Psychometric properties and reliability of the Brazilian version of Parent Attitudes about Childhood Vaccine (PACV-BR) / Propriedades psicométricas e confiabilidade da versão brasileira do Parent Attitudes about Childhood Vaccine (PACV-BR)

ABSTRACT Objective: To evaluate the psychometric properties and reliability of the Brazilian version of the tool Parent Attitudes about Childhood Vaccine (PACV-BR). Methods: The sample included 110 parents of children up to two years old served by Family Health Basic Units. The tool's internal consistency and factor validity were respectively assessed by Cronbach's alpha and exploratory factor analysis (EFA). The test-retest reliability was assessed by the intraclass correlation coefficient (ICC). Results: The EFA results indicated a proper structural adequacy of the PACV-BR (15 items and two factors). The reliability generated Cronbach's alpha values between 0.715 and 0.854 for the items, of 0.918 for the tool as a whole, of 0.877 for factor 1 and of 0.825 for factor 2, in addition to an ICC of 0.984. Conclusions: The PACV-BR showed evidence of construct validity and reliability.

RESUMO Objetivo: Avaliar as propriedades psicométricas e a confiabilidade da versão brasileira do instrumento Parent Attitudes about Childhood Vaccine (PACV-BR). Métodos: A amostra incluiu 110 pais de crianças de até dois anos atendidas em Unidades Básicas de Saúde da Família. A consistência interna e a validade fatorial do instrumento foram avaliadas, respectivamente, pelo alfa de Cronbach e pela análise fatorial exploratória (EFA). A confiabilidade teste-reteste foi avaliada pelo coeficiente de correlação intraclasse (ICC). Resultados: Os resultados da AFE indicaram adequação estrutural do PACV-BR (15 itens e dois fatores). A confiabilidade indicou valores de alfa de Cronbach entre 0,715 e 0,854 para os itens, de 0,918 para o instrumento como um todo, de 0,877 para o fator 1 e de 0,825 para o fator 2, além de ICC de 0,984. Conclusões: O PACV-BR apresentou evidências de validade de construto e confiabilidade.

COVID-19 vaccine hesitancy in KwaZulu-Natal, South Africa: A survey of unvaccinated adults

Background: Concerns and misconceptions surrounding coronavirus disease 2019 (COVID-19) vaccines may account for vaccine hesitancy and low uptake. Aim: To determine prevalence of COVID-19 vaccine hesitancy, vaccine-related misconceptions, and predictors of vaccine hesitancy among South Africans. Setting: Community setting in five districts in KwaZulu- Natal province. Methods: Between August 20, 2021, and September 27, 2021, we conducted a cross-sectional survey, interviewing 300 unvaccinated adults amid the national vaccination campaign. Predictors of hesitancy were identified through multivariable logistic regression analysis. Results: Participants had a median age of 29 years (IQR: 23­39), 86.7% were Black African, 63.2% were male, 53.3% resided in rural communities, and 59.3% (95% CI: 53.8% ­ 64.9%) were classified as vaccine hesitant. The primary reason for not vaccinating was a lack of trust in the vaccine (62.1%). Factors associated with reduced vaccine hesitancy included age (participants aged 35­49 years: OR: 0.28, 95% CI: 0.18­0.64, p = 0.003; participants over 50 years: OR: 0.18, 95% CI: 0.07­0.47, p = 0.0004), previous COVID-19 infection (OR: 0.31, 95% CI: 0.11­0.87, p = 0.03), and receiving vaccine information from healthcare workers (OR: 0.32, 95% CI: 0.10­1.0, p = 0.05). Unemployed (OR: 2.14, 95% CI: 1.1­4.2, p = 0.03) and self-employed individuals (OR: 2.98, 95% CI: 1.27­7.02, p = 0.01) were more likely to be vaccine hesitant. Conclusion: COVID-19 vaccine hesitancy rates are high in KwaZulu-Natal. Uptake could be enhanced by healthcare workers leading information campaigns with messages targeting younger individuals, the unemployed, and the self-employed. Contribution: This survey provides evidence to improve COVID-19 vaccination uptake in South Africa.

Hesitação da vacina da febre amarela e sua relação com influências contextuais, individuais ou de grupo e questões específicas da vacina: uma revisão de escopo / Yellow fever vaccine hesitancy and its relationship with contextual, individual, or group influences and vaccine-specific issues: a scoping review

Resumo A hesitação vacinal é um fenômeno com potencial para reduzir as taxas de cobertura vacinal, como observado na vacina contra febre amarela (VFA), propiciar epidemias e a reintrodução de doenças imunopreveníveis controladas. O objetivo deste estudo é mapear junto à literatura científica a relação entre a falta de informação, a segurança da vacina e os eventos adversos e a hesitação vacinal da VFA. Foi realizada uma revisão de escopo nas bases Biblioteca Virtual em Saúde (BVS), National Library of Medicine (PubMed), SCOPUS, Embase e Web of Science utilizando descritores controlados (DeCS/MeSH) e não controlados. Foram selecionados 11 artigos publicados nos idiomas inglês, espanhol e português, sem delimitação de tempo e que atenderam aos critérios de inclusão. Estiveram relacionados à hesitação vacinal da VFA informações falsas, conhecimento inadequado sobre o imunizante, falta de tempo para se vacinar, aceitação da vacina, insegurança na vacina e medo dos eventos adversos. Este estudo reforça a importância do acesso a informações adequadas, orientações sobre a segurança e os eventos adversos da VFA e pode auxiliar na elaboração de estratégias de saúde pública para mitigar a hesitação vacinal.

Abstract Vaccine hesitancy is a phenomenon with the potential to reduce vaccination coverage rates, as observed with the yellow fever vaccine (YFV), leading to epidemics and the reintroduction of controlled immunopreventable diseases. This study, together with the scientific literature, aims to map the relationship among the lack of information, vaccine safety and adverse events, and vaccine hesitancy concerning YFV. A scoping review was conducted in the Virtual Health Library (VHL), National Library of Medicine (PubMed), SCOPUS, Embase, and Web of Science databases, using controlled (DeCS/MeSH) and uncontrolled descriptors. In this work, we selected eleven articles, published in English, Spanish, and Portuguese, with no time limits, which met the inclusion criteria. False information, inadequate knowledge about the immunizer, lack of time to take a vaccination, acceptance of the vaccine, vaccine safety, and fear of adverse events were related to vaccine hesitancy. This study reinforces the importance of access to adequate information, provides guidance on YFV safety and adverse events, and can aid in the development of public health strategies to mitigate hesitancy.

Are Parents Willing to Vaccinate Their 6- To 11-Year-Old Children Against COVID-19? A Community Based Study in Murshidabad, India

Context/Background: The future of Corona virus disease is still uncertain due to viral mutations. Immuniza-tion against COVID-19 has not yet been introduced for children aged 6-11 years. Parents are instrumental for the success of any immunization programme, being the chief decision makers for their wards. The study aims to assess the perceptions of parents regarding COVID 19 vaccination among children aged 6-11 years in an urban slum of Murshidabad and identify the factors influencing such perceptions among them. Methodology: A cross sectional study was conducted among 106 parents in a slum area of Murshidabad, West Bengal. Participants were interviewed using a validated WHO Vaccine Hesitancy Scale (VHS). Bivariate and multivariable analysis were done using Chi square test and binary logistic regression respectively. Results: Majority of the study subjects instead of parents were unlikely to vaccinate their children against COVID-19. The major concern centered around the safety (73.5%) of the vaccine. Higher level of education (p=0.003), previous history of COVID-19 infection in the family (p=0.004) and having a children aged between 6-8 years (p=0.006), influenced such perceptions, with the latter being the single most important predictor (AOR 4.126, P=0.007). Conclusions: The likelihood of parents to vaccinate their child was found to be low. This underscores the im-portance of an effective communication strategy when such programme will be rolled out.

Factors Related to Low COVID-19 Vaccination Rate in Pregnant and Postpartum Women with and without COVID-19 / Fatores relacionados à baixa taxa de vacinação contra COVID-19 em gestantes e puérperas com e sem COVID-19

Abstract Objective This study focused on pregnant and postpartum women during the COVID-19 pandemic, aiming to determine the attitudes and behaviors of vaccinated and unvaccinated groups, and the vaccination behaviors in the groups with and without the disease. The reasons for refusing the vaccine were also questioned. Methods This cross-sectional study was performed from September 2021 to October 2021. The study data were collected using a face-to-face questionnaire. The participants were pregnant women who applied to the hospital for routine antenatal care and were hospitalized, and women in the postpartum period. Additionally, pregnant and postpartum patients who were diagnosed with COVID-19 at the time of admission and were hospitalized and admitted to the intensive care unit due to this disease were also included in the study. Results A total of 1,146 pregnant and postpartum women who completed the questionnaire were included in our study. Only 43 (3.8%) of the participants were vaccinated; 154 (13.4%) of the participants had comorbidities. The number of COVID-19-positive patients was 153. The lack of sufficient information about the safety of the COVID-19 vaccine is the most common reason for the refusal. Conclusion Vaccine refusal can significantly delay or hinder herd immunity, resulting in higher morbidity and mortality. Considering the adverse effects of COVID-19 on pregnancy, it is essential to understand pregnant and postpartum women's perceptions toward vaccination to end the pandemic.

Facilitators of and barriers to COVID-19 vaccination in Grenada: a qualitative study / Factores que facilitan u obstaculizan la vacunación contra la COVID-19 en Granada: estudio cualitativo / Facilitadores e barreiras para a vacinação contra a covid-19 em Granada: um estudo qualitativo

ABSTRACT Objectives. To identify the factors contributing to coronavirus disease 2019 (COVID-19) vaccine hesitancy in Grenada. Methods. A phenomenological study was conducted using semi-structured interviews at vaccination and pop-up testing clinics during a spike in COVID-19 cases on the island. Interview questions were developed using the health belief model related to perceived threat of COVID-19, perceived benefits of and barriers to COVID-19 vaccination, and cues to action. Data were analyzed using a deductive approach to identify themes, categories, and subcategories. Results. Twenty-five interviews were transcribed and coded. In all, 68% of participants were unvaccinated, 12% were partially vaccinated, and 20% were fully vaccinated. Data analysis revealed two main themes: facilitators and barriers. Factors more likely to encourage vaccination (facilitators) included trust in medical advice and vaccine efficacy, social responsibility, and vaccine mandates for travel, employment, and social activities. Factors hindering vaccination (barriers) included: perceived low threat of COVID-19; preference for natural remedies; concerns about contraindications because of underlying health conditions; fear; mistrust of vaccines and related messaging; vaccine accessibility; and the many different information sources. Conclusions. Overcoming vaccine hesitancy is key to combating the detrimental effects of COVID-19 in Grenada. Public health interventions and policies that address barriers and capitalize on facilitators can increase vaccine uptake.

RESUMEN Objetivos. Determinar cuáles son los factores que contribuyen con la reticencia a la vacunación contra la enfermedad por el coronavirus del 2019 (COVID-19) en Granada. Métodos. Se realizó un estudio fenomenológico utilizando entrevistas semiestructuradas realizadas en puestos transitorios de prueba y vacunación durante un aumento en el número de casos de COVID-19 en la isla. Se elaboraron las preguntas de la entrevista según el modelo de creencias de salud en relación con la amenaza percibida respecto de la COVID-19, los obstáculos y los beneficios percibidos respecto de la vacunación contra la COVID-19 y los incentivos para la acción. Los datos se analizaron mediante un enfoque deductivo con el fin de determinar los principales temas, categorías y subcategorías. Resultados. Se transcribieron y codificaron veinticinco entrevistas. En total, el 68% de los participantes no estaban vacunados, el 12% estaban parcialmente vacunados y el 20% tenían el esquema completo de vacunación. El análisis de los datos reveló dos temas principales: los factores facilitadores y los obstáculos. Entre los factores con mayores probabilidades de incentivar la vacunación (factores facilitadores) se encuentran la confianza en el asesoramiento médico y la eficacia de la vacuna, la responsabilidad social y los mandatos de vacunación para viajes, empleo y actividades sociales. Entre los factores que obstaculizan la vacunación (obstáculos) se encuentran la percepción de que la COVID-19 no es una amenaza grave; la preferencia por los remedios naturales; las preocupaciones por las contraindicaciones debido a afecciones de salud subyacentes; el miedo; la desconfianza en las vacunas y los mensajes relacionados; la accesibilidad a las vacunas; y las muy diferentes fuentes de información. Conclusiones. Es necesario superar la reticencia a la vacunación para combatir los efectos nocivos de la COVID-19 en Granada. Las políticas e intervenciones de salud pública que abordan los obstáculos y capitalizan los factores facilitadores pueden aumentar el uso efectivo de las vacunas.

RESUMO Objetivos. Identificar os fatores que contribuem para a hesitação em relação à vacina contra a doença por coronavírus 2019 (covid-19) em Granada. Métodos. Realizou-se um estudo fenomenológico com entrevistas semiestruturadas em clínicas de vacinação e testagem rápida durante um pico de casos de covid-19 na ilha. As perguntas da entrevista foram elaboradas com base no modelo de crenças em saúde relacionado à percepção de ameaça da covid-19, à percepção de benefícios e barreiras relativos à vacinação contra a covid-19, e aos estímulos para ação. Os dados foram analisados por um método dedutivo para identificar temas, categorias e subcategorias. Resultados. Vinte e cinco entrevistas foram transcritas e codificadas. No total, 68% dos participantes não eram vacinados, 12% eram parcialmente vacinados e 20% eram totalmente vacinados. A análise dos dados evidenciou dois temas principais: facilitadores e barreiras. Os fatores mais propensos a incentivar a vacinação (facilitadores) foram confiança na orientação médica e na eficácia da vacina, responsabilidade social e exigência de vacinação em viagens, no emprego e em atividades sociais. Entre os fatores que impediam a vacinação (barreiras) estavam: percepção de baixa ameaça da covid-19; preferência por remédios naturais; preocupação com contraindicações em razão de problemas de saúde preexistentes; medo; desconfiança das vacinas e mensagens relacionadas; acessibilidade da vacina; e as muitas diferentes fontes de informação. Conclusões. Superar a hesitação vacinal é imprescindível para combater as consequências negativas da covid-19 em Granada. As intervenções e políticas de saúde pública que afastam barreiras e promovem facilitadores podem aumentar a aceitação da vacina.

Attitudes, hesitancy, concerns, and inconsistencies regarding vaccines reported by parents of preschool children / Atitudes, hesitações, preocupações e inconsistências relacionadas a vacinas relatadas por pais de crianças pré-escolares

Abstract Objective: This study aimed to assess attitudes, concerns, information and knowledge about vaccines among parents of preschool children attending kindergartens in a city in the interior of São Paulo, Brazil, using a self-administered questionnaire. Methods: Cross-sectional, questionnaire-based study of knowledge and attitudes regarding vaccination among parents of children aged up to 72 months from public and private schools, between 2018 and 2019. Results: Among the 2,528 questionnaires, 1,261 were answered and grouped by respondents' educational level. According to information, 96.6% of the children were up to date with vaccines. The prevalence of vaccine hesitancy was 5.0%. The lower the educational level, the lower was the income, the larger the number of household members, and the greater the lack of knowledge about vaccines. The higher the educational level, the lower was the vaccine hesitancy, and the greater the dissatisfaction with the information received. Conclusions: Generally, parents consider vaccines to be important for preventing diseases and to be safe, with their benefits outweighing the risks. Positive comments were accompanied by doubts, concerns, hesitancy, and inconsistencies. The level of educational attainment makes a difference in the access to information, medical care provided by pediatricians, and the feeling of obligation to vaccinate. Parents have vaccinated and still intend to vaccinate their children, but ensuring adequate levels of vaccination coverage will be a post-pandemic challenge.

RESUMO Objetivo: Este estudo procurou avaliar atitudes, preocupações, informações e conhecimentos sobre vacinas por parte de responsáveis por crianças em idade pré-escolar que frequentam instituições de ensino infantil em um município do interior de São Paulo, Brasil, por meio de questionário autoaplicável. Métodos: Estudo transversal com o uso de questionário dirigido aos pais de crianças de até 72 meses, em escolas públicas e privadas, sobre conhecimentos e atitudes quanto à vacinação das crianças entre 2018 e 2019. Resultados: Entre 2.528 questionários entregues, 1.261 foram respondidos e agrupados conforme a escolaridade dos entrevistados. De acordo com as informações, 96,6% das crianças estavam com vacinas em dia. A prevalência de hesitação vacinal foi de 5,0%. Quanto menor a escolaridade, menor a renda, maior o número de habitantes na casa e maior o desconhecimento sobre vacinas. Quanto maior a escolaridade, menor hesitação e maior insatisfação com as informações recebidas. Conclusões: Em geral, os pais consideram as vacinas importantes para prevenir doenças, como proteção, e dizem que os benefícios superam os riscos. Manifestações positivas foram acompanhadas por dúvidas, preocupações, hesitações e inconsistências. O nível de escolaridade faz diferença no acesso a informações, no atendimento médico por pediatras e no sentimento de obrigatoriedade em vacinar. Os pais têm vacinado e ainda pretendem vacinar, mas garantir níveis de cobertura vacinal adequados será um desafio pós-pandemia.

Boosting COVID-19 vaccine inoculation and booster shots: a systematic review and meta-analysis of factors that influence coronavirus vaccine uptake in practice

Introduction: Vaccines alone do not control pandemics, but vaccinations. The hope of COVID-19 pandemic control is hinged on vaccinations and other public health measures. This systematic review/meta-analysis (SR/MA) investigated the factors that inform coronavirus vaccine uptake globally in an attempt to improve COVID-19 immunization. Method: The PRISMA 2020 methodology was used for this review. A total of 2902 articles were identified from electronic databases and other sources. After screening, 33 articles were included in the review and quantitative meta-analysis. Comprehensive meta-analysis software version 3 was used for the meta-analysis. Results: We observed that vaccine effectiveness, side effects and the proportion of acquaintances vaccinated significantly influenced respondents' COVID-19 immunization decision. Also, associations of vaccine effectiveness, smaller risks to serious side effects, free and voluntary vaccinations and fewer vaccine doses, and longer duration to wanning were observed. We also observed variations in vaccine hesitancy trends in studies carried out in Asia, Europe, America, and Africa. Conclusion: Wanning and acquaintance's vaccination status as factors to vaccination are insights the present paper is bringing to the limelight. Health promotion and COVID-19 vaccination planning are crucial for enhancing vaccine uptake

Assessment of COVID-19 vaccine hesitancy among people living with HIV/AIDS: a single-centered study

Introduction: as the coronavirus disease 2019 (COVID-19) vaccines are distributed and administered globally, hesitancy towards the vaccine hinders the immunisation of a significant number of vulnerable populations, such as people living with HIV/AIDS. Hence, this study aims to assess COVID-19 vaccine hesitancy among people living with HIV/AIDS (PLHIV) attending clinicaloutpatient follow-up at State Specialist Hospital Maiduguri (SSHM), Borno State, Nigeria. Methods: a hospital-based cross-sectional study design was conducted to assess COVID-19 vaccine hesitancy among 344 PLHIV receiving antiretroviral therapy (ART) at the United States President´s Emergency Plan for AIDS (PEPFAR) clinic in SSHM from 4 th January to 25th February 2022. Data were collected using a structured and pretested interviewer-administered questionnaire. The results were presented using frequencies and percentages. The factors that are associated with COVID-19 vaccine hesitancy were identified using the Chi-square statistical test. Results: among the 344 respondents of the study, only 88 (26.6%) received the COVID-19 vaccine. Out of the 256 respondents that did not receive the vaccine, only 10.5% (27/256) are willing to be vaccinated, while the majority; 57.8% (148/256) are not willing to be vaccinated and 31.7% (81/256) of the respondents are uncertain, thus resulting in a hesitation rate of 89.45%. There was no statistically significant association between COVID-19 vaccine hesitancy and the study´s independent variables; where p-value is greater than 0.05. Conclusion: hesitancy towards COVID-19 vaccine is high among PLHIV and there is no any statistically significant association between COVID-19 vaccine hesitancy and the independent variables of the study where p-value is greater than 0.05. Hence, it is necessary to develop targeted strategies to boost vaccine uptake among this vulnerable population.

COVID-19 vaccine hesitancy in ASEAN: Insights from a multi-wave survey database from July 2020 to March 2021

Objectives@#Early studies on COVID-19 vaccine hesitancy showed varied intensity across countries, which was linked to various factors such as socio-economic conditions, information sources, and issues of trust in government, scientific experts, and the health sector. This study aims to evaluate the determinants of vaccine hesitancy to offer insights into the strategies that may be successful in designing communications campaigns for enhanced vaccination uptake. @*Methods@#Through logistic regression, this study examines correlates of survey data from five Southeast Asian countries, namely Indonesia (ID), Malaysia (MY), Philippines (PH), Thailand (TH), Vietnam (VN) collected by the Massachusetts Institute of Technology Initiative on Digital Economy and Facebook between July 2020 and March 2021.@*Results@#Some significant determinants at the 5% or 1% level of significance of COVID-19 vaccine hesitancy in the countries of interest include gender [ID: 1.17 (1.01, 1.15), MY: 1.35 (1.2,1.53), PH: 1.92 (1.68,2.19), VN: 1.28 (1.04,1.58)], age [MY:1.11 (1.06,1.17), PH: 0.92 (0.88, 0.97), TH: 1.17 (1.11, 1.23)], knowing someone who tested positive for COVID-19 [ID: 0.75 (0.65,0.88), MY: 0.82 (0.71,0.95), PH: 0.76 (0.67, 0.87), TH: 0.76 (0.59, 0.99), VN: 0.72 (0.54,0.97)], and perceived effectiveness of mask wearing [ID: 0.83 (0.74, 0.94), MY: 0.86 (0.79, 0.95), TH: 0.88 (0.8,0.98)]. Vaccine hesitancy is particularly strong among women in 3 countries—peaking at 52% in Indonesia, 42% in Malaysia, and 56% in the Philippines.@*Conclusion@#Results from the survey highlight the significance of a targeted vaccine education and research campaign. This study calls for streamlining of communications campaigns towards messages that promote vaccine uptake in the region, while better targeting those groups most vulnerable guided by the empirical findings herein.

Addressing vaccine hesitancy during the COVID-19 pandemic: Learning from the past and moving forward

Excerpt@#Anong hirap ang kailangan niyong maranasan para kayo ay magpabakuna na? How much suffering are you willing to risk experiencing to persuade you to go for COVID-19 vaccination? @*@#Working at a COVID-19 Referral Center, we probably saw a lot more critically ill COVID-19 patients than in other hospitals in the Philippines. During the height of the Delta surge in 2021, our intensive care units (ICUs) for adults and pediatric critical COVID-19 were always full with a long waiting line. The typical medical history of the patients would be a senior retiree, usually a Lolo (grandfather) or a Lola (grandmother), who needed urgent support to be hooked to a mechanical ventilator because they could not breathe on their own anymore. When asked about their COVID-19 vaccination status, Lolo and Lola were often not vaccinated. Other times, the patient may not yet be old enough to be considered a Lolo or Lola but may have illnesses like heart failure, diabetes, hypertension, or on dialysis. They too were often not vaccinated. And occasionally, we admitted small children who would seemingly be out of place in the sea of adult patients in the Emergency Room. One would think that because the very young have not yet been allowed to get vaccinated, the people around them would strive to be vaccinated to protect these little ones. On the contrary, though, we saw many young patients whose exposures to COVID-19 came from their unvaccinated parents. This heartbreaking situation continued despite the intensive COVID-19 vaccination program of our government. When one thinks about it, it is possible that some of the many deaths and sufferings of patients and the anguish of grieving families, as well as the lonely exits of beloved ones dying alone amidst CPR machines and teams, may have been avoided had unvaccinated patients opted to be vaccinated. Now over 2 ½ years into the pandemic with many cases said to be mild, we continue to have a continuous flow of admissions for COVID-19 which fall into the moderate, severe, and even critical COVID-19, and some of them are because they have remained unvaccinated. Where and how can we improve the situation?

Research progress of vaccine hesitancy in China in recent years / 上海预防医学

The 2030 Immunization Agenda of the World Health Organization （WHO） states that everyone in the world should fully benefit from vaccines to achieve good health and well-being. With the ever-changing disease spectrum and the improvement of residents' health literacy， relying solely on vaccines included in the National Immunization Program （NIP） is insufficient to meet the current requirements for disease prevention and control. Non-NIP vaccines play an important role in meeting people's diverse needs. Vaccine hesitancy is a global issue and an important factor affecting vaccine uptake. By reviewing relevant studies on vaccine hesitancy in recent years， this paper summarized different vaccination situations， current situation of vaccine hesitancy， measuring tools of vaccine hesitancy， and major influencing factors. It aims to provide references for the development of scientific and effective vaccine education strategies， which can increase public knowledge and understanding of vaccines， enhance healthcare professional's willingness and behavior in recommending vaccines， improve public vaccine literacy， and reduce vaccine hesitancy. At the same time， the supervision and guidance of media discourse should be strengthened to enhance the protective role of non-NIP vaccines in immunization barriers.

Malaysian Newspapers’ Coverage of Anti-vaxxers: Implication on Vaccine Intakes

@#Introduction: The World Health Organization (WHO) named anti-vaxxers as one of the top ten public health hazards in 2019. Anti-vaxxers are a health danger since they are mostly responsible for the re-emergence of deadly contagious diseases such as measles, which has increased in recent years. The media such as newspapers, are responsible for disseminating messages and public knowledge about health issues, particularly health hazards. To particularly combat anti-vaccine views online, newspaper must provide critical information, such as scientific and verifiable facts. Newspapers need to also take a clear stand against anti-vaccine sentiments. Method: A quantitative content analysis was conducted on four newspapers (Harian Metro, Berita Harian, New Straits Times, and The Star) over a three-year period beginning 1 January 2019 and ending 30 September 2021. The 43-month period offered adequate data for analysing reporting trends. Result: The findings suggested that newspapers do significantly report about the antivaxxers with 247 news were focused on them. Conclusion: However, the newspapers tend to only publish generic information about the antivaxxers and rarely make compelling arguments against them.

Assessment of Knowledge, Attitude & Perception towards COVID-19 Vaccine among the rural and urban population of Navi Mumbai: An Alarming Scenario

Objective: To assess the knowledge, attitude, and perception towards COVID-19 vaccination among rural and urban areas. To study and analyze any socio-demographic barriers and economic factors affecting the immunization program. Methodology: A cross-sectional comparative study was conducted between the urban and rural populations with the help of pre-designed and pre-structured questionnaires. Data were collected from 205 subjects from the urban population with the help of Google form and 242 subjects from the rural population through an interview. Results: 97.1% of the urban population were aware of the Arogya Setu app of which 80% were using it while 87.6% of the rural population were not aware of the Arogya Setu app. 60.3% of the rural population had the perception that the Covid-19 vaccine can be eradicated without the vaccine whereas 77.1% of the urban population had the opposite perception. Conclusion: Most of the urban population had good knowledge about the Covid 19 vaccine with a positive attitude of accepting the vaccine as the most important preventive measure of prevention and control of the Covid 19 pandemic as compared to the rural population.

A qualitative study on perceptions of COVID-19 vaccine among health care worker in a rural area of West Bengal, India

Background: COVID vaccines have been rolled out all over the world after emergency use authorization in the prevailing pandemic situation. However, hesitancy about its safety and efficacy exists among beneficiaries. Vaccine hesitancy can be a barrier to adequate immunization coverage. Aims and Objectives: This qualitative study was undertaken among health care workers in the rural field practice area of a tertiary care hospital, to find out their perceptions about COVID vaccines, and reasons behind hesitancy toward the same. Materials and Methods: Six focused group discussions (FGD) were held with the help of moderator. Each FGD had five members, so 30 members were included in the study. Health care workers included doctors, nurses, ANM/ASHAs, and other health care workers. Results: There were 17 males and 13 females. Doctors had a positive attitude toward vaccination, but other health care workers had mixed perception regarding vaccination. Most grass root level workers were sceptical about the efficacy of the vaccine. Conclusion: Mostly positive attitude toward COVID vaccines was observed in the present study. Hesitancy toward vaccines was observed in some health care workers, and it likely rooted from their inadequate knowledge about the vaccine.

COVID-19 Infection Rate following COVID-19 Vaccination among Healthcare Professionals at a Tertiary Care Public Hospital in City of Mumbai

Background : India launched COVID-19 mass Vaccination campaign after regulatory approval of Covishield & Covaxin vaccines. However, inspite of Vaccination, cases of COVID-19 infection are being reported. Hence, this study is aimed to assess the COVID-19 infection and/or re-infection rate, including breakthrough infections, following vaccination among Health Care Workers at a Tertiary Care Dedicated COVID Hospital. This questionnaire-based survey was initiated following Institutional Ethics Committee approval. We also looked at reasons for Vaccine hesitancy and occurrence of adverse reactions following vaccination, their management and duration amongst the Healthcare Workers. Results : Of 564 Healthcare Workers (HCWs) who consented to participate, only 503 filled in the questionnaire completely. Majority of the HCWs received Covishield vaccine (78.56%). The infection rate postvaccination was 8.28% (with a median of 22 days and IQR of 8-43 days). This infection rate was significantly higher in those who were not vaccinated as compared to the Vaccinated HCWs (OR = 0.10, 95 CI% = 0.05�22, p <0.0001). Breakthrough infection rate was 2.42. Although 58.39% of the participants suffered adverse reactions after vaccination, like myalgia, Fever, Headache, these were mild in nature lasting for an average of 3-4 days. The vaccine hesitancy rate at our hospital HCWs was 6.36%, the main issue being the concerns regarding safety and effectiveness of the vaccines against the COVID-19 infection. Discussion/Conclusion : The infection and Breakthrough infection rates in our study were low and severity of COVID infection post vaccination was mild, not requiring hospitalisation

Parents’ Perception Towards Covid-19 Vaccination for Children in Surat: A Cross Sectional Study

Background: Vaccine hesitancy has been recognized as a public health issue which needs to be ad-dressed urgently. With reopening of school unvaccinated children might become major carriers of COVID-19. An assessment of the determinants of vaccine hesitancy will aid in the acceleration of vaccine administration among children. Objective: This study aims to explore parental COVID-19 vaccine hesitancy in Surat and determine fac-tors associated with it. Methodology: This is a cross sectional study in Surat among 250 participants selected from Rural and Urban field practice area by Systematic Random Sampling. Data collection was done by data collectors in an interview during the month of January and February, 2022. Univariate analysis was done, followed by Chi square test to establish associations. Predictors were determined by Binomial Logistic Regression. Results: Mean age of population was 31.3 + 10.7 years. Vaccine Hesitancy was recorded in 154 (61.6%) participants. Urban address (p=0.013), Full Vaccination status of parents (<0.001) and Perceived Bene-fits of vaccine to the child (p=0.001) were significant predictors of Vaccine Hesitancy. Conclusion: High proportion of Vaccine hesitancy was found in this study. Interventions can be planned on the basis of factors affecting Vaccine Hesitancy.

A Perspective On COVID-19 Vaccine Hesitancy in India

India started vaccination drives in January of 2021. One of the biggest challenges faced by the govern-ment was the hesitancy to get vaccinated. Vaccine hesitancy causes the vaccination process to be de-layed, affecting the process of building herd immunity and allowing the virus to evolve. Certain anthropo-logical factors are responsible for vaccine hesitancy in a community. These factors are broadly catego-rised as personal beliefs, the role of media, and religion. An in-depth analysis of available literature, including the grey literature indicated that these factors influence an individual’s decision-making. Vac-cine hesitancy was largely affected by rumours surrounding it. Contradictory information regarding the vaccines created uncertainty about the consequences of getting vaccinated. A holistic approach is neces-sary to tackle vaccine hesitancy. The interventions from the government need to consider these social and cultural factors to address vaccine hesitancy in the future. Due to the diverse sample size, there is a need for various actors and stakeholders to come together and implement demographic-specific measures to address vaccine hesitancy in India.

COVID-19 Vaccine Hesitancy in Systemic Lupus Erythematosus – Experience From a Tertiary Care Rheumatology Centre in South India

Background: Patients with rheumatological diseases like SLE are at an increased risk of COVID-19 infection and hence should be prioritized for vaccination. Vaccine hesitancy is a major hindrance in achieving herd immunity against COVID-19. In this study, we aim to determine the COVID-19 vaccination rate in our SLE population and the factors associated with vaccine hesitancy. Materials and methods: We conducted an interview-based cross-sectional study on patients >18 years attending the lupus clinic of our Institute. Questionnaires were used to collect demographic details, disease status, vaccination-related data, and information regarding attitude and beliefs about COVID-19 vaccination. Descriptive statistics were used for analysis. Results: Of the 584 patients studied, the vaccination rate was 67%, and there was vaccine hesitancy of 21%, and vaccine resistance of 12%. Non-vaccination was strongly associated with older age, rural living, unemployment, and in patients with anti-phospholipid antibodies, prior stroke, prior COVID- 19 infection, and those who were currently using corticosteroids. The major reasons for vaccine hesitancy were fear of worsening lupus, fear of side effects, and religious reasons. We also came to know about various misconceptions regarding COVID vaccination prevalent among SLE patients under our follow-up causing them to opt against the vaccine. The vaccine-hesitant group may rethink their decision if there is proper reassurance and guidance from their treating physician or if more friends and family members start accepting vaccines. Conclusions: Vaccine hesitancy is a major problem in our group of SLE patients keeping the vaccination rates low. The reasons for vaccine hesitancy must be looked into and addressed to improve the vaccination rates and thereby achieve herd immunity. Proper guidance from the treating rheumatologist was reported as the major factor which may encourage the vaccine-hesitant population to opt in for the vaccination.

COVID-19 Vaccine Hesitancy among Pregnant Women: A Facility-Based Cross-Sectional Study in Imphal, Manipur

Background: Vaccine hesitancy has been recognized as a public health issue which needs to be addressed urgently. Pregnant women with COVID-19 are at increased risk of adverse pregnancy outcomes. An assessment of the determinants of vaccine hesitancy will aid in the acceleration of vaccine administration among pregnant women. Objectives: The present study aimed to determine COVID-19 vaccine hesitancy among pregnant women in Imphal, Manipur and assess associated factors. Methods: A cross-sectional study was conducted among pregnant women attending Obstetrics and Gynecology Department of a Tertiary Care Institute in Imphal, Manipur during August 2021. One hundred and sixty-three pregnant women were interviewed using a structured questionnaire over phone calls. Univariate analysis was carried out using the Chi?square test and multivariable logistic regression was performed to determine the factors significantly associated with vaccine acceptance. Results: The mean age of the participants was 28.3 ± 5.5 years and majority, 102 (62.6%) were multigravida and 27 (16.6%) had comorbidities. Vaccine hesitancy was found in 127 (77.9%) participants. Logistic regression analysis indicated that awareness on COVID?19 vaccine eligibility (P = 0.002), disagreement of vaccine being unsafe during pregnancy (P = 0.005), and agreement on vaccine benefiting the baby (P = 0.003) were the significant predictors of vaccine acceptance. Conclusion: Nearly four out of every five pregnant women had COVID?19 vaccine hesitancy. Pregnant women should be informed about the benefits and encouraged to take COVID?19 vaccine.