Hesitation towards COVID-19 booster vaccination among dialysis patients: a cross-sectional study in Taizhou, China.

PURPOSE: This research aimed to explore hesitation towards the COVID-19 booster vaccine among dialysis patients and study the association between COVID-19 pandemic-induced health behavior and vaccination hesitancy. METHODS: A self-administered online questionnaire evaluating dialysis patients' hesitation to take COVID-19 booster vaccination was conducted between March 24 and 22 April 2022 in Taizhou, China. The logistic regression method was applied to identify factors associated with vaccination hesitancy, and all data were analyzed using R software. RESULTS: Of the 365 study participants, 272 (74.5%) individuals hesitated to take the booster dose. Health behavior was found to be a significant factor for hesitation to take COVID-19 vaccines, with OR (95% CI) of 1.09 (1.02-1.17). Influenza vaccination history was also significantly associated with the hesitation (OR (95% CI) = 0.39 (0.21-0.74)). In addition, participants with higher education levels exhibited lower vaccine hesitancy compared to those with junior secondary or below, with ORs (95% CIs) of 0.49 (0.27-0.91) for senior secondary and 0.35 (0.14-0.89) for junior college or above, respectively. CONCLUSION: The proportion of hesitancy for taking the booster vaccination of the COVID-19 vaccine was high among dialysis patients. Health behaviors, influenza vaccination history, and education levels were risk factors in their vaccination hesitancy. These findings may aid efforts to help vaccinate people with underlying diseases against future pandemics.

Parental hesitancy against COVID-19 vaccination for children and associated factors in Taiwan.

BACKGROUND: Since July 2021, some countries and regions have initiated the vaccination of minors against coronavirus disease (COVID-19), and parental COVID-19 vaccine hesitancy will affect the vaccination of minors. We aimed to identify the level of parental hesitancy to vaccinate their children against COVID-19 in Taiwan and the factors associated with vaccine hesitancy. METHODS: We conducted a population-based, self-administered online questionnaire in Taiwan to assess parental hesitancy and the factors influencing their children's vaccination against COVID-19. RESULTS: Among 384 respondents, 64.1% were hesitant to have their children vaccinated against COVID-19. Mothers were more likely to hesitate to vaccinate their teens than their fathers (67.5% vs. 50%, P < 0.005). Multiple regression results showed that parents who were hesitant to vaccinate themselves (OR = 3.81, 95% CI:2.07-7.02) and those who scored lower on their perception of their children's vaccination (OR = 9.73, 95% CI:5.62-16.84) were more hesitant to vaccinate their children with COVID-19 vaccine. CONCLUSIONS: According to the study findings, 64.1% of Taiwanese parents were hesitant to vaccinate their children against COVID-19. Parents who were hesitant to receive the COVID-19 vaccine for themselves and had negative views of the vaccine for their children were more likely to be hesitant to vaccinate their children. An in-depth discussion of the factors affecting vaccine hesitancy and targeted health education is conducive to promoting vaccination in children with COVID-19.

Hydroxytyrosol and Oleuropein Inhibit Migration and Invasion via Induction of Autophagy in ER-Positive Breast Cancer Cell Lines (MCF7 and T47D).

Hydroxytyrosol (HT) and oleuropein (OL), the most abundant of the phenolic compounds in olives, have anticancer properties against breast cancer (BC). However, little attention has been paid to the mechanism of HT or OL in BC cells. The objective of this study was to identify the underlying molecular mechanisms of these compounds. ER-positive BC MCF7 and T47D cells were treated with HT and OL in combination with hepatocyte growth factor (HGF), rapamycin (Rapa, an agonist of autophagy) or 3-methyladenine (3-MA, an inhibitor of autophagy). Cell viability, metastasis capability and autophagy-related proteins were evaluated by wound healing assays, Transwell assays and Western blot. HT and OL reduced the cell viability of MCF-7 and T47D cells in a dose-dependent manner. Both cells were more sensitive to HT than OL. In addition, Rapa significantly inhibited HGF-induced migration and invasion, indicating that metastases of both BC cells could be inhibited by suppression of autophagy. Moreover, HT and OL significantly blocked HGF- or 3-MA-induced cell migration and invasion by reversing LC3II/LC3I and Beclin-1 downregulation and p62 upregulation. These findings revealed that HT and OL could suppress migration and invasion by activating autophagy in ER-positive BC cells, which might be a promising therapeutic strategy.

Positive and negative factors of parents vaccinating their children against COVID-19: An umbrella review.

Purpose: This umbrella review summarized the factors influencing parents' hesitancy to vaccinate their children against COVID-19 and the evidence to reduce it. Methods: The analysis included PubMed, Embase, Cochrane Library, Web of Science, and Scopus articles published before March 22, 2024. It considered all meta-analyses that investigated parental COVID-19 vaccine hesitancy. Results: Eight studies were included. Hesitancy rate of parents from five continents to vaccinate their children against COVID-19 was between 0.69 % and 95.0 %. The comprehensive synthesis in this review shows that the influencing factors originate from four aspects: Parents' attitudes, including their trust in the scientific community, concerns about COVID-19 complications, perceptions of children's susceptibility, and support from the social environment, including government incentives, low vaccination costs, and specific sociodemographic characteristics, were positive factors that reduced parental vaccine hesitancy in children. Conversely, negative aspects, including vaccine distrust, the spread of misinformation, poor economic status, and concern about unprecedentedly short development time, were associated with increased hesitancy. Conclusion: Our study identified positive and negative factors for parental COVID-19 vaccine hesitancy in children and highlighted that parental attitude was the most important determinant.

Impact of prior SARS-CoV-2 infection on college students' hesitancy to receive additional COVID-19 vaccine booster doses: A study from Taizhou, China.

Purpose: This study aimed to examine the impact of a history of SARS-CoV-2 infection on the hesitancy of college students to receive additional COVID-19 vaccine booster doses. Methods: A population-based self-administered online survey was conducted in July 2024 in Taizhou, China. A total of 792 respondents were included in this study. Logistic regression was conducted to identify factors associated with college students' hesitation to receive booster doses of the COVID-19 vaccine. Results: Of 792 respondents, 32.2 % hesitated to receive additional doses of the COVID-19 vaccine booster. Furthermore, 23.5 % of the respondents reported an increase in hesitancy to receiving additional COVID-19 vaccine booster doses compared to before they were infected with SARS-CoV-2. In the regression analyses, college students who had a secondary infection were more hesitant to receive additional COVID-19 vaccine booster doses (OR = 0.481, 95 % CI: (0.299-0.774), P = 0.003). Moreover, students with secondary infections who were male (OR = 0.417, 95 % CI: 0.221-0.784, P = 0.007), with lower than a bachelor's degree (OR = 0.471, 95 % CI: 0.272-0.815, P = 0.007), in non-medical majors (OR = 0.460, 95 % CI: 0.248-0.856, P = 0.014), and sophomores or below (OR = 0.483, 95 % CI: 0.286-0.817, P = 0.007) were more hesitant to receive additional COVID-19 vaccine booster doses. Conclusion: A history of SARS-CoV-2 infection affects college students' hesitation to receive additional COVID-19 vaccine booster doses, which was higher in those who experienced secondary infections.

[Hepatitis B e antigen perturbs the LPS-stimulated production of inflammatory cytokines by mononuclear-derived dendritic cells].

OBJECTIVE: To investigate whether hepatitis B e antigen (HBeAg) can modulate the ability of dendritic cells (DCs) to produce inflammatory cytokines (IL-12/IL-6) upon stimulation in vitro. METHODS: Purified adherent mononuclear cells isolated by Ficoll-hypaque density gradient centrifugation were cultured in complete medium containing granulocyte macrophage colony-stimulating factor plus interleukin (IL)-4 to generate immature (i)DCs. Microscopic analysis and flow cytometry were performed to define the phenotypic characteristics of the iDCs. Then, different concentrations (1, 2 and 5 mug/ml) of HBeAg were added to the culture medium and for 24 hrs of incubation. To induce iDCs' maturation, the various groups of cells were incubated for 24 hrs in differentiation culture with lipopolysaccharide (LPS). Effects on secreted inflammatory cytokines were determined by enzyme-linked immunosorbent assay of the cells' supernatants. RESULTS: All concentrations of HBeAg led to significant reductions in IL-6 (all P less than 0.05). Similar significant reduction trends were seen for IL-12 at the HBeAg concentrations of 2 and 5 mug/ml (both P less than 0.05), but not at the 1 mug/ml concentration. CONCLUSION: HBeAg may suppress the production of cytokines from DCs; this mechanism may contribute to the immune escape of HBV that supports persistent infection.

Relationship between COVID-19 vaccine hesitancy and willingness to pay for the booster dose of COVID-19 vaccine of oncology patients in Taizhou, China.

OBJECTIVE: This population-based study aimed to determine the hesitancy and willingness to pay (WTP) for the booster dose of a coronavirus disease (COVID-19) vaccine among patients with cancer in Taizhou, China. PATIENTS AND METHODS: A self-administered online questionnaire was administered to patients with cancer in Taizhou, China. The chi-square test, binary logistic regression model were used to evaluate the WTP for the booster dose of a COVID-19 vaccine. The minimum sample size was 218, determined by G*Power software (latest ver. 3.1.9.7). A total of 354 patients received the survey, and 256 (72.3%) patients responded. RESULTS: Overall, 69.9% (179/256) of respondents were willing to pay for the booster dose, and 78.8% (141/179) of these patients were willing to pay 1-99 CNY. Furthermore, 50.4% (129/256) of respondents were hesitant to receive a COVID-19 vaccine. Being unhesitant was significantly associated with WTP for the booster dose (aOR: 3.040; 95% CI: 1.669-5.540). CONCLUSION: Hesitant patients with cancer had a lower WTP for the booster dose against COVID-19 than non-hesitant participants. These results imply that further health education programmes are essential to decrease the hesitancy of patients with cancer and enhance booster dose vaccination rates for public health improvements.KEY MESSAGESOur research showed that 70% of patients with cancer are willing to pay for the booster dose of the COVID-19 vaccine, and most are willing to pay less than 100 CNY, and this result reflects the economic value and affordability of the third dose of vaccination.COVID-19 vaccine-hesitant patients with cancer had a lower willingness to pay for a booster dose against COVID-19 than non-hesitant participants and few patients are still unwilling to pay among patients do not hesitate to receive the third dose.Therefore, promoting willingness to pay among oncology patients and addressing vaccine hesitancy remains key.

Willingness of college students to receive COVID-19 heterologous vaccination in Taizhou, China.

This study aimed to determine the willingness of college students to choose COVID-19 heterologous vaccination and its associated influencing factors in Taizhou, China. A population-based, self-administered online questionnaire was conducted from March 15 to 17, 2022. Of the 2,463 participants who had received the invitation, 1,821 responded to the survey (response rate = 73.9%). Only 14% (86/614) of those willing to receive a booster would chose a heterologous vaccination; the perception of better effectiveness of a COVID-19 heterologous vaccination booster was the significant factor (X2 = 22.671, p < .001). Additionally, female college students'older age (χ2 = 7.523, P = .023), major of medical (χ2 = 6.294, P = .012), and better perceived effectiveness of COVID-19 heterologous vaccination booster (χ2 = 22.659, P < .001), were more willing to receive heterologous booster doses. Chinese college students have a strong willingness to receive booster shots, but the percentage of those willing to receive a heterologous vaccine is only 14.0%, and the lack of understanding of its effectiveness is an important factor in the low proportion of heterologous vaccine selection. Health education, public health awareness, and the disclosure of heterologous vaccine information can help improve the public's understanding of heterologous vaccines and provide them with more choices.

Parents' willingness to pay for their children's COVID-19 vaccine in Taiwan, China: A cross-sectional study.

Most COVID-19 studies aim to assess factors influencing willingness to pay for vaccines between the public and medical staff. However, few studies focus on parents' willingness to pay for their children's COVID-19 vaccine. The current study aimed to assess parents' willingness to pay for their children's vaccination against COVID-19 and its influencing factors. This population-based cross-sectional study used a self-administered questionnaire. The inclusion criterion was parents with at least one child younger than 18 years. The final analysis included 384 valid data points. A total of 89.1% of the parents indicated that they are willing to pay for their children's vaccination against COVID-19. Among them, both fathers' and mothers' willingness to pay for their children's COVID-19 vaccine was 89.6%. The mean and median willingness to pay were% would pay for their children. Excluding other confounding factors, willingness to pay for the COVID-19 vaccine for themselves and hesitation to vaccinate their children were significantly associated with parents' willingness to pay for their children's COVID-19 vaccine. We found that 89.1% of the parents in Taiwan would pay for their children's COVID-19 vaccine. Parents' willingness to pay for themselves and hesitation to vaccinate their children were associated with willingness to pay. Reducing hesitation about vaccines and developing policies for vaccine payment may have a positive impact on willingness to pay for vaccines and promoting COVID-19 vaccination.

Impact of household decision makers' hesitancy to vaccinate children against COVID-19 on other household members: A family-based study in Taizhou, China.

Background: Vaccination is the most effective means of preventing outbreaks of infectious diseases, and family ;decision makers play an important role in decision-making regarding family matters and may influence other family members to take an active role in vaccinating children against COVID-19. Purpose: This study examined the influence of family decision makers on the hesitation of other family members to vaccinate their children against COVID-19. Methods: A population-based, self-administered online questionnaire was administered in Taizhou, China, from September 1, 2021, to September 15, 2021. The questionnaire included demographic information, knowledge, attitudes, and perceptions about the COVID-19 vaccine as well as hesitation regarding the use of the COVID-19 vaccination in children. In total, 490 respondents were included in this study. Logistic regression was used to assess the factors associated with vaccine hesitancy. Results: In total, 490 respondents from 190 households were interviewed. Of the 190 family decision makers, 43.7% (83/190) were hesitant to vaccinate their children against COVID-19. When family decision makers were hesitant to vaccinate children against COVID-19, 65.1% (82/126) of the other family members expressed similar hesitancy regarding vaccination. When family decision makers were not hesitant to vaccinate children, only 21.3% (37/174) of other family members were hesitant to do so. In the regression analysis, family decision makers' hesitation to vaccinate their children was associated with other family members' hesitation (OR=6.264, 95% CI:3.132-12.526). In addition, decision makers' perceptions of the safety of the vaccine (OR=0.422, 95% CI:0.215-0.826) and hesitation to vaccinate themselves (OR=8.967, 95% CI:4.745-16.948) influenced their hesitation to vaccinate their children. Conclusion: The present study found that family decision makers' hesitation to vaccinate children against COVID-19 influenced other family members' hesitation to vaccinate children. In addition, family decision makers' perceptions of the safety of the vaccine and their hesitation to vaccinate themselves influenced other family members' hesitation to vaccinate their children.

Why do parents willingness-to-pay to vaccinate their children against COVID-19? A real-world evidence in Taizhou, China.

PURPOSE: This population-based cross-sectional study was conducted to explore whether parents are willing to pay to vaccinate their children against COVID-19 in China. METHODS: With a self-administered online questionnaire, we investigated parents' willingness to pay for their children to be vaccinated against COVID-19 in Taizhou, China. Of the 1,845 parents who answered the structured questionnaire when they received an e-mail or e-poster invitation, 1788 samples with valid data underwent data analysis. RESULTS: A total of 66.1% of parents reported being willing to pay to inoculate their children with the COVID-19 vaccine. After adjustment for confounding factors, lower education level, one-child family (yes vs. no, OR = 1.35, 95%CI: 1.04-1.74), knowledge score of vaccination against COVID-19 (high vs. low, OR = 1.31, 95%CI: 1.01-1.69), awareness of the permitted use of the vaccine (yes vs. no, OR = 1.51, 95%CI: 1.16-1.97), and willingness to pay for a COVID-19 vaccine for themselves (yes vs. no, OR = 16.31, 95%CI: 12.59-21.14) were significantly associated with parents' willingness to pay for their children. CONCLUSION: We found that a moderate proportion of parents reported unwillingness to pay for their child to be vaccinated against COVID-19. The results indicate that further detailed assessment and more health education planning are required to increasing parents' WTP for the vaccination of children in China.

Willingness to receive a booster dose of inactivated coronavirus disease 2019 vaccine in Taizhou, China.

PURPOSE: This population-based study aimed to determine the willingness to receive a booster dose of vaccine against coronavirus disease (COVID-19) in Taizhou, China. METHODS: An online questionnaire investigation addressing participants' willingness to receive a booster dose of the COVID-19 vaccine was organized in Taizhou, China. Of the 2318 interviewees who received the invitation, 1576 finished a qualifying questionnaire, corresponding to a response rate of 68.0%. RESULTS: The majority of respondents (n = 1435 [91.1%]) were willing to accept a booster vaccination against COVID-19. History of allergic reaction to other vaccines (OR = 0.30), confidence in the safety of the COVID-19 vaccines (OR = 3.20), confidence in the effectiveness of the COVID-19 vaccines against SARS-CoV-2 (OR = 2.25) and its variants (useful versus [vs.] useless, OR = 2.33), and vaccine recipients (OR = 3.09) remained significantly associated with willingness to accept a booster dose of COVID-19 vaccines. CONCLUSION: A moderate proportion of the participants who responded were willing to receive a booster dose of the COVID-19 vaccine. These results are valuable for starting health education and interventions to accelerate vaccine uptake and improve public health outcomes during the COVID-19 pandemic in China.

The main decision-making competence for willingness-to-pay towards COVID-19 vaccination: a family-based study in Taizhou, China.

PURPOSE: This research aimed to explore individuals' willingness to pay (WTP) and studied the role of family decision makers in WTP for COVID-19 vaccines. METHODS: A self-administered online questionnaire evaluating the willingness of community residents to pay for booster vaccination of COVID-19 vaccine was conducted among families in a community in Taizhou, China. The logistic regression model was performed to identify the factors associated with WTP for the COVID-19 vaccines, and all data were analysed by R software, version 4.1.0. RESULTS: 44.2% and 43.7% of 824 community residents were willing to pay for the first two doses and the booster dose of the COVID-19 vaccine, respectively. Decision-makers were more willing to pay for both the first two doses and the boost dose of the COVID-19 vaccines, with OR (95%CI) being 1.75 (1.25-2.47) and 1.89 (1.34-2.67), respectively. Besides, participants' WTP for COVID-19 vaccines were also associated with their occupation and monthly household income. CONCLUSION: This study found that family decision-makers were more willing to pay for both the first two doses and the booster dose of COVID-19 vaccines in Taizhou, China. To improve the WTP for COVID-19 vaccines, public policy programs need to conduct a comprehensive cost-benefit analysis and focus on the role of family decision makers in vaccination.Key MessagesA study evaluating the willingness of community residents to pay for booster vaccination of COVID-19 vaccine was conducted among families in a community in Taizhou, China.Family decision-makers were more willing to pay for both the first two doses and the booster dose of COVID-19 vaccines.To improve the WTP for COVID-19 vaccines, public policy programs need to conduct a comprehensive cost-benefit analysis and focus on the role of family decision-makers in vaccination.

COVID-19 vaccine hesitancy between teachers and students in a college, a cross-sectional study in China.

Studies have identified teacher effects on students' attitudes. This study explored the differences in and associations between teachers' and students' COVID-19 vaccine hesitancy, and the factors that affect it. A population-based self-administered online survey was conducted to evaluate the COVID-19 vaccine hesitancy of teachers and students in a college in Taizhou, China. A total of 835 valid questionnaires were obtained. All data were analyzed using IBM SPSS statistics 26.0 software. The proportions of COVID-19 vaccine hesitancy for teachers and students were 31.7%, and 23.8%, respectively. In the binary logistic regression analysis, teachers who perceived the safety of the COVID-19 vaccine as low (OR = 6.794 , 95%CI: 1.701-27.143), did not pay continuous attention to the vaccine news (OR = 3.498, 95%CI: 1.150-10.640), and suffered chronic diseases (OR = 2.659, 95%CI: 1.135-6.227) were more likely to hesitate to get vaccinated against COVID-19. The group of students who perceived the COVID-19 vaccine safety as being low (OR = 1.805, 95%CI: 1.094-2.979) were more hesitant to get the COVID-19 vaccine. While both teachers and students were hesitant about the COVID-19 vaccine, teachers were found to be more so. Perceptions regarding the safety of COVID-19 vaccines, attention to and awareness of vaccine news, and chronic medical conditions were the main factors that influenced the hesitation regarding COVID-19 vaccines. Therefore, students' vaccine hesitancy may depend largely on the perceptions of the vaccine's safety rather than teachers' vaccine hesitancy.

Willingness-to-pay for a booster dose of inactivated SARS-CoV-2 vaccine in Taizhou, China.

This study was conducted to ascertain whether people in China would be willing to pay for an inactivated COVID-19 vaccine booster dose. An online survey estimating participants' willingness to pay (WTP) for a booster dose of COVID-19 vaccine was conducted in Taizhou, China. The participants received ane-mail or e-poster on WeChat. A total of 1576 subjects participated the survey. A total of 66.4% (1046/1576) of the respondents were willing to pay for a booster dose of COVID-19 vaccine for themselves. Using binary logistic regression analysis, the following factors were significantly related to a WTP for a booster dose of COVID-19 vaccine: 1) confidence in the safety of the COVID-19 vaccines (high vs. low, OR: 4.30, 95%CI: 1.61-11.43), 2) confidence in the preventive effectiveness of the COVID-19 vaccines against SARS-CoV-2 virus (moderate vs. little, OR: 1.76, 95%CI: 1.30-2.38; great vs. little, OR: 2.244, 95%CI: 1.62-3.12), and 3) COVID-19 vaccine hesitancy (unhesitant vs. very unhesitant, OR: 0.67, 95%CI: 0.45-1.02; hesitant vs. very unhesitant, OR: 0.29, 95%CI: 0.19-0.44; very hesitant vs. very unhesitant, OR: 0.09, 95%CI: 0.03-0.27). This study revealed that a moderate proportion of participants responded that they would be willing to pay for a booster dose of COVID-19 vaccine. These findings suggest the importance of a detailed assessment and a health education plan that better understands the population's risk perception as well as the potential health risks in China.

Intentions of Patients with Hypertension to Receive a Booster Dose of the COVID-19 Vaccine: A Cross-Sectional Survey in Taizhou, China.

COVID-19 patients with hypertension have increased hospital complications and mortality rates. Moreover, these patients also have lower antibody titers after receiving the coronavirus disease (COVID-19) vaccine. Therefore, patients with hypertension should receive a COVID-19 vaccine booster. To promote the uptake of COVID-19 vaccine booster among hypertensive patients, this study investigated patients' willingness and factors that influence patients with hypertension to receive the COVID-19 vaccine booster. From July 2021 to August, 410 patients with hypertension were surveyed. Overall, 76.8% of patients were willing to receive the COVID-19 vaccine booster, as 82.7% of patients without comorbidities and 72.7% of patients with comorbidities were willing to receive the vaccine booster. The main factors that influenced the willingness of patients with hypertension to receive a booster dose were the preventive effect of the vaccine (χ2 = 52.827, p < 0.05), vaccine safety (χ2 = 42.423, p < 0.05), vaccine knowledge (χ2 = 7.831, p < 0.05), presence of comorbidities (χ2 = 4.862, p < 0.05), disease control (χ2 = 5.039, p < 0.05), and antihypertensive treatments (χ2 = 12.565, p < 0.05). This study's findings highlight the need to promote knowledge about booster vaccination among patients and health management. These measures would improve patients' willingness and knowledge about the vaccine and their health status, which are the main factors that influence patients' intention to receive booster vaccines.

Willingness of Older Adults with Chronic Diseases to Receive a Booster Dose of Inactivated Coronavirus Disease 2019 Vaccine: A Cross-Sectional Study in Taizhou, China.

Vaccination is an important measure to control the spread of COVID-19 among elderly high-risk groups; however, the propensity to receive COVID-19 vaccine boosters has not been evaluated in these populations. Here, we aimed to investigate the willingness to receive a COVID-19 vaccine booster among the elderly chronic disease population in Taizhou, China. A cross-sectional, hospital-based survey was conducted in the outpatient department of a tertiary care hospital between 6 July and 11 August 2021 in Taizhou, China, and the data were uploaded to Wen-Juan-Xing, one of the largest online platforms used to collect survey data in China. The targeted population was non-oncology chronic disease patients aged 60 years and above. The minimum sample size was 229, determined by the G*Power software (v3.1.9.2, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany). A total of 254 patients with valid data were enrolled in this study, with a response rate of 82.5% (254/308). Chi-square tests and one-way binary regression were used to compare the proportions and the degree of influence of categorical factors. The magnitude of the effect for the comparisons was measured by Gramer's V. A multivariate binary logistic regression model was used to correct for confounders and to identify factors. All data were analyzed using SPSS v24.0 (IBM Corporation, Armonk, NY, USA). A total of 198 respondents (77.9%) were willing to receive a COVID-19 vaccine booster dose, and 77.6% of respondents were willing to receive the primary dose. Age < 70 years (OR 2.82), stable disease control (OR 2.79), confidence in the effectiveness of the COVID-19 vaccine (OR 3.11), and vaccine recipient (OR 5.02) were significantly associated with the willingness to receive a COVID-19 vaccine booster dose. Promoting primary dose vaccination is essential for advancing booster vaccination, and it is important to focus on elderly patients' confidence in the vaccine, in addition to strengthening health management and promoting disease stability. Follow-up studies should focus on elderly patients who belong to specific disease groups.

Relationship between knowledge, attitudes, and practices and COVID-19 vaccine hesitancy: A cross-sectional study in Taizhou, China.

Objective: This study aimed to explore COVID-19 vaccine hesitancy in Chinese adults and analyzed the relationship between knowledge, attitudes, practices (KAP), and COVID-19 vaccine hesitancy. Methods: A population-based self-administered online survey was conducted in Taizhou, China to evaluate the population's hesitancy to receive COVID-19 vaccination. A total of 2.463 adults received the invitation for the survey through WeChat (A Chinese app that is used for chat, social media, and mobile payment), and 1.788 interviewees answered the structured questionnaire. The overall response rate was 72.6%. Results: Total 45.2% of people were hesitant about the COVID-19 vaccination. Using binary logistic regression analysis, we found low perception of safety (Model 3: Odds ratio = 2.977, Confidence interval: 2.237-3.963) and efficacy (Model 3: OR = 1.904, 95%CI: 1.462-2.479) of the COVID-19 vaccine in adults is the most important risk factor for COVID-19 vaccine hesitation. People who know more about COVID-19 vaccination are less hesitant (Model 2: OR = 0.967, 95% CI: 0.951-0.983). People who did not seek information independently about the COVID-19 vaccine are more likely to be skeptical (Model 4: OR = 1.300, 95% CI: 1.058-1.598, P = 0.013). Conclusion: In China, the population had higher levels of COVID-19 vaccine hesitation, and their knowledge of the COVID-19 vaccine, perceptions of safety and efficacy, and physical health status were significantly associated with vaccine hesitation. These results provide ideas for promoting COVID-19 vaccination and intervention and have far-reaching implications for further strengthening research on vaccine hesitancy in COVID-19 and exploring strategies for COVID-19 vaccine promotion.

The impact of the Omicron epidemic on the health behavior in Cape Town, South Africa.

Background: South Africa was the first country with a case of Omicron variant infection diagnosed; therefore, this study aimed to elucidate the impact of the Omicron mutant strain outbreak on the health behavior of the South African population and encourage the population to adopt timely protective behaviors against Omicron mutant strain infection. Study design and methods: This was a population-based, cross-sectional study conducted in Cape Town, South Africa, in December 2021. We distributed 300 questionnaires to adults aged >18 years, and they were all returned. Results: Of the South African population, 60.3% expressed a high level of concern regarding Omicron; 89.3% improved on at least one of the following three health behaviors: mask-wearing, washing hands, and reducing socialization; and only 10.7% exhibited no improvement in health behaviors. Of these, 71.3% and 57.0% increased the length of time they wore a mask and washed their hands, respectively, and 47% decreased the number of times they socialized. Age, residence, education level, chronic disease, and whether they had received the COVID-19 vaccine were significantly different (p < 0.05) between the presence and absence of enhanced health behaviors. The levels of concern and knowledge regarding the Omicron virus significantly influenced health-behavior change (all P < 0.05). Conclusion: There has been a positive change in the South African population toward adopting mask-wearing, hand washing, and reducing socialization in response to the Omicron virus strain epidemic. Based on one health approach, it is important to focus on populations with chronic diseases, those who have not yet received the COVID-19 vaccine, and other populations with low rates of health behavior change.

Adverse reactions to inactivated COVID-19 vaccination in patients with chronic liver disease: The effect of anxiety.

Studies have shown that patients with chronic liver disease are at a higher risk of contracting novel coronavirus pneumonia than healthy individuals, and many guidelines state that patients with chronic liver disease should be prioritized for COVID-19 vaccination, but there are a few studies on its safety in CLD patients. We aimed to evaluate the safety of the inactivated COVID-19 vaccine in patients with chronic liver disease, and the effect of anxiety on adverse reactions. A questionnaire survey for self-administered post-vaccination adverse reaction monitoring was conducted from June 17, 2021, to August 11, 2021, in patients with chronic liver disease attending a tertiary care hospital in Taizhou, China. We analyzed the data from of a total of 160 participants who scanned the QR code on social media to respond to the questionnaire. The overall incidence of adverse reactions after COVID-19 vaccination in patients with chronic liver disease was 44.4% (71/160), and the most common adverse reaction was local injection site reaction, accounting for 80.3% of adverse reactions (57/71). No serious adverse reactions were reported. Approximately 53.1% of the patients had anxiety about vaccination, and 51.8% of those who felt anxious reported adverse reactions. The safety of COVID-19 vaccination in patients with chronic liver disease is good, and there is a strong association between adverse reactions and vaccine anxiety. Pre-vaccination education for patients with vaccine anxiety and psychological counseling may reduce reports of adverse reactions and improve patients' confidence in the vaccine.