Hesitation towards the COVID-19 vaccine in the United States: a digital ethnographic study. / Vacilación ante la vacuna contra el covid-19 en Estados Unidos de América: un estudio etnográfico digital.

Following the authorization the use of COVID-19 vaccines in babies age six months through children four years old in the United States, some individuals (parents, pediatricians, and communicators) framed COVID-19 vaccination as an issue of access, while many others expressed hesitancy and some resisted recommendations from the US Centers for Disease Control and Prevention. In this context, this study aimed to explore: 1) divergent reactions to the authorization of COVID-19 vaccine use in children aged six months to four years; and 2) opposing logics underlying attitudes towards pro-vaccination, anti-vaccination, and vaccine hesitancy regarding COVID-19 vaccines. To achieve this, a digital ethnography was conducted, involving monitoring of 5,700 reactions to a series of eight infographics published on social media by the John Hopkins Bloomberg School of Public Health, and participant observation in an online focus group over a one-year period, from December 2021 to December 2022, consisting of 18 mothers. The findings suggest that healthcare professionals should consider different notions of "risk" when interacting with patients, especially those who are hesitant to vaccinate.

Luego de que se autorizara en EEUU el uso de la vacuna contra el covid-19 en bebés de seis meses a niños y niñas de cuatro años, algunas personas (padres, madres, pediatras y comunicadores) plantearon la vacunación contra el covid-19 como una cuestión de acceso; sin embargo, muchas otras se mostraron reacias y otras se resistieron a las recomendaciones de los Centers for Disease Control and Prevention de EEUU. En este contexto, este estudio se propuso explorar: 1) reacciones divergentes ante la autorización de uso de la vacuna contra el covid-19 en niños y niñas de seis meses a cuatro años; y 2) lógicas contrapuestas que subyacen a las actitudes provacunación, antivacunación y vacilación ante las vacunas contra el covid-19. Para ello, se realizó una etnografía digital, con monitoreo de 5.700 reacciones a una serie de ocho infografías publicadas en las redes sociales por la John Hopkins Bloomberg School of Public Health, y observación participante en un grupo focal en línea a lo largo de un año, desde diciembre de 2021 hasta diciembre de 2022, conformado por 18 madres. Los resultados indican que el personal médico debe considerar diferentes nociones de "riesgo" al interactuar con los pacientes, especialmente aquellos que dudan en vacunarse.

Assessing the determinants of influenza and COVID-19 vaccine co-administration decisions in the elderly.

This research examines the low rate of co-administration of influenza and COVID-19 vaccines among seniors aged 65 and older in Korea, despite recommendations from authorities and academia worldwide. The study aimed to understand the influence of general characteristics and health beliefs on the vaccination choices of seniors, who were categorized into four groups based on their vaccination status: influenza only, COVID-19 only, both, or neither. A total of 400 participants, aged 65 and above, were selected through proportional stratified random sampling from five major Korean regions for a survey conducted between November 24th and December 15th, 2023. The results indicated no significant differences in general characteristics across these groups. However, regarding the health beliefs showed significant differences in perceived susceptibility and self-efficacy between the influenza-only and co-administration groups. Higher levels of perceived susceptibility and self-efficacy were associated with choosing co-administration. Contrary to previous studies focusing on safety concerns as a primary factor in vaccine hesitancy, this study highlights the role of individual health-related beliefs, particularly perceived susceptibility and self-efficacy, as critical in influencing the decision for co-administration among the elderly in Korea.

Vaccine hesitancy and trust in sub-Saharan Africa.

Lack of trust is a primary reason behind the global rise in vaccine hesitancy. Existing research on the trust-vaccine hesitancy nexus has almost exclusively focused on COVID-19 with the vast majority of studies examining industrialized countries. In this study, we investigated the influence of trust in different policy-relevant actors (government, science, media, pharmaceutical companies, society) on vaccine hesitancy for recently available vaccines related to polio and HPV which we benchmark against a COVID-19 vaccine. Leveraging unique primary data on 5203 individuals from six countries (Ghana, Kenya, Nigeria, South Africa, Tanzania, and Uganda), we showed that individuals' trust in the government and society are key predictors of vaccine hesitancy. Furthermore, we demonstrated that these relationships are remarkably stable across vaccine, disease, and country contexts.

Trust and COVID-19 vaccine hesitancy in the Dominican Republic: a national cross-sectional household survey, June-October 2021.

OBJECTIVE: This study investigates the role of trust in shaping COVID-19 vaccine acceptance in the Dominican Republic (DR) during the COVID-19 pandemic. DESIGN: Cross-sectional household survey. SETTING: Randomly selected households across 134 clusters in the DR, from 30 June 2021 to 12 October 2021. PARTICIPANTS: 5999 participants ≥16 years of age were enrolled. OUTCOME MEASURES: COVID-19 vaccine hesitancy (CVH) data were collected from participants ≥16 years of age and analysed as both an ordinal and binary variable. RESULTS: Overall, CVH was low (5.2% (95% CI 4.6% to 5.8%)), but more common among younger individuals, women and individuals of Mestizo ethnicity. Higher trust in local government, national government, scientists and local doctors (considered official sources) was associated with lower odds of CVH (OR 0.89 (95% CI 0.72 to 0.88), 0.89 (95% CI 0.81 to 0.98), 0.87 (95% CI 0.80 to 0.94) and 0.70 (95% CI 0.62 to 0.80), respectively). Higher trust in religious leaders, social media and traditional media (considered unofficial sources) was associated with higher odds of CVH, with respective ORs of 1.32 (95% CI 1.18 to 1.47), 1.30 (95% CI 1.19 to 1.41) and 1.08 (95% CI 0.97 to 1.22). CONCLUSION: We report findings on CVH from a national household survey in the DR and identify overall low rates of CVH but marked heterogeneity by age, gender and ethnicity. Trust in unofficial versus official sources of information is associated with increased CVH. These findings highlight and quantify the importance of trust as a key parameter when considering public health communication strategies.

Sexual and preventive behaviors associated with HAV, HBV, and HPV vaccine hesitancy among men who have sex with men in France.

Vaccination coverage against hepatitis A virus (HAV), hepatitis B virus (HBV), and human papillomaviruses (HPV) is insufficient among men who have sex with men (MSM), partly because of their high prevalence of vaccine hesitancy (VH) specific to these vaccines. This study aimed to investigate determinants of specific VH in MSM, focusing on characteristics of their sexual activity, propensity to use prevention tools and medical care, disclosure of sexual orientation to health care professionals (HCPs), and perceived stigmatization. A cross-sectional electronic survey (February - August 2022) collected perceptions of HBV, HAV, and HPV, and of their respective vaccines among 3,730 French MSM and enabled the construction of a specific VH variable. Using agglomerative hierarchical cluster analysis, we constructed a typology of MSM sexual and prevention practices. We identified three MSM clusters (low- (C1, 24%), moderate- (C2, 41%), and high- (C3, 35%) "sexual activity/medical engagement") that showed an increasing gradient in the use of medical prevention with regular medical care and exposure to high-risk sexual practices. A multiple ordinal logistic regression showed that overall specific VH was higher in the C1 cluster and in men who had not informed their physician of their sexual orientation. This typology could usefully help to adapt vaccination communication strategies for MSM prevention program according to patients' profiles. HCPs should be encouraged and trained to ask men about their sexual practices and to provide appropriate vaccination recommendations nonjudgmentally.

Factors associated with SARS-CoV-2 vaccine hesitancy after stroke: a cross-sectional study.

BACKGROUND: The vaccination status of post-stroke patients, who are at high risk of severe outcomes from Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), is a significant concern, yet it remains unclear. We aimed to explore the vaccination status, factors associated with vaccine hesitancy, and adverse effects after vaccination among post-stroke patients. METHODS: This multi-center observational study enrolled hospitalized post-stroke patients from six Chinese hospitals (Oct 1, 2020 - Mar 31, 2021), examining vaccine uptake and self-reported reasons for vaccine hesitancy, utilizing logistic regression to investigate risk factors for vaccine hesitancy, and recording any adverse reactions post-vaccination. RESULTS: Of the total 710 post-stroke patients included in the study, 430 (60.6%) had completed the recommended full-3 dose SARS-CoV-2 vaccination, with 176 (24.8%) remaining unvaccinated. The most common reasons for vaccine hesitancy were concerns about vaccine side effects (41.5%) and impaired mobility (33.9%). Logistic regression identified advanced age (aOR = 1.97, 95%CI: 1.36-2.85, P = 0.001), lower Barthel Index score (aOR = 0.88, 95%CI: 0.82-0.93, P = 0.018), higher Modified Rankin Scale score (aOR = 1.85, 95%CI: 1.32-2.56, P = 0.004), and poorer usual activity level of EuroQol 5-Dimension (aOR = 2.82, 95%CI: 1.51-5.28, P = 0.001) as independent risk factors for vaccine hesitancy. Approximately 14.8% reported minor adverse reactions, mainly pain at the injection site. CONCLUSION: We found that post-stroke patients have insufficient SARS-CoV-2 vaccination rates, with key risk factors for vaccine hesitancy including concerns about side effects, advanced age, and functional impairments. No severe adverse reactions were observed among the vaccinated population.

Quantifying the impact of misinformation and vaccine-skeptical content on Facebook.

Low uptake of the COVID-19 vaccine in the US has been widely attributed to social media misinformation. To evaluate this claim, we introduce a framework combining lab experiments (total N = 18,725), crowdsourcing, and machine learning to estimate the causal effect of 13,206 vaccine-related URLs on the vaccination intentions of US Facebook users (N ≈ 233 million). We estimate that the impact of unflagged content that nonetheless encouraged vaccine skepticism was 46-fold greater than that of misinformation flagged by fact-checkers. Although misinformation reduced predicted vaccination intentions significantly more than unflagged vaccine content when viewed, Facebook users' exposure to flagged content was limited. In contrast, unflagged stories highlighting rare deaths after vaccination were among Facebook's most-viewed stories. Our work emphasizes the need to scrutinize factually accurate but potentially misleading content in addition to outright falsehoods.

A pre-post evaluation study of a social media-based COVID-19 communication campaign to improve attitudes and behaviors toward COVID-19 vaccination in Tanzania.

In Tanzania, the One by One: Target COVID-19 campaign was launched nationally in July 2022 to address the prevalent vaccine hesitancy and lack of confidence in COVID-19 vaccines. The campaign mobilized social media influencers and viral content with the ultimate goal of increasing COVID-19 vaccine uptake in the country. The objective of this study was to empirically assess the impact of the campaign on three outcomes: vaccine confidence, vaccine hesitancy, and vaccination status. Using programmatic data collected through an online survey before and after the campaign, we conducted a difference-in-difference (DiD) analysis and performed a crude, adjusted, and propensity score-matched analysis for each study outcome. Lastly, to observe whether there was any differential impact of the campaign across age groups, we repeated the analyses on age-stratified subgroups. Data included 5,804 survey responses, with 3,442 and 2,362 responses collected before and after the campaign, respectively. Although there was only weak evidence of increased COVID-19 vaccine confidence in the campaign-exposed group compared to the control group across all age groups, we observed a differential impact among different age groups. While no significant change was observed among young adults aged 18-24 years, the campaign exposure led to a statistically significant increase in vaccine confidence (weighted/adjusted DiD coefficient = 0.76; 95% CI: 0.06, 1.5; p-value = 0.034) and vaccination uptake (weighted/adjusted DiD coefficient = 1.69.; 95% CI: 1.02, 2.81; p-value = 0.023) among young adults aged 25-34 years. Among adults aged 35 years and above, the campaign exposure led to a significant decrease in vaccine hesitancy (weighted/adjusted DiD coefficient = -15; 95% CI: -21, -8.3; p-value<0.001). The social media campaign successfully improved vaccine hesitancy, confidence, and uptake in the Tanzanian population, albeit to varying degrees across age groups. Our study provides valuable insights for the planning and evaluation of similar social media communication campaigns aiming to bolster vaccination efforts.

COVID-19 vaccine acceptance among pregnant women: a multicentre cross-sectional survey in Port Harcourt, Nigeria.

Introduction: effective COVID-19 vaccines for the prevention of severe illness have been available for more than one year now. This study was carried out to ascertain vaccine hesitancy and its associations among pregnant women receiving antenatal care in Port Harcourt, a large cosmopolitan town in Nigeria. Methods: we conducted a cross-sectional online survey over 2 months among consenting pregnant women receiving antenatal care in the 3 largest obstetric service centers in Port Harcourt to evaluate COVID-19 vaccine hesitancy and its associations. Results: the prevalence of vaccine hesitancy was 669 (72.2%). Of the respondents, 27 (2.9%) had been infected or had a close family member infected with SARS-CoV-2, and 897 (96.8%) of them had heard of the COVID-19 vaccine; however, only 133 (14.4%) had been vaccinated against COVID-19. The safety of the mother in 260 (32.8%) and the safety of the unborn baby in 114 (14.4%) of the respondents were the reasons for vaccine hesitancy. A small proportion of women 7(0.9%) were hesitant on religious grounds. Tertiary education, use of childhood immunization for previous infants delivered, and availability of COVID-19 vaccine in the antenatal clinic at no cost to the women, were statistically significant predictors of vaccine uptake among the respondents. Conclusion: the prevalence of vaccine hesitancy among pregnant women in Port Harcourt was 72.2%. Higher academic achievement and availability of the COVID-19 vaccine in the antenatal clinic were predictors of vaccine uptake, while reasons for hesitancy were mostly due to safety concerns for the mother and unborn baby.

A psychological insight of Moroccan adults' immunisation behaviour towards emergency vaccines.

BACKGROUND: The psychology of vaccination behaviour explains how thoughts and feelings influence people's willingness to receive vaccines. Understanding vaccination behaviour is crucial to successfully managing vaccination campaigns. AIM: Investigating factors associated with immunisation stress among students at Mohammed First University. SETTING: This study was conducted on students at Mohammed First University institutions. METHODS: This study is a descriptive and analytical cross-sectional study. It was conducted on 305 students at Mohammed First University institutions using a 90-item questionnaire. RESULTS: Three hundred and five participants have been included in this survey. Overall, 65.5% of the students in our sample had a positive perception towards COVID-19 vaccines. Nevertheless, 34.5% had a negative opinion regarding immunisation. According to the analysis of perceived stress scale, 40% (n = 122) of students expressed moderate to high stress regarding vaccination. Students with a negative perception of vaccine showed a higher level of stress than those with a positive one. Stressed students tended to be older than others, coming from other institutions, other than the medical faculty, and were renting alone. Vaccine accessibility was the less significant reason associated with stress regarding vaccination. Moreover, participants with high levels of confidence in social media, exhibited higher stress. Nevertheless, those who believed in scientific journals were significantly less stressed. CONCLUSION: These results reflect a positive perception and acceptance of vaccines, with a considerable level of stress regarding vaccination.Contribution: This study suggests emphasising the mental health of Moroccan young adults, to better sensitise and inform them about immunisation.

A psychometric assessment of a novel scale for evaluating vaccination attitudes amidst a major public health crisis.

Despite abundant scientific evidence supporting immunization benefits, vaccine hesitancy remains a significant global health concern, particularly during public health crises. Exploring public attitudes towards vaccination is crucial. This study aimed to develop and validate a tailored Public Vaccination Attitudes Scale specifically under the unique circumstances of a public health crisis. A psychometric evaluation was conducted using a cross-sectional study during the peak of a major public health crisis. The scale was developed and its psychometric properties validated using three approaches: (1) generating the item pool through literature research and focus group discussions; (2) assessing the items through expert consultation; and (3) evaluating construct validity, content validity, and internal consistency reliability through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Data from a total of 3921 respondents were randomly divided into two subsets, one for EFA (n = 1935) and the other for CFA (n = 1986). A 22-item draft scale with five factors was created after literature research and focus group discussion. The content validity of this scale ranged between 0.88 and 1.00. EFA showed a 17-item scale with four factors (Cronbach's α > 0.7) accounting for 68.044% of the total variance. CFA showed that the values of the fit indices, including convergent validity and discriminant validity, were excellent or acceptable. The overall Cronbach's α was 0.874, and each factor ranged from 0.726 to 0.885. This study introduces a valuable tool for assessing vaccination attitudes during public health crises, aiding researchers, policymakers, and nurses in combating vaccine hesitancy. Emphasizing the importance of fostering vaccine acceptance, it enhances disease control during emergencies, contributing to the knowledge needed for more effective public health strategies and crisis responses.

Cross-Country Discrepancies in Monkeypox Vaccine Hesitancy Among Postgraduate and Undergraduate Medical Students.

BACKGROUND: Medical students hold significant importance, as they represent the future of healthcare provision. This study aimed to explore psychological antecedents towards the monkeypox (mpox) vaccines among postgraduate and undergraduate medical students across countries. METHODS: A cross-sectional survey was conducted among medical students aged 18 years old and above in 7 countries; Egypt, Romania, Malaysia, and Yemen, Iraq, India, and Nigeria. We used social media platforms between September 27 and November 4, 2022. An anonymous online survey using the 5C scale was conducted using snowball and convenience Sampling methods to assess the 5 psychological antecedents of vaccination (i.e., confidence, constraints, complacency, and calculation, as well as collective responsibility). RESULTS: A total of 2780 participants were recruited. Participants' median age was 22 years and 52.1% of them were males. The 5C psychological antecedents of vaccination were as follows: 55% were confident about vaccination, 10% were complacent, 12% experienced constraints, and 41% calculated the risk and benefit. Lastly, 32% were willing to be vaccinated for the prevention of infection transmission to others. The Country was a significant predictor of confidence, complacency, having constraints, and calculation domains (P < 0.001). Having any idea about the mpox vaccine was linked to 1.6 times higher odds of being more confident [OR = 1.58 (95% CI, 1.26-1.98), P < 0.001] Additionally, living in a rural area significantly increased complacency [OR = 1.42 (95% CI, 1.05-1.95), P = 0.024] as well as having anyone die from mpox [OR = 3.3 (95% CI, 1.64-6.68), P < 0.001]. Education level was associated with increased calculation [OR = 2.74 (95% CI, 1.62-4.64), P < 0.001]. Moreover, being single and having no chronic diseases significantly increased the calculation domain [OR = 1.40 (95% CI, 1.06-1.98), P = 0.02] and [OR = 1.54 (95% CI, 1.10-2.16), P = 0.012] respectively. Predictors of collective responsibility were age 31-45 years [OR = 2.89 (95% CI, 1.29-6.48), P = 0.01], being single [OR = 2.76 (95% CI, 1.94 -3.92), P < 0.001], being a graduate [OR = 1.59 (95% CI (1.32-1.92), P < 0.001], having no chronic disease [OR = 2.14 (95% CI, 1.56-2.93), P < 0.001], and not knowing anyone who died from mpox [OR = 2.54 (95% CI, 1.39-4.64), P < 0.001), as well as living in a middle-income country [OR = 0.623, (95% CI, 0.51-0.73), P < 0.001]. CONCLUSIONS: This study underscores the multifaceted nature of psychological antecedents of vaccination, emphasizing the impact of socio-demographic factors, geographic location, and awareness, as well as previous experiences on individual attitudes and collective responsibility towards vaccination.

Experiences from a COVID-19 vaccination center at a tertiary care teaching hospital in Delhi, India: Challenges and solutions.

India began its nationwide coronavirus disease 2019 (COVID-19) vaccination program on January 16, 2021, in a phased manner. In this paper, we have discussed our experience at one of the COVID-19 vaccination centers in the country and have identified a few of the major challenges and their implications. The guidelines for COVID-19 vaccination in the country were changing frequently, leading to ambiguity among the beneficiaries. Co-WIN software, used for program implementation, had some glitches, which caused dissatisfaction among the service providers and beneficiaries. Vaccine hesitancy and eagerness caused low vaccine uptake initially and overcrowding at vaccination centers later. Some of the vaccination centers had the potential to become hot spots for further spread of the virus due to insufficient infrastructure. The disparity in access to vaccines for the homeless and other vulnerable groups was another hurdle for adequate vaccination coverage. These challenges could have been addressed by pretesting the information technology platform, long-term planning with a vision for handling vaccine hesitancy and eagerness, strong communication systems, removing disparities in vaccine access, and maintaining uniformity in messages for frequently updating guidelines.

Hesitancy towards R21/Matrix-M malaria vaccine among Ghanaian parents and attitudes towards immunizing non-eligible children: a cross-sectional survey.

BACKGROUND: The newly developed malaria vaccine called "R21/Matrix-M malaria vaccine" showed a high safety and efficacy level, and Ghana is the first country to approve this new vaccine. The present study aimed to evaluate the rate of vaccine hesitancy (VH) towards the newly developed malaria vaccine among parents who currently have children who are not eligible for the vaccine but may be eligible in the near future. Additionally, the study aimed to identify the factors that could potentially influence VH. METHODS: A cross-sectional survey using both online-based questionnaires and face-to-face interviews was conducted in Ghana from June to August 2023. The survey specifically targeted parents of ineligible children for vaccination, including those aged less than 5 months or between 3 and 12 years. The Parent Attitudes about Childhood Vaccination (PACV) scale was used to assess parental VH. RESULTS: A total of 765 people participated in this study. Their median age was 36.0 years with an interquartile range of 31.0-41.0 years, 67.7% were females, 41.8% completed their tertiary education, 63.3% were married, 81.6% worked in non-healthcare sectors, and 59.7% reported that their monthly income was insufficient. About one-third (34.5%) of the parents were hesitant to give their children the R21/Matrix-M malaria vaccine. The following predictors were associated with VH: working in the healthcare sector (adjusted odds ratio (AOR) = 0.50; 95% confidence interval (CI) 0.30-0.80; p = 0.005), having the other parent working in the healthcare sector (AOR = 0.54; 95% CI 0.30-0.94; p = 0.034), and not taking scheduled routine vaccinations (AOR = 1.90; 95% CI 1.27-2.84; p = 0.002). CONCLUSIONS: Addressing VH is crucial for optimizing R21/Matrix-M vaccine coverage in Ghana's malaria control strategy. By tackling VH issues, Ghana can effectively safeguard children's health in malaria-prone areas.

COVID-19 vaccine hesitancy among adults in India: A primary study based on health behavior theories and 5C psychological antecedents model.

Despite the significant success of India's COVID-19 vaccination program, a sizeable proportion of the adult population remains unvaccinated or has received a single dose of the vaccine. Despite the recommendations of the Government of India for the two doses of the COVID-19 vaccine and the precautionary booster dose, many people were still hesitant towards the COVID-19 full vaccination. Hence, this study aimed to identify the primary behavioral and psychological factors contributing to vaccine hesitancy. Cross-sectional data was collected via a multi-stage sampling design by using a scheduled sample survey in the Gorakhpur district of Uttar Pradesh, India, between 15 July 2022 to 30 September 2022. This study has utilized three health behavior models-the Health Belief Model (HBM), the Theory of Planned Behavior (TPB), and the 5C Psychological Antecedents of vaccination, and employed bivariate and multivariable binary logistic regression model to assess the level of vaccine hesitancy and predictive health behavior of the respondents. Results indicate that among the constructs of the HBM and 5C Antecedents models, "perceived benefits", "confidence" and "collective responsibility" showed a lesser likelihood of COVID-19 vaccine hesitancy. However, in the TPB model constructs, a 'negative attitude towards the vaccine' showed a four times higher likelihood of COVID-19 vaccine hesitancy. From the future policy perspective, this study suggested that addressing the issue of 'negative attitudes towards the vaccine' and increasing the trust or confidence for the vaccine through increasing awareness about the benefits of the vaccination in India may reduce vaccine hesitancy.

Language barriers during vaccination practice, the point of view of healthcare providers.

Background: Language barriers are one of the main obstacles faced by migrants in accessing healthcare services. A compromised communication between migrants and Healthcare Providers in vaccination setting can result in increased vaccine hesitancy and decreased vaccine uptake. The objective of the current study is to investigate Healthcare Providers' perceptions about linguistic barriers faced during both routinary vaccination practice and the extraordinary vaccination program for Ukrainian refugees in the Local Health Authorities of Bologna and Romagna (Italy). Methods: A cross-sectional study was conducted through the administration of a questionnaire examining Healthcare Providers' perceptions. A descriptive analysis and a multiple logistic regression model were adopted to analyze the collected data. Results: Language barriers resulted as an obstacle to informed consent and to doctor-patient relationship. The strategies adopted were perceived as helpful in increasing vaccination adherence, despite communication difficulties were still experienced during refugees' vaccinations. Results suggest that the implementation of translated material and the use of professional interpreters may represent important strategies to overcome linguistic barriers, along with Healthcare Providers' training. Healthcare Providers' opinions could assist the implementation of new tools capable of countering language barriers. Conclusions: The current study represents an example of providers' involvement in understanding the complexities behind the issue of language barriers in vaccination practice.

"Let's get back to normal": emotions mediate the effects of persuasive messages on willingness to vaccinate for COVID-19.

Objective: We examined the effectiveness of three different messages for persuading individuals to get vaccinated against COVID-19, and the role that emotions play in persuasion. Methods: Four hundred-thirty-six participants reported their concern about the COVID-19 pandemic and confidence/hesitancy toward vaccines. Participants were randomly assigned to one of three text conditions: (1) self-interest: a persuasive message that focused on how much of a "serious threat COVID-19 is to you," and to get vaccinated to "protect yourself"; (2) self-interest + altruistic: a persuasive message that focused on the "threat to you and your community" and to get vaccinated to "protect you and your loved ones"; (3) self-interest + altruistic + normal: a persuasive message that included (2) but added "This is the only way we can get back to a normal life."; and, (4) a baseline control: no text. After reading, participants reported their emotions toward COVID-19 vaccines and their willingness to get vaccinated. Results: Individuals in the self-interest + altruistic + normal condition were more willing to get vaccinated compared to the control condition and self-interest + altruistic condition. However, there were no differences in willingness between the self-interest + altruistic + normal condition and the self-interest condition. Moreover, emotions mediated relations between vaccine confidence/hesitancy and willingness. Conclusion: A message that focuses on "getting back to normal" can achieve important public health action by increasing vaccine uptake to protect the population. Future work is needed across multiple countries and contexts (i.e., non-pandemic) to assess message effectiveness.

Partnering With Churches to Address COVID-19 Vaccine Hesitancy and Uptake in Trustworthy Contexts.

The Black church has long been seen as a crucial partner in addressing public health issues. This paper describes the development, implementation, and evaluation of a community-engaged church intervention addressing COVID-19 vaccine hesitancy in underserved Black communities in Jefferson County, Alabama. We partnered with churches to implement and evaluate the intervention between March and June of 2022 and found that our church partners were capable of significant messaging reach, particularly through electronic means. (Am J Public Health. 2024;114(S5):S392-S395. https://doi.org/10.2105/AJPH.2024.307683).

Trust in primary health care and COVID-19 vaccine uptake among Iranian pediatric: a web-based cross-sectional survey.

BACKGROUND: Children are the most vulnerable group to diseases. Thus, it's critical to evaluate parents' or guardians' willingness to vaccinate their children. This study aims to investigate the prevalence and predictors of pediatric COVID-19 vaccination in Iran and its relationship with trust in the Primary Health Care (PHC) system. METHOD: A cross-sectional online survey of 549 Iranian parents was conducted between January and March 2023. This study collected data from all provinces of Iran using a questionnaire shared on Google Forms and various social media platforms. After considering various background factors, we used a multivariable logistic regression model. This model explored how trust in the PHC system and parent-related and child-related factors were related to parents' vaccine uptake for their children. RESULTS: Of 549 parents aged between 19 and 67 years (median = 38 years), 65.2% (358) were female. The prevalence of vaccine uptake among parents was 46.8%. After adjusting for background features, child's age (adjusted odds ratio [AOR] 0.81, 95% CI 0.71-0.91), vaccine doses (1-dose: AOR 14.72, 95% CI 6.44-33.65, 2-dose: AOR 32.54, 95% CI 15.22-69.57), child's disease (AOR 5.31, 95% CI 2.19-12.85), and trust in PHC (AOR 1.01, 95% CI 1.00-1.02) were associated with parental uptake of the COVID-19 vaccine. CONCLUSIONS: The findings of this study suggest that the child's age, vaccine doses received, diseases, and trust in PHC are significant predictors of parental uptake of the COVID-19 vaccine for children in Iran. The results can be used in service planning regarding children's COVID-19 vaccination.