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Collett G, Godec T, Gupta AK. Factors influencing attitudes toward vaccine safety and vaccine effectiveness amongst UK healthcare professionals prior to and at the time of COVID-19 vaccine rollout: Insights from the CoPE-HCP cohort study. Hum Vaccin Immunother 2023; 19:2188823. [PMID: 36977613 PMCID: PMC10078128 DOI: 10.1080/21645515.2023.2188823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023] Open
Abstract
Given the potential for nosocomial outbreaks, we must understand factors associated with negative vaccine attitudes amongst healthcare professionals (HCPs) before the rollout of a newly developed vaccine in a pandemic setting. The aim of this prospective cohort study was to study the impact of preexisting and prevailing mental health on United Kingdom HCPs' attitudes towards a newly developed COVID-19 vaccine. Two online surveys were distributed: first during vaccine development (July-September, 2020) and second during nationwide vaccine rollout (December 2020-March 2021). Mental health (PHQ-9 for depression; GAD-7 for anxiety) was assessed in both surveys. Negative attitude regarding vaccine safety and vaccine effectiveness was assessed at vaccine rollout. A series of logistic regression models were developed relating mental health (preexisting during vaccine development, ongoing and new-onset during rollout, and changes in symptom severity) to negative vaccine attitudes. In 634 HCPs, the presence of depression and/or anxiety during vaccine development was associated with elevated negative attitude towards vaccine safety (adj. OR 1.74 [95% CI 1.10-2.75], p = .02), but not vaccine effectiveness (1.13 [0.77-1.66], p = .53) at rollout. This was independent of other characteristics: age, ethnicity, professional role, and history of contracting COVID-19. Ongoing depression and/or anxiety (1.72 [1.10-2.69], p = .02) was associated with elevated negative attitude regarding vaccine effectiveness, but not vaccine safety. Worsened combined symptom scores over time were associated with elevated negative vaccine effectiveness attitudes (1.03 [1.00-1.05], p < .05), but not vaccine safety. Overall, adverse mental health can impact on HCPs' attitudes towards a newly developed vaccine. Further work is required to understand how this translates to vaccine uptake.
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Affiliation(s)
- George Collett
- William Harvey Research Institute, Queen Mary University of London, London, UK
| | - Thomas Godec
- William Harvey Research Institute, Queen Mary University of London, London, UK
| | - Ajay K Gupta
- William Harvey Research Institute, Queen Mary University of London, London, UK
- Barts Heart Centre, St. Bartholomew's Hospital, Barts Health NHS Trust, London, UK
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Bakare AA, Olojede OE, King C, Graham H, Uchendu O, Colbourn T, Falade AG, Alvesson HM. Care seeking for under-five children and vaccine perceptions during the first two waves of the COVID-19 pandemic in Lagos State, Nigeria: a qualitative exploratory study. BMJ Open 2023; 13:e069294. [PMID: 36882237 PMCID: PMC10008198 DOI: 10.1136/bmjopen-2022-069294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 02/20/2023] [Indexed: 03/09/2023] Open
Abstract
OBJECTIVE To explore healthcare seeking practices for children and the context-specific direct and indirect effects of public health interventions during the first two waves of COVID-19 in Lagos State, Nigeria. We also explored decision-making around vaccine acceptance at the start of COVID-19 vaccine roll-out in Nigeria. DESIGN, SETTING AND PARTICIPANTS A qualitative explorative study involving 19 semistructured interviews with healthcare providers from public and private primary health facilities and 32 interviews with caregivers of under-five children in Lagos from December 2020 to March 2021. Participants were purposively selected from healthcare facilities to include community health workers, nurses and doctors, and interviews were conducted in quiet locations at facilities. A data-driven reflexive thematic analysis according to Braun and Clark was conducted. FINDINGS Two themes were developed: appropriating COVID-19 in belief systems, and ambiguity about COVID-19 preventive measures. The interpretation of COVID-19 ranged from fearful to considering it as a 'scam' or 'falsification from the government'. Underlying distrust in government fuelled COVID-19 misperceptions. Care seeking for children under five was affected, as facilities were seen as contagious places for COVID-19. Caregivers resorted to alternative care and self-management of childhood illnesses. COVID-19 vaccine hesitancy was a major concern among healthcare providers compared with community members at the time of vaccine roll-out in Lagos, Nigeria. Indirect impacts of COVID-19 lockdown included diminished household income, worsening food insecurity, mental health challenges for caregivers and reduced clinic visits for immunisation. CONCLUSION The first wave of the COVID-19 pandemic in Lagos was associated with reductions in care seeking for children, clinic attendance for childhood immunisations and household income. Strengthening health and social support systems with context-specific interventions and correcting misinformation is crucial to building adaptive capacity for response to future pandemics. TRIAL REGISTRATION NUMBER ACTRN12621001071819.
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Affiliation(s)
- Ayobami Adebayo Bakare
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Department of Community Medicine, University College Hospital, Ibadan, Nigeria
| | - Omotayo E Olojede
- Department of Paediatrics, University College Hospital, Ibadan, Nigeria
| | - Carina King
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Hamish Graham
- Department of Paediatrics, University College Hospital, Ibadan, Nigeria
- Centre for International Child Health, Murdoch Children's Research Institute, Royal Children's Hospital, University of Melbourne, Parkville, Victoria, Australia
| | - Obioma Uchendu
- Department of Community Medicine, University College Hospital, Ibadan, Nigeria
- Department of Community Medicine, University of Ibadan College of Medicine, Ibadan, Nigeria
| | - Tim Colbourn
- Institute for Global Health, University College London, London, UK
| | - Adegoke G Falade
- Department of Paediatrics, University College Hospital, Ibadan, Nigeria
- Department of Paediatrics, University of Ibadan College of Medicine, Ibadan, Nigeria
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Khalid S, Usmani BA, Siddiqi S. COVID-19 Vaccine Hesitancy in Pakistan: A Mini Review of the Published Discourse. Front Public Health 2022; 10:841842. [PMID: 35712302 PMCID: PMC9194092 DOI: 10.3389/fpubh.2022.841842] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 04/19/2022] [Indexed: 11/13/2022] Open
Abstract
This minireview provides a summary of the main findings, features, as well as limitations and gaps in the current epidemiologic research on COVID-19 vaccine hesitancy (VH) in Pakistani population. For this purpose, data on VH studies were extracted from January 2020 to October 2021, using a systematic review and meta-analysis approach. Literature review and other narrative studies were excluded. There exists a significant heterogeneity in the reported vaccine hesitancy in the population (pooled estimates from random-effects meta-analysis: 35% (95% CI, 28-43%). However, none of the co-variables included in the studies explained the observed variance/heterogeneity in the moderator analysis models. In this minireview and critical appraisal of current VH research, we conclude that an in-depth analysis of COVID-19 vaccine hesitancy in a representative sample of Pakistani population is crucial to measure the magnitude of VH as well to explore and identify the determinants of VH in Pakistani population. This is an important step toward informing intervention and policy design and to address this issue at its root cause. To this end, focused, methodologically robust and hypothesis-driven VH research is needed using a wide range of co-variables to support a detailed coverage of the individual and environmental level VH attributes.
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Affiliation(s)
- Sumaira Khalid
- Epidemiology and Biostatistics Section, Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Bilal Ahmed Usmani
- Epidemiology and Biostatistics Section, Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Sameen Siddiqi
- Health Policy and Management Section, Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
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Rozek LS, Jones P, Menon A, Hicken A, Apsley S, King EJ. Understanding Vaccine Hesitancy in the Context of COVID-19: The Role of Trust and Confidence in a Seventeen-Country Survey. Int J Public Health 2021; 66:636255. [PMID: 34744589 PMCID: PMC8565283 DOI: 10.3389/ijph.2021.636255] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 04/27/2021] [Indexed: 11/29/2022] Open
Abstract
Objectives: An effective vaccine to SARS-CoV-2 cannot be successfully deployed if a significant number of people worldwide are unwilling to accept it. We investigated the relationship between trust in scientists and medical professionals and perceptions of vaccine safety and effectiveness. We also build on past studies by exploring the relationship between confidence in global health organizations and vaccine hesitancy. Methods: We conducted an online survey in seventeen countries/territories across five world regions between May -June 2020. We assessed the relationship between COVID19 vaccine hesitancy, confidence in public health organizations, and trust in key experts and leaders. Results: Our findings strongly suggest that confidence in the World Health Organization combined with trust in domestic scientists and healthcare professionals is a strong driver of vaccine acceptance across multiple countries/territories. Conclusion: We find that hesitancy is widespread, and uptake would be insufficient to achieve herd immunity. There is widespread confidence in how public health organizations have responded to the current pandemic and this is related to vaccine acceptance. Our results also highlight the important role of trust in health care providers and scientists in reducing COVID19 vaccine hesitancy.
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Affiliation(s)
- Laura S Rozek
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Pauline Jones
- Department of Political Science, College of Literature, Sciences and the Arts University of Michigan, Ann Arbor, MI, United States
| | - Anil Menon
- Department of Political Science, College of Literature, Sciences and the Arts University of Michigan, Ann Arbor, MI, United States
| | - Allen Hicken
- Department of Political Science, College of Literature, Sciences and the Arts University of Michigan, Ann Arbor, MI, United States
| | - Samantha Apsley
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Elizabeth J King
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, United States.,Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, United States
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de Albuquerque Veloso Machado M, Roberts B, Wong BLH, van Kessel R, Mossialos E. The Relationship Between the COVID-19 Pandemic and Vaccine Hesitancy: A Scoping Review of Literature Until August 2021. Front Public Health 2021; 9:747787. [PMID: 34650953 PMCID: PMC8505886 DOI: 10.3389/fpubh.2021.747787] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 08/23/2021] [Indexed: 11/18/2022] Open
Abstract
Background: Vaccines have been contributing to eradicate or drastically reduce the incidence of common diseases. Simultaneously, vaccine hesitancy is considered among the top ten global health threats. The COVID-19 pandemic has caused a tremendous impact on health, economics, and society worldwide, while also reinforcing faulty beliefs about the necessity of vaccine programs as a whole. This study aims to synthesise evidence on the impact of the COVID-19 pandemic on vaccine hesitancy. Methods: A scoping review of literature between 1 January 2020 and 1 August 2021 was performed. Results: COVID-19 vaccine acceptance decreased from more than 70 to <50% in 8 months starting from January 2020. Healthcare professionals demonstrate higher rates of vaccine receptivity than the public, which was more influenced by (social) media. The circulation of misinformation was associated with increased fear of side effects related to COVID-19 vaccines. Regarding other vaccines coverage, parents' intentions to vaccinate their children against influenza increased 15.8% during the COVID-19 pandemic so far. Nonetheless, the number of vaccines administered decreased, influenced by factors like fear of being exposed to the virus at healthcare facilities and restrictions. Conclusions: Several efforts should be undertaken to improve vaccine acceptance and coverage now and beyond the pandemic to optimal population protection.
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Affiliation(s)
| | | | - Brian Li Han Wong
- Medical Research Council Unit for Lifelong Health and Ageing (MRC), London, United Kingdom.,Association of Schools of Public Health in the European Region (ASPHER), Brussels, Belgium
| | - Robin van Kessel
- Department of International Health, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands.,Studio Europa, Maastricht University, Maastricht, Netherlands.,Research Committee, Global Health Workforce Network (GHWN) Youth Hub, World Health Organization, Geneva, Switzerland
| | - Elias Mossialos
- Department of Health Policy, London School of Economics and Political Science, London, United Kingdom.,Institute of Global Health Innovation, Imperial College London, London, United Kingdom
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Tavolacci MP, Dechelotte P, Ladner J. COVID-19 Vaccine Acceptance, Hesitancy, and Resistancy among University Students in France. Vaccines (Basel) 2021; 9:654. [PMID: 34203847 PMCID: PMC8232624 DOI: 10.3390/vaccines9060654] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 06/09/2021] [Accepted: 06/11/2021] [Indexed: 12/21/2022] Open
Abstract
The objectives were to explore, among university students, the level of COVID-19 vaccine acceptance, hesitancy, and resistancy and to determine the motivations and barriers, and the reasons that may change student vaccination decision making. An online observational cross-sectional study was conducted among students of a French university in January 2021 with questions about the intention to be vaccinated against COVID-19, the motivations and the barriers. The convenience sample included 3089 students, with a mean of age of 20.3 (SD = 1.9). To the question on the intention to vaccinate against the COVID-19, 58.0% of students reported that they would choose to have a vaccination, 17.0% reported that they would not and 25.0% were not sure. The main motivations for vaccine acceptance were "I don't want to transmit COVID-19 to others", the main barriers for vaccine resistance or hesitancy were "I prefer to wait until I have more experience with these new vaccines". Age, female gender, being in first three years of study, studied sciences courses and neither sciences nor healthcare courses of study were significantly associated with a higher risk of vaccine hesitancy or resistancy. Self-estimated knowledge of conventional vaccines and COVID-19 vaccines, and confidence in efficiency and safety of conventional vaccination were associated with a lower risk of vaccine hesitancy or resistancy. It is relevant to disseminate evidence-based interventions to promote COVID-19 vaccine acceptability for college students, especially for the students in neither sciences nor healthcare courses of study, as college students will soon be eligible to receive a COVID-19 vaccine.
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Affiliation(s)
- Marie Pierre Tavolacci
- Clinical Investigation Center, CHU Rouen, U 1073, Normandie University, F 76000 Rouen, France
| | - Pierre Dechelotte
- Department of Nutrition CHU Rouen, U 1073, Normandie University, F 76000 Rouen, France;
| | - Joel Ladner
- Department of Epidemiology and Health Promotion, CHU Rouen, U 1073, Normandie University, F 76000 Rouen, France;
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Zigron A, Dror AA, Morozov NG, Shani T, Haj Khalil T, Eisenbach N, Rayan D, Daoud A, Kablan F, Marei H, Sela E, Srouji S. COVID-19 Vaccine Acceptance Among Dental Professionals Based on Employment Status During the Pandemic. Front Med (Lausanne) 2021; 8:618403. [PMID: 33634149 PMCID: PMC7901230 DOI: 10.3389/fmed.2021.618403] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 01/04/2021] [Indexed: 11/21/2022] Open
Abstract
The COVID-19 pandemic spread rapidly across the globe, leading governments to impose prolonged lockdowns on both movement and commerce. Although lockdowns decrease the rates of novel infections, they can have devastating consequences on the economy and employment levels. One of the most severely affected sectors during this crisis has been dental medicine. Dental professionals are uniquely exposed to environments with high levels of occupational hazards, conferring additional risks of viral exposure and transmission. We analyzed 506 anonymous questionnaires completed by dentists and residents regarding acceptance of a future potential SARS-CoV-2 vaccine. Our results demonstrate a statistically significant correlation between the individual's unemployment rate and their willingness to inoculate with a SARS-CoV-2 vaccine when it becomes available. This information can be used to predict trends of vaccine acceptance or rejection based on economic burden during the COVID-19 pandemic by different sectors as part of the preparedness toward global vaccination programs.
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Affiliation(s)
- Asaf Zigron
- Oral and Maxillofacial Department, Galilee Medical Center, Nahariya, Israel.,Department of Otolaryngology, Head and Neck Surgery, Galilee Medical Center, Nahariya, Israel
| | - Amiel A Dror
- Department of Otolaryngology, Head and Neck Surgery, Galilee Medical Center, Nahariya, Israel.,The Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Nicole G Morozov
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tali Shani
- Oral and Maxillofacial Department, Galilee Medical Center, Nahariya, Israel.,The Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | | | - Netanel Eisenbach
- Department of Otolaryngology, Head and Neck Surgery, Galilee Medical Center, Nahariya, Israel.,The Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Doaa Rayan
- Department of Otolaryngology, Head and Neck Surgery, Galilee Medical Center, Nahariya, Israel.,The Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Amani Daoud
- Department of Otolaryngology, Head and Neck Surgery, Galilee Medical Center, Nahariya, Israel.,The Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Fares Kablan
- Oral and Maxillofacial Department, Galilee Medical Center, Nahariya, Israel.,The Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Hesham Marei
- College of Dentistry, Gulf Medical University (GMU), Ajman, United Arab Emirates
| | - Eyal Sela
- Department of Otolaryngology, Head and Neck Surgery, Galilee Medical Center, Nahariya, Israel.,The Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Samer Srouji
- Oral and Maxillofacial Department, Galilee Medical Center, Nahariya, Israel.,The Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
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