COVID-19 vaccination beliefs, attitudes, and behaviours among health and social care workers in the UK: A mixed-methods study.

BACKGROUND: The UK began delivering its COVID-19 vaccination programme on 8 December 2020, with health and social care workers (H&SCWs) given high priority for vaccination. Despite well-documented occupational exposure risks, however, there is evidence of lower uptake among some H&SCW groups. METHODS: We used a mixed-methods approach-involving an online cross-sectional survey and semi-structured interviews-to gain insight into COVID-19 vaccination beliefs, attitudes, and behaviours amongst H&SCWs in the UK by socio-demographic and employment variables. 1917 people were surveyed- 1656 healthcare workers (HCWs) and 261 social care workers (SCWs). Twenty participants were interviewed. FINDINGS: Workplace factors contributed to vaccination access and uptake. SCWs were more likely to not be offered COVID-19 vaccination than HCWs (OR:1.453, 95%CI: 1.244-1.696). SCWs specifically reported uncertainties around how to access COVID-19 vaccination. Participants who indicated stronger agreement with the statement 'I would recommend my organisation as a place to work' were more likely to have been offered COVID-19 vaccination (OR:1.285, 95%CI: 1.056-1.563). Those who agreed more strongly with the statement 'I feel/felt under pressure from my employer to get a COVID-19 vaccine' were more likely to have declined vaccination (OR:1.751, 95%CI: 1.271-2.413). Interviewees that experienced employer pressure to get vaccinated felt this exacerbated their vaccine concerns and increased distrust. In comparison to White British and White Irish participants, Black African and Mixed Black African participants were more likely to not be offered (OR:2.011, 95%CI: 1.026-3.943) and more likely to have declined COVID-19 vaccination (OR:5.550, 95%CI: 2.294-13.428). Reasons for declining vaccination among Black African participants included distrust in COVID-19 vaccination, healthcare providers, and policymakers. CONCLUSION: H&SCW employers are in a pivotal position to facilitate COVID-19 vaccination access, by ensuring staff are aware of how to get vaccinated and promoting a workplace environment in which vaccination decisions are informed and voluntary.

Do previously held vaccine attitudes dictate the extent and influence of vaccine information-seeking behavior during pregnancy?

Pregnancy represents a high information need state, where uncertainty around medical intervention is common. As such, the pertussis vaccination given during pregnancy presents a unique opportunity to study the interaction between vaccine attitudes and vaccine information-seeking behavior. We surveyed a sample of pregnant women (N = 182) during early pregnancy and again during late pregnancy. The variables of vaccine confidence and risk perception of vaccination during pregnancy were measured across two questionnaires. Additional variables of decision conflict and intention to vaccinate were recorded during early pregnancy, while vaccine information-seeking behavior and vaccine uptake were recorded during late pregnancy. 88.8% of participants reported seeking additional information about the pertussis vaccine during pregnancy. Women that had a lower confidence in vaccination (p = .004) and those that saw the risk of pertussis disease as high compared to the risk of side effects from the pertussis vaccination during pregnancy (p = .004) spent significantly more time seeking information about the pertussis vaccination. Women's perception of risk related to vaccination during pregnancy significantly changed throughout the pregnancy (t(182) = 4.685 p< .001), with women perceiving the risk of pertussis disease higher as compared to the risk of side effects from the vaccine as the pregnancy progresses. The strength and influence of information found through seeking was predicted by intention to vaccinate (p = .011). As such, we suggest that intention to vaccinate during early pregnancy plays a role in whether the information found through seeking influences women towards or away from vaccination.

Determinants of satisfaction with information and additional information-seeking behaviour for the pertussis vaccination given during pregnancy.

OBJECTIVES: Information search and processing is critical to the vaccine decision-making process. However, the role of drivers of information satisfaction and search is not fully understood. Here, we investigated the predictive potential of psychosocial characteristics related to satisfaction with information and additional information-seeking about the pertussis vaccine currently recommended during pregnancy. DESIGN: Cross-sectional online questionnaire study. METHODS: A UK based sample of 314 women who had given birth during the previous six months was recruited to participate. The questionnaire included measures of the psycho-social predictors: trust, coping strategies, attitude towards vaccine information-seeking behaviour and risk perception of vaccination during pregnancy, and measures of two outcome variables: satisfaction with information received from a health care professional and whether participants engaged in vaccine information-seeking behaviour. RESULTS: Trust in health care professionals, a perceived behavioural control of own vaccine information-seeking behaviour, and an engaged problem-focused strategy for coping with stress were significant predictors of satisfaction with official information given by a health care professional. 40% of women sought out additional information about vaccination however, none of the psychosocial factors measured significantly predicted the behaviour. CONCLUSIONS: We found that high trust in health care professionals, a perceived ability to seek out accurate information about vaccines and actively focusing on problems as a means of coping with stress, drives satisfaction in official vaccine information. We also developed measures of these variables that could be used in further research.

Measuring trust in vaccination: A systematic review.

Vaccine acceptance depends on public trust and confidence in the safety and efficacy of vaccines and immunization, the health system, healthcare professionals and the wider vaccine research community. This systematic review analyses the current breadth and depth of vaccine research literature that explicitly refers to the concept of trust within their stated aims or research questions. After duplicates were removed, 19,643 articles were screened by title and abstract. Of these 2,779 were screened by full text, 35 of which were included in the final analysis. These studies examined a range of trust relationships as they pertain to vaccination, including trust in healthcare professionals, the health system, the government, and friends and family members. Three studies examined generalized trust. Findings indicated that trust is often referred to implicitly (19/35), rather than explicitly examined in the context of a formal definition or discussion of the existing literature on trust in a health context. Within the quantitative research analysed, trust was commonly measured with a single-item measure (9/25). Only two studies used validated multi-item measures of trust. Three studies examined changes in trust, either following an intervention or over the course of a pandemic. The findings of this review indicate a disconnect between the current vaccine hesitancy research and the wider health-related trust literature, a dearth in research on trust in low and middle-income settings, a need for studies on how trust levels change over time and investigations on how resilience to trust-eroding information can be built into a trustworthy health system.

Are Psychology Journals Anti-replication? A Snapshot of Editorial Practices.

Recent research in psychology has highlighted a number of replication problems in the discipline, with publication bias - the preference for publishing original and positive results, and a resistance to publishing negative results and replications- identified as one reason for replication failure. However, little empirical research exists to demonstrate that journals explicitly refuse to publish replications. We reviewed the instructions to authors and the published aims of 1151 psychology journals and examined whether they indicated that replications were permitted and accepted. We also examined whether journal practices differed across branches of the discipline, and whether editorial practices differed between low and high impact journals. Thirty three journals (3%) stated in their aims or instructions to authors that they accepted replications. There was no difference between high and low impact journals. The implications of these findings for psychology are discussed.