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10 pages, 258 KiB

Open AccessArticle

COVID-19 Vaccination among HIV+ Patients: An Italian Cross-Sectional Survey

by Fabrizio Bert, Alex Pivi, Antonino Russotto, Benedetta Mollero, Gianluca Voglino, Giancarlo Orofino and Roberta Siliquini

Vaccines 2022, 10(9), 1438; https://doi.org/10.3390/vaccines10091438 - 1 Sep 2022

Cited by 10 | Viewed by 1790

Abstract

Background: This study aims to evaluate knowledge, attitudes and practices (KAP) of HIV-patients about COVID-19 vaccination. Methods: A cross-sectional study was conducted by administering questionnaires to 160 patients followed by Amedeo di Savoia Hospital in Turin. Statistical analyses were performed in order to [...] Read more.

Background: This study aims to evaluate knowledge, attitudes and practices (KAP) of HIV-patients about COVID-19 vaccination. Methods: A cross-sectional study was conducted by administering questionnaires to 160 patients followed by Amedeo di Savoia Hospital in Turin. Statistical analyses were performed in order to identify predictors of infection and severity of COVID-19 disease risk perception. Results: The 86.2% of patients were vaccinated for COVID-19, while 7.6% do not intend to be vaccinated; 50.7% thought that there is a minimal risk to get COVID-19; 85.8% thought that COVID-19 is a serious illness. The 56% and the 36.5 thought that seropositivity carries a greater risk to develop respectively COVID-19-related complications or vaccine complications. At the multivariate analysis having a job, proactive research of vaccine information and being HIV+ for several years are related to a lower risk perception of infection. The perception of COVID-19 severity is influenced by age, by being LGB and by believing that HIV+ status correlates with a higher risk of developing complications from COVID-19. Conclusions: as the pandemic can adversely impact the HIV care with increasing loss to follow-up, vaccination is essential to contrast infection in HIV+ patients. Our findings suggested that some HIV+ patients refuse vaccination against COVID-19. Full article

(This article belongs to the Special Issue Knowledge and Beliefs on Vaccines)

15 pages, 2418 KiB

Open AccessArticle

Cautious Sexual Attitudes Diminish Intent to Vaccinate Children against HPV in Utah

by David S. Redd, Jamie L. Jensen, Ruth J. Bodily, Abigail A. Lee, Ty J. Skyles and Brian D. Poole

Vaccines 2022, 10(9), 1382; https://doi.org/10.3390/vaccines10091382 - 24 Aug 2022

Cited by 5 | Viewed by 2112

Abstract

Although most Human papillomavirus (HPV) infections are mild and are cleared by the immune system, some high-risk HPV strains can cause various cancers. Vaccines have been developed that protect against high-risk HPV strains. HPV vaccines have been approved for use by the CDC [...] Read more.

Although most Human papillomavirus (HPV) infections are mild and are cleared by the immune system, some high-risk HPV strains can cause various cancers. Vaccines have been developed that protect against high-risk HPV strains. HPV vaccines have been approved for use by the CDC (Centers for Disease Control and Prevention) and are recommended for everyone aged 11–26. Despite the availability of safe and effective vaccines, uptake is low. HPV vaccine uptake has been extensively studied on a national and international level, but less is known about vaccine acceptance on a state or local level. The state of Utah, in the United States of America, has a relatively low HPV vaccination rate. In this study, we identified factors that impact the intent of Utah parents to vaccinate their children against HPV. A survey was distributed electronically to Utah residents. Survey results were analyzed using confirmatory factor analysis, structural equation modeling, and univariate analysis. Knowledge about HPV and positive vaccine attitudes had the greatest positive effect on intent to vaccinate children against HPV. Cautious sexual attitudes and high religious practice were found to have a negative impact on intent to vaccinate. Effective public health messaging will consider the cultural and religious influences of the target population. Full article

(This article belongs to the Special Issue Knowledge and Beliefs on Vaccines)

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11 pages, 548 KiB

Open AccessArticle

Attitudes and Perceptions of University Students in Healthcare Settings towards Vaccines and Vaccinations Strategies during the COVID-19 Pandemic Period in Italy

by Angela Bechini, Alfredo Vannacci, Giada Crescioli, Niccolò Lombardi, Marco Del Riccio, Giuseppe Albora, Jonida Shtylla, Marco Masoni, Maria Renza Guelfi, Paolo Bonanni and Sara Boccalini

Vaccines 2022, 10(8), 1288; https://doi.org/10.3390/vaccines10081288 - 10 Aug 2022

Cited by 3 | Viewed by 2291

Abstract

Background: Healthcare students that refuse to get vaccinated may expose themselves and their patients to several vaccine-preventable diseases, especially during outbreaks or at peak epidemic activity, becoming a threat to themselves and their patients. This study aimed to assess their attitudes towards and [...] Read more.

Background: Healthcare students that refuse to get vaccinated may expose themselves and their patients to several vaccine-preventable diseases, especially during outbreaks or at peak epidemic activity, becoming a threat to themselves and their patients. This study aimed to assess their attitudes towards and perception of vaccines and vaccination. Methods: An anonymous questionnaire was shared with medical students, pharmacy students and medical residents in Hygiene and Preventive Medicine at the University of Florence (Italy), in February 2021. The questionnaire contained 39 questions with open, multi-choice, yes–no, Likert scale answers. A Vaccine Hesitancy Index (VHI) was then calculated. A descriptive statistical analysis was performed. Results: A total of 473 students participated in this study. All students were in favour of vaccination (99.2%) but a relatively low number of participants judged their level of knowledge about vaccinations as “good” (21.8%) or “excellent” (0.6%). About half of students declared that they are not adequately trained during their academic courses. The VHI showed low levels of vaccine hesitancy (mean ± SD 0.38 ± 0.16); moreover, the students were willing to get vaccinated against SARS-CoV-2 when recommended (88.2%) and thought that these vaccines are generally safe. Few students considered the development of SARS-CoV-2 vaccines (13.1%) and the procedures for evaluating clinical trials for marketing authorisation of these vaccines (12.9%) too fast to guarantee their efficacy and safety. Conclusions: Since vaccination and vaccine hesitancy and acceptance topics are being paid increasing attention by the population, new strategies to increase future healthcare professionals’ willingness to promote vaccination and get vaccinated, as well as knowledge on vaccines and vaccination, will be of the utmost importance to fight vaccine preventable diseases. Full article

(This article belongs to the Special Issue Knowledge and Beliefs on Vaccines)

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11 pages, 691 KiB

Open AccessArticle

Students as Community Vaccinators: Implementation of A Service-Learning COVID-19 Vaccination Program

by Andrew R. Griswold, Julia Klein, Neville Dusaj, Jeff Zhu, Allegra Keeler, Erika L. Abramson and Dana Gurvitch

Vaccines 2022, 10(7), 1058; https://doi.org/10.3390/vaccines10071058 - 30 Jun 2022

Cited by 6 | Viewed by 2594

Abstract

While the COVID-19 pandemic has caused major educational disruptions, it has also catalyzed innovation in service-learning as a real-time response to pandemic-related problems. The limited number of qualified providers was primed to restrict SARS-CoV-2 vaccination efforts. Thus, New York State temporarily allowed healthcare [...] Read more.

While the COVID-19 pandemic has caused major educational disruptions, it has also catalyzed innovation in service-learning as a real-time response to pandemic-related problems. The limited number of qualified providers was primed to restrict SARS-CoV-2 vaccination efforts. Thus, New York State temporarily allowed healthcare professional trainees to vaccinate, enabling medical students to support an overwhelmed healthcare system and contribute to the public health crisis. Here, we describe a service-learning vaccination program directed towards underserved communities. A faculty-led curriculum prepared medical students to communicate with patients about COVID-19 vaccines and to administer intramuscular injections. Qualified students were deployed to public vaccination clinics located in under-served neighborhoods in collaboration with an established community partner. Throughout the program, 128 students worked at 103 local events, helping to administer 26,889 vaccine doses. Analysis of a retrospective survey administered to participants revealed the program taught fundamental clinical skills and was a transformative service-learning experience. As new virus variants emerge and nations battle recurrent waves of infection, the need for effective vaccination plans continues to grow. The program described here offers a novel framework that academic medical centers could adapt to increase vaccine access in their local community and provide students with a uniquely meaningful educational experience. Full article

(This article belongs to the Special Issue Knowledge and Beliefs on Vaccines)

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11 pages, 266 KiB

Open AccessArticle

Faith, Fear, and Facts: A COVID-19 Vaccination Hesitancy Intervention for Black Church Congregations

by Bridgette Peteet, Valerie Watts, Eunique Tucker, Paige Brown, Mariam Hanna, Amanda Saddlemire, Miriam Rizk, Juan Carlos Belliard, Jacinda C. Abdul-Mutakabbir, Samuel Casey and Kelvin Simmons

Vaccines 2022, 10(7), 1039; https://doi.org/10.3390/vaccines10071039 - 28 Jun 2022

Cited by 19 | Viewed by 2906

Abstract

Background: Blacks are dying from the novel coronavirus of 2019 (COVID-19) at disproportionate rates and tend to have more COVID-19 vaccine hesitancy than Whites. These disparities may be attributable to health knowledge and government/medical mistrust stemming from negative experiences with the medical system [...] Read more.

Background: Blacks are dying from the novel coronavirus of 2019 (COVID-19) at disproportionate rates and tend to have more COVID-19 vaccine hesitancy than Whites. These disparities may be attributable to health knowledge and government/medical mistrust stemming from negative experiences with the medical system historically and presently (e.g., the Tuskegee Experiment, provider maltreatment). Method: The present study assessed COVID-19 vaccine hesitancy and the effectiveness of a 1.5 h, dialogue-based, web intervention hosted by an academic–community partnership team. The webinar included approximately 220 male and female, English speaking, Black churchgoers in the western U.S. The webinar focused on the psychology of fear and facts about the vaccine development. Results: The sample was mostly females who had higher vaccine hesitancy than men. A third of participants feared hospitalization if they contracted COVID-19. Many participants reported that learning facts about COVID-19 was most impactful. Statistical analyses indicated an increased willingness to get vaccinated after the webinar in comparison to before (t(25) = −3.08, p = 0.005). Conclusion: The findings suggest that virtual webinars may be effective at reducing COVID-19 vaccine hesitancy among Black churchgoers and may be applicable in addressing other health behaviors. Full article

(This article belongs to the Special Issue Knowledge and Beliefs on Vaccines)

21 pages, 302 KiB

Open AccessArticle

Acceptance of COVID-19 Vaccines among Adults in Lilongwe, Malawi: A Cross-Sectional Study Based on the Health Belief Model

by Qun Ao, Robert Okia Egolet, Hui Yin and Fuqiang Cui

Vaccines 2022, 10(5), 760; https://doi.org/10.3390/vaccines10050760 - 11 May 2022

Cited by 9 | Viewed by 4286

Abstract

The COVID-19 pandemic has had a significant economic and social impact on Malawi. Promoting vaccination is a key protection measure against COVID-19. Employing the health beliefs model (HBM), this study explores various factors that influence COVID-19 vaccination acceptance (intentions and behavior) among adult [...] Read more.

The COVID-19 pandemic has had a significant economic and social impact on Malawi. Promoting vaccination is a key protection measure against COVID-19. Employing the health beliefs model (HBM), this study explores various factors that influence COVID-19 vaccination acceptance (intentions and behavior) among adult residents of Malawi. A semi-structured questionnaire was used for data collection. A field-based survey was conducted among adult residents in Lilongwe, Malawi. Descriptive statistics, linear regression, the Chi-square test, and Pearson’s correlation statistics were used for data analysis. A total of 758 questionnaires were involved. Respondents aged 18–24 (OR = 5.079, 95% CI 2.303–11.202), 25–34 (OR = 2.723, 95% CI 1.363–5.438), urban residents (OR = 1.915, 95% CI 1.151–3.187), graduates/professionals (OR = 1.193, 95% CI 0.857–1.651), health workers (OR = 4.080, 95% CI 1.387–12.000), perceived susceptibility (OR = 1.787, 95% CI 1.226–2.605), perceived benefit (OR = 2.992, 95% CI 1.851–4.834), and action cues (OR = 2.001, 95% CI 1.285–3.115) were predictors for “acceptance of COVID-19 vaccine”. The health belief model structure can be used as a good predictor of vaccine acceptance, especially “perceived susceptibility,” “perceived benefit,” and “action cues”. Strengthening COVID-19 vaccine education in these areas will be an important future intervention. Full article

(This article belongs to the Special Issue Knowledge and Beliefs on Vaccines)

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14 pages, 2622 KiB

Open AccessArticle

Facilitating Informed Decision Making: Determinants of University Students’ COVID-19 Vaccine Uptake

by Tugce Varol, Francine Schneider, Ilse Mesters, Robert A. C. Ruiter, Gerjo Kok and Gill A. Ten Hoor

Vaccines 2022, 10(5), 704; https://doi.org/10.3390/vaccines10050704 - 29 Apr 2022

Cited by 8 | Viewed by 2270

Abstract

Background: Although several COVID-19 vaccines are available, the current challenge is achieving high vaccine uptake. We aimed to explore university students’ intention to get vaccinated and select the most relevant determinants/beliefs to facilitate informed decision making around COVID-19 vaccine uptake. Methods: A cross-sectional [...] Read more.

Background: Although several COVID-19 vaccines are available, the current challenge is achieving high vaccine uptake. We aimed to explore university students’ intention to get vaccinated and select the most relevant determinants/beliefs to facilitate informed decision making around COVID-19 vaccine uptake. Methods: A cross-sectional online survey with students (N = 434) from Maastricht University was conducted in March 2021. The most relevant determinants/beliefs of students’ COVID-19 vaccine intention (i.e., determinants linked to vaccination intention, and with enough potential for change) were visualized using CIBER plots. Results: Students’ intention to get the COVID-19 vaccine was high (80%). Concerns about safety and side effects of the vaccine and trust in government, quality control, and the pharmaceutical industry were identified as the most relevant determinants of vaccine intention. Other determinants were risk perception, attitude, perceived norm, and self-efficacy beliefs. Conclusion: Our study identified several determinants of COVID-19 vaccine intention (e.g., safety, trust, risk perception, etc.) and helped to select the most relevant determinants/beliefs to target in an intervention to maximize COVID-19 vaccination uptake. Concerns and trust related to the COVID-19 vaccine are the most important targets for future interventions. Other determinants that were already positive (i.e., risk perception, attitudes, perceived norms, and self-efficacy) could be further confirmed. Full article

(This article belongs to the Special Issue Knowledge and Beliefs on Vaccines)

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12 pages, 2137 KiB

Open AccessArticle

COVID-19 Vaccine Booster Hesitancy among Healthcare Workers: A Retrospective Observational Study in Singapore

by Sky Wei Chee Koh, Hwei Ming Tan, Wayne Han Lee, Jancy Mathews and Doris Young

Vaccines 2022, 10(3), 464; https://doi.org/10.3390/vaccines10030464 - 17 Mar 2022

Cited by 30 | Viewed by 5292

Abstract

Background: COVID-19 booster uptake remained poor among healthcare workers (HCW) despite evidence of improved immunity against Delta and Omicron variants. While most studies used a questionnaire to assess hesitancy, this study aimed to identify factors affecting booster hesitancy by examining actual vaccine uptake [...] Read more.

Background: COVID-19 booster uptake remained poor among healthcare workers (HCW) despite evidence of improved immunity against Delta and Omicron variants. While most studies used a questionnaire to assess hesitancy, this study aimed to identify factors affecting booster hesitancy by examining actual vaccine uptake across time. Method: COVID-19 vaccination database records among HCW working at seven Singaporean public primary care clinics between January to December 2021 were extracted, with sex, profession, place of practice, vaccination type, and dates. Time to booster was calculated from the date of vaccination minus date of eligibility. Chi-square test was used to compare the relationship between first dose and booster hesitancy, Kaplan–Meier method and log-rank test were adopted to evaluate differences in cumulative booster uptake. Multivariate Cox regression was used to investigate predictors for timely booster vaccination. Vaccination rate was charted across time and corroborated with media releases pertaining to legislative changes. Results: A total of 877 of 891 (98.9%) primary care HCW were fully vaccinated, 73.8% of eligible HCW had taken the booster. HCW were less booster hesitant [median 16 (5–31.3) days] compared to the first dose [median 39 (13–119.3) days]. First dose-hesitant HCW were more likely to be booster hesitant (OR = 3.66, 95%CI 2.61–5.14). Adjusting for sex, workplace, and time to first dose, ancillary (HR = 1.53, 95%CI 1.03–2.28), medical (HR = 1.8, 95%CI 1.18–2.74), and nursing (HR = 1.8, 95%CI 1.18–2.37) received boosters earlier compared with administrative staff. No temporal relationship was observed between booster uptake, legislative changes, and COVID-19 infection numbers. Conclusion: Vaccine hesitancy among HCW had improved from first dose to booster, with timely booster vaccination among medical and nursing staff. Tailored education, risk messaging, and strategic legislation might help to reduce delayed booster vaccination. Full article

(This article belongs to the Special Issue Knowledge and Beliefs on Vaccines)

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13 pages, 721 KiB

Open AccessArticle

Vaccine Attitudes and COVID-19 Vaccine Intentions and Prevention Behaviors among Young People At-Risk for and Living with HIV in Los Angeles and New Orleans

by Dallas Swendeman, Peter Norwood, Jessica Saleska, Katherine Lewis, Wilson Ramos, Nicholas SantaBarbara, Stephanie Sumstine, Warren Scott Comulada, Sergio Jimenez, Manuel A. Ocasio, Elizabeth M. Arnold, Karin Nielsen-Saines, Maria Isabel Fernandez, Mary Jane Rotheram-Borus and on behalf of the Adolescent HIV Medicine Trials Network (ATN) CARES Team

Vaccines 2022, 10(3), 413; https://doi.org/10.3390/vaccines10030413 - 9 Mar 2022

Cited by 20 | Viewed by 3542

Abstract

Sexual and gender minority (SGM) and racial or ethnic minority youth at-risk for or living with HIV may have higher risk of SARS-CoV-2 infection. However, there are few data on vaccine hesitancy/acceptance and COVID-19 self-protective behaviors among this population. Youth aged 15–24 years [...] Read more.

Sexual and gender minority (SGM) and racial or ethnic minority youth at-risk for or living with HIV may have higher risk of SARS-CoV-2 infection. However, there are few data on vaccine hesitancy/acceptance and COVID-19 self-protective behaviors among this population. Youth aged 15–24 years (n = 440), predominantly African American and Latine (73%, n = 320) SGM, from Los Angeles and New Orleans reported their vaccine attitudes and COVID-19 and HIV preventive behaviors in October 2020. Latent class analyses categorized individuals into groups based on their vaccine attitudes and preventive behaviors. Relationships between these groups and other factors were analyzed using Fisher’s exact tests, ANOVA, and logistic regression. Most youth had accepting vaccine attitudes (70.2%, n = 309), with 20.7% hesitant (n = 91), and 9.1% resistant (n = 40). SGM and African Americans were significantly less accepting than their cis-gender and heterosexual peers. About two-thirds (63.2%, n = 278) of the respondents reported consistent COVID-19 self-protective behaviors. Youth with pro-vaccine attitudes were most consistently self-protective; however, only 54.4% (n= 168/309) intended to take a COVID-19 vaccine. Homelessness history, race, and sexual orientation were associated with vaccine attitudes. Accepting vaccine attitudes and consistent COVID-19 self-protective behaviors were closely related. COVID-19 attitudes/behaviors were not associated with HIV risk and only loosely associated with SARS-CoV-2 vaccine intentions. Full article

(This article belongs to the Special Issue Knowledge and Beliefs on Vaccines)

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12 pages, 436 KiB

Open AccessArticle

An Opportunity to Understand Concerns about COVID-19 Vaccination: Perspectives from EMS Professionals

by Sarah R. MacEwan, Alice A. Gaughan, Megan E. Gregory, Laura J. Rush, Jonathan R. Powell, Jordan D. Kurth, Ashish R. Panchal and Ann Scheck McAlearney

Vaccines 2022, 10(3), 380; https://doi.org/10.3390/vaccines10030380 - 2 Mar 2022

Cited by 4 | Viewed by 4590

Abstract

Some healthcare professionals, including emergency medical service (EMS) professionals, remain hesitant about receiving COVID-19 vaccines. This study sought to understand EMS professionals’ perspectives regarding COVID-19 vaccination. Using open-ended comments from a national survey deployed electronically to over 19,000 EMS professionals in April of [...] Read more.

Some healthcare professionals, including emergency medical service (EMS) professionals, remain hesitant about receiving COVID-19 vaccines. This study sought to understand EMS professionals’ perspectives regarding COVID-19 vaccination. Using open-ended comments from a national survey deployed electronically to over 19,000 EMS professionals in April of 2021, we examined perspectives about acceptance of and hesitancy toward COVID-19 vaccines. Survey comments revealed differences in perspectives between vaccinated and unvaccinated EMS professionals regarding their personal role in improving public health through COVID-19 vaccination as well as vaccine benefits and the protection conferred by vaccination. Unvaccinated individuals also expressed concerns over the research and development of the COVID-19 vaccines that led to their decision not to get vaccinated. Individuals who were vaccinated suggested ways to increase uptake of the vaccine including having healthcare professionals serve as leaders for vaccination and educating individuals about COVID-19 vaccination through credible resources. Vaccine hesitancy remains a challenge to achieving herd immunity to COVID-19 through vaccination, even among healthcare professionals. Understanding the perspectives of those who have chosen not to be vaccinated can help direct strategies to reduce confusion and concerns. The perspectives of vaccinated individuals may also be valuable in identifying opportunities to promote vaccination in the professional setting. Full article

(This article belongs to the Special Issue Knowledge and Beliefs on Vaccines)

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13 pages, 283 KiB

Open AccessArticle

A Safe Return to Campus in Times of COVID-19: A Survey Study among University Personnel to Inform Decision Makers

by Tugce Varol, Francine Schneider, Ilse Mesters, Robert A. C. Ruiter, Gerjo Kok and Gill A. Ten Hoor

Vaccines 2022, 10(3), 371; https://doi.org/10.3390/vaccines10030371 - 27 Feb 2022

Cited by 2 | Viewed by 2817

Abstract

Halfway through 2021 in the midst of a public health crisis, a new academic year was fast approaching. Dutch universities were preparing to reopen their campuses to students and personnel in a safe manner. As the vaccination uptake was increasing and societies were [...] Read more.

Halfway through 2021 in the midst of a public health crisis, a new academic year was fast approaching. Dutch universities were preparing to reopen their campuses to students and personnel in a safe manner. As the vaccination uptake was increasing and societies were slowly reopening, inviting students and personnel to campus became the next step to “the new normal”. To absorb this change seamlessly, it was considered important to investigate personnel’s beliefs about returning to campus and their perceptions of a safe working environment. An online survey was conducted among personnel (N = 1965) of Maastricht University, the Netherlands. University personnel’s beliefs about a safe return to campus were assessed. The data were collected between 11 June and 28 June 2021. This study showed that, while most personnel (94.7%) were already vaccinated or willing to do so, not all personnel did feel safe to return to campus in September 2021. Over half of the respondents (58%) thought that the university is a safe place to return to work when the new academic year starts. However, the remainder of personnel felt unsafe or were uncertain for various reasons such as meeting in large groups or becoming infected. Moreover, when returning to campus, employees stated that they would require some time to reacclimate to their former work culture. The group who felt relatively more unsafe indicated that returning in September was too risky and that they worried about being infected. They wanted the safety guidelines to still be in force. On the other hand, the “safe” group stated safely returning to be “certainly possible” and trusted that others would still stick to the prevention guidelines. The findings led to practical recommendations for the University Board as they were preparing for organizing research and teaching for the upcoming academic year in the context of the COVID-19 pandemic. A brief intervention was developed: a webinar in which the data were linked to the board’s plans for safe returning. This study demonstrates that university boards may use research among personnel to develop adequate measures promoting safety and feelings of safety among personnel in similar future situations. Full article

(This article belongs to the Special Issue Knowledge and Beliefs on Vaccines)

14 pages, 874 KiB

Open AccessArticle

COVID-19 Vaccine Hesitancy: The Role of Socioeconomic Factors and Spatial Effects

by Jim Lee and Yuxia Huang

Vaccines 2022, 10(3), 352; https://doi.org/10.3390/vaccines10030352 - 24 Feb 2022

Cited by 45 | Viewed by 5096

Abstract

This paper investigates the spatial dimension of socioeconomic and demographic factors behind COVID-19 vaccine hesitancy. With a focus on a county with considerable sociodemographic diversity in the state of Texas, USA, we apply regression models to census-tract-level data of the unvaccinated population. In [...] Read more.

This paper investigates the spatial dimension of socioeconomic and demographic factors behind COVID-19 vaccine hesitancy. With a focus on a county with considerable sociodemographic diversity in the state of Texas, USA, we apply regression models to census-tract-level data of the unvaccinated population. In addition to disparities in accessing the vaccination service, particularly for residents in rural areas, empirical results confirm under-vaccination among lower socioeconomic neighborhoods and communities with signs of distrust in government. The spatial model regressions further underscore the impact that vaccine hesitancy among residents in one community spread to its nearby communities. This observed spatial spillover effect is attributable to the geographic interactions of similar socioeconomic groups. Full article

(This article belongs to the Special Issue Knowledge and Beliefs on Vaccines)

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9 pages, 215 KiB

Open AccessArticle

COVID-19 Vaccine Hesitancy Prevalence and Predictors among the Students of Jazan University, Saudi Arabia Using the Health Belief Model: A Cross-Sectional Study

by Husameldin Elsawi Khalafalla, Maria Zenaida Tumambeng, Majidah Hussain Asiri Halawi, Enas Mohammed Ali Masmali, Thekra Badr Mohammed Tashari, Fatimah Hasser Abdullah Arishi, Roaa Hassan Mohammed Shadad, Sarah Zaki Abdullah Alfaraj, Shroog Mohammed Ali Fathi and Mohamed Salih Mahfouz

Vaccines 2022, 10(2), 289; https://doi.org/10.3390/vaccines10020289 - 14 Feb 2022

Cited by 18 | Viewed by 3383

Abstract

Vaccination has a major role in the control of the COVID-19 pandemic. The behavior toward accepting the COVID-19 vaccine is complex and multifactorial, while the level of acceptance and hesitancy depends on many factors. This study aims to measure the level of vaccine [...] Read more.

Vaccination has a major role in the control of the COVID-19 pandemic. The behavior toward accepting the COVID-19 vaccine is complex and multifactorial, while the level of acceptance and hesitancy depends on many factors. This study aims to measure the level of vaccine acceptance among Jazan University students and identify its predictors. In this cross-sectional study, an online questionnaire based on the health belief model (HBM) was sent through social media “WhatsApp” to two strata of students selected by convenient sampling. The overall desire to get vaccinated was noted in 83.6% of participants, and 16.4% reported no desire to be vaccinated. The constructs of the HBM were shown to significantly predict vaccine acceptance with the exception of “perceived susceptibility”. In conclusion, the level of acceptance of the COVID-19 vaccine among Jazan University students was relatively high. The HBM constructs are important predictors of the vaccination behavior with the exception of the construct “perceived susceptibility”. Full article

(This article belongs to the Special Issue Knowledge and Beliefs on Vaccines)

12 pages, 273 KiB

Open AccessArticle

Knowledge, Attitudes, and Perception towards COVID-19 Vaccination among the Adult Population: A Cross-Sectional Study in Turkey

by Meliha Cagla Sonmezer, Taha Koray Sahin, Enes Erul, Furkan Sacit Ceylan, Muhammed Yusuf Hamurcu, Nihal Morova, Ipek Rudvan Al and Serhat Unal

Vaccines 2022, 10(2), 278; https://doi.org/10.3390/vaccines10020278 - 11 Feb 2022

Cited by 25 | Viewed by 8010

Abstract

Background: The coronavirus disease 2019 (COVID-19) pandemic continues to wreak havoc on lives and ravage the world. Several vaccines have been approved for use against COVID-19; however, there may be hesitancy and negative perceptions towards vaccination, which may reduce the willingness to be [...] Read more.

Background: The coronavirus disease 2019 (COVID-19) pandemic continues to wreak havoc on lives and ravage the world. Several vaccines have been approved for use against COVID-19; however, there may be hesitancy and negative perceptions towards vaccination, which may reduce the willingness to be vaccinated. Further, studies assessing the current perception toward COVID-19 vaccination are scarce. This study aimed to assess community knowledge, attitudes, and perceptions regarding COVID-19 vaccines among the general population of Turkey. Methods: A cross-sectional survey was carried out among 1009 adult participants from the 13–20 April 2021. Demographic data were collected, and attitudes and perceptions toward COVID-19 vaccines were evaluated. A multivariable regression analysis was performed to identify the factors predicting perception towards COVID-19 vaccinations. Results: Just over half of participants were male (52.6%) and the majority of respondents were aged between 30 and 39 years (33.8%). Our study revealed that 62.7% of participants had positive perceptions of COVID-19 vaccines. Logistic regression analysis results showed that older people (≥30 vs. <30) were less likely to have a positive perception towards COVID-19 vaccines (OR = 0.70, 95% CI = 0.51–0.94). We also found participants who had a previous history of influenza vaccines (OR = 2.01, 95% CI = 1.43–2.84), bachelor’s degrees or above (OR = 1.47, 95% CI = 1.12–1.91), and a personal history of COVID-19 (OR = 1.58, 95% CI = 1.10–2.26) were more likely to have a positive perception regarding COVID-19 vaccines. Conclusion: The proportion of the general population in Turkey who believe in COVID-19 vaccine effectiveness is not inferior to that of other countries. However, the low positive perception even among the population applying for vaccination indicates that understanding the perception of the general population and its influencing factors may contribute to developing a strategy for improving vaccination rates by addressing these factors. Full article

(This article belongs to the Special Issue Knowledge and Beliefs on Vaccines)

15 pages, 718 KiB

Open AccessArticle

COVID-19: Why Do People Refuse Vaccination? The Role of Social Identities and Conspiracy Beliefs: Evidence from Nationwide Samples of Polish Adults

by Marta Marchlewska, Katarzyna Hamer, Maria Baran, Paulina Górska and Krzysztof Kaniasty

Vaccines 2022, 10(2), 268; https://doi.org/10.3390/vaccines10020268 - 10 Feb 2022

Cited by 34 | Viewed by 6288

Abstract

In the present research, we focus on COVID-19 vaccine hesitancy, and empirically examine how different forms of social identity (defensive vs. secure national identity and identification with all humanity) and conspiracy beliefs are associated with COVID-19 vaccine hesitancy. In two cross-sectional nationwide surveys [...] Read more.

In the present research, we focus on COVID-19 vaccine hesitancy, and empirically examine how different forms of social identity (defensive vs. secure national identity and identification with all humanity) and conspiracy beliefs are associated with COVID-19 vaccine hesitancy. In two cross-sectional nationwide surveys (Study 1, n = 432, and Study 2, n = 807), we found that willingness to vaccinate against COVID-19 was negatively linked to national narcissism, but positively related to a secure national identification, that is, national identification without the narcissistic component. In both studies, we also found that the relationship between narcissistic (vs. secure) national identity and unwillingness to vaccinate against COVID-19 was mediated by COVID-19 vaccine conspiracy beliefs. These effects were present even when we accounted for basic demographics (Studies 1 and 2) and identification with all humanity (Study 2), which had been found to be a significant predictor of health behaviors during COVID-19. In line with previous research, identification with all humanity was positively associated with the willingness to vaccinate against COVID-19. We discuss the implications for understanding the role of the way in which people identify with their national and supranational groups in antiscience attitudes and (mal)adaptive behaviors during COVID-19 pandemic. Full article

(This article belongs to the Special Issue Knowledge and Beliefs on Vaccines)

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19 pages, 25570 KiB

Open AccessArticle

Behavioural Determinants of COVID-19-Vaccine Acceptance in Rural Areas of Six Lower- and Middle-Income Countries

by Thomas P. Davis, Jr., Adugna Kebede Yimam, Md Abul Kalam, Asrat Dibaba Tolossa, Robert Kanwagi, Sarah Bauler, Loria Kulathungam and Heidi Larson

Vaccines 2022, 10(2), 214; https://doi.org/10.3390/vaccines10020214 - 29 Jan 2022

Cited by 33 | Viewed by 7146

Abstract

Delayed acceptance or refusal of COVID-19 vaccines may increase and prolong the threat to global public health and the economy. Identifying behavioural determinants is considered a critical step in explaining and addressing the barriers of vaccine refusal. This study aimed to identify the [...] Read more.

Delayed acceptance or refusal of COVID-19 vaccines may increase and prolong the threat to global public health and the economy. Identifying behavioural determinants is considered a critical step in explaining and addressing the barriers of vaccine refusal. This study aimed to identify the behavioural determinants of COVID-19-vaccine acceptance and provide recommendations to design actionable interventions to increase uptake of the COVID-19 vaccine in six lower- and middle-income countries. Taking into consideration the health belief model and the theory of reasoned action, a barrier analysis approach was employed to examine twelve potential behavioural determinants of vaccine acceptance in Bangladesh, India, Myanmar, Kenya, the Democratic Republic of the Congo (DRC), and Tanzania. In all six countries, at least 45 interviews with those who intended to get the vaccine (“Acceptors”) and another 45 or more interviews with those who did not (“Non-acceptors”) were conducted, totalling 542 interviews. Data analysis was performed to find statistically significant (p < 0.05) differences between Acceptors and Non-acceptors of COVID-19 vaccines and to identify which beliefs were most highly associated with acceptance and non-acceptance of vaccination based on the estimated relative risk. The analysis showed that perceived social norms, perceived positive and negative consequences, perceived risk, perceived severity, trust, perceived safety, and expected access to COVID-19 vaccines had the highest associations with COVID-19-vaccine acceptance in Bangladesh, Kenya, Tanzania, and the DRC. Additional behavioural determinants found to be significant in Myanmar and India were perceived self-efficacy, trust in COVID-19 information provided by leaders, perceived divine will, and perceived action efficacy of the COVID-19 vaccines. Many of the determinants were found to be significant, and their level of significance varied from country to country. National and local plans should include messages and activities that address the behavioural determinants found in this study to significantly increase the uptake of COVID-19 vaccines across these countries. Full article

(This article belongs to the Special Issue Knowledge and Beliefs on Vaccines)

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23 pages, 1207 KiB

Open AccessArticle

Tetanus Vaccination Status and Vaccine Hesitancy in Amateur Basketball Players (Italy, 2020)

by Matteo Riccò and Simona Peruzzi

Vaccines 2022, 10(1), 131; https://doi.org/10.3390/vaccines10010131 - 17 Jan 2022

Cited by 7 | Viewed by 2624

Abstract

Basketball is among the third most popular team sport in Italy. Albeit not usually perceived as being at high risk for tetanus, the Italian legal framework (Law No. 292 of 1963; Presidential Decree 1301/1965) requires tetanus vaccination (TeV) even for amateur practice. Even [...] Read more.

Basketball is among the third most popular team sport in Italy. Albeit not usually perceived as being at high risk for tetanus, the Italian legal framework (Law No. 292 of 1963; Presidential Decree 1301/1965) requires tetanus vaccination (TeV) even for amateur practice. Even though some previous reports have suggested a relatively low adherence towards vaccination practice among basketball player, corresponding knowledge, attitudes and practices towards TeV remain largely unknown. Our study specifically investigated such topics in a total of 270 amateur basketball players participating into an internet-based survey by completing a structured questionnaire. Of them, 73.0% had a proper vaccination status, but a third of respondents (33.3%) exhibited some degree of vaccine hesitancy. The average understanding of TeV and tetanus (79.8% with a potential range 0–100) as well as the risk perception for natural infection (63.9% ± 26.6) were quite good. Even though unmotivated fears towards TeV were more scarcely reported (14.0% ± 15.4), they still represented the main reasons for having missed vaccination shots (63.0%). Knowledge status and risk perception for natural infection and TeV were well correlated (R = 0.22 and R = −0.64, respectively). Appropriate TeV status was more likely in respondents not exhibiting vaccine hesitancy (Odds Ratio (OR) 0.114, 95% Confidence Interval (95%CI) 0.059–0.225). In turn, vaccine hesitancy was more frequently reported among individuals of male gender (OR 3.148, 95%CI 1.072–9.244), while better formal education (OR 0.065, 95%CI 0.013–0.319) and working in healthcare settings (OR 0.042, 95%CI 0.007–0.265) were characterized as negative effectors. Vaccinations in athletes represent an often overlooked issue, with a considerable lack of available evidence. The results stress the opportunity for appropriate TeV screening programs among amateur athletes and the potential relevance of interventions aimed at raising the perceived significance of TeV in order to cope with a significant share of vaccine-hesitant athletes. Full article

(This article belongs to the Special Issue Knowledge and Beliefs on Vaccines)

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13 pages, 3396 KiB

Open AccessArticle

Factors That Impact Acceptance of COVID-19 Vaccination in Different Community-Dwelling Populations in China

by Jinhua Pan, Kezhong A, Zhixi Liu, Peng Zhang, Zhiyin Xu, Xiaoqin Guo, Guangtao Liu, Ao Xu, Jing Wang, Xinyu Wang and Weibing Wang

Vaccines 2022, 10(1), 91; https://doi.org/10.3390/vaccines10010091 - 8 Jan 2022

Cited by 9 | Viewed by 2790

Abstract

(1) Background: It is important to improve vaccination strategies and immunization programs to achieve herd immunity to infectious diseases. (2) Methods: To assess the acceptance of COVID-19 vaccination, we conducted face-to-face surveys and online surveys in Shanghai, Zhejiang, and Qinghai provinces. A fixed-effect [...] Read more.

(1) Background: It is important to improve vaccination strategies and immunization programs to achieve herd immunity to infectious diseases. (2) Methods: To assess the acceptance of COVID-19 vaccination, we conducted face-to-face surveys and online surveys in Shanghai, Zhejiang, and Qinghai provinces. A fixed-effect model and a random effects model were used to analyze factors associated with the acceptance of COVID-19 vaccination. (3) Findings: We initially recruited 3173 participants, 3172 participants completed the full questionnaire (the response rate was nearly 100%), of which 2169 were valid questionnaires, with an effective rate of 87.3%. The results indicated that 82.6% of participants were willing to receive vaccination when it was available in the community, and 57.2% of deliverymen, 43.3% of medical workers, 78.2% of parents of primary and secondary school children, and 72.2% of parents of preschool children were willing to receive vaccination. The models showed that participants who were male (female vs. male: OR = 1.49, 95% CI (1.12, 1.98)), 60 to 69 years-old (60–69 vs. <30: OR = 0.52, 95% CI (0.29, 0.92)), had less education (medium vs. low: OR = 1.50, 95% CI (1.05, 2.23)), had good health status (good vs. low: OR = 0.36, 95% CI (0.15, 0.88)), and had positive attitudes and trust (OR = 0.14, 95% CI (0.10, 0.20)) in vaccines approved by the National Health Commission were more likely to accept vaccination. Participants also had an increased vaccination acceptance if it was recommended by government sources, doctors, relatives, or friends. Most participants learned about COVID-19 vaccination from television, radio, and newspapers, followed by community or hospital campaigns and the internet. (4) Conclusions: Government sources and doctors could increase the acceptance of vaccination by promoting the efficacy and safety of COVID-19 vaccination by the use of mass media and emphasizing the necessity of vaccination for everyone. Full article

(This article belongs to the Special Issue Knowledge and Beliefs on Vaccines)

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Review

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9 pages, 686 KiB

Open AccessReview

Nurses’ Influenza Vaccination and Hesitancy: A Systematic Review of Qualitative Literature

by Natacha Pinatel, Catherine Plotton, Bruno Pozzetto and Xavier Gocko

Vaccines 2022, 10(7), 997; https://doi.org/10.3390/vaccines10070997 - 22 Jun 2022

Cited by 4 | Viewed by 2418

Abstract

Vaccine hesitancy (VH) is defined as “delaying or refusing a secure vaccine despite its availability”. This hesitancy affects caregivers and more specifically nurses. The purpose of this study is to assess determinants of influenza VH in the nurse’s community. We conducted [...] Read more.

Vaccine hesitancy (VH) is defined as “delaying or refusing a secure vaccine despite its availability”. This hesitancy affects caregivers and more specifically nurses. The purpose of this study is to assess determinants of influenza VH in the nurse’s community. We conducted a systematic review of qualitative literature according to criteria of Preferred Reporting Items for Systematic Review and Meta-Analysis and Enhancing Transparency in Reporting the synthesis of Qualitative Research from 2009 until October 2020. Eleven qualitative studies analysed (ten thematic content analyses and one grounded theory method) found three main factors in VH. The first determinant was the benefit–risk equation considered as unfavourable due to an ineffective vaccine and fears about adverse effects as the pain of the injection. Wrong immunological beliefs brought into hesitancy. Disease barriers (hand washing and masks) and personal immunity were regarded as more effective than the vaccine. Lastly, dehumanised vaccination and the difficulties of access to healthcare were institutional determinants. Nurses ask for a vaccine promotion by hierarchy and doctors with transparent information and respect for autonomy. The availability of vaccines and methods of pain control seem to be some tracks to reduce nurses’ VH. Full article

(This article belongs to the Special Issue Knowledge and Beliefs on Vaccines)

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17 pages, 2949 KiB

Open AccessReview

Effect of COVID-19 Pandemic on Influenza Vaccination Intention: A Meta-Analysis and Systematic Review

by Gwyneth Kong, Nicole-Ann Lim, Yip Han Chin, Yvonne Peng Mei Ng and Zubair Amin

Vaccines 2022, 10(4), 606; https://doi.org/10.3390/vaccines10040606 - 13 Apr 2022

Cited by 64 | Viewed by 5542

Abstract

Poorer outcomes have been reported with COVID-19 and influenza coinfections. As the COVID-19 pandemic rages on, protection against influenza by vaccination is becoming increasingly important. This study examines how COVID-19 has influenced influenza vaccination intentions from a global perspective. A literature search was [...] Read more.

Poorer outcomes have been reported with COVID-19 and influenza coinfections. As the COVID-19 pandemic rages on, protection against influenza by vaccination is becoming increasingly important. This study examines how COVID-19 has influenced influenza vaccination intentions from a global perspective. A literature search was conducted on Embase, PubMed, and CNKI from 1 January 2019 to 31 December 2021 for articles reporting rates of influenza vaccination pre-COVID-19 (19/20 season), and intention and/or uptake of influenza vaccination post-COVID-19 (20/21 season). The changes in vaccination intention and reasons for changes were reported. Subgroup analyses were performed by region, gender, age, and occupation. Newcastle Ottawa Scale was used for quality assessment of the articles. Twenty-seven studies with 39,193 participants were included. Among 22 studies reporting intention to vaccinate in 20/21, there was increased intention to vaccinate (RR 1.50, 95% CI 1.32–1.69, p < 0.001) regardless of age, gender, and occupation. The remaining five studies reporting vaccination intention and uptake in 20/21 showed a similar increase (RR 1.68, 95%CI 1.20–2.36). Important determinants include historical vaccine acceptance, and perception of influenza severity and vaccine safety. The COVID-19 pandemic has increased intention to vaccinate against influenza internationally. The pandemic could be a window of opportunity to promote influenza vaccination and decrease vaccine hesitancy. Full article

(This article belongs to the Special Issue Knowledge and Beliefs on Vaccines)

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25 pages, 687 KiB

Open AccessReview

The Effectiveness of Interventions for Increasing COVID-19 Vaccine Uptake: A Systematic Review

by Eleonore Batteux, Freya Mills, Leah Ffion Jones, Charles Symons and Dale Weston

Vaccines 2022, 10(3), 386; https://doi.org/10.3390/vaccines10030386 - 3 Mar 2022

Cited by 75 | Viewed by 11275

Abstract

Vaccination is vital to protect the public against COVID-19. The aim of this systematic review is to identify and evaluate the effectiveness of interventions to increase COVID-19 vaccine uptake. We searched a range of databases (Embase, Medline, Psychology & Behavioral Science, PsycInfo, Web [...] Read more.

Vaccination is vital to protect the public against COVID-19. The aim of this systematic review is to identify and evaluate the effectiveness of interventions to increase COVID-19 vaccine uptake. We searched a range of databases (Embase, Medline, Psychology & Behavioral Science, PsycInfo, Web of Science and NIH Preprints Portfolio) from March 2020 to July 2021 for studies which reported primary quantitative or qualitative research on interventions to increase COVID-19 vaccine uptake. Outcome measures included vaccination uptake and reported intention to vaccinate. Reviews, position papers, conference abstracts, protocol papers and papers not in English were excluded. The NHLBI quality assessment was used to assess risk of bias. In total, 39 studies across 33 papers met the inclusion criteria. A total of 28 were assessed as good quality. They included interventions relating to communication content, communication delivery, communication presentation, policy or vaccination delivery, with 7 measuring vaccination uptake and 32 measuring vaccination intention. A narrative synthesis was conducted, which highlighted that there is reasonable evidence from studies investigating real behaviour suggesting that personalising communications and sending booking reminders via text message increases vaccine uptake. Findings on vaccination intention are mixed but suggest that communicating uncertainty about the vaccine does not decrease intention, whereas making vaccination mandatory could have a negative impact. Although much of the research used experimental designs, very few measured real behavioural outcomes. Understanding which interventions are most effective amongst vaccine-hesitant populations and in the context of booster vaccinations will be important as vaccine roll outs continue across the world. Full article

(This article belongs to the Special Issue Knowledge and Beliefs on Vaccines)

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