An Experimental Study on how Messaging from CDC Affects Attitudes toward Mandatory MMR Vaccination for Schoolchildren.

BACKGROUND: During the COVID-19 pandemic, public health institutions, particularly the Centers for Disease Control and Prevention (CDC), were frequently attacked by politicians. Popular trust in these institutions declined, particularly among self-identified Republicans. Therefore, the effectiveness of public health institutions as vaccination messengers might have been weakened in the post-COVID-19 period. We conducted a survey experiment examining the effectiveness of messaging from the CDC in shaping people's attitudes toward mandatory MMR (measles-mumps-rubella) vaccination for schoolchildren. METHODS: The experiment was embedded in a survey fielded in South Dakota, a "red state" with a population predisposed to distrust the CDC. Using registration-sampling, we received 747 responses. We used difference-in-means tests and multivariate regression to analyze the data. RESULTS: We found that participants who received a message from the CDC were more likely to support MMR vaccine mandate for schoolchildren than participants who received the same prompt from a state agency. Further analyses showed that messaging from the CDC was particularly effective among Republicans. DISCUSSION: Overall, our study showed that although the CDC was caught up in the political skirmishes during the COVID-19 pandemic, it remains an authoritative source of public health information. CONCLUSIONS: Public health officials at the local and state levels should not shy away from referring to the CDC in their vaccination messaging.

Nursing vaccine mandates: Ethically justified, an infringement on autonomy, or both?

After almost a year and a half of the COVID-19 pandemic, many healthcare institutions in the United States announced that they would mandate COVID-19 vaccination, with medical and religious exceptions, as a term of employment. The mandates resulted in widely publicized protests from hospital staff, including some nurses, who argued that these medical institutions violated the ethical principle of autonomy. As the world enters the "post-pandemic period," decisions such as these, made during times of crisis, must be reviewed to provide clarity for when the next pandemic occurs. In this paper, we support the argument that such mandates are ethically justifiable. We explore the framework of objections that were brought forward by dissenters of this vaccine mandate. Next, we provide an analysis of conflicting ethical principles present when such mandates were deployed. Utilizing the American Nurses Association's Code of Ethics for Nurses, notably provisions 2, 3, and 6 we argue that it is an ethical duty of the nurse to be vaccinated. Specifically, we turn to provision two, which most explicitly underscores the necessity of vaccination as a function of the nurse's primary commitment to the patient. Next, we highlight the International Council of Nurses Code of Ethics which provides similar guidance internationally. Finally, we examine the applicability of the principles of public health, care ethics, and the nursing role as frameworks to underpin such mandates both for the current and for potential future pandemics, arguing that the nurse's ethical duty to be vaccinated spans these contexts.

An Ethical Anaylsis of the Arguments Both For and Against COVID-19 Vaccine Mandates for Healthcare Workers.

BACKGROUND: Since the development of the first U.S. Food and Drug Administration-approved vaccine for the prevention of serious disease and death associated with the SARS-CoV-2 virus, health care workers have been expected to comply with mandatory immunization requirements or face potential termination of employment and censure by their state medical boards. Although most accepted this mandate, there have been several who have felt this was an unnecessary intrusion and violation of their right to choose their own health care mitigation strategies, or an infringement on their autonomy and other civil liberties. Others have argued that being a health care professional places your duties above your own self-interests, so-called fiduciary duties. As a result of these duties, there is an expected obligation to do the best action to achieve the "most good" for society. A so-called "utilitarian argument." DISCUSSION: We explore arguments both for and against these mandatory vaccine requirements and conclude using duty- and consequence-based moral reasoning to weigh the merits of each. CONCLUSIONS: Although arguments for and against vaccine mandates are compelling, it is the opinion of the Ethics Committee of the American Academy of Emergency Medicine that vaccine mandates for health care workers are ethically just and appropriate, and the benefit to society far outweighs the minor inconvenience to an individual's personal liberties.

Attitudes toward COVID-19 vaccine mandate: The role of psychological characteristics and partisan self-identification.

Governments around the world are increasingly considering vaccine mandates to curb the spread of COVID-19. In May 2022, we surveyed 394 residents of South Dakota to examine predictors of popular attitudes toward a COVID-19 vaccine mandate. We investigated the role of Big Five personality traits, right-wing authoritarianism, and social dominance orientation, as well as partisan self-identification, evangelical identity, and COVID-19 vaccination status. Results showed that Big Five personality traits (openness and emotional stability), right-wing authoritarianism, social dominance orientation, evangelical identity, and partisan self-identification are linked to attitudes toward a COVID-19 vaccine mandate. Our findings underscore the politicization of the COVID-19 pandemic as well as the impact of dispositional factors on attitudes toward mandatory COVID-19 vaccination.

Mandating COVID-19 Vaccination on Campus: A Qualitative Analysis of a Cross-Sectional Study of California College Students.

The purpose of this study was to examine college student perceptions related to institutional vaccine mandates. We utilized qualitative data (n = 2,212) from five open-ended questions in a cross-sectional study of students enrolled or intending to enroll in an institute of higher education in California in fall 2021. Data were collected between June and August 2021. Thematic analysis was employed to analyze student beliefs, and four themes were developed from the data: (1) Polarizing views and language; (2) deciding who to trust; (3) conveying rights and risk; and (4) staying focused on education. The themes represented vaccinated and nonvaccinated student perspectives, capturing views about trust, rights, and risk. Many responses were polarizing and included language that was emotional and political. Despite the range of responses, most students expressed appreciation and approval of the vaccination mandate on college campuses. Findings illustrate the important contributions of qualitative research and suggest opportunities for public health practitioners to lead and engage in critical dialogue about science and public health practices as we aim to promote public perceptions of vaccination programs and health promotion practice.

Predictors of older adults' attitudes toward various COVID-19 vaccine mandates.

Governments are considering adopting various COVID-19 vaccine mandates to protect the most vulnerable groups from infection. We conducted a panel survey of 240 adults aged 65 years or older in April 2021 and April 2022 on their attitudes toward COVID-19 vaccine mandates for all adults, adults 65 and older, and health care workers. Results of a series of logistic regression models show that partisan self-identification is central in predicting attitudes of older adults toward these mandates. The findings of our study will be of relevance for decision-makers as they craft policies to protect the most vulnerable groups in society.

Can "My Body, My Choice" anti-vaxxers be pro-life?

Many "anti-vaxxers" oppose COVID-19 vaccination mandates on the grounds that they wrongfully infringe on bodily autonomy. Their view has been expressed with the slogan "My Body, My Choice," co-opted from the pro-choice abortion rights movement. Yet, many of those same people are pro-life and support abortion restrictions that are effectively a kind of gestation mandate. Both vaccine and gestation mandates impose restrictions on bodily autonomy in order to prevent serious harms. This article evaluates the defensibility of the anti-vax pro-life position. We argue that the case for opposing gestation mandates on grounds of bodily autonomy is much stronger than the case for opposing vaccine mandates-even if fetuses have full moral status. Thus, there is a deep tension in being a pro-life, COVID anti-vaxxer concerned with bodily autonomy.

COVID-19 Misinformation and Social Network Crowdfunding: Cross-sectional Study of Alternative Treatments and Antivaccine Mandates.

BACKGROUND: Crowdfunding is increasingly used to offset the financial burdens of illness and health care. In the era of the COVID-19 pandemic and associated infodemic, the role of crowdfunding to support controversial COVID-19 stances is unknown. OBJECTIVE: We sought to examine COVID-19-related crowdfunding focusing on the funding of alternative treatments not endorsed by major medical entities, including campaigns with an explicit antivaccine, antimask, or antihealth care stances. METHODS: We performed a cross-sectional analysis of GoFundMe campaigns for individuals requesting donations for COVID-19 relief. Campaigns were identified by key word and manual review to categorize campaigns into "Traditional treatments," "Alternative treatments," "Business-related," "Mandate," "First Response," and "General." For each campaign, we extracted basic narrative, engagement, and financial variables. Among those that were manually reviewed, the additional variables of "mandate type," "mandate stance," and presence of COVID-19 misinformation within the campaign narrative were also included. COVID-19 misinformation was defined as "false or misleading statements," where cited evidence could be provided to refute the claim. Descriptive statistics were used to characterize the study cohort. RESULTS: A total of 30,368 campaigns met the criteria for final analysis. After manual review, we identified 53 campaigns (0.17%) seeking funding for alternative medical treatment for COVID-19, including popularized treatments such as ivermectin (n=14, 26%), hydroxychloroquine (n=6, 11%), and vitamin D (n=4, 7.5%). Moreover, 23 (43%) of the 53 campaigns seeking support for alternative treatments contained COVID-19 misinformation. There were 80 campaigns that opposed mandating masks or vaccination, 48 (60%) of which contained COVID-19 misinformation. Alternative treatment campaigns had a lower median amount raised (US $1135) compared to traditional (US $2828) treatments (P<.001) and a lower median percentile of target achieved (11.9% vs 31.1%; P=.003). Campaigns for alternative treatments raised substantially lower amounts (US $115,000 vs US $52,715,000, respectively) and lower proportions of fundraising goals (2.1% vs 12.5%) for alternative versus conventional campaigns. The median goal for campaigns was significantly higher (US $25,000 vs US $10,000) for campaigns opposing mask or vaccine mandates relative to those in support of upholding mandates (P=.04). Campaigns seeking funding to lift mandates on health care workers reached US $622 (0.15%) out of a US $410,000 goal. CONCLUSIONS: A small minority of web-based crowdfunding campaigns for COVID-19 were directed at unproven COVID-19 treatments and support for campaigns aimed against masking or vaccine mandates. Approximately half (71/133, 53%) of these campaigns contained verifiably false or misleading information and had limited fundraising success. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1001/jamainternmed.2019.3330.

Politics of COVID-19 vaccine mandates: Left/right-wing authoritarianism, social dominance orientation, and libertarianism.

Mandatory and punitive vaccination policies, such as requiring vaccination certificates for public activities and firing employees who refuse vaccination, have raised considerable objections. With a sample of U.S. crowdsourced workers (N = 983), this study investigates how four ideologies-left-wing authoritarianism (LWA), right-wing authoritarianism (RWA), social dominance orientation (SDO), and libertarianism-explain vaccine acceptance and attitudes toward vaccine policies. Results show that LWA predicts higher vaccine acceptance and support for COVID-19 vaccine mandates and the punishment of unvaccinated individuals, whereas libertarianism and RWA show negative relationships. SDO is linked to opposition to vaccine mandates. This study underscores the role of specific ideological components in shaping attitudes toward vaccine policies while also contributing to the arguments that LWA and libertarianism have important implications for studying sociopolitical attitudes.

Public attitudes towards COVID-19 vaccine mandates and vaccine certificates in Canada: a time series study.

INTRODUCTION: Since the beginning of the pandemic, numerous public health measures such as COVID-19 vaccines, vaccine mandates and vaccination certificates have been introduced to mitigate the spread of COVID-19. Public opinion and attitudes towards these measures have fluctuated in response to the dynamic political, social, and cultural landscape of the pandemic. METHODS: We conducted a time-series study consisting of national cross-sectional surveys between November 2021 to March 2022 to evaluate the Canadian public's attitudes towards COVID-19 vaccine mandates and vaccine certificates. RESULTS: When examining public sentiment towards COVID-19 vaccine certificates and proof of vaccination measures, there was a shift in responses over time. The proportion of participants "strongly supporting" these measures decreased from 66.0 to 43.1% between W25(Capacity Limits), -W32 (Mask Mandate Removed), whereas "strongly oppose" was the second most common response and rose from 15.9 to 20.6% during this same time period. Concurrently, when examining participants views surrounding mandates, many participants believed that their province was reopening at "about the right pace", which remained relatively stable over time (33.0-35.4%) between W28 (Emergency Act)-W32 (Mask Mandate Removed). CONCLUSION: Our study's findings on the public's attitudes towards COVID-19 vaccine mandates and vaccine certificates in Canada may aid to guide and streamline the implementation of future similar public health interventions. Future research should include extended follow-up and a more comprehensive examination of trust in government institutions and polarized perspectives on vaccine mandates.

Collective good and individual choice: Perceptions on COVID-19 vaccine mandate among COVID-19 vaccinated individuals.

INTRODUCTION: Vaccine mandates are controversial, and people vary widely in their preferences to support or reject vaccine mandates. For some, vaccine mandates represent a commitment to reduce harm and support public health. For others, vaccine mandates are viewed as a threat to individual freedom and a violation of personal choice. This manuscript investigated support for a COVID-19 vaccine mandate among COVID-19-vaccinated individuals and identified differences by demographic characteristics and COVID-19 experience. METHODS: Cross-sectional surveys were given to COVID-19-vaccinated individuals at a vaccination clinic in South Texas in the U.S. with the goal of identifying attitudes, beliefs, and perceptions about COVID-19 vaccination and willingness to support a COVID-19 vaccination mandate. Associations of interest were analyzed using descriptive statistics. KEY RESULTS: Approximately half of the sample was of Hispanic or Latino origin (48 %); most respondents identified as White (59 %), followed by 12 % who identified as Asian. Overall, 59 % of participants supported the possibility for a COVID-19 vaccine mandate. Preliminary data showed significant racial differences in willingness to support a possible COVID-19 vaccine mandate (χ2 (1, n = 893) = 26.7, p < .001, phi = .17); 80 % of Asian people reported support for COVID-19 vaccination mandate compared to 50 % to 57 % for other racial groups. Significant differences also emerged by ethnicity (χ2 (4, n = 1033) = 7.12, p = .008, phi = .08) whereby a higher percentage of Latino participants (66 %) reported willingness to support a COVID-19 vaccine mandate. Similarly, significant differences were found by age (χ2 (4, n = 1045) = 20.92, p < .001, phi = .21), yet no significant differences were found by sex or previous COVID-19 diagnosis. CONCLUSION: Support for a COVID-19 vaccination mandate is controversial even among vaccinated people. Identifying and understanding cultural and contextual factors that underlie differences in attitudes and beliefs about COVID-19 vaccination mandates is essential to advance dialogue and inform educational health campaigns to increase COVID-19 vaccination rates.

Procedural Dimensions of Religious Exemptions to Covid-19 Vaccine Mandates: Promoting Clarity, Fairness, and Transparency in Applications.

This study examines the procedural ethical considerations surrounding religious exemptions to Covid vaccine mandates, specifically focusing on immigrant healthcare personnel (HCP) and HCPs of color. It emphasizes communication issues with applicants by investigating exemption applications and their accompanying guidelines. While there is extensive literature on the ethical implications of religious exemptions, a notable gap remains in addressing the procedural aspects of religious exemption applications and their reviewing processes. The study scrutinized religious exemption application forms and accompanying guidelines from 32 selected non-teaching and teaching hospitals for the years 2022-2023. The findings highlight significant variability in exemption application criteria and processes across institutions. Importantly, many application forms lacked comprehensive procedural information, which may result in subjective evaluations and potential misinterpretations of non-Western and non-mainstream religious beliefs, especially those of immigrant HCPs and HCPs of color. The study proposes various strategies to advocate for more equitable and transparent procedures, underlining the significance of diversity, equity, and inclusion in the religious exemption review process for vaccine mandates.

Despite mandated primary series, health care personnel still hesitant about COVID-19 vaccine and immunizing children.

IMPORTANCE: Healthcare personnel (HCP) are important messengers for promoting vaccines, for both adults and children. Our investigation describes perceptions of fully vaccinated HCP about COVID-19 vaccine for themselves and primary series for their children. OBJECTIVE: To determine associations between sociodemographic, employment characteristics and perceptions of COVID-19 vaccines among HCP overall and the subset of HCP with children, who were all mandated to receive a COVID-19 vaccine, in a large US metropolitan region. DESIGN: Cross-sectional survey of fully vaccinated HCP from a large integrated health system. SETTING: Participants were electronically enrolled within a multi-site NYS healthcare system from December 21, 2021, to January 21, 2022. PARTICIPANTS: Of 78,000 employees, approximately one-third accessed promotional emails; 6,537 employees started surveys and 4165 completed them. Immunocompromised HCP (self-reported) were excluded. EXPOSURE(S) (FOR OBSERVATIONAL STUDIES): We conducted a survey with measures including demographic variables, employment history, booster status, child vaccination status; vaccine recommendation, confidence, and knowledge. MAIN OUTCOME(S) AND MEASURES: The primary outcome was COVID-19 vaccine hesitancy for all dose types - primary series or booster doses - among HCP. RESULTS: Findings from 4,165 completed surveys indicated that almost 17.2 % of all HCP, including administrative and clinical staff, were hesitant or unsure about receiving a COVID-19 vaccine booster, despite the NYS recommendation to do so. Depending on age group, between 20 % and 40 % of HCP were hesitant about having their children vaccinated for COVID-19, regardless of clinical versus non-clinical duties. In multivariable regression analyses, lack of booster dose, unvaccinated children, females, income less than $50,000, and residence in Manhattan remained significantly associated with vaccine hesitancy. CONCLUSIONS AND RELEVANCE: Despite mandated COVID-19 vaccination, a substantial proportion of HCP remained vaccine hesitant towards adult booster doses and pediatric COVID-19 vaccination. While provider recommendation has been the mainstay of combatting COVID-19 vaccine hesitancy, a gap exists between HCP-despite clinical or administrative status-and the ability to communicate the need for vaccination in a healthcare setting. While previous studies describe the HCP vaccine mandate as a positive force to overcome vaccine hesitancy, we have found that despite a mandate, there is still substantial COVID-19 vaccine hesitancy, misinformation, and reluctance to vaccinate children.

Political Partisanship and Trust in Government Predict Popular Support for COVID-19 Vaccine Mandates for Various Professions and Demographic Groups: A Research Note.

Due to the slow rate of COVID-19 vaccine uptake and the spread of the highly contagious Omicron variant, governments are considering mandating COVID-19 vaccination for specific professions and demographic groups. This study evaluates popular attitudes toward such policies. We fielded a survey of 535 registered voters in South Dakota to examine popular attitudes towards vaccine mandates for five groups-children 12 and older, K-12 teachers, medical staff, nursing homes staff, and police personnel. We estimated a series of logistic regression models and presented predicted probabilities to find the primary determinants of these attitudes. Results revealed that political partisanship and trust in government are strong predictors of support for vaccine mandates across all models. Should government and public health officials wish to increase the proportion of people vaccinated for COVID-19, they must recognize the limitations of current public health campaigns, and reshape their efforts in congruence with scientific findings.

Urban-rural divide in COVID-19 infection and vaccination rates in healthcare workers in British Columbia, Canada.

Introduction: Healthcare workers (HCWs) play a critical role in responding to the COVID-19 pandemic. Early in the pandemic, urban centres were hit hardest globally; rural areas gradually became more impacted. We compared COVID-19 infection and vaccine uptake in HCWs living in urban versus rural locations within, and between, two health regions in British Columbia (BC), Canada. We also analysed the impact of a vaccine mandate for HCWs. Methods: We tracked laboratory-confirmed SARS-CoV-2 infections, positivity rates and vaccine uptake in all 29,021 HCWs in Interior Health (IH) and all 24,634 HCWs in Vancouver Coastal Health (VCH), by occupation, age and home location, comparing to the general population in that region. We then evaluated the impact of infection rates as well as the mandate on vaccination uptake. Results: While we found an association between vaccine uptake by HCWs and HCW COVID-19 rates in the preceding 2-week period, the higher rates of COVID-19 infection in some occupational groups did not lead to increased vaccination in these groups. By 27 October 2021, the date that unvaccinated HCWs were prohibited from providing healthcare, only 1.6% in VCH compared with 6.5% in IH remained unvaccinated. Rural workers in both areas had significantly higher unvaccinated rates compared with urban dwellers. Over 1800 workers, comprising 6.7% of rural HCWs and 3.6% of urban HCWs, remained unvaccinated and set to be terminated from their employment. While the mandate prompted a significant increase in uptake of second doses, the impact on the unvaccinated was less clear. Conclusions: As rural areas often suffer from under-staffing, loss of HCWs could have serious impacts on healthcare provision as well as on the livelihoods of unvaccinated HCWs. Greater efforts are needed to understand how to better address the drivers of rural-related vaccine hesitancy.

Résumé Introduction: Les travailleurs de la santé (TS) jouent un rôle essentiel dans la réponse à la pandémie de COVID-19. Au début de la pandémie, les centres urbains ont été les plus durement touchés à l'échelle mondiale; les zones rurales ont progressivement été plus touchées. Nous avons comparé l'infection à la COVID-19 et l'adoption du vaccin chez les travailleuses et travailleurs de la santé vivant dans des zones urbaines et rurales au sein de deux régions sanitaires de la Colombie-Britannique (C.-B.), au Canada, et entre ces régions. Nous avons également analysé l'impact d'un mandat de vaccination pour les travailleuses et travailleurs de la santé. Méthodes: Nous avons suivi les infections au SRAS-CoV-2 confirmées en laboratoire, les taux de positivité et l'adoption du vaccin chez les 29 021 TS d'Interior Health (IH) et les 24 634 TS de Vancouver Coastal Health (VCH), par profession, âge et lieu de résidence, en les comparant à la population générale de cette région. Nous avons ensuite évalué l'impact des taux d'infection ainsi que du mandat sur le recours à la vaccination. Résultats: Bien que nous ayons trouvé une association entre l'adoption du vaccin par les TS et les taux de COVID-19 des travailleurs de la santé au cours de la période de deux semaines précédentes, les taux plus élevés d'infection par la COVID-19 dans certains groupes professionnels n'ont pas entraîné une augmentation de la vaccination dans ces groupes. En date du 27 octobre 2021, date à laquelle il était interdit aux travailleuses et travailleurs de santé non vaccinés de fournir des soins de santé, seul 1,6% des travailleuses et travailleurs de la VCH, contre 6,5% des travailleuses et travailleurs de l'IH, n'étaient toujours pas vaccinés. Les travailleuses et travailleurs ruraux des deux zones présentaient des taux de non-vaccination significativement plus élevés que les citadins. Plus de 1 800 travailleuses et travailleurs, soit 6,7% des TS ruraux et 3,6% des TS urbains, n'étaient toujours pas vaccinés et devaient être licenciés. Bien que le mandat ait entraîné une augmentation significative de la prise des deuxièmes doses, l'impact sur les personnes non-vaccinées était moins clair. Conclusions: Comme les zones rurales souffrent souvent d'un manque de personnel, la perte de TS pourrait avoir de graves répercussions sur la prestation des soins de santé ainsi que sur les moyens de subsistance des TS non-vaccinés. Des efforts plus importants sont nécessaires pour comprendre comment mieux aborder les facteurs d'hésitation à SE faire vacciner en milieu rural. Mots-clés: Travailleuses et travailleurs de la santé, COVID-19, vaccination, mandat de vaccination, milieu rural.

Partisan self-identification predicts attitudes of South Dakota nurses toward COVID-19 vaccine mandate for healthcare workers.

Objectives: Nurses are at greater risk of infection from COVID-19. However, mistrust of the vaccine exists even among this group. In the United States, the government implemented a vaccine mandate for health care workers to increase vaccination rates. This study investigated the drivers of nurses' attitudes toward the mandate. Methods: We fielded a survey to study the attitudes of nurses toward COVID-19 vaccine mandate for HCWs. We contacted nurses in South Dakota, United States, based on the information from the South Dakota Board of Nursing. The survey was open in June and July 2022. We conducted a multivariate regression analysis to identify the factors that predict attitudes toward this regulation. Results: We received 1,084 responses. Results of regression analysis showed statistically significant relationships between partisan self-identification, evangelical identity, gender, and COVID-19 vaccination status and support for COVID-19 vaccine mandate for healthcare workers. Age, time with patients, positive COIVD-19 test in the last year, education, and nurse classification variables were not statistically significant. Conclusions: The same factors that drive people's attitudes toward COVID-19 mitigation policies also explain nurses' attitudes toward a vaccine mandate for healthcare workers. The politicization of the COVID-19 pandemic is present also among nurses. Health care officials should be mindful of the influence of these biases as they evaluate the vaccine mandate and develop new regulations.

Unraveling the association between vaccine attitude, vaccine conspiracies and self-reported side effects following COVID-19 vaccination among nurses and physicians in Jordan.

Background: The negative impact of vaccine conspiracies is linked with negative health behavior. The aim of the current study was to examine the association between attitudes toward booster COVID-19, influenza, and monkeypox (mpox) vaccinations with post-COVID-19 vaccine side effects, vaccine conspiracies, and attitude towards mandatory vaccination among nurses and physicians in Jordan. Methods: A structured closed-ended questionnaire was used to collect data on demographics, COVID-19 history, COVID-19 vaccine type and doses received, self-reported side effects post-COVID-19 vaccination, acceptance of booster COVID-19, seasonal influenza, and mpox vaccinations, attitudes towards mandatory vaccination, and beliefs in vaccine conspiracies. Results: The study sample comprised a total of 341 participants. Acceptance of yearly booster COVID-19 vaccination was expressed by 46.6% of the sample, while 73.3% accepted seasonal influenza vaccination, and only 37.0% accepted mpox vaccination. A higher frequency of self-reported side effects following the first COVID-19 vaccine dose was associated with embrace of vaccine conspiracies and vaccine type. For the second vaccine dose, a higher frequency of self-reported side effects was associated with the embrace of vaccine conspiracies, older age, and affiliation to private sector. In multinomial logistic regression analyses, the lower embrace of vaccine conspiracies was associated with lower odds of reporting side effects post-COVID-19 vaccination. The lower embrace of vaccine conspiracies and favorable attitude towards mandatory vaccination were associated with the willingness to get COVID-19, influenza, and mpox vaccinations. Conclusion: The study findings highlighted the negative impact of embracing vaccine conspiracies on health-seeking behavior among nurses and physicians. The findings indicated that the willingness to get vaccinated was associated with lower endorsement of vaccine conspiracies. Additionally, the lower embrace of vaccine conspiracies was associated with a lower frequency of self-reported side effects following COVID-19 vaccination. These results emphasize the importance of addressing vaccine misinformation and promoting accurate information to ensure optimal vaccine uptake and public health outcomes.

Previous Vaccination History and Psychological Factors as Significant Predictors of Willingness to Receive Mpox Vaccination and a Favorable Attitude towards Compulsory Vaccination.

During the ongoing multi-country monkeypox (Mpox) outbreak, healthcare workers (HCWs) have represented a key group in mitigating disease spread. The current study aimed to evaluate the attitude of nurses and physicians in Jordan towards Mpox vaccination, as well as their attitude towards compulsory vaccination against coronavirus disease 2019 (COVID-19), influenza, and Mpox. An online survey was distributed in January 2023 based on the previously validated 5C scale for psychological determinants of vaccination. Previous vaccination behavior was assessed by inquiring about the history of getting the primary and booster COVID-19 vaccination, influenza vaccine uptake during COVID-19, and any history of influenza vaccine uptake. The study sample consisted of 495 respondents: nurses (n = 302, 61.0%) and physicians (n = 193, 39.0%). Four hundred and thirty respondents (86.9%) had heard of Mpox before the study, and formed the final sample considered for Mpox knowledge analysis. Deficiencies in Mpox knowledge were reflected in a mean knowledge score of 13.3 ± 2.7 (out of 20.0 as the maximum score), with significantly lower knowledge among nurses and females. The intention to receive Mpox vaccination was reported by 28.9% of the participants (n = 143), while 33.3% were hesitant (n = 165), and 37.8% were resistant (n = 187). In multivariate analysis, Mpox vaccine acceptance was significantly associated with previous vaccination behavior, reflected in higher vaccine uptake and with higher 5C scores, while Mpox knowledge was not correlated with Mpox vaccination intention. The overall attitude towards compulsory vaccination was neutral, while a favorable attitude towards compulsory vaccination was associated with higher 5C scores and a history of previous vaccination uptake. The current study showed a low intention to get Mpox vaccination in a sample of nurses and physicians practicing in Jordan. The psychological factors and previous vaccination behavior appeared as the most significant determinants of Mpox vaccine acceptance and of attitudes towards compulsory vaccination. The consideration of these factors is central to policies and strategies aiming to promote vaccination among health professionals in efforts to prepare for future infectious disease epidemics.

Investigating Canadian Public Attitudes Toward COVID-19 Vaccine Mandates with a Nested Analysis Framework.

BACKGROUND: Social media is an important medium for studying public attitudes toward COVID-19 vaccine mandates in Canada, and Reddit network communities are a good source for this. METHODS: This study applied a "nested analysis" framework. We collected 20378 Reddit comments via the Pushshift API and developed a BERT-based binary classification model to screen for relevance to COVID-19 vaccine mandates. We then used a Guided Latent Dirichlet Allocation (LDA) model on relevant comments to extract key topics and assign each comment to its most relevant topic. RESULTS: There were 3179 (15.6%) relevant and 17199 (84.4%) irrelevant comments. Our BERT-based model achieved 91% accuracy trained with 300 Reddit comments after 60 epochs. The Guided LDA model had an optimal coherence score of 0.471 with four topics: travel, government, certification, and institutions. Human evaluation of the Guided LDA model showed an 83% accuracy in assigning samples to their topic groups. CONCLUSION: We develop a screening tool for filtering and analyzing Reddit comments on COVID-19 vaccine mandates through topic modelling. Future research could develop more effective seed word-choosing and evaluation methods to reduce the need for human judgment.

Primary care professionals' support for Covid-19 vaccination mandates: Findings from a US national survey.

Healthcare organizations have been early adopters of Covid-19 vaccine mandates as a strategy to end the pandemic. We sought to evaluate support for such mandates among pediatric primary care professionals (PCPs) in the United States. In February-March 2021, we conducted a national online survey of 1,047 PCPs (71% physicians). We used multivariable logistic regression to assess correlates of PCPs' support for Covid-19 vaccine mandates for health care workers. Most PCPs supported Covid-19 vaccine mandates for health care workers (83%). PCPs were more likely to support mandates if they perceived health care workers to be at highest risk of getting Covid-19 compared to other worker types (8 percentage points, p < 0.01). PCPs were also more likely to support mandates if their clinic recommended or required vaccination (11 percentage points and 20 percentage points respectively, both p < 0.01). However, PCPs were less likely to support mandates if their clinic offered incentives to vaccinate (10 percentage points, p < 0.05). Clinic recommendations and requirements for Covid-19 vaccination may increase support for mandates. Incentives may decrease support, perhaps by creating the perception that viable alternatives to mandates exist.