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Chen G, Yao Y, Zhang Y, Zhao F. The impact of risk perception and institutional trust on COVID-19 vaccine hesitancy in China. Hum Vaccin Immunother 2024; 20:2301793. [PMID: 38282324 PMCID: PMC10826627 DOI: 10.1080/21645515.2024.2301793] [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: 10/26/2023] [Accepted: 01/01/2024] [Indexed: 01/30/2024] Open
Abstract
Vaccination has become the primary means for citizens to prevent severe morbidity and mortality during the pandemic. However, vaccine hesitancy poses a major threat to global public health security. Based on the data from Chinese General Social Survey in 2021, this study aims to explore the socio-political aspects of COVID-19 vaccine hesitancy, focusing on the relationship between COVID-19 risk perceptions, institutional trust and vaccine hesitancy. Among the samples, 39.8% of the respondents exhibited COVID-19 vaccine hesitancy, 48.9% had a high awareness of the risk of COVID-19, and 74.6% presented a high level of trust in institutions. The results showed that higher risk perception and institutional trust are negatively correlated with vaccine hesitancy (p < .001). Institutional trust had no statistically significant moderating effect on the association between risk perception and vaccine hesitancy, but the role of institutional trust in influencing vaccine hesitancy is more significant at a lower level of perceptions of COVID-19 risk. Furthermore, regional variations in the factors contributing to vaccine hesitancy were demonstrated in China. These findings have important implications for developing strategies to address vaccine hesitancy.
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Affiliation(s)
- Guiwu Chen
- Department of Public Administration, School of Public Administration and Emergency Mangement, Jinan University, Guangzhou, Guangdong, China
| | - Yiyun Yao
- Department of Public Administration, School of Public Administration and Emergency Mangement, Jinan University, Guangzhou, Guangdong, China
| | - Yaowen Zhang
- The Department of Rehabilitation Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
- Master of Public Administration Education Center, School of Public Administration and Emergency Mangement, Jinan University, Guangzhou, Guangdong, China
| | - Fei Zhao
- The Department of Rehabilitation Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
- Master of Public Administration Education Center, School of Public Administration and Emergency Mangement, Jinan University, Guangzhou, Guangdong, China
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Shen Z, Li Q, Wu J, Zhu D, Bai J, Ren R, Zhang J, Li Y, Wang M, Gu J, Li Y, Dong W, Wang H, Sun T, Yang F, Zhou X, Yang J, Tarimo CS, Ma M, Feng Y, Miao Y. Dynamic evolution of COVID-19 vaccine hesitancy over 2021-2023 among Chinese population: Repeated nationwide cross-sectional study. J Med Virol 2024; 96:e29800. [PMID: 39014958 DOI: 10.1002/jmv.29800] [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: 04/22/2024] [Revised: 06/29/2024] [Accepted: 07/04/2024] [Indexed: 07/18/2024]
Abstract
Globally, the rollout of COVID-19 vaccine had been faced with a significant barrier in the form of vaccine hesitancy. This study adopts a multi-stage perspective to explore the prevalence and determinants of COVID-19 vaccine hesitancy, focusing on their dynamic evolutionary features. Guided by the integrated framework of the 3Cs model (complacency, confidence, and convenience) and the EAH model (environmental, agent, and host), this study conducted three repeated national cross-sectional surveys. These surveys carried out from July 2021 to February 2023 across mainland China, targeted individuals aged 18 and older. They were strategically timed to coincide with three critical vaccination phases: universal coverage (stage 1), partial coverage (stage 2), and key population coverage (stage 3). From 2021 to 2023, the surveys examined sample sizes of 29 925, 6659, and 5407, respectively. The COVID-19 vaccine hesitation rates increased from 8.39% in 2021 to 29.72% in 2023. Urban residency, chronic condition, and low trust in vaccine developer contributed to significant COVID-19 vaccine hesitancy across the pandemic. Negative correlations between the intensity of vaccination policies and vaccine hesitancy, and positive correlations between vaccine hesitancy and long COVID, were confirmed. This study provides insights for designing future effective vaccination programs for emerging vaccine-preventable infectious X diseases.
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Affiliation(s)
- Zhanlei Shen
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- Henan Province Engineering Research Center of Health Economy & Health Technology Assessment, Zhengzhou, China
| | - Quanman Li
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- Henan Province Engineering Research Center of Health Economy & Health Technology Assessment, Zhengzhou, China
| | - Jian Wu
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- Henan Province Engineering Research Center of Health Economy & Health Technology Assessment, Zhengzhou, China
| | - Dongfang Zhu
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- Henan Province Engineering Research Center of Health Economy & Health Technology Assessment, Zhengzhou, China
| | - Junwen Bai
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- Henan Province Engineering Research Center of Health Economy & Health Technology Assessment, Zhengzhou, China
| | - Ruizhe Ren
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- Henan Province Engineering Research Center of Health Economy & Health Technology Assessment, Zhengzhou, China
| | - Jingbao Zhang
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- Henan Province Engineering Research Center of Health Economy & Health Technology Assessment, Zhengzhou, China
| | - Yi Li
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- Henan Province Engineering Research Center of Health Economy & Health Technology Assessment, Zhengzhou, China
| | - Meiyun Wang
- Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Henan, China
| | - Jianqin Gu
- School of Medicine, Southern University of Science and Technology, Guangdong, China
| | - Yinfei Li
- Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Henan, China
| | - Wenyong Dong
- Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Henan, China
| | - Haipeng Wang
- Center for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Tao Sun
- Department of Health Policy and Management, School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Fan Yang
- School of Public Health, Fudan University, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Xue Zhou
- College of Health Management, Mudanjiang Medical University, Mudanjiang, Heilongjiang, China
| | - Jian Yang
- Department of Global Health, School of Public Health, Peking University, Beijing, China
| | - Clifford Silver Tarimo
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- Henan Province Engineering Research Center of Health Economy & Health Technology Assessment, Zhengzhou, China
| | - Mingze Ma
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- Henan Province Engineering Research Center of Health Economy & Health Technology Assessment, Zhengzhou, China
| | - Yifei Feng
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- Henan Province Engineering Research Center of Health Economy & Health Technology Assessment, Zhengzhou, China
| | - Yudong Miao
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- Henan Province Engineering Research Center of Health Economy & Health Technology Assessment, Zhengzhou, China
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Yim VWC, Wang Q, Li Y, Qin C, Tang W, Tang S, Jit M, Smith JS, Larson HJ, Tucker JD, Li J, Lin L, Wu D. Between now and later: a mixed methods study of HPV vaccination delay among Chinese caregivers in urban Chengdu, China. BMC Public Health 2024; 24:183. [PMID: 38225563 PMCID: PMC10790461 DOI: 10.1186/s12889-024-17697-6] [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: 05/25/2023] [Accepted: 01/08/2024] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND Adolescent girls in China have a low HPV vaccination rate. Although vaccination is recommended by the Chinese health authorities, the cost is not covered by the national immunisation programme. Vaccination delay, among other reasons such as supply shortage and poor affordability, may contribute to low uptake. This sequential mixed methods study aimed to identify potential factors of delayed HPV vaccination among Chinese adolescent girls. METHODS Quantitative data about the attitudes and perceptions of HPV vaccination were collected from 100 caregivers of 14-18-year-old girls using an online survey in Chengdu, China. The survey data informed a subsequent qualitative study using four focus group discussions. We conducted a descriptive analysis of the survey data and a thematic analysis of the qualitative data. The findings were interpreted using a health behaviour model adapted from the Health Belief Model and the Andersen's Behavioural Model for Health Services Use. RESULTS A total of 100 caregivers - 85 were mothers and 15 were fathers - participated in the survey; 21 caregivers joined focus group discussions. When asked about their intended course of action if the 9vHPV vaccine was out-of-stock, 74% chose to delay until the 9vHPV vaccine is available while 26% would consider 2vHPV or 4vHPV vaccines or seek alternative ways to procure the vaccine. Qualitative results confirmed that caregivers preferred delaying HPV vaccination for adolescent girls. The intent to delay was influenced by systemic barriers such as supply shortage and individual-level factors such as a preference for the 9vHPV vaccine, safety concerns, inadequate health communication, and the belief that adolescents were unlikely to be sexually active. CONCLUSION In urban areas, Chinese caregivers' intent to delay vaccination in favour of 9vHPV vaccine over receiving the more accessible options was influenced by a mix of individual and contextual factors. Focussed health communication strategies are needed to accelerate HPV vaccination among adolescents.
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Affiliation(s)
| | - Qianyun Wang
- Department of Social Welfare, University of California, Los Angeles, USA
- SESH (Social Entrepreneurship to Spur Health) Team, Guangzhou, China
| | - Yifan Li
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Chuanyun Qin
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Weiming Tang
- School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- SESH (Social Entrepreneurship to Spur Health) Team, Guangzhou, China
| | - Shenglan Tang
- Global Health Research Centre, Duke Kunshan University, Jiangsu, China
- Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Mark Jit
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, GB, UK
| | - Jennifer S Smith
- Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Heidi J Larson
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, GB, UK
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA
| | - Joseph D Tucker
- School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- SESH (Social Entrepreneurship to Spur Health) Team, Guangzhou, China
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, Room 360, Keppel St, London, WC1E 7HT, UK
| | - Jing Li
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Leesa Lin
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, GB, UK
- Laboratory of Data Discovery for Health Limited (D24H), Hong Kong Science Park, Hong Kong SAR, China
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Dan Wu
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA.
- Department of Social Medicine and Health Education, School of Public Health of Nanjing Medical University, No. 101 Longmian Avenue, Nanjing Jiangsu, China.
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Brnic S, Buric B, Marcec R, Likic R. The relationship between vaccine acceptance and COVID-19 mortality in Europe: A Cross-Country analysis of public opinion and Epidemiological data. Vaccine X 2023; 15:100391. [PMID: 37772201 PMCID: PMC10522863 DOI: 10.1016/j.jvacx.2023.100391] [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: 05/07/2023] [Revised: 09/03/2023] [Accepted: 09/18/2023] [Indexed: 09/30/2023] Open
Abstract
Introduction More than two years after SARS-CoV-2 emerged in Wuhan, China, COVID-19 has become one of the most severe pandemics in modern human history. Prior to the widespread availability of specific vaccines in 2021, public opinion surveys indicated significant vaccine hesitancy in 26 European countries. Materials and methods Epidemiological data on COVID-19 morbidity and mortality for 26 European countries were collected in November 2021 and compared with the proportions of people willing to receive the SARS-CoV-2 vaccine according to public opinion surveys analysed in 2020. Correlations between various variables were calculated using the Pearson correlation test and visualized with the R programming language. Results Paired Student's t-test revealed no significant differences between survey results and actual vaccination rates (p = 0.9546), suggesting that the polls were good predictors. The percentage of people willing to receive the SARS-CoV-2 vaccine was significantly positively correlated with actual vaccination rates (R = 0.72, p = 0.00003) and significantly negatively correlated with the number of cumulative deaths per million people (R = -0.78, p = 0.0000024). However, there was no significant correlation with the number of cumulative cases per million people (R = -0.27, p = 0.18). These findings indicate that vaccines used in Europe were particularly effective at preventing severe COVID-19 and disease-related deaths, but did not necessarily provide strong protection against SARS-CoV-2 infection itself. Conclusion Encouraging widespread immunization through vaccination was crucial for rapidly improving the epidemiological situation in Europe.
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Affiliation(s)
- Stjepan Brnic
- School of Medicine, University of Zagreb, Šalata 3, Zagreb, Croatia
| | - Bruno Buric
- School of Medicine, University of Zagreb, Šalata 3, Zagreb, Croatia
| | - Robert Marcec
- School of Medicine, University of Zagreb, Šalata 3, Zagreb, Croatia
| | - Robert Likic
- School of Medicine, University of Zagreb, Šalata 3, Zagreb, Croatia
- Clinical Hospital Centre Zagreb, Department of Internal Medicine, Unit for Clinical Pharmacology, Kišpatićeva ul. 12, Zagreb, Croatia
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Phiriyasart F, Aimyong N, Jirapongsuwan A, Roseh N. COVID-19 vaccine hesitancy among older adult Thai Muslim people: A case-control study. Vaccine 2023; 41:6048-6054. [PMID: 37643925 DOI: 10.1016/j.vaccine.2023.08.050] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 08/06/2023] [Accepted: 08/19/2023] [Indexed: 08/31/2023]
Abstract
The highest death toll during the COVID-19 pandemic in Thailand was among unvaccinated older adults. Deaths among older adults in Narathiwat Province were related to a lower COVID-19 vaccination rate. This study explored the factors influencing COVID-19 vaccination hesitancy in a Muslim community with low vaccination rates. A case-control study was conducted with participants assigned to the unvaccinated "case" group and the vaccinated "control" group. The sample was Thai older adults who practiced Islam and lived in Narathiwat Province. Purposive sampling was conducted by selecting a case house and finding the control around the case house in a 1:2 ratio. This study included 141 participants with a median age of 67 years (interquartile range [IQR], 8). More than 80% of both groups were retired and lived with their extended relatives. More participants in the vaccinated group believed that vaccines could prevent death from COVID-19 than in the unvaccinated group. In the multivariable analysis, factors related to the low perceived importance of the COVID-19 vaccination (odds ratio [OR] = 2.63) and a lack of vaccine recommendation from religious leaders (OR = 4.67) significantly influenced COVID-19 vaccination refusal. The COVID-19 guidance from religious leaders and the perceived importance of COVID-19 vaccination influence vaccination uptake among Muslim older adults in Thailand.
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Affiliation(s)
- Farooq Phiriyasart
- MPH Program, Faculty of Public Health, Mahidol University and Su-ngai Kolok Hospital, Narathiwat Provincial Public Health Office, 96120, Thailand.
| | - Natnaree Aimyong
- Department of Epidemiology, Faculty of Public Health, Mahidol University, 10400, Thailand.
| | - Ann Jirapongsuwan
- Department of Public Health Nursing, Faculty of Public Health, Mahidol University, 10400, Thailand.
| | - Norisan Roseh
- Kampong Baru Community Public Healthcare Center, Social Medicine Department, Naradhiwas Rajanagarindra Hospital, Narathiwat Province 96000, Thailand.
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Karashiali C, Konstantinou P, Christodoulou A, Kyprianidou M, Nicolaou C, Karekla M, Middleton N, Kassianos AP. A qualitative study exploring the social contagion of attitudes and uptake of COVID-19 vaccinations. Hum Vaccin Immunother 2023; 19:2260038. [PMID: 37758300 PMCID: PMC10538449 DOI: 10.1080/21645515.2023.2260038] [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: 07/12/2023] [Accepted: 09/13/2023] [Indexed: 09/30/2023] Open
Abstract
Vaccination attitudes and uptake can spread within social networks. This study aims to understand the perceived social contagion mechanisms of vaccination uptake in the context of COVID-19 pandemic. Eleven semi-structured interviews were conducted following a purposive sampling of three hesitant, three anti- COVID-19 vaccine and five pro- COVID-19 vaccine (27% females). Thematic Analysis suggested two general themes reflecting the type of contagion: 1) information contagion and 2) behavior contagion. Transcending these themes was the notion of ownership of choice/decision. Almost all participants used the media and experts as the main source of information regarding vaccination. They influenced - and they were being influenced by - friends and family members with whom they share similar traits and attitudes and have a close relationship of trust and intimacy. Also, being exposed to positive attitudes and beliefs toward vaccination and COVID-19 vaccines, enhanced vaccination behaviors. However, the vaccination decision-making process was not perceived as a passive process - there was ownership over the decisions made. This study highlights the perceived mechanisms of social contagion. It also suggests that the meaning individuals pose on their social world is crucial on their decision-making. Policymakers are advised to consider including social networks of individuals and trusted sources (i.e. healthcare providers) when delivering interventions or educational campaigns on vaccinations.
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Affiliation(s)
| | | | - Andria Christodoulou
- Department of Social and Behavioral Sciences, European University Cyprus, Nicosia, Cyprus
| | - Maria Kyprianidou
- Department of Psychology, University of Cyprus, Nicosia, Cyprus
- Department of Nursing, Cyprus University of Technology, Limassol, Cyprus
| | | | - Maria Karekla
- Department of Psychology, University of Cyprus, Nicosia, Cyprus
| | - Nicos Middleton
- Department of Nursing, Cyprus University of Technology, Limassol, Cyprus
| | - Angelos P. Kassianos
- Department of Psychology, University of Cyprus, Nicosia, Cyprus
- Department of Nursing, Cyprus University of Technology, Limassol, Cyprus
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Liu J, Lu S, Zheng H. Analysis of Differences in User Groups and Post Sentiment of COVID-19 Vaccine Hesitators in Chinese Social-Media Platforms. Healthcare (Basel) 2023; 11:healthcare11091207. [PMID: 37174749 PMCID: PMC10177948 DOI: 10.3390/healthcare11091207] [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: 01/31/2023] [Revised: 04/18/2023] [Accepted: 04/20/2023] [Indexed: 05/15/2023] Open
Abstract
(1) Background: The COVID-19 epidemic is still global and no specific drug has been developed for COVID-19. Vaccination can both prevent infection and limit the spread of the epidemic. Eliminating hesitation to the COVID-19 vaccine and achieving early herd immunity is a common goal for all countries. However, efforts in this area have not been significant and there is still a long way to go to eliminate vaccine hesitancy. (2) Objective: This study aimed to uncover differences in the characteristics and sentiments of COVID-19 vaccine hesitators on Chinese social-media platforms and to achieve a classification of vaccine-hesitant groups. (3) Methods: COVID-19-vaccine-hesitation posts and user characteristics were collected on the Sina Microblog platform for posting times spanning one year, and posts were identified for hesitation types. Logistic regression was used to conduct user-group analysis. The differences in user characteristics between the various types of COVID-19 vaccine posts were analysed according to four user characteristics: gender, address type, degree of personal-information disclosure, and whether they followed health topics. Sentiment analysis was conducted using sentiment analysis tools to calculate the sentiment scores and sentiment polarity of various COVID-19 vaccine posts, and the K-W test was used to uncover the sentiment differences between various types of COVID-19-vaccine-hesitation posts. (4) Results: There are differences in the types of COVID-19-vaccine-hesitation posts posted by users with different characteristics, and different types of COVID-19-vaccine-hesitation posts differ in terms of sentiment. Differences in user attributes and user behaviors are found across the different COVID-19-vaccine-hesitation types. Ultimately, two COVID-19-vaccine-hesitant user groups were identified: Body-related and Non-bodily-related. Users who posted body-related vaccine-hesitation posts are more often female, disclose more personal information and follow health topics on social-media platforms. Users who posted non-bodily-related posts are more often male, disclose less personal information, and do not follow health topics. The average sentiment score for all COVID-19-vaccine-hesitant-type posts is less than 0.45, with negative-sentiment posts outweighing positive- and neutral-sentiment posts in each type, among which the "Individual rights" type is the most negative. (5) Conclusions: This paper complements the application of user groups in the field of vaccine hesitation, and the results of the analysis of group characteristics and post sentiment can help to provide an in-depth and comprehensive analysis of the concerns and needs of COVID-19 vaccine hesitators. This will help public-health agencies to implement more targeted strategies to eliminate vaccine hesitancy and improve their work related to the COVID-19 vaccine, with far-reaching implications for COVID-19-vaccine promotion and vaccination.
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Affiliation(s)
- Jingfang Liu
- School of Management, Shanghai University, No. 20, Chengzhong Road, Jiading District, Shanghai 201899, China
| | - Shuangjinhua Lu
- School of Management, Shanghai University, No. 20, Chengzhong Road, Jiading District, Shanghai 201899, China
| | - Huiqin Zheng
- School of Management, Shanghai University, No. 20, Chengzhong Road, Jiading District, Shanghai 201899, China
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Boragno P, Fiabane E, Taino I, Maffoni M, Sommovigo V, Setti I, Gabanelli P. Perceptions of COVID-19 Vaccines: Protective Shields or Threatening Risks? A Descriptive Exploratory Study among the Italian Population. Vaccines (Basel) 2023; 11:642. [PMID: 36992226 PMCID: PMC10054618 DOI: 10.3390/vaccines11030642] [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: 02/16/2023] [Revised: 03/06/2023] [Accepted: 03/07/2023] [Indexed: 03/16/2023] Open
Abstract
Although several quantitative studies have explored vaccine hesitancy, qualitative research on the factors underlying attitudes toward vaccination is still lacking. To fill this gap, this study aimed to investigate the general perceptions of COVID-19 vaccines among the Italian population with a qualitative approach. The sample included 700 Italian participants who completed an online survey. Open questions underwent a descriptive analysis for unveiling meaning categories, while differences in the prevalence of categories were calculated using chi-square or Fisher's exact tests. Vaccination was associated with the following seven main themes: 'safety', 'healthcare', 'vaccine delivery', 'progress', 'ambivalence', 'mistrust', and 'ethics'. Vaccinated individuals more frequently reported words related to the safety theme (χ2 = 46.7, p < 0.001), while unvaccinated individuals more frequently reported words related to mistrust (χ2 = 123, p < 0.001) and ambivalence (χ2 = 48.3, p < 0.001) themes. Working in the healthcare sector and being younger than 40 years affected the general perceptions of vaccination in terms of pro-vaccine attitudes. Unvaccinated individuals were more affected by the negative experiences of their acquaintances and manifested more distrust of scientific researchers, doctors, and pharmaceutical companies than vaccinated individuals. These findings suggest promoting collaborative efforts of governments, health policymakers, and media sources, including social media companies, in order to deal with cognitions and emotions supporting vaccine hesitancy.
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Affiliation(s)
- Paola Boragno
- Istituti Clinici Scientifici Maugeri IRCCS, Psychology Unit of Pavia Institute, 27100 Pavia, Italy
| | - Elena Fiabane
- Istituti Clinici Scientifici Maugeri IRCCS, Psychology Unit of Pavia Institute, 27100 Pavia, Italy
| | - Irene Taino
- Istituti Clinici Scientifici Maugeri IRCCS, Psychology Unit of Pavia Institute, 27100 Pavia, Italy
| | - Marina Maffoni
- Istituti Clinici Scientifici Maugeri IRCCS, Psychology Unit of Montescano Institute, 27040 Montescano, Italy
| | - Valentina Sommovigo
- Department of Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, 00185 Roma, Italy
| | - Ilaria Setti
- Unit of Applied Psychology, Department of Brain and Behavioural Sciences, University of Pavia, 27100 Pavia, Italy
| | - Paola Gabanelli
- Istituti Clinici Scientifici Maugeri IRCCS, Psychology Unit of Pavia Institute, 27100 Pavia, Italy
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9
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COVID-19 vaccine uptake and vaccine hesitancy in rural-to-urban migrant workers at the first round of COVID-19 vaccination in China. BMC Public Health 2023; 23:139. [PMID: 36658507 PMCID: PMC9851897 DOI: 10.1186/s12889-023-15068-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 01/16/2023] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Migration can be linked to the transmission of COVID-19. COVID-19 vaccine uptake and hesitancy among rural-to-urban migrant workers in China, the largest group of internal migrants in the world, has not been characterized. OBJECTIVE To investigate COVID-19 vaccine uptake and identify vaccine hesitancy-associated factors among rural-to-urban migrant workers in the first round of COVID-19 vaccination in China. METHODS A cross-sectional questionnaire-based survey was conducted, including 14,917 participants. Socio-demographics, COVID-19 vaccine uptake, vaccine hesitancy and its associated factors based on Vaccine Hesitancy Determinants Matrix (VHDM) were applied for the survey. Data were principally analyzed by logistic regression analysis. RESULTS The COVID-19 vaccine uptake and vaccine hesitancy rates were 7.1% and 57.7%, respectively. Vaccine hesitancy was strongly associated with VHDM, including individual factors (female, higher annual income and fewer medical knowledge), group factors (less family support, friend support and public opinion support), COVID-19 epidemic factors (lower fatality, infection and emotional distress) and vaccine factors (less vaccine necessity, vaccine safety, vaccine efficacy, vaccine importance and vaccine reliability). CONCLUSION The VHDM model has the potential utility in efforts to reduce COVID-19 vaccine hesitancy. Greater efforts should be put into addressing positive predictors associated with vaccine hesitancy.
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Rehman E, Rehman N, Akhlaq M, Hussain I, Holy O. COVID-19 vaccine reluctance and possible driving factors: A comparative assessment among pregnant and non-pregnant women. Front Public Health 2023; 10:1100130. [PMID: 36699898 PMCID: PMC9870249 DOI: 10.3389/fpubh.2022.1100130] [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: 11/16/2022] [Accepted: 12/19/2022] [Indexed: 01/11/2023] Open
Abstract
The coronavirus disease of 2019 (COVID-19) constitutes a serious threat to pregnant women. One of the key strategies for preventing and managing the COVID-19 epidemic is vaccination. Herd immunity is significantly hampered by COVID-19 vaccine reluctance, which poses a potential threat to population health. Therefore, the present work intends to ascertain the incidence and severity of COVID-19 vaccine hesitancy among Pakistani pregnant women, the determinants driving their decision, and a comparative assessment with non-pregnant participants. This cross-sectional survey was carried out from November 2021 to February 2022. The validated vaccination attitude examination (VAX) scale about vaccination reluctance was undertaken by participants, who were also required to indicate whether they would be inclined to acquire the COVID-19 vaccine along with the reasons for reluctance. In comparison to the non-pregnant category with 353 participants, the group of 372 pregnant participants who responded to the questionnaire had a much greater proportion of hesitant respondents. Likewise, contrasted to 31% of non-pregnant participants, about 40% of them attributed their willingness to get vaccinated against coronavirus to social media. They also demonstrated a considerably stronger mean score on all subcategories of the VAX measure. The adjusted odd ratio findings showed that the independent factors for vaccine reluctance appeared to be trusting rumors on social media (adj OR: 2.58), not being afraid of covid-19 (adj OR: 2.01), not believing in COVID-19 existence (adj OR: 2.53), and not believing in vaccines (adj OR: 4.25). Uncertainty about the COVID-19 vaccine is very prevalent among expectant mothers. The investigation accentuates the pressing need to administer COVID-19 vaccination to the general public, including expectant mothers who might be anxious about the vaccine.
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Affiliation(s)
- Erum Rehman
- School of Economics, Shandong University of Finance and Economics, Jinan, China
| | - Nadia Rehman
- Department of Mathematics, COMSATS University, Islamabad, Pakistan
| | - Muhammad Akhlaq
- Department of Pharmacy, Hazara University, Mansehra, Pakistan
| | - Iftikhar Hussain
- Department of Mathematical Sciences, Karakoram International University Gilgit, Gilgit, Pakistan
| | - Ondrej Holy
- Science and Research Center, Faculty of Health Sciences, Palacký University Olomouc, Olomouc, Czechia,*Correspondence: Ondrej Holy ✉
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11
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Tostrud L, Thelen J, Palatnik A. Models of determinants of COVID-19 vaccine hesitancy in non-pregnant and pregnant population: Review of current literature". Hum Vaccin Immunother 2022; 18:2138047. [PMID: 36345571 PMCID: PMC9746492 DOI: 10.1080/21645515.2022.2138047] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 09/26/2022] [Accepted: 10/15/2022] [Indexed: 11/09/2022] Open
Abstract
Vaccination has proven to be the most effective tool in controlling the COVID-19 pandemic. While pregnant individuals are considered to be a high-risk population and are more likely to experience adverse effects from COVID-19, vaccination rates among pregnant individuals are significantly lower than in the general population. The Health Belief Model (HBM), Theory of Planned Behavior (TPB), 3C model, 5C model, and 5A model have been used to assess vaccination hesitancy behaviors. In this paper, we review the use of each of these models to address vaccine hesitancy, with a focus on the pregnant population and the COVID-19 vaccine. The HBM, TPB, 3C model, and 5C model have demonstrated great versatility in their ability to evaluate, explain, and modify vaccine hesitancy and behavior. Up to date, the HBM and 3C models appear to be the most effective models to study and address vaccination hesitancy within the pregnant persons.
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Affiliation(s)
- Lauren Tostrud
- Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Julia Thelen
- Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Anna Palatnik
- Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
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12
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Khan YH, Rasheed M, Mallhi TH, Salman M, Alzarea AI, Alanazi AS, Alotaibi NH, Khan SUD, Alatawi AD, Butt MH, Alzarea SI, Alharbi KS, Alharthi SS, Algarni MA, Alahmari AK, Almalki ZS, Iqbal MS. Barriers and facilitators of childhood COVID-19 vaccination among parents: A systematic review. Front Pediatr 2022; 10:950406. [PMID: 36507133 PMCID: PMC9731120 DOI: 10.3389/fped.2022.950406] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Accepted: 09/14/2022] [Indexed: 11/25/2022] Open
Abstract
Background The acceptance of vaccination against COVID-19 among parents of young children plays a significant role in controlling the current pandemic. A wide range of factors that influence vaccine hesitancy in adults has been reported worldwide, but less attention has been given to COVID-19 vaccination among children. Vaccine hesitancy is considered a major challenge in achieving herd immunity, and it is more challenging among parents as they remain deeply concerned about their child's health. In this context, a systematic review of the current literature is inevitable to assess vaccine hesitancy among parents of young children to ensure a successful ongoing vaccination program. Method A systematic search of peer-reviewed English literature indexed in Google Scholar, PubMed, Embase, and Web of science was performed using developed keywords between 1 January 2020 and August 2022. This systematic review included only those studies that focused on parental concerns about COVID-19 vaccines in children up to 12 years without a diagnosis of COVID-19. Following PRISMA guidelines, a total of 108 studies were included. The quality appraisal of the study was performed by Newcastle-Ottawa Scale (NOS). Results The results of 108 studies depict that vaccine hesitancy rates differed globally with a considerably large number of factors associated with it. The highest vaccine hesitancy rates among parents were reported in a study from the USA (86.1%) and two studies from Saudi Arabia (>85%) and Turkey (89.6%). Conversely, the lowest vaccine hesitancy rates ranging from 0.69 and 2% were found in two studies from South Africa and Switzerland, respectively. The largest study (n = 227,740) was conducted in Switzerland while the smallest sample size (n = 12) was represented by a study conducted in the USA. The most commonly reported barriers to childhood vaccination were mothers' lower education level (N = 46/108, 43%), followed by financial instability (N = 19/108, 18%), low confidence in new vaccines (N = 13/108, 12%), and unmonitored social media platforms (N = 5/108, 4.6%). These factors were significantly associated with vaccine refusal among parents. However, the potential facilitators for vaccine uptake among respondents who intended to have their children vaccinated include higher education level (N = 12/108, 11%), followed by information obtained through healthcare professionals (N = 9/108, 8.3%) and strong confidence in preventive measures taken by the government (N = 5/81, 4.6%). Conclusion This review underscores that parents around the globe are hesitant to vaccinate their kids against COVID-19. The spectrum of factors associated with vaccine hesitancy and uptake varies across the globe. There is a dire need to address vaccine hesitancy concerns regarding the efficacy and safety of approved vaccines. Local context is inevitable to take into account while developing programs to reduce vaccine hesitancy. There is a dire need to devise strategies to address vaccine hesitancy among parents through the identification of attributing factors.
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Affiliation(s)
- Yusra Habib Khan
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka, Al-Jouf, Saudi Arabia
| | - Maria Rasheed
- Institute of Pharmacy, Lahore College for Women University, Lahore, Pakistan
| | - Tauqeer Hussain Mallhi
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka, Al-Jouf, Saudi Arabia
| | - Muhammad Salman
- Institute of Pharmacy, Faculty of Pharmaceutical and Allied Health Sciences, Lahore College for Women University, Lahore, Pakistan
| | - Abdulaziz Ibrahim Alzarea
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka, Al-Jouf, Saudi Arabia
| | - Abdullah Salah Alanazi
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka, Al-Jouf, Saudi Arabia
| | - Nasser Hadal Alotaibi
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka, Al-Jouf, Saudi Arabia
| | - Salah-Ud-Din Khan
- Department of Biochemistry, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Ahmed D. Alatawi
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka, Al-Jouf, Saudi Arabia
| | - Muhammad Hammad Butt
- Department of Medicinal Chemistry, Faculty of Pharmacy, Uppsala University, Uppsala, Sweden
| | - Sami I. Alzarea
- Department of Pharmacology, College of Pharmacy, Jouf University, Sakaka, Al-Jouf, Saudi Arabia
| | - Khalid Saad Alharbi
- Department of Pharmacology, College of Pharmacy, Jouf University, Sakaka, Al-Jouf, Saudi Arabia
| | | | - Majed Ahmed Algarni
- Department of Clinical Pharmacy, College of Pharmacy, Taif University, Taif, Saudi Arabia
| | - Abdullah K. Alahmari
- Department of Clinical Pharmacy, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Ziyad Saeed Almalki
- Department of Clinical Pharmacy, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Muhammad Shahid Iqbal
- Department of Clinical Pharmacy, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
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Elbarazi I, Yacoub M, Reyad OA, Abdou MS, Elhadi YAM, Kheirallah KA, Ababneh BF, Hamada BA, El Saeh HM, Ali N, Rahma AT, Tahoun MM, Ghazy RM. Exploring enablers and barriers toward COVID-19 vaccine acceptance among Arabs: A qualitative study. INTERNATIONAL JOURNAL OF DISASTER RISK REDUCTION : IJDRR 2022; 82:103304. [PMID: 36193257 PMCID: PMC9519527 DOI: 10.1016/j.ijdrr.2022.103304] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 07/02/2022] [Accepted: 09/13/2022] [Indexed: 05/26/2023]
Abstract
BACKGROUND With the emergence of the coronavirus disease 2019 (COVID-19) and rapid vaccine development, research interest in vaccine hesitancy (VH) has increased. Research usually focuses on quantitative estimates which largely neglected the qualitative underpinnings of this phenomenon. This study aimed to explore the beliefs and views towards COVID-19 vaccination among Arabs in different countries. Furthermore, we explored the effect of confidence in the healthcare system, misinformation, and scientific approaches adopted to mitigate COVID-19 on how individuals are following the recommended preventative actions including vaccination. METHODS This study was based on the Strategic Advisory Group of Experts (SAGE)-VH Model: A qualitative design that utilized in-depth, online interviews. The study was conducted in seven Arab countries (Egypt, Qatar, Kingdom of Saudi Arabia, Libya, Sudan, United Arab Emirates and Jordan) from June 2020 to December 2021. Transcripts were analyzed using NVivo 12 Software. RESULTS A total of 100 participants, 44 males and 56 females, of different age groups (37.1 ± 11.56 years) were interviewed. Findings revealed six themes as enablers and barriers to COVID-19 vaccination. Many participants indicated trusting the vaccines, the healthcare systems, and the vaccination policies were the main driver to get the vaccine. Participants showed concerns towards potential long-term vaccine effects. A consistent inclination towards collective responsibility, which is the willingness to protect others by own vaccination, was also reported. CONCLUSION Enablers and barriers of COVID-19 vaccination acceptance in the Arab region, from sociocultural and political perspectives, are critical to guide policymakers in designing target-oriented interventions that can improve vaccine acceptance.
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Key Words
- Arab Countries
- COVID-19
- COVID-19, Coronavirus disease 2019
- ECDC, European Centre for Disease Prevention and Control
- GDP, Gross Domestic Product
- HCWs, Health care workers
- KSA, Kingdom of Saudia Arabia
- LMIC, Low- and middle-income countries
- PI, Principal investigator
- Qualitative
- SAGE
- SAGE, Strategic Advisory Group of Experts on immunization
- SARS-CoV-2
- UAE, United Arab Emirates
- US, United States
- VH, Vaccine hesitancy
- Vaccine acceptance
- Vaccine hesitancy
- WHO, World Health Organization
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Affiliation(s)
- Iffat Elbarazi
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, AlAin, United Arab Emirates
| | - Mohamed Yacoub
- English Department, Florida International University, Miami, FL, USA
| | - Omar Ahmed Reyad
- Internal Medicine and Cardiology Clinical Pharmacy Department, Alexandria Main University Hospital, Alexandria, Egypt
| | - Marwa Shawky Abdou
- Department of Epidemiology, High Institute of Public Health, Alexandria University, Egypt
| | - Yasir Ahmed Mohammed Elhadi
- Department of Public Health, Medical Research Office, Sudanese Medical Research Association, Khartoum, Sudan
| | - Khalid A Kheirallah
- Department of Public Health, Medical School of Jordan University of Science and Technology, Irbid, Jordan
| | - Bayan F Ababneh
- Department of Public Health, Medical School of Jordan University of Science and Technology, Irbid, Jordan
| | - Bayan Abu Hamada
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, AlAin, United Arab Emirates
| | - Haider M El Saeh
- Community Medicine Department, Faculty of Medicine, University of Tripoli, Tripoli, Libya
| | - Nancy Ali
- Department of Communication and Media, Indiana University of Pennsylvania, Pennsylvania, USA
| | - Azhar T Rahma
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, AlAin, United Arab Emirates
| | - Mohamed Mostafa Tahoun
- Department of Epidemiology, High Institute of Public Health, Alexandria University, Egypt
| | - Ramy Mohamed Ghazy
- Tropical Health Department, High Institute of Public Health, Alexandria University, Egypt
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Mustafa ZU, Bashir S, Shahid A, Raees I, Salman M, Merchant HA, Aldeyab MA, Kow CS, Hasan SS. COVID-19 Vaccine Hesitancy among Pregnant Women Attending Antenatal Clinics in Pakistan: A Multicentric, Prospective, Survey-Based Study. Viruses 2022; 14:v14112344. [PMID: 36366442 PMCID: PMC9694328 DOI: 10.3390/v14112344] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/15/2022] [Accepted: 10/19/2022] [Indexed: 02/01/2023] Open
Abstract
This study aimed to assess the vaccination status and factors contributing to vaccine hesitancy among pregnant women in the largest province of Pakistan. A multicentric, prospective, survey-based study using an interviewer-administered tool was conducted among pregnant women attending antenatal clinics between 1 December 2021 through 30 January 2022 across seven hospitals in Pakistan. The healthcare professionals providing care at the participating hospitals administered the survey. Four hundred and five pregnant women fully consented and completed the study. The majority of the study participants (70.6%, n = 286) were aged between 25 and 34 and had a previous successful pregnancy history. More than half of the study participants (56.0%, n = 227) did not receive COVID-19 vaccination at the time of data collection despite their family members (93.9%, n = 372) had already received at least one dose of COVID-19 vaccine. Among those who received COVID-19 vaccination (n = 173), vaccine efficacy, protection for the foetus, and risk of COVID-19-associated hospitalisation were the main driving factors for vaccine hesitancy. The majority of the unvaccinated women (77.8%, n = 182) had no intention of receiving the vaccine. However, more than two-thirds (85.7%, n = 342) consulted the doctor about COVID-19 vaccines, and most were recommended to receive COVID-19 vaccines by the doctors (80.7%, n = 280). Women were significantly more likely to be vaccinated if they had employment (odds ratio [OR] 4.47, 95% confidence interval [CI]: 2.31-8.64) compared with their counterparts who were homemakers, consulted their doctors (OR 0.12, 95% CI: 0.04-0.35), and if they did not have pregnancy-related issues (OR 6.02, 95% CI: 2.36-15.33). In this study, vaccine hesitancy was prevalent, and vaccine uptake was low among pregnant women. Education and employment did impact COVID vaccination uptake, emphasising the need for more targeted efforts to enhance the trust in vaccines.
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Affiliation(s)
- Zia Ul Mustafa
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang 11800, Malaysia
- Department of Pharmacy Services, District Headquarters (DHQ) Hospital, Pakpattan 57400, Pakistan
| | - Shazma Bashir
- School of Health, Sport and Bioscience, University of East London, Stratford Campus, London W1S 3PR, UK
| | - Arfah Shahid
- Department of Medicine, Rawalpindi Medical University, Rawalpindi 46000, Pakistan
| | - Iqra Raees
- Department of Medicine, Faisalabad Medical University, Faisalabad 38000, Pakistan
| | - Muhammad Salman
- Institute of Pharmacy, Faculty of Pharmaceutical and Allied Health Sciences, Lahore College for Women University, Lahore 54000, Pakistan
| | - Hamid A. Merchant
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield HD1 3DH, UK
| | - Mamoon A. Aldeyab
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield HD1 3DH, UK
| | - Chia Siang Kow
- Department of Pharmacy Practice, School of Pharmacy, International Medical University, Kuala Lumpur 57000, Malaysia
- Correspondence: (C.S.K.); (S.S.H.)
| | - Syed Shahzad Hasan
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield HD1 3DH, UK
- Correspondence: (C.S.K.); (S.S.H.)
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Kenworthy T, Harmon SL, Delouche A, Abugattas N, Zwiebel H, Martinez J, Sauvigné KC, Nelson CM, Horigian VE, Gwynn L, Pulgaron ER. Community voices on factors influencing COVID-19 concerns and health decisions among racial and ethnic minorities in the school setting. Front Public Health 2022; 10:1002209. [PMID: 36339209 PMCID: PMC9627500 DOI: 10.3389/fpubh.2022.1002209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 09/27/2022] [Indexed: 01/27/2023] Open
Abstract
Racial and ethnic minority communities have been disproportionately affected by COVID-19, but the uptake of COVID-19 mitigation strategies like vaccination and testing have been slower in these populations. With the continued spread of COVID-19 while in-person learning is a priority, school-aged youth and their caregivers must make health-related decisions daily to ensure health at school. It is critical to understand factors associated with COVID-related health decisions such as vaccination, testing, and other health behaviors (e.g., wearing masks, hand washing). Community-engaged campaigns are necessary to overcome barriers to these health behaviors and promote health equity. The aim of this study was to examine COVID-19-related concerns and influences on health decisions in middle and high schools serving primarily racial and ethnic minority, low-income families. Seven focus groups were conducted with school staff, parents, and students (aged 16 years and older). Qualitative data were analyzed using a general inductive approach. Factors related to COVID-19 concerns and health decisions centered on (1) vaccine hesitancy, (2) testing hesitancy, (3) developmental stage (i.e., ability to engage in health behaviors based on developmental factors like age), (4) cultural and family traditions and beliefs, (5) compatibility of policies and places with recommended health behaviors, (6) reliability of information, and (7) perceived risk. We explore sub-themes in further detail. It is important to understand the community's level of concern and identify factors that influence COVID-19 medical decision making to better address disparities in COVID-19 testing and vaccination uptake.
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Affiliation(s)
- Tara Kenworthy
- University of Miami Miller School of Medicine, Miami, FL, United States
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Determinants of COVID-19 Vaccination Intention among Health Care Workers in France: A Qualitative Study. Vaccines (Basel) 2022; 10:vaccines10101661. [PMID: 36298526 PMCID: PMC9611955 DOI: 10.3390/vaccines10101661] [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: 09/02/2022] [Revised: 09/28/2022] [Accepted: 09/30/2022] [Indexed: 01/24/2023] Open
Abstract
COVID-19 vaccines are one of the best tools to limit the spread of the virus. However, vaccine hesitancy is increasing worldwide, and France is one of the most hesitant countries. From the beginning of the COVID-19 vaccination campaign, health care workers (HCW) have been prioritized in the vaccination strategy but were also hesitant. This study was conducted to identify and understand the determinants of COVID-19 vaccination intention in the French context, with a view to promoting HCW vaccination. A qualitative study using individual semi-structured interviews of HCWs was carried out at the beginning of the vaccination campaign (January to April 2021) in a French university hospital. Interviews indicated that the vaccination intention of HCWs was influenced by confidence in the proposed vaccines, past experience with vaccines and disease, the opinions and vaccination status of others, and media handling of information related to COVID-19 vaccination. Improving HCW vaccination intention regarding COVID-19 vaccines could be achieved through the dissemination of clear, reassuring, scientific information. Information should be disseminated by HCWs and vaccination experts and adapted to local contexts. To improve the level of confidence and vaccination uptake through a compliance effect, it would be useful to promote positive COVID-19 vaccination experiences and increased rates of immunization.
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Wang X, Wang H, Du A, Wang J, Shi J, Zhang Y, Zhang Y, Ma J, Meng W, Lv J, Luo H. COVID-19 vaccine hesitancy and associated factors among infertile couples undergoing assisted reproductive treatment. Front Immunol 2022; 13:973600. [PMID: 36238271 PMCID: PMC9552881 DOI: 10.3389/fimmu.2022.973600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 09/09/2022] [Indexed: 01/09/2023] Open
Abstract
Although periconception vaccination is important to maternal and neonatal health, little is known about the COVID-19 vaccine hesitancy among infertile couples seeking fertility treatment. Thus, we conducted this survey among infertile patients in a reproductive medicine center, between September 2021 and December 2021, to estimate the prevalence of COVID-19 vaccine hesitancy and its influencing factors. Information was collected through face-to-face interviews among volunteers. Among the 987 included interviewees, 17.33% reported hesitancy in primary vaccination, 25.63% reported hesitancy in booster vaccination, and 32.32% delayed the primary vaccination. Hesitancy in primary vaccination was associated with unexplained infertility (OR: 1.77, 95% CI: 1.05-2.98), ongoing IVF treatment (OR: 2.17, 95% CI: 1.22-3.89), concerns for vaccine safety (OR: 4.13, 95% CI: 2.66-6.42), effectiveness (OR: 1.62, 95% CI: 1.15-2.28), and influence on pregnancy (OR: 2.80, 95% CI: 1.68-4.67). These factors were also associated with hesitancy in booster vaccination. Delay of the primary vaccination was inversely associated with a college or above degree (OR: 0.49, 95% CI: 0.27-0.87), previous history of influenza vaccination (OR: 0.67, 95% CI: 0.46-0.98), and was positively associated with concerns for the influence on pregnancy (OR: 7.78, 95% CI: 5.01-12.07). It is necessary to carry out targeted education program by health professionals to publicize the benefits of periconception vaccination, and to reduce the resistance to COVID-19 vaccine among infertile couples.
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Long S, Wu J, Wang S, Zhao Y, Wang J, Zhao S, Niu Q, Jin H. Changes of factors associated with vaccine hesitancy in Chinese residents: A qualitative study. Front Public Health 2022; 10:929407. [PMID: 36203693 PMCID: PMC9530596 DOI: 10.3389/fpubh.2022.929407] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 08/24/2022] [Indexed: 01/24/2023] Open
Abstract
Introduction There is an urgent need to address vaccine hesitancy to achieve booster vaccination. This study aimed to reveal the factors associated with vaccine hesitancy (including COVID-19 vaccine) among Chinese residents, address modifications of the factors since the previous year, and propose vaccination rate improvement measures. Materials and methods This qualitative return visit study was performed between January and mid-February 2022, following the last interview conducted between February and March 2021. According to an outline designed in advance, 60 Chinese residents from 12 provinces participated in semi-structured interviews. Results Vaccine safety was the biggest concern raised by respondents, followed by self-immunity and vaccine effectiveness, eliciting concern since the interview last year. Notably, online media accounted for a more significant portion of suggestion sources than before, and fear of pain was a novel factor affecting vaccine hesitancy. Moreover, unlike other areas, those from provinces with a per capita gross domestic product of 3-5 (RMB 10,000) reported less concern about vaccine price and effectiveness. They tended to seek advice via online media less and were greatly influenced by vaccination policies. Conclusions Influential factors of vaccine hesitancy among Chinese residents are changing dynamically. Monitoring these trends is essential for public health measures and higher vaccination levels.
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Affiliation(s)
- Sigui Long
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China,Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Jingying Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China,Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Shile Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China,Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Yaqi Zhao
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China,Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Jianli Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China,Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Shuangyu Zhao
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China,Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Qing Niu
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China,Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China,*Correspondence: Qing Niu
| | - Hui Jin
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China,Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China,Hui Jin
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19
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Citu IM, Citu C, Gorun F, Motoc A, Gorun OM, Burlea B, Bratosin F, Tudorache E, Margan MM, Hosin S, Malita D. Determinants of COVID-19 Vaccination Hesitancy among Romanian Pregnant Women. Vaccines (Basel) 2022; 10:vaccines10020275. [PMID: 35214732 PMCID: PMC8874778 DOI: 10.3390/vaccines10020275] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 02/08/2022] [Accepted: 02/10/2022] [Indexed: 12/04/2022] Open
Abstract
Universal COVID-19 immunization is seen as a critical approach for limiting the spread of SARS-CoV-2 and reducing the danger of new variations emerging in the general population, especially in pregnant women. The literature and accessible research data indicate that vaccination intentions vary greatly by country, with Romania ranking among the European nations with the lowest vaccination rates. Thus, we aimed to investigate the prevalence and extent of COVID-19 vaccine hesitancy among pregnant women in Romania and the factors influencing their decision. A cross-sectional study was conducted on pregnant women referred to the Obstetrics and Gynecology Clinic of the Timisoara Municipal Emergency Hospital in Romania. Participants were asked to complete the validated VAX scale about vaccine hesitancy and to report their willingness to receive a COVID-19 vaccine and their reasons for hesitancy. The group of 184 pregnant women who completed the survey recorded significantly more hesitant respondents than the non-pregnant group with 161 respondents (52.2% vs. 40.3%). They had significantly higher average scores in all VAX scale subsections, while 78.1% of them gave credits to social media for their COVID-19 vaccination decision, compared with 63.0% of non-pregnant women. The independent risk factors for hesitancy were determined as not being afraid of COVID-19 OR = 1.89, below-average income OR = 2.06, trusting social media rumors OR = 2.38, not believing in SARS-CoV-2 existence OR = 2.67, and being a vaccination non-believer OR = 3.15. We advocate for pregnant women to get vaccinated against COVID-19 and for the development of targeted campaigns to address the factors of hesitation. This research emphasizes the critical need for delivering the COVID-19 immunization to the whole community, including pregnant women who may have vaccine-related concerns.
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Affiliation(s)
- Ioana Mihaela Citu
- Department of Internal Medicine I, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Cosmin Citu
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
- Correspondence: ; Tel.: +40-722-322-877
| | - Florin Gorun
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Andrei Motoc
- Department of Anatomy and Embryology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Oana Maria Gorun
- Department of Obstetrics and Gynecology, Municipal Emergency Clinical Hospital Timisoara, 1-3 Alexandru Odobescu Street, 300202 Timisoara, Romania; (O.M.G.); (B.B.)
| | - Bogdan Burlea
- Department of Obstetrics and Gynecology, Municipal Emergency Clinical Hospital Timisoara, 1-3 Alexandru Odobescu Street, 300202 Timisoara, Romania; (O.M.G.); (B.B.)
| | - Felix Bratosin
- Methodological and Infectious Diseases Research Center, Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Emanuela Tudorache
- Department of Pulmonology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Madalin-Marius Margan
- Faculty of General Medicine, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Samer Hosin
- Department of Orthopedics, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Daniel Malita
- Department of Radiology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
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The Uptake and Vaccination Willingness of COVID-19 Vaccine among Chinese Residents: Web-Based Online Cross-Sectional Study. Vaccines (Basel) 2022; 10:vaccines10010090. [PMID: 35062751 PMCID: PMC8780410 DOI: 10.3390/vaccines10010090] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/03/2022] [Accepted: 01/05/2022] [Indexed: 02/01/2023] Open
Abstract
Objective: To investigate the uptake and vaccination willingness of the COVID-19 vaccine among Chinese residents and analyze the difference and factors that impact vaccination. Methods: The snowball sampling method was used to distribute online questionnaires. Relevant sociodemographic data along with the circumstances of COVID-19 vaccination were collected from the respondents. The χ2 test, independent samples t test and binary logistic regression analysis were used to analyze the data. Results: Among 786 respondents, 84.22% had been vaccinated. Over 80% of the vaccinated population have completed all the injections because of supporting the national vaccination policies of China, while the unvaccinated population (23.91%) is mainly due to personal health status. Meanwhile, statistical analysis revealed that the main predictors of not being vaccinated were younger age (3 to 18 years old), personal health status, and lower vaccinated proportion of family members and close friends (p < 0.05). Conclusions: There was a high level of uptake of the COVID-19 vaccine in China, and people who have not been vaccinated generally had a low willingness to vaccinate in the future. Based on our results, it suggested the next work to expand the coverage of the COVID-19 vaccination should be concentrated on targeted publicity and education for people who have not been vaccinated.
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