1
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Liu S, Durantini MR, Calabrese C, Sanchez F, Albarracin D. A systematic review and meta-analysis of strategies to promote vaccination uptake. Nat Hum Behav 2024:10.1038/s41562-024-01940-6. [PMID: 39090405 DOI: 10.1038/s41562-024-01940-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 07/01/2024] [Indexed: 08/04/2024]
Abstract
Although immunization can dramatically curb the mortality and morbidity associated with vaccine-preventable diseases, vaccination uptake remains suboptimal in many areas of the world. Here, in this meta-analysis, we analysed the results from 88 eligible randomized controlled trials testing interventions to increase vaccination uptake with 1,628,768 participants from 17 countries with variable development levels (for example, Human Development Index ranging from 0.485 to 0.955). We estimated the efficacy of seven intervention strategies including increasing access to vaccination, sending vaccination reminders, providing incentives, supplying information, correcting misinformation, promoting both active and passive motivation and teaching behavioural skills. We showed that the odds of vaccination were 1.5 (95% confidence interval, 1.27 to 1.77) times higher for intervention than control conditions. Among the intervention strategies, using incentives and increasing access were most promising in improving vaccination uptake, with the access strategy being particularly effective in countries with lower incomes and less access to healthcare.
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Affiliation(s)
- Sicong Liu
- School of Physical Education and Sports Science, South China Normal University, Guangzhou, China.
- Annenberg Public Policy Center, University of Pennsylvania, Philadelphia, PA, USA.
| | - Marta R Durantini
- Annenberg Public Policy Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Christopher Calabrese
- Annenberg Public Policy Center, University of Pennsylvania, Philadelphia, PA, USA
- College of Behavioral, Social and Health Sciences, Clemson University, Clemson, SC, USA
| | - Flor Sanchez
- Department of Psychology, Universidad Autónoma de Madrid, Madrid, Spain
| | - Dolores Albarracin
- Annenberg Public Policy Center, University of Pennsylvania, Philadelphia, PA, USA.
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA.
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA, USA.
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2
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Marinthe G, Brown G, Cristea M, Kutlaca M. Predicting vaccination hesitancy: The role of basic needs satisfaction and institutional trust. Vaccine 2024; 42:3592-3600. [PMID: 38704252 DOI: 10.1016/j.vaccine.2024.04.068] [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] [Received: 05/16/2023] [Revised: 01/15/2024] [Accepted: 04/23/2024] [Indexed: 05/06/2024]
Abstract
Autonomous motivation is considered a powerful driver of health behaviour, but less is known about the specific roles played by basic needs. Drawing on the context of the COVID-19 pandemic, this research examined basic needs as a motivational determinant of vaccination. We hypothesized that satisfaction of basic needs (autonomy, competence, relatedness) has both a direct and an indirect effect (through trust in science and government) on vaccine hesitancy. Two studies (Study 1: N = 968 French and British; Study 2, pre-registered: N = 716 Americans) tested our hypotheses and compared vaccinated and non-vaccinated individuals using multigroup structural equation models. We found positive direct (in both studies) and indirect (in Study 1) effects of autonomy satisfaction on vaccine acceptance. In contrast, competence satisfaction was directly and indirectly, via science mistrust, related to vaccine hesitancy, particularly among non-vaccinated people. Competence satisfaction also indirectly reduced the intention to vaccinate in both studies. We found no impact of relatedness. Complementing previous work on self-determination theory, our research demonstrates the importance of considering the distinct roles of basic needs. Moreover, we highlight that increasing autonomy and science trust may be an efficient strategy to improve vaccine acceptance and vaccination, even among reluctant individuals.
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Affiliation(s)
- Gaëlle Marinthe
- Laboratoire Parisien de Psychologie Sociale, University of Paris 8 Vincennes, 2 rue de la Liberté, 93200 Saint-Denis, France.
| | - Genavee Brown
- Department of Psychology, Northumbria University, Ellison Pl, Newcastle upon Tyne NE1 8ST, United Kingdom.
| | - Mioara Cristea
- School of Social Sciences, Heriot Watt University, Edinburgh EH14 4AS, United Kingdom.
| | - Maja Kutlaca
- Department of Psychology, Durham University, Upper Mountjoy, South Rd, Durham DH1 3LE, United Kingdom.
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3
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Thai H, Audet ÉC, Koestner R. Motivation for COVID-19 Vaccination: Applying a Self-Determination Theory Perspective to a Global Health Crisis. Vaccine 2024; 42:3282-3287. [PMID: 38599989 DOI: 10.1016/j.vaccine.2024.04.023] [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] [Received: 11/09/2023] [Revised: 03/23/2024] [Accepted: 04/04/2024] [Indexed: 04/12/2024]
Abstract
Examining the spectrum of vaccine attitudes within the general public, spanning from hesitancy to confidence, is pivotal in addressing the challenges posed by the COVID-19 pandemic. Despite widespread campaigns advocating for vaccine uptake, a proportion of the population harbour reservations about the safety and efficacy of vaccines. This study seeks to explore the determinants of vaccine attitudes in Canada, leveraging key concepts from the well-established Self-Determination Theory (SDT), including basic psychological needs and the quality of an individual's motivation. During a crucial juncture in the COVID-19 pandemic (December 2021), 292 participants were recruited and completed an online survey assessing levels of satisfaction/frustration of basic psychological needs (sense of autonomy, relatedness, and competence), vaccine attitudes (confidence and hesitancy), and motivation towards vaccination (controlled and autonomous). Two mediation models were employed to examine whether autonomous-controlled motivation mediated the relationship between need satisfaction-frustration and vaccine attitudes. Model 1 revealed a full mediating effect, indicating that need satisfaction influenced vaccine confidence only through autonomous motivation (ab1 = 0.09, SE = 0.04, z = 2.19, 95 % CI [0.01, 0.18]). Meanwhile, Model 2 demonstrated that need frustration was associated with vaccine hesitancy partially through controlled motivation (ab2 = 0.05, SE = 0.02, z = 2.54, 95 % CI [0.02, 0.10]). These findings underscore the applicability of SDT in investigating the motivational mechanisms that shape vaccine attitudes. Recognizing psychosocial factors, including the balance of basic needs and quality of motivations, may be integral to informing effective public health strategies.
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Affiliation(s)
- Helen Thai
- Department of Psychology, McGill University, Montreal, Quebec, Canada.
| | - Élodie C Audet
- Department of Psychology, McGill University, Montreal, Quebec, Canada.
| | - Richard Koestner
- Department of Psychology, McGill University, Montreal, Quebec, Canada.
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4
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Cacace M, Castelli M, Toth F. Strategies to Promote Vaccine Uptake in the COVID-19 Pandemic: Exploring the "Ladder of Intrusiveness" in Three Countries. JOURNAL OF HEALTH POLITICS, POLICY AND LAW 2024; 49:133-162. [PMID: 37522380 DOI: 10.1215/03616878-10910251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
CONTEXT A key task for countries around the world facing the COVID-19 pandemic was to achieve high vaccination coverage of the population. To overcome "vaccination inertia," governments adopted a variety of policy instruments. These instruments can be placed along a "ladder of intrusiveness" based on their degree of constraint of individual freedoms. The aim of this study is to investigate how the governments of three European countries moved along the ladder of intrusiveness and how the choice of policy instruments was influenced by contextual factors. METHODS The study draws on secondary data sources, including academic and gray literature, policy documents, and opinion polls, over an observation period from December 2020 to summer 2022. The study employs inductive logic to analyze data and identify the factors explaining similarities and differences across England, Germany, and Italy. FINDINGS The study identifies similarities and differences in how the three countries advanced along the ladder of intrusiveness. Contextual factors such as policy legacy, social acceptability, and ideological orientation contribute to explain the observations. CONCLUSIONS Country-specific contextual factors play an important role in understanding the choice of policy instruments adopted by the three countries. Policy makers should carefully consider these factors when planning immunization strategies.
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5
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Sharp M, Lozano P, Southworth A, Peters A, Lam H, Randal FT, Quinn M, Kim KE. Mixed methods approach to understanding COVID-19 vaccine hesitancy among immigrants in the Chicago. Vaccine 2024:S0264-410X(23)01508-6. [PMID: 38199924 DOI: 10.1016/j.vaccine.2023.12.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 11/30/2023] [Accepted: 12/20/2023] [Indexed: 01/12/2024]
Abstract
BACKGROUND COVID-19 vaccine hesitancy has been particularly high among immigrant populations, whose experience is shaped by a history of racism and discriminations, and distrust of the healthcare system. In this study we draw from the Theory of Planned Behavior to examine COVID-19 vaccine hesitancy among immigrants in Chicago. METHODS A mixed-methods approach comprising of both focus groups and a health survey was conducted from February to August 2022. Five focus groups were held (N = 35) among Black, Asian and Arab/Palestine participants to understand attitudes and beliefs around the COVID-19 vaccine. Focus groups were analyzed using a modified template approach to text analysis. Based on these findings and themes, we developed a survey that was conducted among 413 immigrants from the mentioned communities. We used hierarchical ordinal regression analyses to examine the relationship between COVID-19 vaccine hesitancy and vaccination status. RESULTS Qualitative analysis suggest that the major factors influencing COVID-19 vaccine hesitancy included fear of adverse reactions, misinformation around COVID-19 and the vaccine, negative social norms around vaccination, and external pressure to get vaccinated. From our quantitative analysis we found that 24% of participants were unvaccinated, 5% were partially vaccinated, 32.3% were vaccinated but not boosted, and 39% were vaccinated and boosted for COVID-19. Hierarchical regression models suggest that immigrants who hold negative attitudes and social norms around the COVID-19 vaccine are less likely to vaccinate. CONCLUSIONS Understanding vaccine hesitancy among immigrants allows for the creation of culturally and linguistically tailored education that can be utilized to increase vaccine confidence and uptake.
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Affiliation(s)
| | - Paula Lozano
- University of Chicago Center for Asian Health Equity, Chicago, IL, United States
| | | | - Aven Peters
- University of Chicago Center for Asian Health Equity, Chicago, IL, United States
| | - Helen Lam
- University of Chicago Center for Asian Health Equity, Chicago, IL, United States
| | | | - Michael Quinn
- University of Chicago Center for Asian Health Equity, Chicago, IL, United States
| | - Karen E Kim
- University of Chicago Center for Asian Health Equity, Chicago, IL, United States
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6
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Baser O, Rodchenko K, Chen L, Yapar N. Short-term and long-term behavioral effects of vaccination mandates. Hum Vaccin Immunother 2023; 19:2294525. [PMID: 38114192 PMCID: PMC10732688 DOI: 10.1080/21645515.2023.2294525] [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] [Received: 09/06/2023] [Accepted: 12/10/2023] [Indexed: 12/21/2023] Open
Abstract
Current COVID-19 vaccination levels are insufficient to achieve herd immunity. To implement effective interventions toward ending the pandemic, it is essential to understand why people are motivated and willing to receive vaccination. The study aims to evaluate attitudes toward COVID-19 vaccination mandates and the impact of policies on future vaccine uptake and behavior utilizing self-determination theory. We conducted an online survey (n = 569) in the U.S. and Turkey to investigate a relationship between respondents' psychological needs and their willingness and motivation to receive COVID vaccination. The study examined the possible impact of vaccine mandates on these needs. Autonomy satisfaction was the leading predictor of willingness to receive vaccination (p < .0001). Relatedness satisfaction was the leading predictor of one's intention to receive vaccination (OR = 3.382; p = .0001). The strongest positive correlation was found between needs frustration and external motivation. A moderate positive correlation was found between competence frustration and introjected motivation. No association was found between vaccine mandates and psychological needs. Need satisfaction, especially autonomy and relatedness, appear to positively influence willingness and intention to receive a vaccination. On the other hand, need frustration, especially autonomy and competence frustration, correlates with external motivation, thereby suggesting a detrimental long-term effect on vaccination behavior. Need satisfaction promotes positive vaccination behavior, while need frustration might adversely affect motivation and willingness to receive vaccination. Strategies promoting autonomous decision-making might be more effective than vaccination enforcement in sustaining positive vaccination behavior.
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Affiliation(s)
- Onur Baser
- Department of Economics, Bogazici University, Istanbul, Turkey
- Graduate School of Public Health, City University of New York, New York, NY, USA
| | - Katarzyna Rodchenko
- Health Economics and Outcomes Research, Columbia Data Analytics, New York, NY, USA
| | - Lu Chen
- Health Economics and Outcomes Research, Columbia Data Analytics, San Francisco, CA, USA
| | - Nehir Yapar
- Health Economics and Outcomes Research, Columbia Data Analytics, New York, NY, USA
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7
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Morbée S, Vansteenkiste M, Waterschoot J, Klein O, Luminet O, Schmitz M, Van den Bergh O, Van Oost P, Yzerbyt V. The Role of Communication Style and External Motivators in Predicting Vaccination Experiences and Intentions: An Experimental Vignette Study. HEALTH COMMUNICATION 2023; 38:2894-2903. [PMID: 36162986 DOI: 10.1080/10410236.2022.2125012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
This vignette-based study examined in a sample of unvaccinated Belgian citizens (N = 1918; Mage = 45.99) how health care workers could foster reflection about and intentions to get vaccinated against COVID-19 by experimentally varying their communication style (i.e., autonomy-supportive vs. controlling) and the reference to external motivators (i.e., use of a monetary voucher or corona pass vs. the lack thereof). Each participant was randomly assigned to one of six conditions and rated a vignette in terms of anticipated autonomy satisfaction, perceived effectiveness, reflection, and vaccination intention. An autonomy-supportive, relative to a controlling, communication style predicted greater autonomy need satisfaction, which in turn related positively to perceived effectiveness, reflection, and vaccination intention. External motivators failed to generate positive effects compared to the control condition. The findings highlight the critical role of autonomy support in promoting a self-endorsed decision to get vaccinated.
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Affiliation(s)
- Sofie Morbée
- Department of Developmental, Personality and Social Psychology, Ghent University
| | | | - Joachim Waterschoot
- Department of Developmental, Personality and Social Psychology, Ghent University
| | - Olivier Klein
- Faculty of Psychological Sciences and Education, Université libre de Bruxelles
| | - Olivier Luminet
- Institute for Research in Psychological Sciences, Université catholique de Louvain
| | - Mathias Schmitz
- Institute for Research in Psychological Sciences, Université catholique de Louvain
| | | | - Pascaline Van Oost
- Institute for Research in Psychological Sciences, Université catholique de Louvain
| | - Vincent Yzerbyt
- Institute for Research in Psychological Sciences, Université catholique de Louvain
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8
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Mills F, Carter H, Benny L, Barnard M, Symons C. An online RCT on behavioural expectations effects of COVID-19 certification policies in England. Vaccine X 2023; 15:100389. [PMID: 37829554 PMCID: PMC10565557 DOI: 10.1016/j.jvacx.2023.100389] [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: 06/13/2023] [Revised: 08/29/2023] [Accepted: 09/18/2023] [Indexed: 10/14/2023] Open
Abstract
Objective The aim of this study was to compare the effects of different types of COVID-19 certification policy on subsequent behavioural expectations. Design 4 × 2 between-subjects pre-registered randomised controlled trial. Method In August 2022, participants (n = 2726) in England were presented with a scenario describing a rise in COVID-19 infections and the introduction of new protective measures. The protective measures described varied with regards to the setting (healthcare vs. recreational) and the type of policy (no certification vs. vaccination vs. vaccination or free Lateral Flow test vs. vaccination or Lateral Flow test at personal cost). Participants then answered questions on their expectations to receive another dose of the COVID-19 vaccine, to receive the seasonal influenza vaccine and to adhere to other protective behaviours following the announcement, as well as questions based on Self-Determination Theory, COVID-19 vaccine hesitancy and broader vaccine hesitancy. Results We found no main effects of setting or type of certification on expectation to receive the next dose of the COVID-19 vaccine, to receive the seasonal influenza vaccine, or to adhere to other protective measures, when controlling for baseline expectations. Conclusions These findings suggest that it is unlikely that the concept of certification, however it is framed, alters inclinations in the English population towards COVID-19 and seasonal flu vaccination or inclinations towards adhering to other protective behaviours within settings to which certification would apply. These findings are based on a hypothetical scenario and should be interpreted with caution.
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Affiliation(s)
- Freya Mills
- Behavioural Science and Insights Unit, UK Health Security Agency, United Kingdom
- School of Psychology, University of Sussex, United Kingdom
| | - Holly Carter
- Behavioural Science and Insights Unit, UK Health Security Agency, United Kingdom
| | - Liza Benny
- Evaluation and Social Research Unit, UK Health Security Agency, United Kingdom
| | - Matt Barnard
- Evaluation and Social Research Unit, UK Health Security Agency, United Kingdom
| | - Charles Symons
- Behavioural Science and Insights Unit, UK Health Security Agency, United Kingdom
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9
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Natalia YA, Delporte M, De Witte D, Beutels P, Dewatripont M, Molenberghs G. Assessing the impact of COVID-19 passes and mandates on disease transmission, vaccination intention, and uptake: a scoping review. BMC Public Health 2023; 23:2279. [PMID: 37978472 PMCID: PMC10656887 DOI: 10.1186/s12889-023-17203-4] [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: 06/07/2023] [Accepted: 11/10/2023] [Indexed: 11/19/2023] Open
Abstract
PURPOSE Policymakers have struggled to maintain SARS-CoV-2 transmission at levels that are manageable to contain the COVID-19 disease burden while enabling a maximum of societal and economic activities. One of the tools that have been used to facilitate this is the so-called "COVID-19 pass". We aimed to document current evidence on the effectiveness of COVID-19 passes, distinguishing their indirect effects by improving vaccination intention and uptake from their direct effects on COVID-19 transmission measured by the incidence of cases, hospitalizations, and deaths. METHODS We performed a scoping review on the scientific literature of the proposed topic covering the period January 2021 to September 2022, in accordance with the PRISMA-ScR guidelines for scoping reviews. RESULTS Out of a yield of 4,693 publications, 45 studies from multiple countries were retained for full-text review. The results suggest that implementing COVID-19 passes tends to reduce the incidence of cases, hospitalizations, and deaths due to COVID-19. The use of COVID-19 passes was also shown to improve overall vaccination uptake and intention, but not in people who hold strong anti-COVID-19 vaccine beliefs. CONCLUSION The evidence from the literature we reviewed tends to indicate positive direct and indirect effects from the use of COVID-19 passes. A major limitation to establishing this firmly is the entanglement of individual effects of multiple measures being implemented simultaneously.
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Affiliation(s)
| | - Margaux Delporte
- I-BioStat, Department of Public Health and Primary Care, Faculty of Medicine, KU Leuven, Leuven, Belgium
| | - Dries De Witte
- I-BioStat, Department of Public Health and Primary Care, Faculty of Medicine, KU Leuven, Leuven, Belgium
| | - Philippe Beutels
- Centre for Health Economics Research and Modelling Infectious Diseases, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Mathias Dewatripont
- I3h, ECARES and Solvay Brussels School of Economics and Management, Université Libre de Bruxelles, Brussels, Belgium
| | - Geert Molenberghs
- I-BioStat, Data Science Institute, Hasselt University, Hasselt, Belgium
- I-BioStat, Department of Public Health and Primary Care, Faculty of Medicine, KU Leuven, Leuven, Belgium
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10
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Harjani T, He H, Chao MM. The Moral Foundations of Vaccine Passports. JOURNAL OF BUSINESS ETHICS : JBE 2023:1-29. [PMID: 37359793 PMCID: PMC10200013 DOI: 10.1007/s10551-023-05427-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 04/28/2023] [Indexed: 06/28/2023]
Abstract
The debate around vaccine passports has been polarising and controversial. Although the measure allows businesses to resume in-person operations and enables transitioning out of lockdown due to the COVID-19 pandemic, some have expressed concerns about liberty violations and discrimination. Understanding the splintered viewpoints can aid businesses in communicating such measures to employees and consumers. We conceptualise the business implementation of vaccine passports as a moral decision rooted in individual values that influence reasoning and emotional reaction. We surveyed support for vaccine passports on a nationally representative sample in the United Kingdom in 2021: April (n = 349), May (n = 328), and July (n = 311). Drawing on the Moral Foundations Theory-binding (loyalty, authority, and sanctity), individualising (fairness and harm), and liberty values-we find that individualising values are a positive predictor and liberty values a negative predictor of support for passports, suggesting adoption hinges on addressing liberty concerns. Longitudinal analysis examining the trajectory of change in support over time finds that individualising foundations positively predict changes in utilitarian and deontological reasoning over time. In contrast, a fall in anger over time predicts increased support towards vaccine passports. Our study can inform business and policy communication strategies of existing vaccine passports, general vaccine mandates, and similar measures in future pandemics.
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Affiliation(s)
- Trisha Harjani
- Department of Psychology, University of Cambridge, Cambridge, CB2 3EB UK
| | - Hongwei He
- Alliance Manchester Business School, The University of Manchester, Manchester, M13 9SS UK
| | - Melody Manchi Chao
- Department of Management, School of Business and Management, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong S.A.R
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11
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de Figueiredo A, Simas C, Larson HJ. COVID-19 vaccine acceptance and its socio-demographic and emotional determinants: A multi-country cross-sectional study. Vaccine 2023; 41:354-364. [PMID: 36414475 PMCID: PMC9647027 DOI: 10.1016/j.vaccine.2022.10.051] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 10/12/2022] [Accepted: 10/14/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Multiple COVID-19 vaccines have now been licensed for human use, with other candidate vaccines in different stages of development. Effective and safe vaccines against COVID-19 have been essential in achieving global reductions in severe disease caused by severe acute respiratory coronavirus 2 (SARS-CoV-2), but multiple factors, including vaccine supply and vaccine confidence, continue to impact global uptake of COVID-19 vaccines. In this study, we explore determinants of COVID-19 vaccination intent across17 countries worldwide. METHODS In this large-scale multi-country study, we explored intent to accept a COVID-19 vaccine and the socio-demographic and emotional determinants of uptake for 17 countries and over 19,000 individuals surveyed in June and July 2020 via nationally representative samples. We used Bayesian ordinal logistic regressions to probe the relationship between intent to accept a COVID-19 vaccine and individuals' socio-demographic status, their confidence in COVID-19 vaccines, and their recent emotional status. Gibbs sampling was used for Bayesian model inference, with 95% Bayesian highest posterior density intervals used to capture uncertainty. FINDINGS Intent to accept a COVID-19 vaccine was found to be highest in India, where 77⋅8% (95% HPD, 75⋅5 to 80⋅0%) of respondents strongly agreeing that they would take a new COVID-19 vaccine if it were available. The Democratic Republic of Congo (15⋅5%, 12⋅2 to 18⋅6%) and France (26⋅4%, 23⋅7 to 29⋅2%) had the lowest share of respondents who strongly agreed that they would accept a COVID-19. Confidence in the safety, importance, and effectiveness of COVID-19 vaccines are the most widely informative determinants of vaccination intent. Socio-demographic and emotional determinants played a lesser role, with being male and having higher education associated with increased uptake intent in five countries and being fearful of catching COVID-19 also a strong determinant of uptake intent. INTERPRETATION Barriers to COVID-19 vaccine acceptance are found to be country and context dependent. These findings highlight the importance of regular monitoring of COVID-19 vaccine confidence to identify groups less likely to vaccinate.
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Affiliation(s)
- A de Figueiredo
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
| | - C Simas
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - H J Larson
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK; Department of Health Metrics Sciences, University of Washington, Seattle, WA, USA; Centre for the Evaluation of Vaccination, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
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12
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de Figueiredo A. Forecasting sub-national trends in COVID-19 vaccine uptake in the UK before vaccine rollout. Sci Rep 2022; 12:21529. [PMID: 36513741 PMCID: PMC9746557 DOI: 10.1038/s41598-022-25354-4] [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: 08/09/2022] [Accepted: 11/29/2022] [Indexed: 12/15/2022] Open
Abstract
Vaccines have reduced the burden of COVID-19 disease in the UK since their introduction in December 2020. At the time of their introduction, it was unclear the extent to which COVID-19 vaccines would be accepted and how spatial variations in uptake would emerge, driven by socio-demographic characteristics. In this study, data from a large-scale cross-sectional study of over 17,000 adults, surveyed in September and October 2020, was used to provide sub-national forecasts of COVID-19 vaccine uptake across the UK. Bayesian multilevel regression and poststratification was deployed to forecast COVID-19 vaccine acceptance before vaccine rollout across 174 regions of the UK. Although it was found that a majority of the UK adult population would likely take the vaccine, there were substantial heterogeneities in uptake intent across the UK. Large urban areas, including London and North West England, females, Black or Black British ethnicities, and Polish speakers were among the least likely to state an intent to vaccinate. These predicted spatial trends were validated by comparison to observed observed COVID-19 vaccine uptake in late 2021. The methodological approaches deployed in this validated forecasting study may be replicable for the prediction of routine childhood immunisation uptake. Given recent pandemic-induced disruptions to routine immunisation systems, reliable sub-national forecasts of vaccine uptake may provide policymakers and stakeholders early warning signals of potential vaccine confidence issues.
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Affiliation(s)
- A. de Figueiredo
- grid.8991.90000 0004 0425 469XDepartment of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK ,grid.7445.20000 0001 2113 8111Department of Mathematics, Imperial College London, London, UK
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13
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Chavda VP, Yao Q, Vora LK, Apostolopoulos V, Patel CA, Bezbaruah R, Patel AB, Chen ZS. Fast-track development of vaccines for SARS-CoV-2: The shots that saved the world. Front Immunol 2022; 13:961198. [PMID: 36263030 PMCID: PMC9574046 DOI: 10.3389/fimmu.2022.961198] [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: 06/04/2022] [Accepted: 09/08/2022] [Indexed: 11/13/2022] Open
Abstract
In December 2019, an outbreak emerged of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which leads to coronavirus disease 2019 (COVID-19). The World Health Organisation announced the outbreak a global health emergency on 30 January 2020 and by 11 March 2020 it was declared a pandemic. The spread and severity of the outbreak took a heavy toll and overburdening of the global health system, particularly since there were no available drugs against SARS-CoV-2. With an immediate worldwide effort, communication, and sharing of data, large amounts of funding, researchers and pharmaceutical companies immediately fast-tracked vaccine development in order to prevent severe disease, hospitalizations and death. A number of vaccines were quickly approved for emergency use, and worldwide vaccination rollouts were immediately put in place. However, due to several individuals being hesitant to vaccinations and many poorer countries not having access to vaccines, multiple SARS-CoV-2 variants quickly emerged that were distinct from the original variant. Uncertainties related to the effectiveness of the various vaccines against the new variants as well as vaccine specific-side effects have remained a concern. Despite these uncertainties, fast-track vaccine approval, manufacturing at large scale, and the effective distribution of COVID-19 vaccines remain the topmost priorities around the world. Unprecedented efforts made by vaccine developers/researchers as well as healthcare staff, played a major role in distributing vaccine shots that provided protection and/or reduced disease severity, and deaths, even with the delta and omicron variants. Fortunately, even for those who become infected, vaccination appears to protect against major disease, hospitalisation, and fatality from COVID-19. Herein, we analyse ongoing vaccination studies and vaccine platforms that have saved many deaths from the pandemic.
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Affiliation(s)
- Vivek P. Chavda
- Department of Pharmaceutics and Pharmaceutical Technology, LM College of Pharmacy, Ahmedabad, Gujarat, India
| | - Qian Yao
- Graduate School, University of St. La Salle, Bacolod City, Philippines
| | | | | | - Chirag A. Patel
- Department of Pharmacology, LM College of Pharmacy, Ahmedabad, Gujarat, India
| | - Rajashri Bezbaruah
- Department of Pharmaceutical Sciences, Faculty of Science and Engineering, Dibrugarh University, Dibrugarh, Assam, India
| | - Aayushi B. Patel
- Pharmacy Section, LM. College of Pharmacy, Ahmedabad, Gujarat, India
| | - Zhe-Sheng Chen
- Department of Pharmaceutical Science, College of Pharmacy and Health Sciences, St. John’s University, New York, NY, United States
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14
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Barello S, Acampora M, Paleologo M, Schiavone L, Anderson G, Graffigna G. Public views on the Covid-19 immunity certificate: A scoping review. Health Expect 2022; 25:2645-2657. [PMID: 36168916 PMCID: PMC9538975 DOI: 10.1111/hex.13589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 07/27/2022] [Accepted: 08/10/2022] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Already in its first implementation, the introduction of the Covid-19 immunity certificate has generated some debate among the public. This debate might be a hindrance to the effective realization of this policy. This study aimed to systematically review published research evaluating public feeling of the Covid-19 immunity certificate policy measure and to find which factors might influence its acceptance. METHODS We followed the scoping review methods manual by the Joanna Briggs Institute. We included studies with no time limits that presented novel data, and no exclusions have been made based on study design. We excluded articles that presented just expert opinions. RESULTS We found and reviewed 17 articles. The included studies were conducted in two main countries (the United Kingdom and Switzerland), with the rest from Israel, Italy, Spain, Germany, Australia, Taiwan and China. Both qualitative and quantitative studies were included, and nonrepresentative samples were mostly used to explore the public feeling about the Covid-19 immunity certification. The included studies showed that public views on immunity certification are quite contradictory and influenced by age, gender, ethnicity, political orientation and attitudes towards Covid-19 vaccination. The topic more often addressed by the included studies was the public's views on the positive and negative implications of the Covid-19 immunity certificate in terms of ethical, legal and behavioural consequences of this measure. CONCLUSION The varying acceptance rates are notable and may partly be linked to differences in demographics, Covid-19 concerns and ideological beliefs, as seen in other health-related tracking policies. Moreover, dominant factors behind the (un)success of this policy are complex and entangled with the cultural and political dimensions rather than being just technical. For this reason, it is important to expand psychosocial research to better understand the concerns behind health certifications and allow planning of culturally based and ethically sound suitable strategies. This would be very relevant to increasing public approval and compliance with this public health measure. PATIENT OR PUBLIC CONTRIBUTION This does not apply to our work as it was a review paper.
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Affiliation(s)
- Serena Barello
- EngageMinds HUB-Consumer, Food and Health Engagement Research Center, Università Cattolica del Sacro Cuore, Milan, Italy.,Faculty of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy.,Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Marta Acampora
- EngageMinds HUB-Consumer, Food and Health Engagement Research Center, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Michele Paleologo
- EngageMinds HUB-Consumer, Food and Health Engagement Research Center, Università Cattolica del Sacro Cuore, Milan, Italy.,Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Lavinia Schiavone
- EngageMinds HUB-Consumer, Food and Health Engagement Research Center, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Gloria Anderson
- EngageMinds HUB-Consumer, Food and Health Engagement Research Center, Università Cattolica del Sacro Cuore, Milan, Italy.,Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Guendalina Graffigna
- EngageMinds HUB-Consumer, Food and Health Engagement Research Center, Università Cattolica del Sacro Cuore, Milan, Italy.,Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy.,Faculty of Agriculture, Food and Environmental Sciences, Università Cattolica del Sacro Cuore, Cremona, Italy
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15
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Save the giants: demand beyond production capacity of tantalum raw materials. MINERAL ECONOMICS 2022. [PMCID: PMC9472191 DOI: 10.1007/s13563-022-00344-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Tantalum’s high melting point and ability to store and release electrical charges have attracted high-tech companies since its usage in capacitors began in the 1930s. During the COVID-19 pandemic lockdown, daily life relied on electronic equipment, resulting in a surge in demand for electronic and communication gadgets, which could necessitate many tantalum raw materials and an assured supply chain. Despite tantalum’s high demand from electronic manufacturers, 5G network systems and electric vehicles are currently added to the tantalum consumer list. The authors have examined three interconnected issues linked to tantalum supply interruption, which has resulted in a growing tantalum scarcity: (1) rising demand for tantalum ores and high-tech equipment while mining activities are in decline owing to the COVID-19 pandemic; (2) tantalum ore price volatility constrains the ore supply chain; (3) the challenge of pandemics that shrink mining activities and handicap supply chain. To address the issue of supply shortage in the long-term, the authors suggest that the concerned parties may adopt new norms of reliable, stable, and transparent supply channels instead of relying on an old uncertain and volatile supply system. The authors also suggest the transformation of central African artisanal and small-scale mining (mainly in Rwanda and the Democratic Republic of the Congo) into a modern mining system with a new supply channel that can resist existing and future disruptions.
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16
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A Lesson from the Green Pass Experience in Italy: A Narrative Review. Vaccines (Basel) 2022; 10:vaccines10091483. [PMID: 36146561 PMCID: PMC9505186 DOI: 10.3390/vaccines10091483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/31/2022] [Accepted: 09/03/2022] [Indexed: 11/17/2022] Open
Abstract
The COVID-19 outbreak has raised several global challenges related to disease management while highlighting the need to embrace a multidimensional approach in dealing with events such as. Due to the singular features of SARS-CoV-2, an appropriate medical response was required to develop new vaccines able to tackle it effectively. Mass vaccination plans were thus promptly launched around the world. However, vaccine uptake has been coupled with growing concerns that have affected people’s willingness to get vaccinated. To promote compliance with vaccination campaigns, many governments introduced the use of vaccination certificates and immunization passports. Studies have discussed some benefits and cons coupled with the rollout of vaccine passports or certificates. This paper takes up and extends this discussion by showing the results of a mini- narrative review we undertook with the aim of critically summarizing the existing scholarly research on the Green Pass in Italy. In analyzing the 12 included records, we explored the scientific viability of this measure, as well as the concerns and criticisms it has raised and the recommendations that have been proposed to address them, as a starting point to consider how the lesson learned in the Italian context can contribute to informing future reflections and strategies in view ofanother pandemic event.
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17
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“I Would Never Push a Vaccine on You”: A Qualitative Study of Social Norms and Pressure in Vaccine Behavior in the U.S. Vaccines (Basel) 2022; 10:vaccines10091402. [PMID: 36146480 PMCID: PMC9502292 DOI: 10.3390/vaccines10091402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 08/19/2022] [Accepted: 08/20/2022] [Indexed: 12/16/2022] Open
Abstract
Previous researchers have established the influence of social norms on vaccine behavior. However, little work has been performed contextualizing individuals’ experience with these social factors and how they operate to persuade individuals’ acceptance or refusal of a vaccine. We aimed to determine the mechanisms of familial and societal pressure or expectations that contribute to COVID-19 vaccine decision-making. We conducted four focus groups and eleven individual interviews (total n = 32) with participants from across the U.S. of different vaccination statuses. We identified three emergent themes: (1) Altruistic reasoning was particularly prevalent among initially hesitant late adopters—the desire to protect loved ones and others constituted a dominant motive, more powerful than protecting oneself. Vaccination was also reckoned as part of a joint effort to return to normal life; hence, it invoked a sense of responsibility or “obligation”; (2) expectation often became pressure; although most vaccinated participants stated that they respected others’ choices, late adopters or unvaccinated participants perceived differently and felt rushed or “forced” into choosing, and many resented being “targeted” or “bullied”; (3) vaccination status became a new label, frequently dividing families, thus producing familial mandates, exclusions, or social stratifications. This caused sadness and feelings of isolation, along with the formation of a camaraderie among the excluded unvaccinated. A vaccine decision builds from the complexities of individuals’ experiences and cultures. The vaccinated were not free of hesitancy nor were the unvaccinated all anti-vaxxers. Vigorous vaccine promotion successfully converted some undecided individuals but also fostered distrust of government; alarmingly, the push to receive the COVID-19 vaccine further triggered doubts about established vaccines. Communication strategies need to be developed and implemented carefully so as not to ostracize the unvaccinated community and strengthen their resistance.
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18
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Dubé E, Gagnon D, MacDonald N. Between persuasion and compulsion: The case of COVID-19 vaccination in Canada. Vaccine 2022; 40:3923-3926. [PMID: 35637068 PMCID: PMC9134169 DOI: 10.1016/j.vaccine.2022.05.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 04/19/2022] [Accepted: 05/19/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Eve Dubé
- Institut national de santé publique du Québec, Québec, Canada; Centre de recherche du CHU de Québec - Université Laval, Québec, Canada.
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19
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Abstract
OBJECTIVES While the development of vaccines against the Novel Coronavirus (COVID-19) brought hope of establishing herd immunity and ending the global pandemic, vaccine hesitancy can hinder the progress towards herd immunity. In this study, by analysing the data collected when citizens undergo public health restrictions due to the pandemic, we assess the determinants of vaccine hesitancy, reasons for hesitation and potential effectiveness of vaccine passports used to relax public health restrictions on mitigating vaccine hesitancy. DESIGN Cross-sectional study, longitudinal study and conjoint experimental design. SETTING An online survey conducted in Japan in July 2021. PARTICIPANTS A demographically representative sample of 5000 Japanese adults aged 20-74. PRIMARY OUTCOME MEASURES COVID-19 vaccination intention RESULTS: We found that about 30% of respondents did not intend to get vaccinated or had not yet decided, with major reasons for vaccine hesitancy relating to concerns about the safety and side effects of the vaccine. In line with previous findings, younger age, lower socioeconomic status, and psychological and behavioural factors such as weaker COVID-19 fear were associated with vaccine hesitancy. Easing of public health restrictions such as travel, wearing face masks and dining out at night was associated with an increase in vaccine acceptance by 4%-10%. Moreover, we found that more than 90% of respondents who intended to get vaccinated actually received it while smaller proportions among those undecided and unwilling to get vaccinated did so. CONCLUSION With a major concern about vaccine safety and side effects, interventions to mitigate against these may help to reduce vaccine hesitancy. Moreover, when citizens are imposed with restrictions, vaccine passports that increase their freedom may be helpful to increase vaccination rates.
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Affiliation(s)
- Shohei Okamoto
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Tokyo, Japan
- Institute for Global Health Policy Research, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan
- Research Center for Financial Gerontology, Keio University, Minato-ku, Tokyo, Japan
| | - Kazuki Kamimura
- Research Center for Financial Gerontology, Keio University, Minato-ku, Tokyo, Japan
- Hirao School of Management, Konan University, Nishinomiya, Hyogo, Japan
| | - Kohei Komamura
- Research Center for Financial Gerontology, Keio University, Minato-ku, Tokyo, Japan
- Faculty of Economics, Keio University, Minato-ku, Tokyo, Japan
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20
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EL Hassan ELW, Abu Alhommos AK, Aliadhy D, Alsalman S, Alnafaa O, Mohamed A. Public Knowledge, Beliefs and Attitudes toward the COVID-19 Vaccine in Saudi Arabia: A Cross-Sectional Study. Healthcare (Basel) 2022; 10:healthcare10050853. [PMID: 35627990 PMCID: PMC9140746 DOI: 10.3390/healthcare10050853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/29/2022] [Accepted: 04/30/2022] [Indexed: 12/04/2022] Open
Abstract
Background: With the help of vaccines, the world has witnessed a substantial decrease and even the eradication of many infectious diseases. Many factors influenced the public’s acceptance and compliance with the COVID-19 vaccine. Methods: This is a cross-sectional study that was conducted in Saudi Arabia. The questionnaire link was distributed through social media platforms. The questionnaire tool assessed the participants’ general knowledge and the barriers to taking the COVID-19 vaccine. All people who are currently living in Saudi Arabia and are at least 16 years old were included in the study and formed the study population. Based on our inclusion criteria, a total of 2,198 individuals were enrolled in this study. Results: Participants who were willing to take the vaccine were 68%. After vaccination, 10% of the participants think they can stop wearing face masks and washing their hands. Two-thirds of the participants think that the vaccine is effective in preventing COVID-19 infection. A total of 44.0% of the participants were afraid of the vaccine. The most common reasons were fear of unknown side effects (53.9%) and believing that the vaccine was not tested enough (27%). More than half of the study participants had a preference for receiving the Pfizer vaccine (52%). Conclusion: The public’s acceptance of the COVID-19 vaccine in Saudi Arabia is insufficient. Unknown side effects, widespread misconceptions, and a lack of adequate safety trials are all important reasons for concern among Saudis. More educational materials and awareness efforts will help to alleviate the fear that surrounds it. This will boost the vaccine’s acceptance rate in the long run.
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21
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Bardosh K, de Figueiredo A, Gur-Arie R, Jamrozik E, Doidge J, Lemmens T, Keshavjee S, Graham JE, Baral S. The unintended consequences of COVID-19 vaccine policy: why mandates, passports and restrictions may cause more harm than good. BMJ Glob Health 2022; 7:e008684. [PMID: 35618306 PMCID: PMC9136690 DOI: 10.1136/bmjgh-2022-008684] [Citation(s) in RCA: 103] [Impact Index Per Article: 51.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 05/05/2022] [Indexed: 11/04/2022] Open
Abstract
Vaccination policies have shifted dramatically during COVID-19 with the rapid emergence of population-wide vaccine mandates, domestic vaccine passports and differential restrictions based on vaccination status. While these policies have prompted ethical, scientific, practical, legal and political debate, there has been limited evaluation of their potential unintended consequences. Here, we outline a comprehensive set of hypotheses for why these policies may ultimately be counterproductive and harmful. Our framework considers four domains: (1) behavioural psychology, (2) politics and law, (3) socioeconomics, and (4) the integrity of science and public health. While current vaccines appear to have had a significant impact on decreasing COVID-19-related morbidity and mortality burdens, we argue that current mandatory vaccine policies are scientifically questionable and are likely to cause more societal harm than good. Restricting people's access to work, education, public transport and social life based on COVID-19 vaccination status impinges on human rights, promotes stigma and social polarisation, and adversely affects health and well-being. Current policies may lead to a widening of health and economic inequalities, detrimental long-term impacts on trust in government and scientific institutions, and reduce the uptake of future public health measures, including COVID-19 vaccines as well as routine immunisations. Mandating vaccination is one of the most powerful interventions in public health and should be used sparingly and carefully to uphold ethical norms and trust in institutions. We argue that current COVID-19 vaccine policies should be re-evaluated in light of the negative consequences that we outline. Leveraging empowering strategies based on trust and public consultation, and improving healthcare services and infrastructure, represent a more sustainable approach to optimising COVID-19 vaccination programmes and, more broadly, the health and well-being of the public.
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Affiliation(s)
- Kevin Bardosh
- School of Public Health, University of Washington, Seattle, Washington, USA
- Division of Infection Medicine, University of Edinburgh, Edinburgh, UK
| | - Alex de Figueiredo
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Rachel Gur-Arie
- Berman Institute of Bioethics, Johns Hopkins University, Baltimore, Maryland, USA
- Oxford-Johns Hopkins Global Infectious Disease Collaborative (GLIDE), University of Oxford, Oxford, UK
| | - Euzebiusz Jamrozik
- Oxford-Johns Hopkins Global Infectious Disease Collaborative (GLIDE), University of Oxford, Oxford, UK
- Ethox and the Wellcome Centre for Ethics and Humanities, University of Oxford, Oxford, UK
| | - James Doidge
- Intensive Care National Audit and Research Centre (ICNARC), London, UK
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - Trudo Lemmens
- Faculty of Law and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Salmaan Keshavjee
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Janice E Graham
- Department of Pediatrics (Infectious Diseases), Dalhousie University, Halifax, Nova Scotia, Canada
| | - Stefan Baral
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland, USA
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22
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Digregorio M, Van Ngoc P, Delogne S, Meyers E, Deschepper E, Duysburgh E, De Rop L, De Burghgraeve T, Coen A, De Clercq N, Sutter AD, Verbakel JY, Cools P, Heytens S, Buret L, Scholtes B. Vaccine Hesitancy towards the COVID-19 Vaccine in a Random National Sample of Belgian Nursing Home Staff Members. Vaccines (Basel) 2022; 10:vaccines10040598. [PMID: 35455347 PMCID: PMC9028198 DOI: 10.3390/vaccines10040598] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/08/2022] [Accepted: 04/10/2022] [Indexed: 02/01/2023] Open
Abstract
In Belgium, nursing home staff (NHS) and residents were prioritised for COVID-19 vaccination. However, vaccine hesitancy may have impacted vaccination rates. In this study, a random stratified sample of NHS (N = 1142), vaccinated and unvaccinated, completed an online questionnaire on COVID-19 vaccine hesitancy (between 31 July and 15 November 2021). NHS who hesitated or refused the vaccine were asked for the main reason for their hesitation/refusal. Those who hesitated, but eventually accepted vaccination, were asked why they changed their minds. Overall, 29.5% of all respondents hesitated before accepting vaccination, were still hesitating, or refused vaccination. Principal reasons were fear of unknown future effects (55.1% of vaccinated participants that hesitated and 19.5% who refused), fear of side-effects (12.7% of vaccinated participants that hesitated and 12.2% who refused), and mistrust in vaccination (10.5% of vaccinated participants that hesitated and 12.2% who refused). For vaccinated participants who hesitated initially, protecting the vulnerable was the main reason they changed their minds. Given this degree of fear and proposals to mandate vaccination among healthcare workers, communicating with NHS on the safety and efficacy of the vaccine should be prioritised.
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Affiliation(s)
- Marina Digregorio
- Research Unit of Primary Care and Health, Department of General Medicine, Faculty of Medicine, University of Liège, 4000 Liège, Belgium; (S.D.); (L.B.); (B.S.)
- Correspondence: (M.D.); (P.V.N.)
| | - Pauline Van Ngoc
- Research Unit of Primary Care and Health, Department of General Medicine, Faculty of Medicine, University of Liège, 4000 Liège, Belgium; (S.D.); (L.B.); (B.S.)
- Correspondence: (M.D.); (P.V.N.)
| | - Simon Delogne
- Research Unit of Primary Care and Health, Department of General Medicine, Faculty of Medicine, University of Liège, 4000 Liège, Belgium; (S.D.); (L.B.); (B.S.)
| | - Eline Meyers
- Department of Diagnostic Sciences, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium; (E.M.); (P.C.)
| | - Ellen Deschepper
- Biostatistics Unit, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium;
| | - Els Duysburgh
- Department of Epidemiology and Public Health, Sciensano, 1050 Brussels, Belgium;
| | - Liselore De Rop
- EPI-Centre, Department of Public Health and Primary Care, KU Leuven, 3000 Leuven, Belgium; (L.D.R.); (T.D.B.); (J.Y.V.)
| | - Tine De Burghgraeve
- EPI-Centre, Department of Public Health and Primary Care, KU Leuven, 3000 Leuven, Belgium; (L.D.R.); (T.D.B.); (J.Y.V.)
| | - Anja Coen
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium; (A.C.); (N.D.C.); (A.D.S.); (S.H.)
| | - Nele De Clercq
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium; (A.C.); (N.D.C.); (A.D.S.); (S.H.)
| | - An De Sutter
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium; (A.C.); (N.D.C.); (A.D.S.); (S.H.)
| | - Jan Y. Verbakel
- EPI-Centre, Department of Public Health and Primary Care, KU Leuven, 3000 Leuven, Belgium; (L.D.R.); (T.D.B.); (J.Y.V.)
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK
| | - Piet Cools
- Department of Diagnostic Sciences, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium; (E.M.); (P.C.)
| | - Stefan Heytens
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium; (A.C.); (N.D.C.); (A.D.S.); (S.H.)
| | - Laëtitia Buret
- Research Unit of Primary Care and Health, Department of General Medicine, Faculty of Medicine, University of Liège, 4000 Liège, Belgium; (S.D.); (L.B.); (B.S.)
| | - Beatrice Scholtes
- Research Unit of Primary Care and Health, Department of General Medicine, Faculty of Medicine, University of Liège, 4000 Liège, Belgium; (S.D.); (L.B.); (B.S.)
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23
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Bodas M, Kaim A, Velan B, Ziv A, Jaffe E, Adini B. Overcoming the effect of pandemic fatigue on vaccine hesitancy-Will belief in science triumph? J Nurs Scholarsh 2022; 55:262-271. [PMID: 35388958 PMCID: PMC9115056 DOI: 10.1111/jnu.12778] [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: 03/01/2022] [Revised: 03/23/2022] [Accepted: 03/24/2022] [Indexed: 02/07/2023]
Abstract
PURPOSE The study aims to examine the factors that impact vaccination uptake and additional protective behavior during the fourth wave of the pandemic in Israel, whereas the "pandemic fatigue" phenomenon has been identified as a hurdle to adherence to protective health behaviors against coronavirus disease 2019 (COVID-19). DESIGN A cross-sectional, structured questionnaire was utilized for this investigation in September 2021, during the fourth wave of the pandemic. METHODS A sample of the adult (18+) Israeli population was employed for the study. Recruiting participants for the study was conducted through an online internet panel company that consists of over 100,000 members, representing all geographic and demographic sectors of the Israeli population. RESULTS Our findings indicate that pandemic fatigue has begun to have cascading effects on vaccination efforts. In particular, this study found that at this stage of the COVID-19 pandemic, trust in authorities, and even threat perception components, such as concern and fear of contracting the disease, are incapable of predicting vaccination uptake. Instead, perception of the importance of the vaccine and its effectiveness are predictive of vaccination uptake. CONCLUSION The findings indicate that at this stage of the pandemic, focusing on the robustness of the science behind the vaccine is more important than trying to regain public trust. The findings also suggest that risk communication employing fear tactics is losing its capacity to generate motivation for vaccination. CLINICAL RELEVANCE The findings of this study reveal lessons learned from the COVID-19 global pandemic. Specifically, the study reveals how in times of prolonged crisis, we can currently and, in the future, prepare improved strategies for public communication in order to promote uptake of protective health behavior, such as vaccination.
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Affiliation(s)
- Moran Bodas
- Department of Emergency & Disaster Management, School of Public Health, Faculty of MedicineTel‐Aviv UniversityTel‐Aviv‐YafoIsrael,National Center for Trauma & Emergency Medicine Research, The Gertner Institute for Epidemiology & Health Policy ResearchSheba Medical CenterTel‐HaShomerIsrael
| | - Arielle Kaim
- Department of Emergency & Disaster Management, School of Public Health, Faculty of MedicineTel‐Aviv UniversityTel‐Aviv‐YafoIsrael,National Center for Trauma & Emergency Medicine Research, The Gertner Institute for Epidemiology & Health Policy ResearchSheba Medical CenterTel‐HaShomerIsrael
| | - Baruch Velan
- The Computerization and Information Division, The Gertner Institute for Epidemiology & Health Policy ResearchSheba Medical CenterTel‐HaShomerIsrael
| | - Arnona Ziv
- The Computerization and Information Division, The Gertner Institute for Epidemiology & Health Policy ResearchSheba Medical CenterTel‐HaShomerIsrael
| | - Eli Jaffe
- Magen David Adom (the Israeli Red Cross)Tel AvivIsrael,Medical SchoolBen Gurion University in the NegevBeer‐ShebaIsrael
| | - Bruria Adini
- Department of Emergency & Disaster Management, School of Public Health, Faculty of MedicineTel‐Aviv UniversityTel‐Aviv‐YafoIsrael
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24
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Pre-Vaccination Stress, Post-Vaccination Adverse Reactions, and Attitudes towards Vaccination after Receiving the COVID-19 Vaccine among Health Care Workers. Vaccines (Basel) 2022; 10:vaccines10030401. [PMID: 35335033 PMCID: PMC8952304 DOI: 10.3390/vaccines10030401] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 03/02/2022] [Accepted: 03/03/2022] [Indexed: 02/05/2023] Open
Abstract
The vaccines against COVID-19 are the best treatment for limiting the spread of the epidemic, and from an individual point of view, for avoiding getting sick. A cross-sectional retrospective survey was conducted from 15 May to 15 July 2021 among healthcare workers, including doctors, nurses, midwives, and students at the Medical University of Lodz (nursing, midwifery and medical students) in Poland. Data were obtained from 1080 participants. The aim of the study was to evaluate vaccination coverage against COVID-19 among healthcare workers (HCWs) in Poland, and to analyze their attitude towards the available vaccines, stress before taking, and side effects after administrating them, and motivation towards continuing vaccination in the future (if necessary). The survey also estimated the frequency and quality of adverse post-vaccination reactions after two doses of BioNTech/Pfizer and two doses of AstraZeneca vaccines. The present study revealed that the vaccination ratio after 6 months from the start of vaccination against COVID-19 in Poland among HCWs was very high at 91.2%. However, doctors and medical students were more likely to be vaccinated than nurses and midwives, and nursing and midwifery students (94.8%, 98.3% vs. 78.9% and 86.3%, respectively). The main reasons that HCWs reported receiving a vaccination were to protect the health of themselves and their families, while the main reasons for avoiding a vaccination were fear of side effects, doubts about effectiveness, and an expedited clinical trial process of vaccines. Furthermore, more than two-thirds of those vaccinated reported side effects after receiving at least one dose of the vaccine. Most of the side effects were short-term symptoms with only slight and moderate intensification. The univariate and multivariate logistic regressions showed that the type of vaccine used had a significant impact on the occurrence of adverse post-vaccination effects and the severity and duration of vaccination symptoms. In addition, chronic disease and fear of vaccination also had some influence. Despite this, most participants (more often older than younger participants; p < 0.001) were in favor of compulsory vaccination against COVID-19 for HCWs.
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25
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Ishengoma F. NFC-Blockchain Based COVID-19 Immunity Certificate: Proposed System and Emerging Issues. INFORMATION TECHNOLOGY AND MANAGEMENT SCIENCE 2021. [DOI: 10.7250/itms-2021-0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Vaccine requirements are becoming more mandatory in several countries as public health experts and governments become more concerned about the COVID-19 pandemic and its variants. In the meantime, as the number of vaccine requirements grows, so does the counterfeiting of vaccination documents. Fake vaccination certificates are steadily growing, being sold online and on the dark web. Due to the nature of the COVID-19 pandemic, there is a need of robust authentication mechanisms that support touch-less technologies like Near Field Communication (NFC). Thus, in this paper, a blockchain-NFC based COVID-19 Digital Immunity Certificate (DIC) system is proposed. The vaccination data are first encrypted by the Advanced Encryption Standard (AES) algorithm on Hadoop Distributed File System (HDFS) and then uploaded to the blockchain. The proposed system is based on the amalgamation of NCF and blockchain technologies which can mitigate the issue of fake vaccination certificates. Furthermore, the emerging issues of employing the proposed system are discussed with future directions.
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Waitzberg R, Triki N, Alroy-Preis S, Lotan T, Shiran L, Ash N. The Israeli Experience with the "Green Pass" Policy Highlights Issues to Be Considered by Policymakers in Other Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11212. [PMID: 34769731 PMCID: PMC8582817 DOI: 10.3390/ijerph182111212] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 10/21/2021] [Accepted: 10/22/2021] [Indexed: 02/07/2023]
Abstract
In the first half of 2021, Israel had been ahead of other countries concerning the speed of its rollout and coverage of COVID-19 vaccinations. During that time, Israel had implemented a vaccine certificate policy, the "Green Pass Policy" (GPP), to reduce virus spread and to allow the safe relaxation of COVID-19 restrictions in a time of great uncertainty. Based on an analysis of GPP regulations and public statements compiled from the Israeli Ministry of Health website, we describe the design and implementation of the GPP. We also look back and discuss lessons learned for countries that are considering a GPP policy, given the current upsurge of the Delta variant as of summer 2021. To reduce equity concerns when introducing a GPP, all population groups should be eligible for the vaccine (contingent on approval from the manufacturer) and have access to it. Alternatively, health authorities can grant temporary certificates based on a negative test. We also highlight the fact that in practice, there will be gaps between the GPP regulations and implementation. While some places might require a GPP without legal need, others will not implement it despite a legal obligation. The GPP regulations should have standardised epidemiological criteria, be implemented gradually, remain flexible, and change according to the epidemiological risks.
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Affiliation(s)
- Ruth Waitzberg
- Department of Health Care Management, Faculty of Economics & Management, Technische Universität, 10623 Berlin, Germany
- Department of Health Policy and Management, School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel
- The Smokler Center for Health Policy Research, Myers-JDC-Brookdale Institute, Jerusalem 91037, Israel
| | - Noa Triki
- Ministry of Health, Jerusalem 9101002, Israel; (N.T.); (N.A.)
| | - Sharon Alroy-Preis
- Public Health Services, Ministry of Health, Jerusalem 9101002, Israel; (S.A.-P.); (L.S.)
| | - Tomer Lotan
- Ministry of Public Security, Jerusalem 9103401, Israel;
| | - Liat Shiran
- Public Health Services, Ministry of Health, Jerusalem 9101002, Israel; (S.A.-P.); (L.S.)
| | - Nachman Ash
- Ministry of Health, Jerusalem 9101002, Israel; (N.T.); (N.A.)
- Department of Health Systems Management, School of Health Sciences, Ariel University, Ariel 40700, Israel
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Gallè F, Sabella EA, Roma P, Da Molin G, Diella G, Montagna MT, Ferracuti S, Liguori G, Orsi GB, Napoli C. Acceptance of COVID-19 Vaccination in the Elderly: A Cross-Sectional Study in Southern Italy. Vaccines (Basel) 2021; 9:1222. [PMID: 34835152 PMCID: PMC8618111 DOI: 10.3390/vaccines9111222] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 10/16/2021] [Accepted: 10/19/2021] [Indexed: 12/24/2022] Open
Abstract
In Italy, at the end of 2020, a voluntary immunization plan against COVID-19 was introduced, involving elderly among the first target categories. The aim of this study was to assess, through an online questionnaire, the acceptance of COVID-19 vaccination in a sample of older adults from southern Italy. Of a total of 1041 respondents (41.7% males, mean age 76.6 ± 6.5), 965 (92.7%) were vaccinated or willing to be vaccinated against COVID-19, although less than half of the sample was favorable to vaccinations and agreed with mandatory immunization. Acceptance of COVID-19 vaccination was found to be positively related with higher educational level (OR = 1.875, CI95% = 1.113-3.161; p = 0.018) and having social/mass media as a main source of information (OR = 2.415 CI95% = 1.358-4.296, p = 0.003). On the contrary, an inverse relationship was found between acceptance of COVID-19 vaccination and having fulfilled the questionnaire after the introduction of green pass (OR = 0.218, CI95% = 0.129-0.369; p < 0.001). Therefore, although this evidence needs to be further confirmed, it is possible to agree with previous studies reporting that compulsory measures, such as green pass implementation, must be accompanied by effective education and information strategies of the target population.
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Affiliation(s)
- Francesca Gallè
- Department of Movement Sciences and Wellbeing, University of Naples “Parthenope”, 80133 Naples, Italy;
| | - Elita Anna Sabella
- Inter-University Research Centre “Population, Environment and Health”, University of Bari Aldo Moro, 70121 Bari, Italy; (E.A.S.); (G.D.M.)
| | - Paolo Roma
- Department of Human Neurosciences, “Sapienza” University of Rome, 00185 Rome, Italy; (P.R.); (S.F.)
| | - Giovanna Da Molin
- Inter-University Research Centre “Population, Environment and Health”, University of Bari Aldo Moro, 70121 Bari, Italy; (E.A.S.); (G.D.M.)
| | - Giusy Diella
- Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, 70124 Bari, Italy; (G.D.); (M.T.M.)
| | - Maria Teresa Montagna
- Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, 70124 Bari, Italy; (G.D.); (M.T.M.)
| | - Stefano Ferracuti
- Department of Human Neurosciences, “Sapienza” University of Rome, 00185 Rome, Italy; (P.R.); (S.F.)
| | - Giorgio Liguori
- Department of Movement Sciences and Wellbeing, University of Naples “Parthenope”, 80133 Naples, Italy;
| | - Giovanni Battista Orsi
- Department of Public Health and Infectious Diseases, “Sapienza” University of Rome, 00185 Rome, Italy;
| | - Christian Napoli
- Department of Medical Surgical Sciences and Translational Medicine, “Sapienza” University of Rome, 00189 Rome, Italy;
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Hu M, Jia H, Xie Y. Passport to a Mighty Nation: Exploring Sociocultural Foundation of Chinese Public's Attitude to COVID-19 Vaccine Certificates. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10439. [PMID: 34639739 PMCID: PMC8507679 DOI: 10.3390/ijerph181910439] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 09/30/2021] [Accepted: 10/02/2021] [Indexed: 12/14/2022]
Abstract
Vaccination against COVID-19 is essential against the pandemic. There are broad discussions on adopting certificates for vaccination and the immunity obtained after infection. Based on a national sample of over 2000 participants administered in April 2021, the current study examines the Chinese public's attitudes to the so-called COVID-19 vaccination passport and factors contributing to their viewpoints. Generally, the Chinese people had favorable opinions on the passport. Among possible contributing factors, income, personal benefit perception, the subjective norm of COVID-19 vaccination, and nationalism were significantly associated with the public's positive attitude. At the same time, general vaccine knowledge and scientific literacy had an inconstant effect. Echoing recent studies, these findings reveal a collectivism-oriented attitude of the Chinese public towards the proposal to certify vaccination publicly. Theoretical and practical implications of the results were discussed.
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Affiliation(s)
| | - Hepeng Jia
- School of Communication, Soochow University, Suzhou 215123, China; (M.H.); (Y.X.)
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