVac) composed of inactivated virus. We used a structured self-administered questionnaire to conduct two surveys on COVID-19 vaccination among HCWs in perinatal medicine and obstetrics/gynecology from April 5 to April 21, 2021. In total, 1392 HCWs who had received at least one vaccine dose were included. Of them, 1264 (90.8%) were females and 1047 (75.2%) received two doses. The overall incidence of any AEs after the first and second dose was 38.2% (532/1392) and 31.0% (325/1047) respectively (χ2 = 13.506, P = .0002). Female and HCWs aged 18-30 y were more likely to report AEs. The most common AEs were local reaction, accounting for 48.1% and 67.4% of all AEs after the first and second dose respectively. The systemic AEs were mainly neurological (9.8% and 4.8% after the first and second injection respectively) and flu-like symptoms (6.3% and 3.2%). Overall, most of AEs were mild, only 5.1% (after the first dose) and 2.8% (after the second dose) of individuals with AEs received symptomatic treatment or sick leaves, and none of them required hospitalization. Our data added more evidence that inactivated COVID-19 vaccines are highly safe. The data are valuable to overcome vaccine hesitancy associated with concerns about the safety of COVID-19 vaccines.
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Affiliation(s)
- Yandong Cheng
- Department of Endocrinology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Taishun Li
- Department of Biomedicine Statistics, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Yaning Zheng
- Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Biyun Xu
- Department of Biomedicine Statistics, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Yan Bi
- Department of Endocrinology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Yali Hu
- Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China,CONTACT Yali Hu Department of Obstetrics and Gynecology, NanjingDrum Tower Hospital, Nanjing University Medical SchoolNanjing, Jiangsu, China
| | - Yi-Hua Zhou
- Department of Laboratory Medicine, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China,Department of Infectious Diseases, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China,Yi-Hua Zhou Departments of Laboratory Medicine and Infectious Diseases, Nanjing Drum Tower Hospital, Nanjing210008, China
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Galanis P, Vraka I, Katsiroumpa A, Siskou O, Konstantakopoulou O, Katsoulas T, Mariolis-Sapsakos T, Kaitelidou D. COVID-19 Vaccine Uptake among Healthcare Workers: A Systematic Review and Meta-Analysis. Vaccines (Basel) 2022; 10:1637. [PMID: 36298502 PMCID: PMC9610263 DOI: 10.3390/vaccines10101637] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 09/24/2022] [Accepted: 09/26/2022] [Indexed: 11/17/2022] Open
Abstract
The vaccine-induced immunity of healthcare workers (HCWs) is crucial to controlling the COVID-19 pandemic. Therefore, we conducted a systematic review and meta-analysis to assess the COVID-19 vaccine uptake among HCWs worldwide and to identify predictors of vaccination. We searched Scopus, Web of Science, Medline, PubMed, ProQuest, CINAHL, and medRxiv up to 25 August 2022. We applied the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. We found 25 studies including 491,624 vaccinated HCWs, while the full sample included 555,561 HCWs. The overall proportion of vaccinated HCWs was 77.3%. Vaccine uptake for studies that were conducted in North America (85.6%) was higher than the proportion for studies that were conducted in Asia (79.5%), Europe (72.8%), and Africa (65.6%). The overall prevalence of COVID-19 vaccine uptake was 83.6% and 77.4% for physicians and nurses, respectively. Older age, white race, physicians' profession, seasonal influenza vaccine, direct COVID-19 patient care, and confidence in COVID-19 vaccine safety and effectiveness were positive predictors of vaccine uptake, while history of SARS-CoV-2 infection was a negative predictor. Deep understanding of the factors that influence HCWs' decisions to receive a COVID-19 vaccine is critical to implementing tailored communication strategies for HCWs who are at risk for not getting vaccinated.
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Affiliation(s)
- Petros Galanis
- Clinical Epidemiology Laboratory, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Irene Vraka
- Department of Radiology, P. & A. Kyriakou Children’s Hospital, 11527 Athens, Greece
| | - Aglaia Katsiroumpa
- Clinical Epidemiology Laboratory, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Olga Siskou
- Department of Tourism Studies, University of Piraeus, 18534 Piraeus, Greece
| | - Olympia Konstantakopoulou
- Center for Health Services Management and Evaluation, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Theodoros Katsoulas
- Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | | | - Daphne Kaitelidou
- Center for Health Services Management and Evaluation, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece
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11
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Wang L, Wang Y, Cheng X, Li X, Yang Y, Li J. Acceptance of coronavirus disease 2019 (COVID-19) vaccines among healthcare workers: A meta-analysis. Front Public Health 2022; 10:881903. [PMID: 36187624 PMCID: PMC9525162 DOI: 10.3389/fpubh.2022.881903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 08/24/2022] [Indexed: 01/21/2023] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic has posed increasing challenges to global health systems. Vaccination against COVID-19 can effectively prevent the public, particularly healthcare workers (HCWs), from being infected by this disease. Objectives We aim to understand the factors influencing HCWs' acceptance of COVID-19 vaccines. Methods We searched PubMed, Embase and Web of Science to collect literature published before May 15, 2022, about HCWs' acceptance of COVID-19 vaccines. The Newcastle-Ottawa quality assessment scale was used to assess the risk of bias and the quality of the included studies. We utilized Stata 14.0 software for this meta-analysis with a random-effects model, and odds ratios (ORs) with 95% confidence intervals (CIs) were reported. This meta-analysis was conducted in alignment with the preferred reporting items for systematic review and meta-analysis (PRISMA) guideline. Results Our meta-analysis included 71 articles with 93,508 HCWs involved. The research showed that the acceptance of vaccines had significantly increased among HCWs compared to non-HCWs (OR = 1.91, 95% CI: 1.16-3.12). A willingness to undergo COVID-19 vaccination was observed in 66% (95% CI: 0.61-0.67) of HCWs. Among the HCWs involved, doctors showed a generally increased intention to be vaccinated compared with nurses (OR = 2.22, 95% CI: 1.71-2.89). Additionally, males were found to hold more positive attitudes toward vaccination than females (OR = 1.81, 95% CI: 1.55-2.12). When the effectiveness of COVID-19 vaccines was improved, the vaccination acceptance of HCWs was greatly increased accordingly (OR = 5.03, 95% CI: 2.77-9.11). The HCWs who were willing to vaccinate against seasonal influenza showed an increased acceptance of COVID-19 vaccines (OR = 3.52, 95% CI: 2.34-5.28). Our study also showed that HCWs who were willing to be vaccinated against COVID-19 experienced a reduced rate of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (OR = 0.78, 95% CI: 0.66-0.92). Conclusions Our analysis revealed that the five factors of occupation, gender, vaccine effectiveness, seasonal influenza vaccines, and SARS-CoV-2 infection presumably affected the acceptance of COVID-19 vaccines among HCWs. It is essential to boost the confidence of HCWs in COVID-19 vaccines for the containment of the epidemic.
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Affiliation(s)
- Linlin Wang
- Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Ye Wang
- Department of Pediatrics, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Xianbin Cheng
- Department of Gastrointestinal Colorectal and Anal Surgery, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Xingzhao Li
- Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Yanyan Yang
- Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Jun Li
- Department of Hematology and Oncology, China-Japan Union Hospital of Jilin University, Changchun, China
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12
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Galanis P, Vraka I, Siskou O, Konstantakopoulou O, Katsiroumpa A, Moisoglou I, Kaitelidou D. Predictors of Real-World Parents' Acceptance to Vaccinate Their Children Against the COVID-19. Acta Med Litu 2022; 29:33-43. [PMID: 36061935 PMCID: PMC9428642 DOI: 10.15388/amed.2021.29.1.4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/03/2021] [Accepted: 12/10/2021] [Indexed: 01/23/2023] Open
Abstract
Background As the COVID-19 pandemic continues to threaten public health, the vaccination of children against the disease appears to be a key factor to control the pandemic. Our aim was to investigate the prevalence of parents who have vaccinated their children against the COVID-19 and the factors influencing this decision. Materials and Methods We conducted a web-based cross-sectional study in Greece during the first week of September 2021. The study questionnaire was distributed through social media and a convenience sample was obtained. Only parents with children aged 12-17 years old could participate in the study. We collected socio-demographic data of parents and we measured their attitudes towards vaccination and COVID-19 pandemic. Results Study population included 656 parents. Regarding vaccination, 27.1% of parents had their children vaccinated against the COVID-19, while almost all children had a complete vaccination history (98.9%). The most important reasons for decline of COVID-19 vaccination were doubts about the safety and effectiveness of COVID-19 vaccines (45.3%) and fear of side effects (36.6%). Regarding the information about the COVID-19 vaccines, parents showed more trust in family doctors than in scientists and the government. We found that increased parents' age, increased trust in COVID-19 vaccines, and positive attitude of parents towards vaccination had a positive effect on children's vaccination. Conclusions Understanding the factors influencing parents' decision to vaccinate their children against the COVID-19 is crucial to increase the COVID-19 vaccination coverage rate. Implementation of public health policies is necessary to spread knowledge about COVID-19 vaccines and to regain vaccine confidence.
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Affiliation(s)
- Petros Galanis
- Clinical Epidemiology Laboratory, Faculty of Nursing, National and Kapodistrian University of Athens, Athens
| | - Irene Vraka
- Department of Radiology, P & A Kyriakou Children’s Hospital, Athens, Greece
| | | | - Olympia Konstantakopoulou
- Center for Health Services Management and Evaluation, Faculty of Nursing, National and Kapodistrian University of Athens, Athens, Greece
| | - Aglaia Katsiroumpa
- Faculty of Nursing, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Daphne Kaitelidou
- Center for Health Services Management and Evaluation, Faculty of Nursing, National and Kapodistrian University of Athens, Athens, Greece
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Li T, Qi R, Chen B, Luo Y, Zhang W, Zhou YH, Xu B. COVID-19 vaccination coverage among adolescents aged 12-17 years in three provinces of eastern China: A cross-sectional survey, 2021. Front Public Health 2022; 10:919190. [PMID: 35937249 PMCID: PMC9355633 DOI: 10.3389/fpubh.2022.919190] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 06/27/2022] [Indexed: 11/13/2022] Open
Abstract
High vaccination coverage is essential to prevent and control the spread of the COVID-19 epidemic. Currently, the real-world acceptance of COVID-19 vaccines among adolescents aged 12-17 years in China has not been reported. We aimed to assess the acceptance rate of COVID-19 vaccination among adolescents in eastern China and to identify factors associated with the intention to get vaccinated against COVID-19. We conduct a cross-sectional questionnaire survey among adolescents from three provinces in the eastern part of China from 16 August to 28 October 2021. The questionnaires were distributed to 2,100 students, and 2,048 students completed the questionnaires. The results showed that 98.4% (2,016/2,048) of adolescents had received at least one dose of the COVID-19 vaccine and 1.6% (32/2,048) declined the vaccination. The participants from rural districts, or whose parents were vaccinated, were more likely to accept the vaccine. The main reason for declining vaccination was worry about vaccine safety (25%). The main adverse event after the vaccination was pain at the injection site. In conclusion, the vaccine coverage rate reached 98.4% among the adolescents in this study, which met the criteria for herd immunity to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The high vaccination rate is beneficial to the prevention and control of the COVID-19 pandemic.
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Affiliation(s)
- Taishun Li
- Medical Statistics and Analysis Center, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
| | - Ruowen Qi
- Medical Statistics and Analysis Center, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
| | - Bingwei Chen
- Department of Biostatistics, School of Public Health, Southeast University, Nanjing, China
| | - Yuqian Luo
- Department of Laboratory Medicine and Biomedicine Statistics, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
| | - Wenjun Zhang
- Department of Laboratory Medicine and Biomedicine Statistics, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
| | - Yi-Hua Zhou
- Department of Laboratory Medicine and Biomedicine Statistics, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
| | - Biyun Xu
- Medical Statistics and Analysis Center, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
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14
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Ackah M, Ameyaw L, Gazali Salifu M, Afi Asubonteng DP, Osei Yeboah C, Narkotey Annor E, Abena Kwartemaa Ankapong E, Boakye H. COVID-19 vaccine acceptance among health care workers in Africa: A systematic review and meta-analysis. PLoS One 2022; 17:e0268711. [PMID: 35584110 PMCID: PMC9116626 DOI: 10.1371/journal.pone.0268711] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 05/05/2022] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION Coronavirus Disease (COVID-19) vaccine acceptance, and hesitancy amongst Health Care Workers (HCWs) on the African continent have been examined through observational studies. However, there are currently no comprehensive reviews among these cadre of population in Africa. Hence, we aimed to review the acceptance rate and possible reasons for COVID-19 vaccine non-acceptance/hesitancy amongst HCWs in Africa. METHODS We searched Medline/PubMed, Google Scholar, and Africa Journal Online from January, 2020 to September, 2021. The Newcastle-Ottawa Quality Assessment tool adapted for cross-sectional studies was used to assess the quality of the retrieved studies. DerSimonian and Laird random-effects model was used to pool the COVID-19 vaccine acceptance rate. Sub-group and sensitivity analyses were performed. Reasons for COVID-19 vaccine hesitancy were also systematically analyzed. RESULTS Twenty-one (21) studies were found to be eligible for review out of the 513 initial records. The estimated pooled COVID-19 vaccine acceptance rate was 46% [95% CI: 37%-54%]. The pooled estimated COVID-19 vaccine acceptance rate was 37% [95% CI: 27%-47%] in North Africa, 28% [95% CI: 20%-36%] in Central Africa, 48% [CI: 38%-58%] in West Africa, 49% [95% CI: 30%-69%] in East Africa, and 90% [CI: 85%-96%] in Southern Africa. The estimated pooled vaccine acceptance was 48% [95% CI:38%-57%] for healthcare workers, and 34% [95% CI:29%-39%] for the healthcare students. Major drivers and reasons were the side effects of the vaccine, vaccine's safety, efficacy and effectiveness, short duration of the clinical trials, COVID-19 infections, limited information, and social trust. CONCLUSION The data revealed generally low acceptance of the vaccine amongst HCWs across Africa. The side effects of the vaccine, vaccine's safety, efficacy and effectiveness, short duration of the clinical trials, COVID-19 infections, limited information, and social trust were the major reasons for COVID-19 hesitancy in Africa. The misconceptions and barriers to COVID-19 vaccine acceptance amongst HCWs must be addressed as soon as possible in the continent to boost COVID-19 vaccination rates in Africa.
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Affiliation(s)
- Martin Ackah
- Department of Physiotherapy, Korle Bu Teaching Hospital, Accra, Ghana
- Department of Epidemiology, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Louise Ameyaw
- Department of Epidemiology, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
- Department of Medicine, Achimota Hospital, Accra, Ghana
| | - Mohammed Gazali Salifu
- Department of Epidemiology, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
- Policy Planning Budgeting Monitoring and Evaluation Directorate, Ministry of Health, Accra, Ghana
| | | | | | - Eugene Narkotey Annor
- School of Public Health, East Tennessee State University, Johnson City, Tennessee, United States of America
| | | | - Hosea Boakye
- Department of Physiotherapy, LEKMA Hospital, Accra, Ghana
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15
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Koh SWC, Liow Y, Loh VWK, Liew SJ, Chan YH, Young D. COVID-19 vaccine acceptance and hesitancy among primary healthcare workers in Singapore. BMC PRIMARY CARE 2022; 23:81. [PMID: 35421920 PMCID: PMC9010198 DOI: 10.1186/s12875-022-01693-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 04/04/2022] [Indexed: 02/06/2023]
Abstract
BACKGROUND Factors affecting COVID-19 vaccine acceptance and hesitancy among primary healthcare workers (HCW) remain poorly understood. This study aims to identify factors associated with vaccine acceptance and hesitancy among HCW. METHODS A multi-centre online cross-sectional survey was performed across 6 primary care clinics from May to June 2021, after completion of staff vaccination exercise. Demographics, profession, years working in healthcare, residential status, presence of chronic medical conditions, self-perceived risk of acquiring COVID-19 and previous influenza vaccination were collected. HCW who accepted vaccine were then asked to rank their top 5 reasons for vaccine acceptance; HCW who were vaccine hesitant had to complete the 15-item 5C scale on psychological antecedents of vaccination. RESULTS Five hundred fifty seven out of 1182 eligible HCW responded (47.1%). Twenty nine were excluded due to contraindications. Among 528 respondents, vaccine acceptance rate was 94.9% (n = 501). There were no statistically significant differences in COVID-19 vaccine acceptance between sex, age, ethnicity, profession, number of years in healthcare, living alone, presence of chronic diseases, self-perceived risk or previous influenza vaccination. The top 3 reasons for COVID-19 vaccine acceptance ranked by 501 HCW were to protect their family and friends, protect themselves from COVID-19 and due to high risk of acquiring COVID-19 because of their jobs. HCW with suspected or confirmed COVID-19 exposure were 3.4 times more likely to rank 'high risk at work' as one of the top reasons for vaccine acceptance (χ2 = 41.9, p < 0.001, OR = 3.38, 95%C.I. 2.32-4.93). High mean scores of 'Calculation' (5.79) and low scores for 'Constraint' (2.85) for 5C components among vaccine hesitant HCW (n = 27) highlighted that accessibility was not a concern; HCW took time to weigh vaccine benefits and consequences. CONCLUSION COVID-19 vaccine hesitancy is a minute issue among Singapore primary HCW, having achieved close to 95% acceptance rate. COVID-19 exposure risk influences vaccine acceptance; time is required for HCW to weigh benefits against the risks. Future studies can focus on settings with higher hesitancy rates, and acceptance of booster vaccinations with the emergence of delta and omicron variants.
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Affiliation(s)
- Sky Wei Chee Koh
- National University Polyclinics, National University Health System, Singapore, Singapore
- Department of Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yiyang Liow
- National University Polyclinics, National University Health System, Singapore, Singapore
- Department of Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Victor Weng Keong Loh
- Department of Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Seaw Jia Liew
- Department of Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yiong-Huak Chan
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Doris Young
- Department of Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Galanis P, Moisoglou I, Vraka I, Siskou O, Konstantakopoulou O, Katsiroumpa A, Kaitelidou D. Predictors of COVID-19 Vaccine Uptake in Healthcare Workers: A Cross-Sectional Study in Greece. J Occup Environ Med 2022; 64:e191-e196. [PMID: 35467601 PMCID: PMC9083308 DOI: 10.1097/jom.0000000000002463] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE We assessed the uptake of a COVID-19 vaccine and associated factors in a sample of healthcare workers (HCWs). METHODS An on-line cross-sectional study with 885 HCWs was conducted in Greece during August 2021. We measured socio-demographic data of HCWs and attitudes towards vaccination and the COVID-19 pandemic. A convenience sample was used since the questionnaire was distributed through social media and emails. RESULTS The majority of HCWs were vaccinated against the COVID-19 (91.5%). Females and HCWs with a history of seasonal influenza vaccination had a greater probability to get a COVID-19 vaccine. Also, increased self-perceived knowledge regarding the COVID-19 pandemic and increased trust in COVID-19 vaccines were associated with COVID-19 vaccine uptake. CONCLUSIONS Policymakers and scientists should develop novel strategies to improve COVID-19 vaccine uptake among HCWs.
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Affiliation(s)
- Petros Galanis
- Clinical Epidemiology Laboratory, Faculty of Nursing, National and Kapodistrian University of Athens, Athens, Greece (Dr Galanis and Ms Katsiroumpa); Pulmonary Clinic, General Hospital of Lamia, Lamia, Greece (Dr Moisoglou); Department of Radiology, P & A Kyriakou Children's Hospital, Athens, Greece (Dr Vraka); Center for Health Services Management and Evaluation, Faculty of Nursing, National and Kapodistrian University of Athens, Athens, Greece (Dr Siskou, Dr Konstantakopoulou, and Dr Kaitelidou)
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17
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Galanis P, Vraka I, Siskou O, Konstantakopoulou O, Katsiroumpa A, Kaitelidou D. Willingness, refusal and influential factors of parents to vaccinate their children against the COVID-19: A systematic review and meta-analysis. Prev Med 2022; 157:106994. [PMID: 35183597 PMCID: PMC8861629 DOI: 10.1016/j.ypmed.2022.106994] [Citation(s) in RCA: 80] [Impact Index Per Article: 40.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 02/07/2022] [Accepted: 02/12/2022] [Indexed: 12/03/2022]
Abstract
We aimed to estimate parents' willingness and refusal to vaccinate their children against the COVID-19, and to investigate the predictors for their decision. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. We searched Scopus, Web of Science, Medline, PubMed, CINAHL and medrxiv from inception to December 12, 2021. We applied a random effect model to estimate pooled effects since the heterogeneity was very high. We used subgroup analysis and metaregression analysis to explore sources of heterogeneity. We found 44 studies including 317,055 parents. The overall proportion of parents that intend to vaccinate their children against the COVID-19 was 60.1%, while the proportion of parents that refuse to vaccinate their children was 22.9% and the proportion of unsure parents was 25.8%. The main predictors of parents' intention to vaccinate their children were fathers, older age of parents, higher income, higher levels of perceived threat from the COVID-19, and positive attitudes towards vaccination (e.g. children's complete vaccination history, history of children's and parents' vaccination against influenza, confidence in vaccines and COVID-19 vaccines, and COVID-19 vaccine uptake among parents). Parents' willingness to vaccinate their children against the COVID-19 is moderate and several factors affect this decision. Understanding parental COVID-19 vaccine hesitancy does help policy makers to change the stereotypes and establish broad community COVID-19 vaccination. Identification of the factors that affect parents' willingness to vaccinate their children against COVID-19 will provide opportunities to enhance parents' trust in the COVID-19 vaccines and optimize children's uptake of a COVID-19 vaccine.
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Affiliation(s)
- Petros Galanis
- Clinical Epidemiology Laboratory, Faculty of Nursing, National and Kapodistrian University of Athens, Athens, Greece.
| | - Irene Vraka
- Department of Radiology, P & A Kyriakou Children's Hospital, Athens, Greece
| | - Olga Siskou
- Center for Health Services Management and Evaluation, Faculty of Nursing, National and Kapodistrian University of Athens, Athens, Greece
| | - Olympia Konstantakopoulou
- Center for Health Services Management and Evaluation, Faculty of Nursing, National and Kapodistrian University of Athens, Athens, Greece
| | - Aglaia Katsiroumpa
- Clinical Epidemiology Laboratory, Faculty of Nursing, National and Kapodistrian University of Athens, Athens, Greece
| | - Daphne Kaitelidou
- Center for Health Services Management and Evaluation, Faculty of Nursing, National and Kapodistrian University of Athens, Athens, Greece
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18
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Norhayati MN, Che Yusof R, Azman YM. Systematic Review and Meta-Analysis of COVID-19 Vaccination Acceptance. Front Med (Lausanne) 2022; 8:783982. [PMID: 35155467 PMCID: PMC8828741 DOI: 10.3389/fmed.2021.783982] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 12/28/2021] [Indexed: 12/17/2022] Open
Abstract
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.
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Affiliation(s)
- Mohd Noor Norhayati
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia
| | - Ruhana Che Yusof
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia
| | - Yacob Mohd Azman
- Medical Practice Division, Ministry of Health, Federal Government Administrative Centre, Putrajaya, Malaysia
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19
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Global COVID-19 Vaccine Acceptance: A Systematic Review of Associated Social and Behavioral Factors. Vaccines (Basel) 2022; 10:vaccines10010110. [PMID: 35062771 PMCID: PMC8779795 DOI: 10.3390/vaccines10010110] [Citation(s) in RCA: 87] [Impact Index Per Article: 43.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 01/06/2022] [Accepted: 01/07/2022] [Indexed: 12/12/2022] Open
Abstract
COVID-19 vaccines have met varying levels of acceptance and hesitancy in different parts of the world, which has implications for eliminating the COVID-19 pandemic. The aim of this systematic review is to examine how and why the rates of COVID-19 vaccine acceptance and hesitancy differ across countries and continents. PubMed, Web of Science, IEEE Xplore and Science Direct were searched between 1 January 2020 and 31 July 2021 using keywords such as “COVID-19 vaccine acceptance”. 81 peer-reviewed publications were found to be eligible for review. The analysis shows that there are global variations in vaccine acceptance among different populations. The vaccine-acceptance rates were the highest amongst adults in Ecuador (97%), Malaysia (94.3%) and Indonesia (93.3%) and the lowest amongst adults in Lebanon (21.0%). The general healthcare workers (HCWs) in China (86.20%) and nurses in Italy (91.50%) had the highest acceptance rates, whereas HCWs in the Democratic Republic of Congo had the lowest acceptance (27.70%). A nonparametric one-way ANOVA showed that the differences in vaccine-acceptance rates were statistically significant (H (49) = 75.302, p = 0.009*) between the analyzed countries. However, the reasons behind vaccine hesitancy and acceptance were similar across the board. Low vaccine acceptance was associated with low levels of education and awareness, and inefficient government efforts and initiatives. Furthermore, poor influenza-vaccination history, as well as conspiracy theories relating to infertility and misinformation about the COVID-19 vaccine on social media also resulted in vaccine hesitancy. Strategies to address these concerns may increase global COVID-19 vaccine acceptance and accelerate our efforts to eliminate this pandemic.
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Zhang J, Dean J, Yin Y, Wang D, Sun Y, Zhao Z, Wang J. Determinants of COVID-19 Vaccine Acceptance and Hesitancy: A Health Care Student-Based Online Survey in Northwest China. Front Public Health 2022; 9:777565. [PMID: 35071162 PMCID: PMC8770949 DOI: 10.3389/fpubh.2021.777565] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 12/02/2021] [Indexed: 12/14/2022] Open
Abstract
Background: With the spread of COVID-19 around the world, herd immunity through vaccination became a key measure to control the pandemic, but high uptake of vaccine is not guaranteed. Moreover, the actual acceptance of COVID-19 vaccination and associated factors remain uncertain among health care students in Northwest China. Methods: A cross-sectional survey of a sample of 631 health care students was performed using a questionnaire developed through Wen Juan Xing survey platform to collect information regarding their attitudes, beliefs, and acceptance of COVID-19 vaccination. Binary logistic regression analyses were performed to identify the association between vaccination willingness and demographics, attitudes, and beliefs to determine the factors that actually effect acceptance and hesitancy of COVID-19 vaccine among health care students. Results: Overall, 491 (77.81%) students actually received the COVID-19 vaccine, and of the 140 unvaccinated, 69 were hesitant and 71 rejected. Binary logistic regression analysis showed that the actually vaccinated individuals were those who mostly believed in the effectiveness of the COVID-19 vaccine (OR = 2.94, 95%CI: 1.37, 6.29), those who mostly felt it is their responsibility to receive the vaccine to protect others from infection (OR = 2.75, 95%CI: 1.45, 5.23), with less previous experience about other vaccines (OR = 1.70, 95%CI: 1.06, 2.72), students who mostly thought COVID-19 to be very severe (OR = 1.77, 95%CI: 1.07, 2.93), and students who mostly thought the COVID-19 vaccine was one of the best protection measures (OR = 1.68, 95%CI: 1.03, 2.76). Concerns about side effects of vaccines (OR = 0.30, 95%CI: 0.18, 0.51) and the use of personal protective behavior as an alternative to the COVID-19 vaccination (OR = 0.16, 95%CI: 0.06, 0.39) hindered the vaccine acceptance. Conclusions: Our study showed higher COVID-19 vaccine acceptance among healthcare students. However, the individuals with vaccine hesitancy and rejection were still worrying. Vaccine safety and effectiveness issues continue to be a major factor affecting students' acceptance. To expand vaccine coverage in response to the COVID-19 pandemic, appropriate vaccination strategies and immunization programs are essential, especially for those with negative attitudes and beliefs.
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Affiliation(s)
- Juxia Zhang
- Clinical Educational Department, Gansu Provincial Hospital, Lanzhou, China
| | - Judith Dean
- School of Public Health, The University of Queensland, Herston, QLD, Australia
| | - Yuhuan Yin
- School of Nursing, Gansu University of Chinese Medicine, Lanzhou, China
| | - Dongping Wang
- Clinical Educational Department, Gansu Provincial Hospital, Lanzhou, China
| | - Yanqing Sun
- Clinical Educational Department, Gansu Provincial Hospital, Lanzhou, China
| | - Zhenhua Zhao
- Department of Human Resource, Gansu Provincial Hospital, Lanzhou, China
| | - Jiancheng Wang
- Geriatrics Department, Gansu Provincial Hospital, Lanzhou, China
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21
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Mohammed R, Nguse TM, Habte BM, Fentie AM, Gebretekle GB. COVID-19 vaccine hesitancy among Ethiopian healthcare workers. PLoS One 2021; 16:e0261125. [PMID: 34919597 PMCID: PMC8682893 DOI: 10.1371/journal.pone.0261125] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 11/27/2021] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION COVID-19 poses significant health and economic threat prompting international firms to rapidly develop vaccines and secure quick regulatory approval. Although COVID-19 vaccination priority is given for high-risk individuals including healthcare workers (HCWs), the success of the immunization efforts hinges on peoples' willingness to embrace these vaccines. OBJECTIVE This study aimed to assess HCWs intention to be vaccinated against COVID-19 and the reasons underlying vaccine hesitancy. METHODS A cross-sectional survey was conducted among HCWs in Addis Ababa, Ethiopia from March to July 2021. Data were collected from eligible participants from 18 health facilities using a pre-tested semi-structured questionnaire. Data were summarized using descriptive statistics and multivariable logistic regression was performed to explore factors associated with COVID-19 vaccine hesitancy. A p<0.05 was considered statistically significant. RESULTS A total of 614 HCWs participated in the study, with a mean age of 30.57±6.87 years. Nearly two-thirds (60.3%) of HCWs were hesitant to use the COVID-19 vaccine. Participants under the age of 30 years were approximately five times more likely to be hesitant to be vaccinated compared to those over the age of 40 years. HCWs other than medical doctors and/or nurses (AOR = 2.1; 95%CI; 1.1, 3.8) were more likely to be hesitant for COVID-19 vaccine. Lack of believe in COVID-19 vaccine benefits (AOR = 2.5; 95%CI; 1.3, 4.6), lack of trust in the government (AOR = 1.9; 95%CI; 1.3, 3.1), lack of trust science to produce safe and effective vaccines (AOR = 2.6; 95%CI; 1.6, 4.2); and concern about vaccine safety (AOR = 3.2; 95%CI; 1.9, 5.4) were also found to be predictors of COVID-19 vaccine hesitancy. CONCLUSION COVID-19 vaccine hesitancy showed to be high among HCWs. All concerned bodies including the ministry, regional health authorities, health institutions, and HCWs themselves should work together to increase COVID-19 vaccine uptake and overcome the pandemic.
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Affiliation(s)
| | - Teklehaimanot Mezgebe Nguse
- Departments of Radiography, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Bruck Messele Habte
- School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Atalay Mulu Fentie
- School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Gebremedhin Beedemariam Gebretekle
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, Toronto, Ontario, Canada
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22
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Zheng Y, Shen P, Xu B, Chen Y, Luo Y, Dai Y, Hu Y, Zhou YH. COVID-19 vaccination coverage among healthcare workers in obstetrics and gynecology during the first three months of vaccination campaign: a cross-sectional study in Jiangsu province, China. Hum Vaccin Immunother 2021; 17:4946-4953. [PMID: 34802373 PMCID: PMC8903925 DOI: 10.1080/21645515.2021.1997297] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 09/22/2021] [Accepted: 10/21/2021] [Indexed: 12/26/2022] Open
Abstract
Before the availability of COVID-19 vaccines, surveys showed that vaccine hesitancy may influence the acceptance of COVID-19 vaccination. In this cross-sectional study, we aimed to investigate COVID-19 vaccination coverage among healthcare workers (HCWs) in obstetrics and gynecology, during the first three-month period of the vaccination campaign after COVID-19 vaccines were approved. A total of 662 eligible HCWs, consisting of 250 HCWs (group one) who participated in a Jiangsu provincial symposium and 412 HCWs (group two) in the department of obstetrics and gynecology, Nanjing Drum Tower Hospital, were invited to answer a 23-question questionnaire. In total, 618 (93.4%) HCWs completed the questionnaire. The vaccine acceptance in group one was higher than that in group two (87.2% [197/226] vs 74.2% [291/392], χ2 = 14.436, P < .001). Overall, 488 (79.0%) HCWs received COVID-19 vaccination and 130 (21.0%) declined vaccination. One-third of the 488 vaccinees were not vaccinated until consulted with others or requested by employers. Adjusted logistic regression analysis showed that the decline of vaccination was associated with worry about the safety of the vaccine (OR 1.920, CI 95% 1.196-3.082; P = .007). The main reason for the decline of COVID-19 vaccination included the concern about vaccine safety, pregnancy preparation, pregnancy, or lactation. These results indicate that more safety data about COVID-19 vaccines, particularly in pregnant or lactating women, are required to promote the acceptance of COVID-19 vaccination. In addition, vaccination requests or mandates by employers may increase the acceptance of COVID-19 vaccines.
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Affiliation(s)
- Yaning Zheng
- Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Ping Shen
- Departments of Laboratory Medicine, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Biyun Xu
- Department of Biomedicine Statistics, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Yiying Chen
- Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Yuqian Luo
- Departments of Laboratory Medicine, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Yimin Dai
- Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Yali Hu
- Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Yi-Hua Zhou
- Departments of Laboratory Medicine, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
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23
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Xu B, Zhang Y, Chen L, Yu L, Li L, Wang Q. The influence of social network on COVID-19 vaccine hesitancy among healthcare workers: a cross-sectional survey in Chongqing, China. Hum Vaccin Immunother 2021; 17:5048-5062. [PMID: 34982646 PMCID: PMC8903998 DOI: 10.1080/21645515.2021.2004837] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The factors that lead to coronavirus disease 2019 (COVID-19) vaccine hesitancy among health-care workers (HCWs) are unclear. We aimed to identify the factors that influence HCWs' hesitancy, especially the influence of their social network. Using an online platform, we surveyed HCWs in Chongqing, China, in January 2021 to understand the factors that influence the COVID-19 vaccine hesitancy among HCWs. Proportional allocation stratified sampling method was used to recruit respondents. Multivariable logistic regression and social network analysis (SNA) were used to analyze the influence factors. A total of 5247 HCWs were included and 23.3% of them were vaccine-hesitant. Participants were more hesitant if they had chronic diseases (OR = 1.411, 95% CI: 1.146-1.738), worked in tertiary hospitals (OR = 1.546, 95% CI: 1.231-1.942), and reported a history of vaccine hesitancy (OR = 1.637, 95% CI: 1.395-1.920) and refusal toward other vaccines (OR = 2.433, 95% CI: 2.067-2.863). The participants with a social network to communicate COVID-19 immunization were less hesitant (OR = 0.850, 95% CI: 0.728-0.993). Several influential members with social networks were found in SNA. Most of these influential members in the networks were department leaders who were willing to get COVID-19 vaccines (P < .05). Hesitant subgroups among Chinese HCWs were linked to the lack of a social network to communicate COVID-19 immunization. Our findings may lead to tailored interventions to enhance COVID-19 vaccine uptake among HCWs by targeting key members in social network.
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Affiliation(s)
- Binyue Xu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Sichuan, China,EPI Department, Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
| | - Yi Zhang
- School of Electronic Science and Engineering, University of Electronic Science and Technology of China, Chengdu, China
| | - Lei Chen
- EPI Department, Yuzhong Distinct Center for Disease Control and Prevention, Chongqing, China
| | - Linling Yu
- EPI Department, Yubei Distinct Center for Disease Control and Prevention, Chongqing, China
| | - Lanxin Li
- EPI Department, Shapingba Distinct Center for Disease Control and Prevention, Chongqing, China
| | - Qing Wang
- EPI Department, Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China,CONTACT Qing Wang EPI Department, Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
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24
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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. JOURNAL OF INTEGRATIVE MEDICINE 2021; 20:34-44. [PMID: 34774463 PMCID: PMC8559872 DOI: 10.1016/j.joim.2021.10.004] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 10/11/2021] [Indexed: 01/01/2023]
Abstract
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.
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25
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Sugawara N, Yasui-Furukori N, Fukushima A, Shimoda K. Attitudes of Medical Students toward COVID-19 Vaccination: Who Is Willing to Receive a Third Dose of the Vaccine? Vaccines (Basel) 2021; 9:vaccines9111295. [PMID: 34835226 PMCID: PMC8621301 DOI: 10.3390/vaccines9111295] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 10/26/2021] [Accepted: 11/05/2021] [Indexed: 12/28/2022] Open
Abstract
Medical students may come in contact with individuals infected with COVID-19 in their clinical rotations. A high level of acceptance of vaccination is needed for them to protect their health and the health of patients from this disease. The objectives of this study were to (1) obtain information on medical students' attitudes toward COVID-19 vaccination, (2) assess factors associated with students' attitudes, and (3) identify predictors of their willingness to receive a third dose of the COVID-19 vaccine. Using a cross-sectional design, we conducted a questionnaire survey of medical students in July 2021. For this survey, we employed a 15-item questionnaire specifically developed to assess the students' attitudes toward COVID-19 vaccination. Of the 742 distributed questionnaires, 496 (294 males and 202 females) were completed. Among all the participants, 89.1% (442/496) received the second dose of the vaccine, and 90.7% (450/496) indicated that they would hypothetically receive the COVID-19 vaccine in the future. Furthermore, 84.5% (419/496) of all the participants were willing to receive a third dose of the vaccine. Regarding willingness to receive a third dose of the COVID-19 vaccine, multiple logistic regression models showed that students' grade and their responses to Q1 (positive attitude toward vaccination), Q9 (belief in the protection offered by COVID-19 vaccination), Q10 (concern about the excessively rapid development of COVID-19 vaccines), Q12 (need for aspects of pre-pandemic life), and Q14 (concern about the sustainability of immunity) had significant associations with this outcome. Confidence in vaccines, relaxation of mobility restrictions, and concern about the sustainability of immunity motivate willingness to receive a third dose of the COVID-19 vaccine in medical students.
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Affiliation(s)
- Norio Sugawara
- Health Services Center for Students and Staff, Dokkyo Medical University, 880 Kitakobayashi, Mibu 321-0293, Tochigi, Japan
- Department of Psychiatry, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu 321-0293, Tochigi, Japan; (N.Y.-F.); (K.S.)
- Correspondence: ; Tel.: +81-28-287-2153; Fax: +81-28-286-5187
| | - Norio Yasui-Furukori
- Department of Psychiatry, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu 321-0293, Tochigi, Japan; (N.Y.-F.); (K.S.)
| | - Atsuhito Fukushima
- Department of Infection Control and Clinical Laboratory Medicine, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu 321-0293, Tochigi, Japan;
| | - Kazutaka Shimoda
- Department of Psychiatry, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu 321-0293, Tochigi, Japan; (N.Y.-F.); (K.S.)
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