COVID-19 Vaccine Hesitancy

Knowledge, Attitudes, and Educational Gaps About Vaccination in Chinese Medical Students and Residents: A Pilot Study from a Single Tertiary Referral Center

Objective

Physicians play a key role in vaccination advocacy. To explore potential educational gaps, we surveyed the knowledge and opinions on vaccination, as well as their own vaccination status, among Chinese medical students and residents in a single medical institute.

Methods

We recruited sixth- and seventh-year medical students and internal medicine residents to carry out this investigation. All participants were given a questionnaire to fill out.

Results

In total, 118 responses from medical students (n=75) and residents (n=43) were analyzed. Thus, 58.5% of participants (69/118) declared that they had enough knowledge, and 68.6% (81/118) wanted to learn more. The average knowledge score was 15.3±2.4 (the full mark was 21 points), while the average accuracy rate was 72.9%. Most respondents agreed that vaccines are useful and that the national vaccination program is effective. Although nearly all participants supported the importance of revaccination, only 48.3% had actually received boosters. There were no significant differences in knowledge and general attitude between medical students and residents. Vaccine uptake in childhood was good. With regard to the 12 vaccines other than the national standard immunization program, the most frequently declared vaccine was against coronavirus disease 2019 (89.8%), while 55.1% had received the human papillomavirus vaccine. There were no significant differences in vaccination coverage between medical students and residents, except for varicella vaccine (40% in medical students vs 18.6% in residents, p=0.017).

Conclusion

A large proportion of medical students and residents in this tertiary referral center exhibited attitudes that favored vaccine acceptance. However, there are certain gaps in their knowledge of and attitudes toward vaccination, which could be addressed by implementing a formal standardized vaccine curriculum.

Attitudes towards COVID Vaccine and Vaccine Hesitancy in Dermatology: A Narrative Review

Vaccine hesitancy has been a contentious issue even before the pandemic. The COVID-19 crisis has further amplified vaccine hesitancy, with worries about adverse effects, cultural and religious beliefs, and misinformation on social media. In dermatology, patients with pre-existing skin conditions may have specific concerns about the impact of the vaccine on their skin health. Factors such as cutaneous reactions, potential flares of underlying conditions, and fears of psoriasis worsening post-vaccination contribute to vaccine hesitancy. Healthcare professionals, including dermatologists, play a crucial role in addressing vaccine hesitancy by providing accurate information, addressing concerns, and understanding the psychological impact on patients. The concept of vaccine fatigue is also explored, noting the challenges in sustaining vaccine acceptance over time, especially with regards to booster vaccinations. Overcoming vaccine hesitancy requires trust-building, effective communication strategies, and collaboration between healthcare workers and non-healthcare individuals to combat misinformation. By recognizing and addressing psychological factors, dermatologists can increase vaccine acceptance and improve public health efforts.

Can COVID-19 Vaccines Induce Premature Non-Communicable Diseases: Where Are We Heading to?

According to the WHO, as of January 2023, more than 850 million cases and over 6.6 million deaths from COVID-19 have been reported worldwide. Currently, the death rate has been reduced due to the decreased pathogenicity of new SARS-CoV-2 variants, but the major factor in the reduced death rates is the administration of more than 12.8 billion vaccine doses globally. While the COVID-19 vaccines are saving lives, serious side effects have been reported after vaccinations for several premature non-communicable diseases (NCDs). However, the reported adverse events are low in number. The scientific community must investigate the entire spectrum of COVID-19-vaccine-induced complications so that necessary safety measures can be taken, and current vaccines can be re-engineered to avoid or minimize their side effects. We describe in depth severe adverse events for premature metabolic, mental, and neurological disorders; cardiovascular, renal, and autoimmune diseases, and reproductive health issues detected after COVID-19 vaccinations and whether these are causal or incidental. In any case, it has become clear that the benefits of vaccinations outweigh the risks by a large margin. However, pre-existing conditions in vaccinated individuals need to be taken into account in the prevention and treatment of adverse events.

Role of Occupational Health Services in Planning and Implementing of Staff COVID-19 Vaccination Clinic: A Tertiary Hospital Experience in Singapore

CONTEXT

Healthcare workers all over the world were prioritized for vaccination against COVID-19 in view of the high-risk nature of their job scopes when vaccines were first available in late 2020. Vaccine hesitancy was an important problem to tackle in order to achieve a high vaccination rate, especially for vaccines that were developed using mRNA technology. We aimed to use the '3Cs' model to address vaccine hesitancy to ensure maximal uptake of the Pfizer-BioNTech vaccine among healthcare workers in a tertiary hospital in Singapore.

METHODS

Various measures were used to reduce the confidence, complacency, and convenience barriers. The staff vaccination clinic was on-site and centralized, with appointments given in advance to ensure vaccine availability and to reduce wait time, providing convenience to staff. Direct and repeated communications with the staff via multiple channels were used to address vaccine safety and efficacy so as to promote confidence in the vaccines and overcome complacency barriers. To further encourage staff to get vaccinated, staff were allowed time off for vaccination when at work. Staff with a high risk of exposure to COVID-19 or those caring for immunocompromised patients were prioritized to take the vaccines first. The collection of data on adverse events was via on-site monitoring and consultation at Occupational Health Clinic (OHC).

RESULTS

Nearly 80% of staff had completed vaccination when the vaccination exercise ended at the end of March 2021. With the loosening of the contraindications to vaccination over time, staff vaccination rates reached 89.3% in early July and nearly 99.9% by the end of the year. No major or serious vaccine-related medication or administration errors were reported. No staff had anaphylaxis.

CONCLUSIONS

By using the '3Cs' model to plan out the vaccination exercise, it is possible to achieve a high vaccination rate coupled with effective and customized communications. This multi-disciplinary team approach can be adapted to guide vaccination efforts in various settings in future pandemics.