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1.
Vaccine ; JOUR
Article in English | ScienceDirect | ID: covidwho-2106131

ABSTRACT

Background COVID-19 vaccine hesitancy has emerged as a major public health challenge. Although medical and scientific misinformation has been known to fuel vaccine hesitancy in the past, misinformation surrounding COVID-19 seems to be rampant, and increasing evidence suggests that it is contributing to COVID-19 vaccine hesitancy today. The relationship between misinformation and COVID-19 vaccine hesitancy is complex, however, and it is relatively understudied. Methods In this article, we report qualitative data from two related but distinct studies from a larger project. Study 1 included semi-structured, open-ended interviews conducted in October–November 2020 via phone with 30 participants to investigate the relationship between misinformation and COVID-19 vaccine hesitancy. Study 1’s results then informed the design of open-ended questions for Study 2, an online survey conducted in May–June 2021 to consider the relationship between misinformation and vaccine hesitancy further. The data were examined with thematic analysis. Results Study 1 led to the identification of positive and negative themes related to attitudes toward COVID-19 vaccines. In Study 2, responses from vaccine-hesitant participants included six categories of misinformation: medical, scientific, political, media, religious, and technological. Across both Study 1 and Study 2, six vaccine hesitancy themes were identified from the data: concerns about the vaccines’ future effects, doubts about the vaccines’ effectiveness, commercial profiteering, preference for natural immunity, personal freedom, and COVID-19 denial. Conclusions The relationship between misinformation and vaccine hesitancy is complicated. Various types of misinformation exist, with each related to a specific type of vaccine hesitancy-related attitude. Personal freedom and COVID-19 denial are vaccine attitudes of particular interest, representing important yet understudied phenomena. Medical and scientific approaches may not be sufficient to combat misinformation based in religion, media, or politics;and public health officials may benefit from partnering with experts from those fields to address harmful misinformation that is driving COVID-19 vaccine hesitancy.

2.
Vaccine ; JOUR
Article in English | ScienceDirect | ID: covidwho-2106127

ABSTRACT

Background Multiple COVID-19 vaccines have now been licensed for human use, with other candidate vaccines in different stages of development. Effective and safe vaccines against COVID-19 have been essential in achieving global reductions in severe disease caused by severe acute respiratory coronavirus 2 (SARS-CoV-2), but multiple factors, including vaccine supply and vaccine confidence, continue to impact global uptake of COVID-19 vaccines. In this study, we explore determinants of COVID-19 vaccination intent across17 countries worldwide. Methods In this large-scale multi-country study, we explored intent to accept a COVID-19 vaccine and the socio-demographic and emotional determinants of uptake for 17 countries and over 19,000 individuals surveyed in June and July 2020 via nationally representative samples. We used Bayesian ordinal logistic regressions to probe the relationship between intent to accept a COVID-19 vaccine and individuals’ socio-demographic status, their confidence in COVID-19 vaccines, and their recent emotional status. Gibbs sampling was used for Bayesian model inference, with 95% Bayesian highest posterior density intervals used to capture uncertainty. Findings Intent to accept a COVID-19 vaccine was found to be highest in India, where 77⋅8% (95% HPD, 75⋅5 to 80⋅0%) of respondents strongly agreeing that they would take a new COVID-19 vaccine if it were available. The Democratic Republic of Congo (15⋅5%, 12⋅2 to 18⋅6%) and France (26⋅4%, 23⋅7 to 29⋅2%) had the lowest share of respondents who strongly agreed that they would accept a COVID-19. Confidence in the safety, importance, and effectiveness of COVID-19 vaccines are the most widely informative determinants of vaccination intent. Socio-demographic and emotional determinants played a lesser role, with being male and having higher education associated with increased uptake intent in five countries and being fearful of catching COVID-19 also a strong determinant of uptake intent. Interpretation Barriers to COVID-19 vaccine acceptance are found to be country and context dependent. These findings highlight the importance of regular monitoring of COVID-19 vaccine confidence to identify groups less likely to vaccinate.

3.
SSM - Population Health ; JOUR: 101278,
Article in English | ScienceDirect | ID: covidwho-2106007

ABSTRACT

Background COVID-19 vaccine uptake has been suboptimal and disparities in uptake have exacerbated health inequities. It has been postulated that mistrust in the healthcare system and experiences of discrimination or unfair treatment in other settings may be barriers to uptake of the COVID-19 vaccine, although few studies to date have investigated medical mistrust and perceived discrimination together. Method We conducted a cross-sectional online survey between April 23-May 3, 2021, among a national sample of U.S. adults ages 18 years and older. We assessed receipt of and intention to be vaccinated for COVID-19 and associations with the validated Medical Mistrust Index and Everyday Discrimination Scale. Results 1449 individuals responded, of whom 70.2% either had ≥1 dose of COVID-19 vaccine or reported that they were ‘very’ or ‘somewhat’ likely to be vaccinated in the future. In bivariate analyses, vaccination status was significantly associated with age, race/ethnicity, education, income, employment, marital status, health insurance, and political party affiliation. In multivariable analyses comparing those who had ≥1 vaccine dose or were likely to get vaccinated in the future with those who had not had any vaccine doses or did not intend to be vaccinated, each additional point in the Medical Mistrust Index was independently associated with a 16% decrease in the odds of vaccination (adjusted odds ratio = 0.84;95% confidence interval = 0.81, 0.86). Discriminatory experiences were not associated with vaccination behavior or intention in bivariate or multivariable analyses. Conclusions Medical mistrust is significantly associated with vaccination status and intentions. Increasing uptake of COVID-19 vaccines will likely require substantive efforts on the part of public health and healthcare officials to build trust with those who are not yet fully vaccinated. We recommend that these efforts focus on building the ‘trustworthiness’ of these entities, an approach that will require a paradigm shift away from a focus on correcting individual beliefs and knowledge to acknowledging and addressing the root causes underlying mistrust.

4.
Public Health ; JOUR
Article in English | ScienceDirect | ID: covidwho-2105783

ABSTRACT

Objectives The study set out to measure public understanding of COVID-19 vaccine effectiveness (VE) and how effectiveness wanes with time since vaccination. Because perceived VE is a strong predictor of vaccine uptake, measuring perceptions can inform public health policy and communications. Study Design Online randomised experiment. Method The study was undertaken in Ireland, which has high vaccination rates. A nationally representative sample (n=2,000) responded to a scenario designed to measure perceptions of COVID-19 VE against mortality. The length of time since vaccination in the scenario was randomly varied across four treatment arms (2 weeks, 3 months, 6 months, 9 months). Results The public underestimates VE, with substantial variation in perceptions. A majority (57%) gave responses implying perceived VE against mortality of 0-85%, i.e. below scientific estimates. Among this group, mean perceived VE was just 49%. Over a quarter (26%) gave responses implying perceived VE greater than 95%, i.e. above scientific estimates. Comparing the four treatment groups, responses took no account of vaccine waning. Perceived VE was actually higher 9 months after vaccination than 2 weeks after vaccination. Conclusion Despite high vaccination rates, most of the public in Ireland underestimates VE. Furthermore, the general public has not absorbed the concept of vaccine waning in the months following vaccination. Both misperceptions may reduce vaccine uptake, unless public health authorities act to correct them through improved communication.

5.
Hum Vaccin Immunother ; : 2138047, 2022 Nov 07.
Article in English | MEDLINE | ID: covidwho-2107200

ABSTRACT

Vaccination has proven to be the most effective tool in controlling the COVID-19 pandemic. While pregnant individuals are considered to be a high-risk population and are more likely to experience adverse effects from COVID-19, vaccination rates among pregnant individuals are significantly lower than in the general population. The Health Belief Model (HBM), Theory of Planned Behavior (TPB), 3C model, 5C model, and 5A model have been used to assess vaccination hesitancy behaviors. In this paper, we review the use of each of these models to address vaccine hesitancy, with a focus on the pregnant population and the COVID-19 vaccine. The HBM, TPB, 3C model, and 5C model have demonstrated great versatility in their ability to evaluate, explain, and modify vaccine hesitancy and behavior. Up to date, the HBM and 3C models appear to be the most effective models to study and address vaccination hesitancy within the pregnant persons.

6.
Hum Vaccin Immunother ; : 2131168, 2022 Nov 04.
Article in English | MEDLINE | ID: covidwho-2107198

ABSTRACT

Refugees, immigrants, and migrants (RIM) in the United States (US) have been identified as an underimmunized population prior to the COVID-19 pandemic. Vaccine acceptance is critical to combat the public health threat incited by COVID-19 and other vaccine-preventable disease. To better understand escalating vaccine hesitancy among US RIM, a comprehensive evaluation of the problem and solutions is necessary. In this systematic review, we included 57 studies to describe vaccination rates, barriers, and interventions addressing vaccine hesitancy over the past decade. Meta-analysis was performed among 22 studies, concluding that RIM represent an underimmunized population compared to the general US population. Narrative synthesis and qualitative methods were used to identify critical barriers, including gaps in knowledge, poor access to medical care, and heightened distrust of the medical system. Our results demonstrate the need for effective, evidence-based interventions to increase vaccination rates among diverse RIM populations.

7.
Vaccine ; 40(46): 6658-6663, 2022 Nov 02.
Article in English | MEDLINE | ID: covidwho-2106126

ABSTRACT

BACKGROUND: People with noncommunicable diseases (NCDs) are at a significantly higher risk of worst outcomes if infected with COVID-19 and thus amongst the main target population for vaccination. Despite prioritizing them for vaccination, the number of vaccinated patients with comorbidities stalled post vaccine introduction. Despite that the government along with partners ran a national awareness campaign to ramp up vaccination coverage, the coverage remained suboptimal. Thus, a one-to-one health counselling initiative was implemented to explore the acceptance of COVID-19 vaccines by the NCDs patients and address the main issues surrounding vaccine hesitancy. This study evaluates the impact of this intervention by analyzing the change in COVID-19 vaccine acceptance. METHODS: In this analytical observational study, a random sample of 57,794 people living with NCDs were approached. Out of them, 12,144 received one-to-one counselling by a group of trained health professionals. The counselled group's vaccine acceptance was assessed on a Likert scale from 1 to 5 pre- and post- counselling. Moreover, a random sample was followed up 2 months after initial counselling to measure their vaccine acceptance and update their vaccination status. RESULTS: 44.5% of total respondents were already registered in the vaccination platform. On a scale from 1 to 5, the overall mean confidence significantly increased by 1.63 from 2.48 pre-counselling to 4.11 post-counselling. Two-months post counselling, a random sample was contacted again and had a mean vaccine confidence of 3.71, which is significantly higher than pre-counselling confidence level despite a significant decrease to post-counselling results. DISCUSSION: Implementing an intervention that targets all key factors impacting health decisions, such as health literacy, risk appraisal and response efficacy, helps reach an adaptive response and increase vaccine confidence. Scholars should be cautious when implementing an intervention since it could lead to maladaptive defensive responses. One-to-one interventions are more effective in population when addressing new interventions and vaccines.


Subject(s)
COVID-19 , Noncommunicable Diseases , Vaccines , Humans , COVID-19 Vaccines , Noncommunicable Diseases/prevention & control , Jordan , COVID-19/prevention & control , Vaccination , Counseling
9.
Public Health Pract (Oxf) ; 4: 100338, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-2105786

ABSTRACT

Objectives: The Ethiopian government had planned to vaccinate the total population and started to deliver the COVID-19 vaccine but, there is limited evidence about vaccine acceptance among pregnant women. Thus, this study aimed to assess COVID-19 vaccine acceptance and associated factors among pregnant women attending an antenatal care unit clinic in Eastern Ethiopia. Study design: A facility-based cross-sectional study. Methods: A study was conducted from June 01 to 30/2021 among systematically selected pregnant women. Data were collected using a pre-tested structured questionnaire, which was adapted from previous studies, through a face-to-face interview. Predictors were assessed using a multivariable logistic regression model and reported using an adjusted odds ratio with 95% CI. Statistical significance was declared at p-value less than 0.05. Results: In this study, data from 645 pregnant women were used in the analysis. Overall, 62.2% of pregnant women were willing to be vaccinated if the vaccine is approved by the relevant authority. Fear of side effects (62.04%), a lack of information (54.29%), and uncertainty about the vaccine's safety and efficacy (25%) were the most common reasons for refusal to take the COVID-19 vaccine. The odds of unwillingness to accept the COVID-19 vaccine among pregnant women were increased significantly among mothers who were able to read and write [AOR = 2.9, 95% CI: (1.16, 7.23)], attain 9-12 grade level [AOR = 4.2, 95% CI: (2.1, 8.5)], lack information [AOR = 2.2, 95% CI: (1.41, 3.57)], and having a history of chronic diseases [AOR = 2.52, 95% CI: (1.34, 4.7)]. Conclusion: Less than two-thirds of pregnant women were willing to accept the COVID-19 vaccine. Extensive public health information dissemination aimed at women with lower educational backgrounds and a history of chronic disease could be critical.

10.
Public Health ; 213: 47-53, 2022 Sep 29.
Article in English | MEDLINE | ID: covidwho-2105781

ABSTRACT

OBJECTIVE: The current health emergency caused by COVID-19 disease shows several correspondences with well-known epidemics of the past. The knowledge of their management and overcoming could give us useful tools to face the present COVID-19 pandemic and future epidemics. STUDY DESIGN: On 1 March 1801, the first smallpox vaccinations were carried out in Palermo, and a few weeks later, the vaccine was also administered in Naples and the various provinces of the Kingdom. We aim to study the mass vaccination programme initiated by the Bourbon king Ferdinand IV that was the first large-scale campaign to be conducted in Italy and one of the first in Europe. METHODS: The authors searched and examined historical testimony and different aspects linked to the public health issues on vaccination. It is a topical topic in the current period with the COVID pandemic. RESULTS: Albeit with the due differences determined by the passage of time and by the scientific and cultural advances of modern society, this testimony from the past can provide us with food for thought regarding how to face the present COVID-19 pandemic and to prepare for the future. Indeed, it shows us how the terrible smallpox epidemic was handled and finally overcome, thanks to vaccination.

11.
Trials ; 23(1): 911, 2022 Oct 28.
Article in English | MEDLINE | ID: covidwho-2098443

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) vaccines demonstrate excellent effectiveness against infection, severe disease, and death. However, pediatric COVID-19 vaccination rates lag among individuals from rural and other medically underserved communities. The research objective of the current protocol is to determine the effectiveness of a vaccine communication mobile health (mHealth) application (app) on parental decisions to vaccinate their children against COVID-19. METHODS: Custodial parents/caregivers with ≥ 1 child eligible for COVID-19 vaccination who have not yet received the vaccine will be randomized to download one of two mHealth apps. The intervention app will address logistical and motivational barriers to pediatric COVID-19 vaccination. Participants will receive eight weekly push notifications followed by two monthly push notifications (cues to action) regarding vaccinating their child. Through branching logic, users will access customized content based on their locality, degree of rurality-urbanicity, primary language (English/Spanish), race/ethnicity, and child's age to address COVID-19 vaccine knowledge and confidence gaps. The control app will provide push notifications and information on general pediatric health and infection prevention and mitigation strategies based on recommendations from the American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC). The primary outcome is the proportion of children who complete COVID-19 vaccination series. Secondary outcomes include the proportion of children who receive ≥ 1 dose of COVID-19 vaccine and changes in parent/caregiver scores from baseline to immediately post-intervention on the modified WHO SAGE Vaccine Hesitancy Scale adapted for the COVID-19 vaccine. DISCUSSION: The COVID-19 pandemic inflicts disproportionate harm on individuals from underserved communities, including those in rural settings. Maximizing vaccine uptake in these communities will decrease infection rates, severe illness, and death. Given that most US families from these communities use smart phones, mHealth interventions hold the promise of broad uptake. Bundling multiple mHealth vaccine uptake interventions into a single app may maximize the impact of deploying such a tool to increase COVID-19 vaccination. The new knowledge to be gained from this study will directly inform future efforts to increase COVID-19 vaccination rates across diverse settings and provide an evidentiary base for app-based vaccine communication tools that can be adapted to future vaccine-deployment efforts. CLINICAL TRIALS REGISTRATION: ClinicalTrials.gov NCT05386355 . Registered on May 23, 2022.


Subject(s)
COVID-19 , Telemedicine , Vaccines , Child , Humans , COVID-19 Vaccines , Pandemics/prevention & control , COVID-19/prevention & control , Vaccination , Randomized Controlled Trials as Topic
12.
Trials ; 23(1): 332, 2022 Apr 21.
Article in English | MEDLINE | ID: covidwho-2098442

ABSTRACT

BACKGROUND: We conducted in-depth interviews to characterize reasons for COVID-19 vaccine hesitancy in emergency department (ED) patients and developed messaging platforms that may address their concerns. In this trial, we seek to determine whether provision of these COVID-19 vaccine messaging platforms in EDs will be associated with greater COVID-19 vaccine acceptance and uptake in unvaccinated ED patients. METHODS: This is a cluster-randomized controlled trial (RCT) evaluating our COVID-19 vaccine messaging platforms in seven hospital EDs (mix of academic, community, and safety-net EDs) in four US cities. Within each study site, we randomized 30 1-week periods to the intervention and 30 1-week periods to the control. Adult patients who have not received a COVID-19 vaccine are eligible with these exclusions: (1) major trauma, intoxication, altered mental status, or critical illness; (2) incarceration; (3) psychiatric chief complaint; and (4) suspicion of acute COVID-19 illness. Participants receive an orally administered Intake survey. During intervention weeks, participants then receive three COVID-19 vaccine messaging platforms (4-min video, one-page informational flyer and a brief, scripted face-to-face message delivered by an ED physician or nurse); patients enrolled during non-intervention weeks do not receive these platforms. Approximately, an hour after intake surveys, participants receive a Vaccine Acceptance survey during which the primary outcome of acceptance of the COVID-19 vaccine in the ED is ascertained. The other primary outcome of receipt of a COVID-19 vaccine within 32 days is ascertained by electronic health record review and phone follow-up. To determine whether provision of vaccine messaging platforms is associated with a 7% increase in vaccine acceptance and uptake, we will need to enroll 1290 patients. DISCUSSION: Highlighting the difficulties of trial implementation during the COVID-19 pandemic in acute care settings, our novel trial will lay the groundwork for delivery of public health interventions to vulnerable populations whose only health care access occurs in EDs. CONCLUSIONS: Toward addressing vaccine hesitancy in vulnerable populations who seek care in EDs, our cluster-RCT will determine whether implementation of vaccine messaging platforms is associated with greater COVID-19 vaccine acceptance and uptake in unvaccinated ED patients. TRIAL STATUS: We began enrollment in December 2021 and expect to continue through 2022. TRIAL REGISTRATION: ClinicalTrials.gov NCT05142332 . Registered 02 December 2021.


Subject(s)
COVID-19 Vaccines , COVID-19 , Adult , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Emergency Service, Hospital , Humans , Randomized Controlled Trials as Topic
13.
Trials ; 23(1): 161, 2022 Feb 19.
Article in English | MEDLINE | ID: covidwho-2098429

ABSTRACT

BACKGROUND: Science-driven storytelling and entertainment-education (E-E) media demonstrate potential for promoting improved attitudes and behavioral intent towards health-related practices. Months after the outbreak of coronavirus disease 2019 (COVID-19), emerging research highlights the essential role of interventions to improve public confidence in the COVID-19 vaccine. To improve vaccine confidence, we designed three short, animated videos employing three research-informed pedagogical strategies. These can be distributed globally through social media platforms, because of their wordless and culturally accessible design. However, the effectiveness of short, animated storytelling videos, deploying various pedagogic strategies, needs to be explored across different global regions. METHODS/DESIGN: The present study is a multi-site, parallel group, randomized controlled trial (RCT) comparing the effectiveness of (i) a storytelling-instructional-humor approach, (ii) a storytelling-analogy approach, (iii) a storytelling-emotion-focused approach, and (iv) no video. For our primary outcomes, we will measure vaccine hesitancy, and for secondary outcomes, we will measure behavioral intent to seek vaccination and hope. Using online platforms, we will recruit 12,000 participants (aged 18-59 years) from the USA and China, respectively, yielding a total sample size of 24,000. DISCUSSION: This trial uses innovative online technology, reliable randomization algorithms, validated survey instruments, and list experiments to establish the effectiveness of three short, animated videos employing various research-informed pedagogical strategies. Results will be used to scientifically support the broader distribution of these short, animated video as well as informing the design of future videos for rapid, global public health communication. TRIAL REGISTRATION: German Clinical Trials Register DRKS #00023650 . Date of registration: 2021/02/09.


Subject(s)
COVID-19 , Social Media , Vaccines , Adolescent , Adult , Humans , Middle Aged , Pandemics/prevention & control , SARS-CoV-2 , Young Adult
14.
Am J Health Promot ; : 8901171221136113, 2022 Oct 28.
Article in English | MEDLINE | ID: covidwho-2098213

ABSTRACT

PURPOSE: Drawing from the Health Belief Model, we explored how disadvantaged groups in the U.S., including Black, Hispanic, less educated and wealthy individuals, experienced perceived barriers and cues to action in the context of the COVID-19 vaccination. DESIGN: A cross-sectional survey administered in March 2021. SETTING: USA. SUBJECTS: A national sample of U.S. residents (n = 795) recruited from Prolific. MEASURES: Perceived barriers (clinical, access, trust, religion/spiritual), cues to action (authorities, social circles), attitudes toward COVID-19 vaccination. ANALYSIS: Factor analysis and Structural Equation Model (SEM) were performed in STATA 16. RESULTS: Black and less educated individuals experienced higher clinical barriers (CI [.012, .33]; CI [.027, .10]), trust barriers (CI [.49, .92]; CI [.057, .16]), and religious/spiritual barriers (CI [.28, .66]; CI [.026, .11]). Hispanics experienced lower levels of clinical barriers (CI [-.42, .0001]). Clinical, trust, and religious/spiritual barriers were negatively related to attitudes toward vaccination (CI [-.45, -.15]; CI [-.79, -.51]; CI [-.43, -.13]). Black and less educated individuals experienced fewer cues to action by authority (CI [-.47, -.083]; CI [-.093, -.002]) and social ties (CI [-.75, -.33]; CI [-.18, -.080]). Lower-income individuals experienced fewer cues to action by social ties (CI [-.097, -.032]). Cues from social ties were positively associated with vaccination attitudes (CI [.065, .26]). CONCLUSION: Communication should be personalized to address perceived barriers disadvantaged groups differentially experience and use sources who exert influences on these groups.

15.
Risk Anal ; 42(7): 1409-1422, 2022 07.
Article in English | MEDLINE | ID: covidwho-2097865

ABSTRACT

In 2019, the World Health Organization (WHO) named "Vaccine Hesitancy" one of the top 10 threats to global health. Shortly afterward, the COVID-19 pandemic emerged as the world's predominant health concern. COVID-19 vaccines of several types have been developed, tested, and partially deployed with remarkable speed; vaccines are now the primary control measure and hope for a return to normalcy. However, hesitancy concerning these vaccines, along with resistance to masking and other control measures, remains a substantial obstacle. The previous waves of vaccine hesitancy that led to the WHO threat designation, together with recent COVID-19 experience, provide a window for viewing new forms of social amplification of risk (SAR). Not surprisingly, vaccines provide fertile ground for questions, anxieties, concerns, and rumors. These appear in new globalized hyperconnected communications landscapes and in the context of complex human (social, economic, and political) systems that exhibit evolving concerns about vaccines and authorities. We look at drivers, impacts, and implications for vaccine initiatives in several recent historical examples and in the current efforts with COVID-19 vaccination. Findings and insights were drawn from the Vaccine Confidence Project's decade long monitoring of media and social media and its related research efforts. The trends in vaccine confidence and resistance have implications for updating the social amplification of risk framework (SARF); in turn, SARF has practical implications for guiding efforts to alleviate vaccine hesitancy and to mitigate harms from intentional and unintentional vaccine scares.


Subject(s)
COVID-19 , Vaccines , COVID-19/prevention & control , COVID-19 Vaccines , Humans , Pandemics/prevention & control , Vaccination
16.
Vaccine ; JOUR
Article in English | ScienceDirect | ID: covidwho-2096123

ABSTRACT

We examined parental COVID-19 vaccination intentions for their children, reasons for not vaccinating, and the potential impact of a school/daycare vaccination requirement or pediatrician’s recommendation on vaccination intentions. Two online surveys were conducted in June–July and September–October, 2021, before pediatric COVID-19 vaccines were authorized for emergency use in children age < 12 years, with an internet-based, non-probability sample of U.S. adults. Respondents with children (age < 18 years) in the household were asked about their intention (likelihood) of vaccinating these children against COVID-19. Weighted Chi-square tests using a Rao-Scott correction were performed. Vaccinated (45.7%) versus unvaccinated (6.9%) parents were almost seven times more likely to have vaccinated their 12–17-year-old children. Approximately 58.4% of respondents with unvaccinated children ages 2–11 years and 42.4% of those with children < 2 years said they are “very” or “extremely likely” to vaccinate these children. Female parents were significantly more likely (p < .01 to p < .001) to express lower levels of COVID-19 vaccine intentions. Across all age groups of unvaccinated children, parental vaccine intentions increased with increased household income and education levels. COVID-19 vaccine side effects and safety concerns were primary reasons for not vaccinating children. Strategies including school vaccination requirements and recommendations from pediatricians were shown to increase parental COVID-19 vaccination intentions for some. More research is needed on factors that increase/hinder COVID-19 pediatric vaccine uptake.

17.
Vaccine ; 2022 Nov 07.
Article in English | MEDLINE | ID: covidwho-2096122

ABSTRACT

Monitoring COVID-19 vaccine hesitancy helps design and implement strategies to increase vaccine uptake. Utilizing the large scale cross-sectional Household Pulse Survey data collected between July 21 and October 11 in 2021, this study aims to construct measures of COVID-19 vaccine hesitancy and identify demographic disparities among U.S. adults (18y+). Factor analysis identified three factors of vaccine hesitancy: safety concerns (prevalence: 70.1 %). trust issues (53.5 %), and not seen as necessary (33.8 %). Among those who did not show willingness to receive COVID-19 vaccine, females were more likely to have safety concerns (73.7 %) compared to males (66.7 %), but less likely to have trust issues (female: 49.7 %; male: 57.1 %) or not seen as necessary (female: 23.8 %; male 43.4 %). Higher education was associated with higher prevalence of not seen as necessary. Younger adults and Whites had higher prevalence of having trust issues and not seen as necessary compared to their counter parts.

18.
Vaccine ; 2022 Nov 04.
Article in English | MEDLINE | ID: covidwho-2096117

ABSTRACT

BACKGROUND: The COVID-19 pandemic has brought to light the importance of identifying factors associated with vaccine hesitancy. Disease threat and coping responses are central to health behavior engagement and present potential alterable targets for intervention. PURPOSE: To examine the roles of perceived threat of COVID-19 and coping in vaccine hesitancy, we examined how coping strategies involving approach and avoidance interact with perceived threat of COVID-19 to predict vaccine hesitancy. METHODS: We used data from 1570 North American participants who reported their vaccine hesitancy as part of a longitudinal study assessing psychosocial responses to the pandemic. We used logistic regression models and mean scores of perceived threat of COVID-19, approach coping, and avoidance coping from prior timepoints to predict vaccine hesitancy in December 2020, when COVID-19 vaccines were first being approved for use in North America. RESULTS: Low perceived threat of COVID-19 was associated with greater likelihood of being vaccine hesitant. However, approach coping moderated this association, such that people who engaged in more approach coping were less likely to be vaccine hesitant even when they did not feel personally threatened by COVID-19. In contrast, avoidance coping was associated with greater likelihood of vaccine hesitancy regardless of perceived threat of COVID-19. CONCLUSIONS: Our results illustrate the contributions of approach and avoidance coping to vaccine hesitancy and in doing so, provide preliminary evidence for coping behavior to serve as a target for intervention to reduce vaccine hesitancy.

19.
Ethn Dis ; 32(4): 341-350, 2022.
Article in English | MEDLINE | ID: covidwho-2091257

ABSTRACT

Objective: To explore factors influencing COVID-19 vaccine decision-making among Black adults at high-risk for COVID-19 infection. Despite effective treatment and vaccination availability, Black Americans continue to be disproportionately impacted by COVID-19. Design Setting and Participants: Using community-engaged qualitative methods, we conducted virtual, semi-structured focus groups with Black residents in Los Angeles County before widespread vaccine rollout. Recruitment occurred through local community partners. Main Outcome Measures: Themes and subthemes on factors for vaccine confidence and accessibility. Methods: As part of a larger study exploring COVID-19 vaccine decision-making factors among multiethnic groups, two-hour virtual focus groups were conducted between December 15, 2020 and January 27, 2021. Transcripts were analyzed using reflexive thematic analysis. Results: Three focus groups were conducted with 17 Black participants, who were primarily female (n=15), residents of high-poverty zip codes (n=11) and employed full-time (n=6). Black-specific considerations for vaccine confidence and accessibility include: 1) reduced confidence in COVID-19 vaccines due to historical government inaction and racism (existing health inequities and disparities are rooted in racism; historical unethical research practices); 2) misunderstanding of Black communities' vaccine concerns ("vaccine hesitancy" as an inaccurate label to describe vaccine skepticism; ignorance to root causes of vaccine skepticism); and 3) recognizing and building on resources (community agency to address COVID-19 vaccine needs adequately). Conclusions: Vaccination campaigns should improve understanding of underlying vaccination concerns to improve vaccine outreach effectiveness and should partner with, provide resources to, and invest in local, trusted Black community entities to improve COVID-19 vaccination disparities.

20.
Epidemiol Health ; : e2022056, 2022 Jul 06.
Article in English | MEDLINE | ID: covidwho-2090592

ABSTRACT

Objectives: This study was conducted in Qatar with the objective of exploring beliefs and attitudes among mothers towards Covid-19 vaccination for their children, using validated vaccine hesitancy tools and to understand major factors influencing vaccine hesitancy among these mothers. Study design A population based, , online cross-sectional survey was conducted from 15th October till 15th November 2020. A composite study questionnaire incorporating a validated vaccine hesitancy tool was developed and used. The questionnaire was available in English and Arabic. Ethical approval was sought and obtained from the local ethics committee (MRC 01-2-930). Methods: Participation was voluntary and offered to all adult residents of Qatar through an online link available on social media platforms and local news portals. For the purposes of this study, only respondents aged 18 and over and who identified themselves as mothers were included. No personal identifying data was collected. Results: The main finding was that 29.4% of the mothers in the study population showed Covid-19 vaccine hesitancy towards children. This was also higher than vaccine hesitancy for self at 27.5% among these mothers. Hesitancy levels significantly varied with ethnicity and mothers of Qatari extraction showed the highest hesitancy at 51.3%. Intention to vaccinate children did not differ significantly whether mothers were acceptors or hesitators of Covid-19 vaccination for themselves. The biggest concerns reported by mothers across all groups were around long-term vaccine safety. Mothers relied significantly more on self-directed research around vaccine safety for decision making process. Conclusion: Mothers exhibit higher Covid-19 vaccine hesitancy in relation to their children.

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