Awareness and Attitudes around COVID-19 Vaccination

A special issue of Tropical Medicine and Infectious Disease (ISSN 2414-6366). This special issue belongs to the section "Infectious Diseases".

Deadline for manuscript submissions: closed (20 December 2022) | Viewed by 22535

Special Issue Editors

1. School of Social Work, College of Health and Human Services, The University of North Carolina at Charlotte, Charlotte, NC 28223, USA
2. School of Data Science, The University of North Carolina at Charlotte, Charlotte, NC 28223, USA
Interests: health disparities; healthcare prevention and utilization; public health management of COVID-19
Department of Mathematics and Statistics, Mississippi State University, Starkville, MS 39762, USA
Interests: data science; health informatics; predictive modeling; machine learning; feature selection; statistical analysis

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Guest Editor
1. Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35294, USA
2. Department of Social Work, College of Arts and Sciences, University of Alabama at Birmingham, Birmingham, AL 35294, USA
3. Center for AIDS Research, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA
4. Integrative Center for Aging Research, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA
5. African American Studies, College of Arts and Sciences, University of Alabama at Birmingham, Birmingham, AL 35294, USA
6. Center for Clinical and Translational Science, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA
Interests: public health management and clinical management of hepatitis C virus (HCV) and HIV/HCV co-infection; HCV epidemiology; infectious disease; liver disease

Special Issue Information

Dear Colleagues,

We are pleased to invite you to contribute to a Special Issue entitled “Awareness and Attitudes around COVID-19 Vaccination” in the journal Tropical Medicine and Infectious Disease. The development of safe and effective vaccines was one of the most important scientific breakthroughs in the fight against the COVID-19 pandemic. The COVID-19 vaccine is beneficial in many ways, including but not limited to decreased odds of infection, symptom severity, and death. Optimal vaccination rates at the population level are critical in the public health management of COVID-19. However, perceptions of health risk directly influence people’s health decisions and health behaviors. The discrepancy between real and perceived risks may lead to inaction regarding preventive health behaviors, which can inhibit COVID-19 vaccination uptake. Myths and conspiracy theories about the COVID-19 vaccine mislead people, leading them to be hesitant and hostile towards the COVID-19 vaccine. Rampant resistance and hesitation about the COVID-19 vaccine highlights the need for more scientific evidence on the awareness and attitudes of COVID-19 vaccination. In this Special Issue, we welcome your quantitative, qualitative, and mixed-methods scientific contributions in the domain of awareness and attitudes of COVID-19 vaccination.

Dr. Yuqi Guo
Dr. Jingyi Shi
Dr. Omar T. Sims
Guest Editors

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Keywords

  • vaccine hesitancy
  • vaccine awareness
  • vaccine attitudes
  • vaccine health literacy
  • vaccination behaviors
  • vaccination strategies
  • vaccine education

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Published Papers (7 papers)

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Research

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14 pages, 585 KiB  
Article
Main Predictors of COVID-19 Vaccination Uptake among Italian Healthcare Workers in Relation to Variable Degrees of Hesitancy: Result from a Cross-Sectional Online Survey
by Marco Trabucco Aurilio, Francesco Saverio Mennini, Cristiana Ferrari, Giuseppina Somma, Luca Di Giampaolo, Matteo Bolcato, Fabio De-Giorgio, Roberto Muscatello, Andrea Magrini and Luca Coppeta
Trop. Med. Infect. Dis. 2022, 7(12), 419; https://doi.org/10.3390/tropicalmed7120419 - 6 Dec 2022
Cited by 10 | Viewed by 1660
Abstract
Background: Hesitancy remains one of the major hurdles to vaccination, regardless of the fact that vaccines are indisputable preventive measures against many infectious diseases. Nevertheless, vaccine hesitancy or refusal is a growing phenomenon in the general population as well as among healthcare workers [...] Read more.
Background: Hesitancy remains one of the major hurdles to vaccination, regardless of the fact that vaccines are indisputable preventive measures against many infectious diseases. Nevertheless, vaccine hesitancy or refusal is a growing phenomenon in the general population as well as among healthcare workers (HCWs). Many different factors can contribute to hesitancy to COVID-19 vaccination in the HCWs population, including socio-demographic characteristics (female gender, low socio-economical status, lower age), individual beliefs regarding vaccine efficacy and safety, as well as other factors (occupation, knowledge about COVID-19, etc.). Understanding the determinants of accepting or refusing the COVID-19 vaccination is crucial to plan specific interventions in order to increase the rate of vaccine coverage among health care workers. Methods: We conducted a cross-sectional online survey on HCWs in seventeen Italian regions, between 30 June and 4 July 2021, in order to collect information about potential factors related to vaccine acceptance and hesitancy. Results: We found an overall vaccine uptake rate of 96.4% in our sample. Acceptance was significantly related to job task, with physicians showing the highest rate of uptake compared to other occupations. At univariate analysis, the HCWs population’s vaccine hesitancy was significantly positively associated with fear of vaccination side effects (p < 0.01), and negatively related to confidence in the safety and efficacy of the vaccine (p < 0.01). Through multivariate analysis, we found that only the fear of possible vaccination side effects (OR: 4.631, p < 0.01) and the confidence in vaccine safety and effectiveness (OR: 0.35 p < 0.05) remained significantly associated with hesitancy. Conclusion: Action to improve operator confidence in the efficacy and safety of the vaccine should improve the acceptance rate among operators. Full article
(This article belongs to the Special Issue Awareness and Attitudes around COVID-19 Vaccination)
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13 pages, 1949 KiB  
Article
Assessing the Impact of Use and Trust in Different Sources of Information on COVID-19 Vaccination Uptake in Saudi Arabia (SA) Using the COVID-19 Vaccine Hesitancy and Resistance in SA (CoV-HERSA) Tool
by Anwar A. Sayed
Trop. Med. Infect. Dis. 2022, 7(11), 375; https://doi.org/10.3390/tropicalmed7110375 - 14 Nov 2022
Cited by 10 | Viewed by 2384
Abstract
COVID-19 vaccination has been the cornerstone measure to tackle the severe morbidity and mortality of the ongoing global pandemic. However, vaccine hesitancy and resistance were observed in different populations, including Saudi Arabia (SA), yet such hesitancy was not accurately measured, nor were its [...] Read more.
COVID-19 vaccination has been the cornerstone measure to tackle the severe morbidity and mortality of the ongoing global pandemic. However, vaccine hesitancy and resistance were observed in different populations, including Saudi Arabia (SA), yet such hesitancy was not accurately measured, nor were its influencing factors determined. The COVID-19 Vaccine Hesitance and Resistance in SA (CoV-HERSA) tool was developed, validated, and distributed to 387 participants to accurately measure their COVID-19 vaccine hesitancy and its influencing factors. Different chronic conditions affected participants’ CoV-HERSA differently, with those having autoimmune disorders having the highest CoV-HERSA scores. Previous exposure to COVID-19 significantly increased the CoV-HERSA scores. The use and trust of the different sources of information had a significant influence on the CoV-HERSA scores. Those who used newspapers and healthcare practitioners as their source of information had the highest CoV-HERSA scores, while those who relied on family/friends had the lowest scores. The CoV-HERSA is a validated tool that accurately reflects participants’ willingness and hesitancy to COVID-19 vaccination and can be used to explore the influence of different factors on the participants’ attitudes towards the COVID-19 vaccine. Full article
(This article belongs to the Special Issue Awareness and Attitudes around COVID-19 Vaccination)
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14 pages, 361 KiB  
Article
COVID-19 Vaccination Intention and Factors Associated with Hesitance and Resistance in the Deep South: Montgomery, Alabama
by Cicily A. Gray, Grace Lesser, Yuqi Guo, Swapn Shah, Shauntice Allen, Larrell L. Wilkinson and Omar T. Sims
Trop. Med. Infect. Dis. 2022, 7(11), 331; https://doi.org/10.3390/tropicalmed7110331 - 25 Oct 2022
Cited by 2 | Viewed by 1803
Abstract
Using COVID-19-related survey data collected from residents in the city of Montgomery, Alabama, this study assessed the prevalence of COVID-19 vaccine acceptance, hesitance, and resistance, and identified factors associated with COVID-19 vaccine hesitance and resistance. To analyze the survey data (n = 1000), [...] Read more.
Using COVID-19-related survey data collected from residents in the city of Montgomery, Alabama, this study assessed the prevalence of COVID-19 vaccine acceptance, hesitance, and resistance, and identified factors associated with COVID-19 vaccine hesitance and resistance. To analyze the survey data (n = 1000), a consolidation approach (machine learning modeling and multinomial logistic regression modeling) was used to identify predictors of COVID-19 vaccine hesitancy and resistance. The prevalence of vaccine acceptance, hesitancy, and resistance was 62%, 23%, and 15%, respectively. Female gender and a higher level of trust that friends and family will provide accurate information about the COVID-19 vaccine were positively associated with vaccine hesitancy. Female gender and higher trust that social media will provide accurate information about COVID-19 were positively associated with vaccine resistance. Factors positively associated with COVID-19 vaccine hesitance and resistance in the study’s geographical area are worrisome, especially given the high burden of chronic diseases and health disparities that exist in both Montgomery and the Deep South. More research is needed to elucidate COVID-19 vaccination attitudes and reasons for non-acceptance of the COVID-19 vaccine. Efforts to improve acceptance should remain a priority in this respective geographical area and across the general population. Full article
(This article belongs to the Special Issue Awareness and Attitudes around COVID-19 Vaccination)
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9 pages, 261 KiB  
Article
COVID-19 Booster Vaccine Intention by Health Care Workers in Jakarta, Indonesia: Using the Extended Model of Health Behavior Theories
by Suzy Maria, Dicky C. Pelupessy, Sukamto Koesnoe, Evy Yunihastuti, Dwi Oktavia T. L. Handayani, Tommy Hariman Siddiq, Astri Mulyantini, Ahmad Rhyza Vertando Halim, Endang Sri Wahyuningsih, Alvina Widhani, Ghina Shabrina Awanis, Maulana Girsang Muda, Teguh Harjono Karjadi, Anshari Saifuddin Hasibuan, Iris Rengganis and Samsuridjal Djauzi
Trop. Med. Infect. Dis. 2022, 7(10), 323; https://doi.org/10.3390/tropicalmed7100323 - 21 Oct 2022
Cited by 3 | Viewed by 2000
Abstract
In Indonesia, COVID-19 vaccination hesitancy persists among health care workers (HCWs). Understanding the motives and challenges impacting HCWs’ acceptance of the booster vaccination is critical. Efforts are still needed to overcome apprehension about taking a booster dosage. This study aims to analyze the [...] Read more.
In Indonesia, COVID-19 vaccination hesitancy persists among health care workers (HCWs). Understanding the motives and challenges impacting HCWs’ acceptance of the booster vaccination is critical. Efforts are still needed to overcome apprehension about taking a booster dosage. This study aims to analyze the vaccine acceptance among HCWs in Jakarta using an extended, modified model of health behavior theories, namely The Health Belief Model (HBM) and The Theory of Planned Behavior (TPB). A cross-sectional survey from November 2021 to January 2022 was distributed to health care workers in Jakarta. Bivariate analysis followed by multivariate regression was used to assess factors associated with the vaccine intention and collected 1684 responses. The results have shown that the final model combining the constructs and demographic characteristics could explain 50% of the variance of intention to receive a COVID-19 booster vaccination. Moreover, anticipated regret had the most significant standardized coefficient among the constructs (β = 0.381, p < 0.001). Other significant predictors in the model were attitude (β = 0.243, p < 0.001), perceived benefits (β = 0.103, p < 0.001), subjective norms (β = 0.08, p = 0.005), and perceived susceptibility (β = 0.051, p = 0.016). The findings can be used to strategize interventions to increase vaccine uptake. Full article
(This article belongs to the Special Issue Awareness and Attitudes around COVID-19 Vaccination)
18 pages, 708 KiB  
Article
Validation and Cultural Adaptation of the Parent Attitudes about Childhood Vaccines (PACV) Questionnaire in Arabic Language Widely Spoken in a Region with a High Prevalence of COVID-19 Vaccine Hesitancy
by Doaa Ali ElSayed, Etwal Bou Raad, Salma A. Bekhit, Malik Sallam, Nada M. Ibrahim, Sarah Soliman, Reham Abdullah, Shehata Farag and Ramy Mohamed Ghazy
Trop. Med. Infect. Dis. 2022, 7(9), 234; https://doi.org/10.3390/tropicalmed7090234 - 8 Sep 2022
Cited by 18 | Viewed by 3979
Abstract
The parents’ attitude toward vaccinating children and adolescents against coronavirus disease 2019 (COVID-19) remains inconsistent and needs further elucidation. The high rates of COVID-19 vaccine hesitancy in the Middle East and North Africa (MENA) region require intensive research to understand the determinants of [...] Read more.
The parents’ attitude toward vaccinating children and adolescents against coronavirus disease 2019 (COVID-19) remains inconsistent and needs further elucidation. The high rates of COVID-19 vaccine hesitancy in the Middle East and North Africa (MENA) region require intensive research to understand the determinants of this phenomenon. This study aimed to validate a version of the Parent Attitudes about Childhood Vaccines (PACV) tool in Arabic, the most widely spoken language in the MENA. The study objectives included the investigation of Arab-speaking parents’ views regarding COVID-19 vaccination of their children. Parents living in Egypt with at least one child aged 5–18 years were eligible to participate in the study that was conducted through an online survey with 15 PACV items. The PACV tool was translated into Arabic using forward and backward translation. To assess the psychometric properties of the Arabic version of PACV, Pearson’s correlation coefficient and exploratory and confirmatory factor analysis (EFA and CFA) were performed. A total of 223 parents participated in the study: 59.82% aged 30–39 years, 69.20% were females, 46.19% were university-educated, and 40.63% had one child. The overall Cronbach’s alpha for the Arabic version of PACV was 0.799. The EFA of the 15 items showed that three domains were most conceptually equivalent. All items had a positive significant correlation with the mean score of each subscale except for item 4 (r = 0.016, p = 0.811). Regression analyses results indicated that education, previous COVID-19 infection, vaccine status of parents, and PACV score were significantly associated with the intention of the parents to vaccinate their children against COVID-19. The CFA results showed that most of the factor loadings were statistically significant (p < 0.010) except for items 4 and 7. However, the root mean square error of approximation (RMSEA = 0.080) and the standardized root mean squared residual (SRMR = 0.080) indicated that the model had a reasonable fit, and the three factors were good in reproducing each correlation. Our study results indicated the validity and reliability of the PACV instrument in Arabic language. Consequently, the PACV can be used to assess COVID-19 vaccine hesitancy in a majority of MENA countries for better delineation of this highly prevalent phenomenon in the region. Full article
(This article belongs to the Special Issue Awareness and Attitudes around COVID-19 Vaccination)
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Review

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29 pages, 4604 KiB  
Review
COVID-19 Vaccine Booster Dose Acceptance: Systematic Review and Meta-Analysis
by Shaimaa Abdelaziz Abdelmoneim, Malik Sallam, Dina Mohamed Hafez, Ehab Elrewany, Hesham Metwalli Mousli, Elsayed Mohamed Hammad, Sally Waheed Elkhadry, Mohammed Fathelrahman Adam, Amr Abdelraouf Ghobashy, Manal Naguib, Ahmed El-Sayed Nour El-Deen, Narjiss Aji and Ramy Mohamed Ghazy
Trop. Med. Infect. Dis. 2022, 7(10), 298; https://doi.org/10.3390/tropicalmed7100298 - 13 Oct 2022
Cited by 55 | Viewed by 6745
Abstract
The World Health Organization (WHO) recommended coronavirus disease 2019 (COVID-19) booster dose vaccination after completing the primary vaccination series for individuals ≥18 years and most-at-risk populations. This study aimed to estimate the pooled proportion of COVID-19 vaccine booster dose uptake and intention to [...] Read more.
The World Health Organization (WHO) recommended coronavirus disease 2019 (COVID-19) booster dose vaccination after completing the primary vaccination series for individuals ≥18 years and most-at-risk populations. This study aimed to estimate the pooled proportion of COVID-19 vaccine booster dose uptake and intention to get the booster dose among general populations and healthcare workers (HCWs). We searched PsycINFO, Scopus, EBSCO, MEDLINE Central/PubMed, ProQuest, SciELO, SAGE, Web of Science, Google Scholar, and ScienceDirect according to PRISMA guidelines. From a total of 1079 screened records, 50 studies were extracted. Meta-analysis was conducted using 48 high-quality studies according to the Newcastle-Ottawa Scale quality assessment tool. Using the 48 included studies, the pooled proportion of COVID-19 vaccine booster dose acceptance among 198,831 subjects was 81% (95% confidence interval (CI): 75–85%, I2 = 100%). The actual uptake of the booster dose in eight studies involving 12,995 subjects was 31% (95% CI: 19–46%, I2 = 100%), while the intention to have the booster dose of the vaccine was 79% (95% CI: 72–85%, I2 = 100%). The acceptance of the booster dose of COVID-19 vaccines among HCWs was 66% (95% CI: 58–74%), I2 = 99%). Meta-regression revealed that previous COVID-19 infection was associated with a lower intention to have the booster dose. Conversely, previous COVID-19 infection was associated with a significantly higher level of booster dose actual uptake. The pooled booster dose acceptance in the WHO region of the Americas, which did not include any actual vaccination, was 77% (95% CI: 66–85%, I2 = 100%). The pooled acceptance of the booster dose in the Western Pacific was 89% (95% CI: 84–92%, I2 = 100), followed by the European region: 86% (95% CI: 81–90%, I2 = 99%), the Eastern Mediterranean region: 59% (95% CI: 46–71%, I2 = 99%), and the Southeast Asian region: 52% (95% CI: 43–61%, I2 = 95). Having chronic disease and trust in the vaccine effectiveness were the significant predictors of booster dose COVID-19 vaccine acceptance. The global acceptance rate of COVID-19 booster vaccine is high, but the rates vary by region. To achieve herd immunity for the disease, a high level of vaccination acceptance is required. Intensive vaccination campaigns and programs are still needed around the world to raise public awareness regarding the importance of accepting COVID-19 vaccines needed for proper control of the pandemic. Full article
(This article belongs to the Special Issue Awareness and Attitudes around COVID-19 Vaccination)
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Other

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14 pages, 11953 KiB  
Systematic Review
Prevalence and Determinants of COVID-19 Vaccine Acceptance in South East Asia: A Systematic Review and Meta-Analysis of 1,166,275 Respondents
by Theo Audi Yanto, Nata Pratama Hardjo Lugito, Lie Rebecca Yen Hwei, Cindy Virliani and Gilbert Sterling Octavius
Trop. Med. Infect. Dis. 2022, 7(11), 361; https://doi.org/10.3390/tropicalmed7110361 - 9 Nov 2022
Cited by 7 | Viewed by 2859
Abstract
Despite its importance in guiding public health decisions, studies on COVID-19 vaccination acceptance and its determinants in South East Asia (SEA) are lacking. Therefore, this study aims to determine the prevalence of COVID-19 vaccine acceptance and the variables influencing the vaccine’s acceptance. This [...] Read more.
Despite its importance in guiding public health decisions, studies on COVID-19 vaccination acceptance and its determinants in South East Asia (SEA) are lacking. Therefore, this study aims to determine the prevalence of COVID-19 vaccine acceptance and the variables influencing the vaccine’s acceptance. This review is registered under PROSPERO CRD42022352198. We included studies that reported vaccination acceptance from all SEA countries, utilising five academic databases (Pubmed, MEDLINE, Cochrane Library, Science Direct, and Google Scholar), three Indonesian databases (the Indonesian Scientific Journal Database, Neliti, and Indonesia One Search), two pre-print databases (MedRxiv and BioRxiv), and two Thailand databases (ThaiJo and Thai-Journal Citation Index). The analysis was conducted using STATA 17.0 with metaprop commands. The prevalence for COVID-19 vaccination acceptance in SEA was 71% (95%CI 69–74; I2 99.87%, PI: 68.6–73.5). Myanmar achieved the highest COVID-19 vaccination acceptance prevalence, with 86% (95%CI 84–89), followed by Vietnam with 82% (95% CI 79–85; I2 99.04%) and Malaysia with 78% (95%CI 72–84; I2 99.88%). None of the ten determinants studied (age, sex, education, previous COVID-19 infections, smoking and marriage status, health insurance, living together, chronic diseases, and healthcare workers) were significantly associated with acceptance. This result will be useful in guiding vaccination uptake in SEA. Full article
(This article belongs to the Special Issue Awareness and Attitudes around COVID-19 Vaccination)
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