In the Face of a Pandemic: "I Felt the Same as When the War Started"-A Qualitative Study on COVID-19 Vaccine Acceptance in Bosnia and Herzegovina.

Objectives: To conduct qualitative study with different target groups in Bosnia and Herzegovina in order to explore their views on barriers and drivers for COVID-19 vaccination, and to see if and how barriers and drivers vary between urban and rural locations, and different professional roles. Methods: The theoretical framework underpinning the study is the capability-opportunity-motivation (COM-B) behavior change framework, which has been adapted to monitor vaccine related behavior and attitudes. Data was collected from June to September 2022 through moderated discussions in focus groups. The total of 162 participants participated in 16 focus groups. Results: Among the key barriers to successful immunization identified across target groups were insufficient knowledge about vaccines, pandemic fatigue, concerns about the rapid development of the vaccine and its effectiveness, lack of confidence in the healthcare system. Some of the main drivers of vaccination against COVID-19 were confidence in science and expert recommendations. Conclusion: The COVID-19 immunization policy undergoes continuous changes, as do the pandemic prospects; we encourage further research to track the evolution of vaccine related attitudes, inform immunization policy, and create evidence-based interventions.

COVID-19 Risk Perception, Trust in Institutions and Negative Affect Drive Positive COVID-19 Vaccine Intentions.

Objectives: To investigate country-specific drivers and barriers of positive COVID-19 vaccine intentions in the Federation of Bosnia and Herzegovina (FBiH), one of the two entities comprising Bosnia and Herzegovina. Methods: A cross-sectional study design was used, using an online behavioural insights survey tool adapted to the context of FBiH. Three survey waves, each including approximately 1,000 adults, were conducted in July, September and December 2020. Fixed-effects regression analysis was used to explore the drivers, barriers and attitudes towards accepting a future COVID-19 vaccine. Results: COVID-19 risk perception, trust in health institutions and negative affect were positive predictors of positive COVID-19 vaccine intentions, as were living in urban areas and having a college education (versus having primary or secondary education). Conversely, being female, feeling that the pandemic was overhyped by the media and the country of vaccine production were negative predictors. Conclusion: This study provided snapshots on the state of attitudes regarding a future COVID-19 vaccine acceptance and hesitancy in 2020. These findings provided useful insights into the efforts to introduce and roll out the COVID-19 vaccines in FBiH. Further efforts should focus on better understanding the demographic, cultural and behavioural contexts of COVID-related vaccination perceptions in FBiH.