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1.
PLoS One ; 17(6): e0269299, 2022.
Article in English | MEDLINE | ID: covidwho-2021778

ABSTRACT

The second wave of the COVID-19 pandemic left the Indian healthcare system overwhelmed. The severity of a third wave will depend on the success of the vaccination drive; however, even with a safe and effective COVID-19 vaccine, hesitancy can be an obstacle to achieving high levels of coverage. Our study aims to estimate the population's acceptance of the COVID-19 vaccine in an Indian district. A pilot community-based cross-sectional study was conducted from March-May 2021. The data was collected from eight primary health centres in Tamil Nadu. The eligible study participants were interviewed using a self-constructed questionnaire. A total of 3,130 individuals responded to the survey. Multinomial logistic regression was performed to assess the factors influencing COVID-19 vaccine hesitancy and refusal. Results of our study showed that 46% percent (n = 1432) of the respondents would accept the COVID-19 vaccine if available. Acceptance for the COVID-19 vaccine was higher among males (54%), individuals aged 18-24years (62%), those with higher education (77%), having the higher income (73%), and employed (51%). Individuals with no education (OR: 2.799, 95% CI = 1.103-7.108), and low income (OR: OR: 10.299, 95% CI: 4.879-21.741), were significant predictors of vaccine hesitancy (p < 0.05). Living in urban residence (OR: 0.699, 95% CI = 0.55-0.888) and age between 18 to 25 years (OR: 0.549, 95% CI = 0.309-0.977) were protective factor of COVID-19 vaccine hesitancy. While individuals in the age group 25-54years (OR = 1.601, 95%CI = 1.086-2.359), fewer education (OR = 4.8, 95% CI = 2.448-9.412,), low income (OR = 2.628, 95% CI = 1.777-3.887) and unemployment (OR = 1.351, 95% CI = 1.06-1.722) had high odds of refusing the COVID-19 vaccine. Concerns and suspicions about the safety of the COVID-19 vaccine (63%) was the major reasons causing hesitancy towards the COVID-19 vaccine The public health authorities and government need to design, develop and implement targeted interventions to enhance awareness about COVID-19 vaccines, and barriers and enablers to vaccine acceptance among individuals across diverse settings. Emphasis on involving local and religious leaders, ASHA workers, community healthcare workers, Anganwadi workers, and auxiliary nurse midwives can help to overcome context-specific barriers in areas of low COVID-19 vaccine acceptance, especially in rural settings.


Subject(s)
COVID-19 , Urination Disorders , Adolescent , Adult , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines , Cross-Sectional Studies , Humans , India/epidemiology , Male , Pandemics , Patient Acceptance of Health Care , Vaccination , Young Adult
2.
PLoS One ; 17(6): e0269923, 2022.
Article in English | MEDLINE | ID: covidwho-1993469

ABSTRACT

BACKGROUND: Clinical practitioners are influential figures in the public's health-seeking behavior. Therefore, understanding their attitudes toward the COVID-19 vaccine is critical for implementing successful vaccination programs. Our study aimed to investigate clinical practitioners' acceptance of the COVID-19 vaccine and associated factors for evidence-based interventions. METHODS: Data from 461 clinical practitioners were collected using a cross-sectional design via an online self-administered survey. Descriptive and multiple logistic regression analyses and chi-square tests were conducted using R version 3.6.1. RESULTS: The COVID-19 vaccine was accepted by 84.4 percent of those polled, and 86.1 percent said they would recommend it to others. Individuals with advanced levels of education demonstrated greater readiness for vaccine acceptance (P<0.001) and willingness to recommend (P<0.001). On the other hand, practitioners with concerns about the safety of vaccines developed in emergency settings were less likely to accept vaccines (OR = 0.22). Practitioners influenced by social media posts (OR = 0.91) and religious beliefs (OR = 0.71) were found to be less willing to recommend the vaccine. CONCLUSION: The study demonstrated that interventions to improve clinical practitioners' acceptance and recommendation of the COVID-19 vaccine should consider the following factors: level of experience and education, religious beliefs, safety concerns, specific profession, and source of information. Vaccine literacy efforts that directly address specific concerns and misconceptions, such as those that reconcile social media information and religious beliefs with scientific literature, are recommended.


Subject(s)
COVID-19 Vaccines , COVID-19 , COVID-19/epidemiology , COVID-19/prevention & control , Cross-Sectional Studies , Ethiopia , Humans , Patient Acceptance of Health Care , Vaccination
3.
Sci Rep ; 12(1): 13681, 2022 Aug 11.
Article in English | MEDLINE | ID: covidwho-1991663

ABSTRACT

The current study examined various types of misinformation related to the COVID-19 vaccines and their relationships to vaccine hesitancy and refusal. Study 1 asked a sample of full-time working professionals in the US (n = 505) about possible misinformation they were exposed to related to the COVID-19 vaccines. Study 2 utilized an online survey to examine U.S. college students' (n = 441) knowledge about COVID-19 vaccines, and its associations with vaccine hesitancy and behavioral intention to get a COVID-19 vaccine. Analysis of open-ended responses in Study 1 revealed that 57.6% reported being exposed to conspiratorial misinformation such as COVID-19 vaccines are harmful and dangerous. The results of a structural equation modeling analysis for Study 2 supported our hypotheses predicting a negative association between the knowledge level and vaccine hesitancy and between vaccine hesitancy and behavioral intention. Vaccine hesitancy mediated the relationship between the vaccine knowledge and behavioral intention. Findings across these studies suggest exposure to misinformation and believing it as true could increase vaccine hesitancy and reduce behavioral intention to get vaccinated.


Subject(s)
COVID-19 , Vaccines , COVID-19/prevention & control , COVID-19 Vaccines , Communication , Health Knowledge, Attitudes, Practice , Humans , Patient Acceptance of Health Care , Vaccination , Vaccination Hesitancy
4.
JAMA Netw Open ; 5(8): e2225657, 2022 Aug 01.
Article in English | MEDLINE | ID: covidwho-1990377

ABSTRACT

Importance: After SARS-CoV-2 infection, many patients present with persistent symptoms for at least 6 months, collectively termed post-COVID conditions (PCC). However, the impact of PCC on health care utilization has not been well described. Objectives: To estimate COVID-19-associated excess health care utilization following acute SARS-CoV-2 infection and describe utilization for select PCCs among patients who had positive SARS-CoV-2 test results (including reverse transcription-polymerase chain reaction and antigen tests) compared with control patients whose results were negative. Design, Setting, and Participants: This matched retrospective cohort study included patients of all ages from 8 large integrated health care systems across the United States who completed a SARS-CoV-2 diagnostic test during March 1 to November 1, 2020. Patients were matched on age, sex, race and ethnicity, site, and date of SARS-CoV-2 test and were followed-up for 6 months. Data were analyzed from March 18, 2021, to June 8, 2022. Exposure: SARS-CoV-2 infection. Main Outcomes and Measures: Ratios of rate ratios (RRRs) for COVID-19-associated health care utilization were calculated with a difference-in-difference analysis using Poisson regression models. RRRs were estimated overall, by health care setting, by select population characteristics, and by 44 PCCs. COVID-19-associated excess health care utilization was estimated by health care setting. Results: The final matched cohort included 127 859 patients with test results positive for SARS-CoV-2 and 127 859 patients with test results negative for SARS-CoV-2. The mean (SD) age of the study population was 41.2 (18.6) years, 68 696 patients in each group (53.7%) were female, and each group included 66 211 Hispanic patients (51.8%), 9122 non-Hispanic Asian patients (7.1%), 7983 non-Hispanic Black patients (6.2%), and 34 326 non-Hispanic White patients (26.9%). Overall, SARS-CoV-2 infection was associated with a 4% increase in health care utilization over 6 months (RRR, 1.04 [95% CI, 1.03-1.05]), predominantly for virtual encounters (RRR, 1.14 [95% CI, 1.12-1.16]), followed by emergency department visits (RRR, 1.08 [95% CI, 1.04-1.12]). COVID-19-associated utilization for 18 PCCs remained elevated 6 months from the acute stage of infection, with the largest increase in COVID-19-associated utilization observed for infectious disease sequelae (RRR, 86.00 [95% CI, 5.07-1458.33]), COVID-19 (RRR, 19.47 [95% CI, 10.47-36.22]), alopecia (RRR, 2.52 [95% CI, 2.17-2.92]), bronchitis (RRR, 1.85 [95% CI, 1.62-2.12]), pulmonary embolism or deep vein thrombosis (RRR, 1.74 [95% CI, 1.36-2.23]), and dyspnea (RRR, 1.73 [95% CI, 1.61-1.86]). In total, COVID-19-associated excess health care utilization amounted to an estimated 27 217 additional medical encounters over 6 months (212.9 [95% CI, 146.5-278.4] visits per 1000 patients). Conclusions and Relevance: This cohort study documented an excess health care burden of PCC in the 6 months after the acute stage of infection. As health care systems evolve during a highly dynamic and ongoing global pandemic, these data provide valuable evidence to inform long-term strategic resource allocation for patients previously infected with SARS-CoV-2.


Subject(s)
COVID-19 , Adult , COVID-19/epidemiology , Cohort Studies , Female , Humans , Infant , Male , Patient Acceptance of Health Care , Retrospective Studies , SARS-CoV-2 , United States/epidemiology
5.
PLoS One ; 17(7): e0270768, 2022.
Article in English | MEDLINE | ID: covidwho-1987145

ABSTRACT

OBJECTIVE: As part of the efforts to curb the COVID-19 pandemic, the government of Ghana has received several shipments of approved vaccines, and administration has begun in the country. Studies examining the determinants of COVID-19 vaccine acceptance in Ghana were mostly conducted before the vaccination exercise. Vaccine acceptance decisions however vary with time and hence, peoples' decisions may have changed once vaccines became accessible. This study examines the level and determinants of COVID-19 vaccine acceptance among adult Ghanaians during the vaccination exercise. METHODS: The study was a cross-sectional online survey involving Ghanaian adults (18 years and above) eligible to take the COVID-19 vaccine. The study was conducted from 18th May 2021 to 14th July 2021 and the questionnaire was answered by 362 respondents. Snowball sampling technique was utilized to obtain the respondents. Probit regression analysis was used to identify factors influencing COVID-19 vaccine acceptance. KEY FINDINGS: Only 62.7% of the respondents indicated that they will accept the COVID-19 vaccine if provided. The regression results revealed that the decision to accept the COVID-19 vaccine was influenced by occupation, perceived susceptibility, perceived benefits and attitudes towards the vaccines. CONCLUSION: The findings suggest that government must implement strategies to enhance positive attitudes toward vaccines, increase the risk perception of contracting the virus and also educate the populace about the benefits of the vaccine.


Subject(s)
COVID-19 , Vaccines , Adult , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines , Cross-Sectional Studies , Ghana , Health Knowledge, Attitudes, Practice , Humans , Pandemics/prevention & control , Patient Acceptance of Health Care , Vaccination
7.
J Infect Public Health ; 15(8): 915-921, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-1983481

ABSTRACT

BACKGROUND: COVID-19 has brought changes in daily life and increased the medical burden. This study aims to evaluate the delays in healthcare services and related factors in the general population during the COVID-19 pandemic. METHODS: We took a nationally representative sample and conducted a mobile phone-based survey. The study was conducted anonymously. Of the 3377 subjects who consented to participate, a total of 2097 finished the survey. The primary outcome was respondents' experiences with delayed (1) health screenings, (2) non-urgent medical visits, (3) medical visits for chronic disease, and (4) emergency visits during the COVID-19 pandemic. RESULTS: Of 2097 respondents, females, residents of the Seoul metropolitan area, those with private insurance, those without chronic diseases, smokers, and drinkers had higher risk of delays in health screening and non-urgent medical visits after adjustment. Among chronic disease patients, those who were over 60 years old (adjusted odds ratio 0.36, 95% CI 0.14-0.92) showed lower risk of delayed medical visit. Residents of the Seoul metropolitan area, those with private insurance, smokers, and drinkers were all associated with experiencing delayed health screening and non-urgent medical visits had higher risk of delays in chronic disease visits and emergent medical visits. CONCLUSIONS: Delayed access to healthcare services is associated with poor outcomes and may cause different complications. Efforts are needed to prevent delays in medical use due to infectious diseases such as COVID-19. Considering the possibility of the emergence of infectious diseases, various countermeasures are needed to prevent delays in medical visit.


Subject(s)
COVID-19 , COVID-19/epidemiology , Delivery of Health Care , Female , Humans , Middle Aged , Pandemics/prevention & control , Patient Acceptance of Health Care , Republic of Korea/epidemiology , SARS-CoV-2 , Surveys and Questionnaires
8.
PLoS One ; 17(8): e0272691, 2022.
Article in English | MEDLINE | ID: covidwho-1978859

ABSTRACT

BACKGROUND: Hesitancy and incomplete vaccination against coronavirus disease 2019 (COVID-19) remains an obstacle to achieving herd immunity. Because of fear of vaccine reactions, patients with medical and allergic co-morbidities express heightened hesitancy. Limited information is available to guide these patients. We sought to identify factors associated with mRNA-based COVID-19 vaccines hesitancy and reactogenicity. METHODS: We surveyed employees of a multi-site health system in central Pennsylvania who were offered the COVID-19 vaccine (N = 18,740) inquiring about their experience with the Moderna and Pfizer-BioNTech mRNA-based vaccines. The survey was administered online using the REDCap platform. We used multivariable regression analysis to determine whether a particular factor(s) (e.g., demographics, selected co-morbid allergic and medical conditions, vaccine brand, and prior COVID-19) were associated with vaccine reactogenicity including the occurrence and severity of local and systemic reactions. We also explored factors and reasons associated with vaccine hesitancy. RESULTS: Of the 5709 who completed the survey (response rate, 30.4%), 369 (6.5%) did not receive the vaccine. Black race and allergy to other vaccines were associated with vaccine hesitancy. Reaction intensity following the first vaccine dose and allergic co-morbidities were associated with incomplete vaccination. Older individuals (>60 years) experienced less reactogenicity. Females had higher odds of local and systemic reactions and reported more severe reactions. Asians reported more severe reactions. As compared to Pfizer-BioNTech, the Moderna vaccine was associated with higher odds of vaccine reactions of higher severity. Prior COVID-19 resulted in more severe reactions following the first dose, but less severe reactions following the second dose. CONCLUSIONS: Targeted campaigns to enhance vaccination acceptance should focus on Black individuals, females, and those with allergic co-morbidities. Prior COVID-19 caused more severe reactions after the first but not the second vaccine dose. Moderna vaccine caused more vaccine reactions. Lessons learned from the early rollout of COVID-19 vaccine may serve to inform future novel vaccine experiences.


Subject(s)
COVID-19 Vaccines , COVID-19 , Hypersensitivity , Vaccination Hesitancy , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Female , Humans , Patient Acceptance of Health Care , RNA, Messenger , Vaccination/psychology , Vaccines
9.
BMC Health Serv Res ; 22(1): 1010, 2022 Aug 08.
Article in English | MEDLINE | ID: covidwho-1978775

ABSTRACT

BACKGROUND: Despite extensive evidence that COVID-19 symptoms may persist for up to a year, their long-term implications for healthcare utilization and costs 6 months post-diagnosis remain relatively unexplored. We examine patient-level association of COVID-19 diagnosis association of COVID-19 diagnosis with average monthly healthcare utilization and medical expenditures for up to 6 months, explore heterogeneity across age groups and determine for how many months post-diagnosis healthcare utilization and costs of COVID-19 patients persist above pre-diagnosis levels. METHODS: This population-based retrospective cohort study followed COVID-19 patients' healthcare utilization and costs from January 2019 through March 2021 using claims data provided by the COVID-19 Research Database. The patient population includes 250,514 individuals infected with COVID-19 during March-September 2020 and whose last recorded claim was not hospitalization with severe symptoms. We measure the monthly number and costs of total visits and by telemedicine, preventive, urgent care, emergency, immunization, cardiology, inpatient or surgical services and established patient or new patient visits. RESULTS: The mean (SD) total number of monthly visits and costs pre-diagnosis were .4783 (4.0839) and 128.06 (1182.78) dollars compared with 1.2078 (8.4962) visits and 351.67 (2473.63) dollars post-diagnosis. COVID-19 diagnosis associated with .7269 (95% CI, 0.7088 to 0.7449 visits; P < .001) more total healthcare visits and an additional $223.60 (95% CI, 218.34 to 228.85; P < .001) in monthly costs. Excess monthly utilization and costs for individuals 17 years old and under subside after 5 months to .070 visits and $2.77, persist at substantial levels for all other groups and most pronounced among individuals age 45-64 (.207 visits and $73.43) and 65 years or older (.133 visits and $60.49). CONCLUSIONS: This study found that COVID-19 diagnosis was associated with increased healthcare utilization and costs over a six-month post-diagnosis period. These findings imply a prolonged burden to the US healthcare system from medical encounters of COVID-19 patients and increased spending.


Subject(s)
COVID-19 , Health Expenditures , Adolescent , COVID-19/complications , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/therapy , COVID-19 Testing , Delivery of Health Care , Health Care Costs , Humans , Middle Aged , Patient Acceptance of Health Care , Retrospective Studies , United States
10.
Rural Remote Health ; 22(3): 7140, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-1975623

ABSTRACT

INTRODUCTION: Vaccine hesitancy has been a major barrier to mitigating the effects of COVID-19, especially in rural Oregon, USA. This study assessed the influence of political affiliation, religious identity, and rurality on vaccine hesitancy in counties across Oregon. METHODS: Cross-sectional association analysis was performed using public data on US President Trump votership in the 2020 election, White Christian identity, population density, and COVID-19 vaccination data for adults as of 29 August 2021. RESULTS: By 29 August 2021, 68.0% of adults had been fully vaccinated in Oregon. Trump votership was the strongest independent association with vaccination status in Oregon (r=0.90, p<0.01), followed by White Christian identity (r= -0.69, p<0.01), and population density (r=0.55, p<0.01). In multivariate analysis, White Christian identity and political affiliation with Trump in the 2020 election explained 84.1% of the variability in COVID-19 vaccination status in Oregon counties. CONCLUSION: White Christian identity, Trump affiliation, and rurality were identified as factors in vaccine hesitancy among counties in Oregon. Without addressing these factors in public health outreach, vaccine hesitancy is likely to continue unabated.


Subject(s)
COVID-19 Vaccines , COVID-19 , Adult , COVID-19/epidemiology , COVID-19/prevention & control , Cross-Sectional Studies , Humans , Oregon , Parents , Patient Acceptance of Health Care , Politics , Religion , Vaccination , Vaccination Hesitancy
11.
Sci Rep ; 12(1): 13293, 2022 Aug 02.
Article in English | MEDLINE | ID: covidwho-1972652

ABSTRACT

Many countries have secured larger quantities of COVID-19 vaccines than their population is willing to take. The abundance and the large variety of vaccines created not only an unprecedented intensity of vaccine related public discourse, but also a historical moment to understand vaccine hesitancy better. Yet, the heterogeneity of hesitancy by vaccine types has been neglected in the existing literature so far. We address this problem by analysing the acceptance and the assessment of five vaccine types. We use information collected with a nationally representative survey at the end of the third wave of the COVID-19 pandemic in Hungary. During the vaccination campaign, individuals could reject the assigned vaccine to wait for a more preferred alternative that enables us to quantify revealed preferences across vaccine types. We find that hesitancy is heterogenous by vaccine types and is driven by individuals' trusted source of information. Believers of conspiracy theories are more likely to evaluate the mRNA vaccines (Pfizer and Moderna) unacceptable. Those who follow the advice of politicians are more likely to evaluate vector-based (AstraZeneca and Sputnik) or whole-virus vaccines (Sinopharm) acceptable. We argue that the greater selection of available vaccine types and the free choice of the individual are desirable conditions to increase the vaccination rate in societies.


Subject(s)
COVID-19 , Urogenital Abnormalities , Vaccines , Viral Vaccines , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines , Humans , Pandemics , Patient Acceptance of Health Care , Vaccination
12.
Nat Commun ; 13(1): 3801, 2022 07 01.
Article in English | MEDLINE | ID: covidwho-1972597

ABSTRACT

The COVID-19 pandemic continues to impact daily life, including health system operations, despite the availability of vaccines that are effective in greatly reducing the risks of death and severe disease. Misperceptions of COVID-19 vaccine safety, efficacy, risks, and mistrust in institutions responsible for vaccination campaigns have been reported as factors contributing to vaccine hesitancy. This study investigated COVID-19 vaccine hesitancy globally in June 2021. Nationally representative samples of 1,000 individuals from 23 countries were surveyed. Data were analyzed descriptively, and weighted multivariable logistic regressions were used to explore associations with vaccine hesitancy. Here, we show that more than three-fourths (75.2%) of the 23,000 respondents report vaccine acceptance, up from 71.5% one year earlier. Across all countries, vaccine hesitancy is associated with a lack of trust in COVID-19 vaccine safety and science, and skepticism about its efficacy. Vaccine hesitant respondents are also highly resistant to required proof of vaccination; 31.7%, 20%, 15%, and 14.8% approve requiring it for access to international travel, indoor activities, employment, and public schools, respectively. For ongoing COVID-19 vaccination campaigns to succeed in improving coverage going forward, substantial challenges remain to be overcome. These include increasing vaccination among those reporting lower vaccine confidence in addition to expanding vaccine access in low- and middle-income countries.


Subject(s)
COVID-19 , Vaccines , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines , Humans , Pandemics , Patient Acceptance of Health Care , Vaccination Hesitancy
13.
Int J Environ Res Public Health ; 19(15)2022 Jul 28.
Article in English | MEDLINE | ID: covidwho-1969228

ABSTRACT

Vaccine hesitation is a topic of utmost importance, with the COVID-19 pandemic serving as a clear reminder of its timeliness. Besides evaluating COVID-19 vaccine acceptance in a sample of Portuguese people, this study aims at understanding cognitive and emotional representations related to vaccination, and their influence on vaccination hesitation. A cross-sectional online survey was conducted between 27 December 2020 and 27 January 2021. It assessed cognitive and emotional COVID-19 representations; vaccination status; cognitive and emotional representations of vaccination and perceived necessity and concerns about vaccines. Of 31 × 58 participants, 91% accepted taking a COVID-19 vaccine. Among several other significant findings, women (71.3%) more often considered that the pandemic affected their lives (p < 0.001) and were more often concerned with being infected (p < 0.001). Likewise, there were significantly more female participants concerned about taking a COVID-19 vaccine and its possible effects, when compared to the number of male participants (p < 0.001). The number of participants with a higher education level that were more worried about becoming infected was greater (p = 0.001), when compared with those less educated. Regarding age groups, people aged 18 to 24 had fewer concerned participants (9.6%), while the number of individuals aged 55 to 64 had the most (p < 0.001). Somewhat surprisingly, perceiving oneself as extremely informed about COVID-19 was not associated with greater vaccine acceptance (OR = 1.534 [1.160-2.029]; (p = 0.003)). Moreover, people aged 25 to 64 years old and with lower education level were more likely not to accept vaccination (OR = 2.799 [1.085-7.221]; (p = 0.033)). Finally, being more concerned about taking a vaccine lowers its acceptance (OR = 4.001 [2.518-6.356]; (p < 0.001)). Cognitive and emotional representations have a great impact and are reliable predictors of vaccine acceptance. Thus, it is of extreme importance that public health messages be adapted to the different characteristics of the population.


Subject(s)
COVID-19 Vaccines , COVID-19 , Adult , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines/therapeutic use , Cognition , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Pandemics , Patient Acceptance of Health Care , Vaccination
14.
Sci Rep ; 12(1): 12988, 2022 Jul 29.
Article in English | MEDLINE | ID: covidwho-1967623

ABSTRACT

The long-term impact of COVID-19 among those with mild infections is not well characterized. Among 81 adults who completed online assessments at 3- and 12-months following infection, quality of life scores did not significantly improve over time. Among 62 subjects who also completed telephone interviews, respiratory symptoms or exercise limitation were reported by 42% at a median follow-up of 387 days (IQR 251-402 days). Those with persistent respiratory symptoms scored lower on the EQ-5D visual analog score compared to those without. Persistent respiratory symptoms were associated with a lower likelihood of full-time employment at 1 year (aOR 0.09, 95%CI 0.01-0.91; P = 0.041). In an adjusted linear regression, persistent respiratory symptoms (P = 0.037) and female sex (P = 0.016) were both independent risks for increased visits to a primary care provider. This cohort study demonstrates that respiratory symptoms are frequent at 1 year following COVID-19 and more importantly, are associated with negative impacts on employment, quality of life, and health care utilization. Further research is needed to determine the pathophysiology and risk factors for persistent symptoms as well as optimal management strategies to improve the level of functioning and quality of life.


Subject(s)
COVID-19 , Quality of Life , Adult , Cohort Studies , Female , Humans , Outpatients , Patient Acceptance of Health Care , Prospective Studies
15.
Cent Eur J Public Health ; 30(2): 99-106, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1964909

ABSTRACT

OBJECTIVES: Vaccine hesitancy presents one of the critical constraints in combating COVID-19 pandemic. The aim of this study was to develop and validate an instrument for measuring factors that contribute to COVID-19 vaccine hesitancy. METHODS: The key constructs in the study instrument were factors that constitute the "3C" model of vaccine hesitancy: Confidence, Complacency and Convenience. Using a cross-sectional, online survey design, the 8-item COVID-19 Vaccine Hesitancy Questionnaire was administered to a sample of 667 adult citizens of Serbia in December 2020. We used confirmatory factor analysis to investigate the model that assumes three latent variables. To ensure that the instrument measures the same constructs in different groups, the measurement invariance examination was conducted. To examine criterion validity, Spearman's correlation was applied to determine the association between the instrument total score and the single-item measuring the likelihood of getting vaccinated against SARS-CoV-2. RESULTS: Confirmatory factor analysis established the three-factor structure, with subscales fitting within the "3C" model of vaccine hesitancy comprising confidence, convenience and complacency. The full scalar invariance was found across gender, and the partial scalar invariance was achieved for the age, region and education level. A higher level of the COVID-19 vaccine hesitancy was associated with the lower likelihood to get vaccinated against the SARS-CoV-2 virus. CONCLUSION: Our scale is brief and consistent, maintaining a good fit across key socio-demographic subgroups. This result implies that the scale could be useful for quick assessment of COVID-19 vaccine hesitancy in various target populations.


Subject(s)
COVID-19 Vaccines , COVID-19 , Adult , COVID-19/epidemiology , COVID-19/prevention & control , Cross-Sectional Studies , Humans , Pandemics , Patient Acceptance of Health Care , SARS-CoV-2 , Surveys and Questionnaires , Vaccination , Vaccination Hesitancy
17.
Front Public Health ; 10: 914943, 2022.
Article in English | MEDLINE | ID: covidwho-1963642

ABSTRACT

Objectives: Preventing severe disease and acquiring population immunity to COVID-19 requires global immunization coverage through mass vaccination. While high-income countries are battling vaccine hesitancy, low-income and fragile nations are facing the double dilemma of vaccine hesitancy and lack of access to vaccines. There is inadequate information on any correlation between vaccine hesitancy and access to vaccines. Our study in a low-income nation aimed to fill this gap. Methods: In the backdrop of a severe shortage of COVID-19 vaccines in Yemen, a low-income fragile nation, we conducted a nation-wide cross-sectional survey among its healthcare workers (HCWs), between 6 July and 10 August 2021. We evaluated factors influencing agreement to accept a COVID-19 vaccine and any potential correlation between vaccine acceptance and lack of access to vaccines. Results: Overall, 61.7% (n = 975) of the 1,581 HCWs agreed to accept a COVID-19 vaccine. Only 45.4% of the participants agreed to have access to a COVID-19 vaccine, with no sex dependent variations. Although several determinants of vaccine acceptance were identified, including, having a systemic disease, following the updates about COVID-19 vaccines, complying with preventive guidelines, having greater anxiety about contracting COVID-19, previous infection with COVID-19, believing COVID-19 to be a severe disease, and lower concern about the side effects of COVID-19, the strongest was access to vaccines (OR: 3.18; 95% CI: 2.5-4.03; p-value: 0.001). Conclusion: The immediate and more dangerous threat in Yemen toward achieving population immunity is the severe shortage and lack of access to vaccines, rather than vaccine hesitancy, meaning, improving access to vaccines could lead to greater acceptance.


Subject(s)
COVID-19 , Vaccines , COVID-19/prevention & control , COVID-19 Vaccines , Cross-Sectional Studies , Health Personnel , Humans , Patient Acceptance of Health Care , Vaccination , Vaccination Hesitancy
18.
Med Care ; 60(9): 673-679, 2022 Sep 01.
Article in English | MEDLINE | ID: covidwho-1961227

ABSTRACT

OBJECTIVE: The COVID pandemic has had a significant impact on the US health care system. Our primary objective was to understand the impact of the COVID pandemic on non-COVID-related health care utilization among insured individuals with chronic conditions. Our secondary objective was to examine the differential impact by individual characteristics. MAIN DATA SOURCE: Medical and pharmacy claims data for individuals enrolled in a large insurer across the United States. RESEARCH DESIGN: A retrospective and repeated cross-sectional study. Overall and condition-specific health care utilization and cost metrics in (1) March 1 to June 15 and (2) June 16 to September 30, 2020 were compared with the same months during 2016-2019. SUBJECTS: Members of all ages with a diagnosis of diabetes, cardiovascular disease, or chronic kidney disease with commercial or Medicare Advantage insurance. RESULTS: Most non-COVID-related health care utilization decreased drastically on March 1 to June 15, 2020 [odds ratio (OR) range across condition-specific tests: 0.55-0.69; incidence rate ratio (IRR) range for hospitalization/emergency department (ED) visit/outpatient visit: 0.65-0.77] but returned to closer to pre-COVID levels by June 16 to September 30, 2020 [OR range across condition-specific tests: 0.93-1.08; IRR range for hospitalization/ED visit/outpatient visit: 0.77-0.97]. Our study found an enormous increase in telehealth use on March 1 to June 15, 2020 (90-170 times prepandemic levels). A differential impact was observed by age, sex, region of residence, and insurance type. IMPLICATIONS: Further investigation is needed to assess the impact of these changes in health care utilization on long-term health outcomes.


Subject(s)
COVID-19 , Pandemics , Aged , COVID-19/epidemiology , Chronic Disease , Cross-Sectional Studies , Emergency Service, Hospital , Humans , Medicare , Patient Acceptance of Health Care , Retrospective Studies , United States/epidemiology
19.
JNCI Cancer Spectr ; 6(4)2022 Jul 01.
Article in English | MEDLINE | ID: covidwho-1961084

ABSTRACT

HPV vaccination is highly effective at preventing several types of cancer; however, vaccine uptake is suboptimal. The COVID-19 pandemic has affected participation in cancer prevention measures such as HPV vaccination. To assess changes and barriers to HPV vaccination during the COVID-19 pandemic, we conducted a statewide cross-sectional survey of health-care professionals (HCPs) in Texas. Specifically, we evaluated changes observed by HCPs regarding HPV vaccination during the COVID-19 pandemic: 1) hesitancy, 2) refusal, and 3) uptake. Decreased HPV vaccination uptake were reported by 19.3% of HCPs, whereas increased HPV vaccination hesitancy and refusal were reported by 17.1% and 14.8% of HCPs in Texas, respectively. The COVID-19 pandemic had a negative impact on HPV vaccination. Our study identified barriers to HPV vaccination that are unique to the COVID-19 pandemic.


Subject(s)
COVID-19 , Papillomavirus Infections , Papillomavirus Vaccines , COVID-19/epidemiology , Cross-Sectional Studies , Health Knowledge, Attitudes, Practice , Humans , Pandemics/prevention & control , Papillomavirus Infections/epidemiology , Papillomavirus Vaccines/therapeutic use , Parents , Patient Acceptance of Health Care , Vaccination
20.
Front Public Health ; 10: 877668, 2022.
Article in English | MEDLINE | ID: covidwho-1952824

ABSTRACT

Background: With promotion of COVID-19 vaccinations, there has been a corresponding vaccine hesitancy, of which older adolescents and young adults represent groups of particular concern. In this report, we investigated the prevalence and reasons for vaccine hesitancy, as well as potential risk factors, within older adolescents and young adults in China. Methods: To assess these issues, an online survey was administered over the period from March 14 to April 15, 2021. Older adolescents (16-17 years old) and young adults (18-21 years old) were recruited nationwide from Wechat groups and results from a total of 2,414 respondents were analyzed. Socio-demographic variables, vaccine hesitancy, psychological distress, abnormal illness behavior, global well-being and social support were analyzed in this report. Results: Compared to young adults (n = 1,405), older adolescents (n = 1,009) showed higher prevalence rates of COVID-19 vaccine hesitancy (16.5 vs. 7.9%, p < 0.001). History of physical diseases (p = 0.007) and abnormal illness behavior (p = 0.001) were risk factors for vaccine hesitancy among older adolescents, while only a good self-reported health status (p = 0.048) was a risk factor for young adults. Concerns over COVID-19 vaccine side effects (67.1%) and beliefs of invulnerability regarding infection risk (41.9%) were the most prevalent reasons for vaccine hesitancy. Providing evidence on the vaccine reduction of COVID-19 infection risk (67.5%), ensuring vaccine safety (56.7%) and the low risk of side effects (52.7%) were the most effective persuasions for promoting vaccinations. Conclusion: In China, older adolescents showed a higher prevalence for vaccine hesitancy than that of young adults. Abnormal illness behavior and history of physical diseases were risk factors for vaccine hesitancy among these older adolescents, while social support represents an important factor which could help to alleviate this hesitancy.


Subject(s)
COVID-19 , Vaccines , Adolescent , Adult , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines , China/epidemiology , Cross-Sectional Studies , Health Knowledge, Attitudes, Practice , Humans , Parents/psychology , Patient Acceptance of Health Care , Vaccination Hesitancy , Young Adult
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