Revisiting Vaccine Hesitancy in Residential Care Homes for the Elderly for Pandemic Preparedness: A Lesson from COVID-19
Abstract
:1. Introduction
1.1. An Outbreak-Prone Healthcare Setting
1.2. Vaccine Hesitancy before Explosive Omicron Outbreaks in RCHEs
1.3. The Need to Revisit Vaccine Hesitancy in RCHEs after Explosive Omicron Outbreaks
1.4. Study Aims and Significance
2. Methodology
2.1. Study Design
2.2. The Study Instrument for Residents
2.2.1. Vaccine Hesitancy
2.2.2. Anxiety
2.2.3. Loneliness
2.3. The Study Instrument for Staff
2.3.1. Vaccine Hesitancy
2.3.2. Anxiety
2.4. The Study Instrument for Facility-Level Attributes
2.5. Statistical Analysis
2.6. Ethics Statement
3. Results
3.1. Characteristics of the Residents
3.2. Characteristics of the Staff
3.3. Characteristics of Study RCHEs
3.4. Predictors of Vaccine Hesitancy among Residents
3.5. Predictors of Vaccine Hesitancy among Staff
4. Discussion
4.1. Principal Findings
4.2. Result Implications
4.3. Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Factors | Residents | Staff |
---|---|---|
Individual level | ||
Age | ✓ | ✓ |
Biological sex | ✓ | ✓ |
Care level | ✓ | ✓ |
Mini-cog score | ✓ | |
Number of doses of COVID-19 vaccines taken | ✓ | ✓ |
Ever infected by COVID-19 | ✓ | ✓ |
Anxiety | ✓ | ✓ |
Emotional loneliness | ✓ | ✓ |
Social loneliness | ✓ | ✓ |
Facility level | ||
Facility size | ✓ | ✓ |
Infection rate of COVID-19 among residents | ✓ | ✓ |
Uptake rate of COVID-19 vaccines (1 dose or more) | ✓ | ✓ |
Characteristics | Residents (N = 204) | Staff (N = 168) | ||
---|---|---|---|---|
n | % | n | % | |
Biological sex | ||||
Male | 134 | 65.69 | 12 | 7.14 |
Female | 70 | 34.31 | 156 | 92.86 |
Age | ||||
Below 55 | 13 a | 6.37 | - | - |
55–64 | 44 | 21.57 | - | - |
65–74 | 52 | 25.49 | - | - |
75–84 | 50 | 24.51 | - | - |
85 or above | 45 | 22.06 | - | - |
Age | ||||
18–34 | - | - | 7 | 4.17 |
35–44 | - | - | 26 | 15.48 |
45–54 | - | - | 60 | 35.71 |
55–64 | - | - | 55 | 32.74 |
65 or above | - | - | 19 | 11.31 |
Missing | - | - | 1 | 0.6 |
Presence of chronic diseases | ||||
No | 6 | 2.94 | 124 | 73.81 |
Yes | 178 | 87.26 | 39 | 23.21 |
Missing | 20 | 9.8 | 5 | 2.98 |
Presence of food or drug allergy | ||||
No | 173 | 84.8 | 144 | 85.71 |
Yes | 15 | 7.35 | 22 | 13.1 |
Missing | 16 | 7.84 | 2 | 1.19 |
Education level | ||||
Primary or below | 95 | 46.57 | 26 | 15.48 |
Secondary | 70 | 34.31 | 120 | 71.43 |
Tertiary | - | - | 20 | 11.9 |
Missing | 39 | 19.12 | 2 | 1.19 |
Care level | ||||
Low | 87 | 42.65 | - | - |
Middle | 62 | 30.39 | - | - |
High | 45 | 22.06 | - | - |
Missing | 10 | 4.9 | - | - |
COVID-19 infection (ever) | ||||
Yes | 174 | 85.29 | 102 | 60.71 |
No | 30 | 14.71 | 66 | 39.29 |
Hospitalization due to COVID-19 | ||||
No | 97 | 47.55 | - | - |
Yes | 13 | 6.37 | - | - |
Missing | 94 | 46.08 | - | - |
Number of COVID-19 vaccines received | ||||
Zero | 5 | 2.45 | 0 | 0 |
One | 19 | 9.31 | 2 | 1.19 |
Two | 73 | 35.78 | 19 | 11.31 |
Three | 99 | 48.53 | 138 | 82.14 |
Four | 8 | 3.92 | 9 | 5.36 |
Variables | Residents (N = 204) | Staff (N = 168) | ||||||
---|---|---|---|---|---|---|---|---|
Missing | Range | Score * | SD | Missing | Range | Score * | SD | |
Mental health | ||||||||
Anxiety | 6 | 0–10 | 2.54 | (2.38) | 11 | 0–21 | 3.04 | (2.97) |
Loneliness | 6 | 0–12 | 3.57 | (2.88) | 10 | 0–22 | 8.79 | (2.71) |
Social loneliness | 7 | 0–6 | 1.79 | (2.15) | 10 | 0–10 | 2.71 | (2.28) |
Emotional loneliness | 6 | 0–6 | 1.78 | (1.63) | 10 | 0–12 | 6.08 | (2.33) |
Vaccine hesitancy | ||||||||
Overall (3C) | 0 | 1–7 | 2.44 | (1.05) | 0 | 1–7 | 2.45 | (0.82) |
Overall (5C) | 0 | 1–7 | 2.64 | (0.86) | 0 | 1–7 | 2.87 | (0.70) |
Confidence | 0 | 1–7 | 5.62 | (1.42) | 0 | 1–7 | 5.87 | (1.04) |
Complacency | 2 | 1–7 | 2.95 | (1.73) | 1 | 1–7 | 3.15 | (1.34) |
Constraints | 0 | 1–7 | 1.88 | (1.30) | 2 | 1–7 | 2.04 | (1.28) |
Calculation | 1 | 1–7 | 4.03 | (1.91) | 2 | 1–7 | 5.02 | (1.37) |
Collective responsibility | 0 | 1–7 | 6.03 | (1.41) | 2 | 1–7 | 5.91 | (1.09) |
Factors | Model 1 (N = 186 †, RCHE = 26) | Model 2 (N = 150 †, RCHE = 20) | ||||||
---|---|---|---|---|---|---|---|---|
b | SE | t | p | b | SE | t | p | |
Age | −0.009 | 0.006 | −1.441 | 0.151 | −0.009 | 0.007 | −1.268 | 0.207 |
Female | −0.024 | 0.163 | −0.146 | 0.884 | 0.121 | 0.194 | 0.622 | 0.535 |
Emotional loneliness | −0.043 | 0.053 | −0.820 | 0.414 | −0.020 | 0.061 | −0.336 | 0.738 |
Social loneliness | 0.061 | 0.035 | 1.759 | 0.080 | 0.081 | 0.040 | 2.007 | 0.047 * |
Anxiety | 0.135 | 0.036 | 3.735 | 0.000 *** | 0.138 | 0.041 | 3.378 | 0.001 ** |
Mini-cog score | −0.222 | 0.090 | −2.457 | 0.015 * | −0.307 | 0.106 | −2.897 | 0.004 ** |
Number of COVID-19 vaccines received | −0.254 | 0.103 | −2.476 | 0.014 * | −0.312 | 0.115 | −2.725 | 0.007 ** |
COVID-19 infection (ever) | −0.143 | 0.226 | −0.630 | 0.529 | −0.212 | 0.247 | −0.859 | 0.392 |
Care level | −0.054 | 0.097 | −0.552 | 0.582 | −0.189 | 0.110 | −1.716 | 0.088 |
Size of the residential home | −0.001 | 0.001 | −0.632 | 0.528 | ||||
Resident infection rate | −0.683 | 0.787 | −0.868 | 0.387 | ||||
RCHE’s vaccination rate (with 1 dose or more) | −0.629 | 0.252 | −2.493 | 0.014 * |
Factors | Model 1 (N = 156 †, RCHE = 25) | Model 2 (N = 125 †, RCHE = 18) | ||||||
---|---|---|---|---|---|---|---|---|
b | SE | t | p | b | SE | t | p | |
Age | 0.000 | 0.006 | 0.056 | 0.955 | 0.002 | 0.007 | 0.301 | 0.764 |
Female | 0.046 | 0.274 | 0.169 | 0.866 | −0.141 | 0.308 | −0.459 | 0.647 |
Emotional loneliness | 0.062 | 0.030 | 2.094 | 0.038 * | 0.097 | 0.034 | 2.909 | 0.004 ** |
Social loneliness | 0.052 | 0.030 | 1.719 | 0.088 | 0.074 | 0.035 | 2.083 | 0.040 * |
Anxiety | 0.045 | 0.023 | 1.932 | 0.055 | 0.059 | 0.029 | 2.033 | 0.044 * |
Number of COVID-19 vaccines received | −0.341 | 0.143 | −2.387 | 0.018 * | −0.339 | 0.141 | −2.400 | 0.018 * |
COVID-19 infection (ever) | −0.029 | 0.135 | −0.218 | 0.828 | 0.077 | 0.142 | 0.543 | 0.588 |
Size of the residential home | 0.003 | 0.001 | 3.212 | 0.002 ** | ||||
Resident infection rate | 0.999 | 0.835 | 1.197 | 0.234 | ||||
RCHE’s vaccination rate (with 1 dose or more) | −0.280 | 0.206 | −1.357 | 0.177 |
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Leung, C.L.K.; Wei, W.I.; Li, K.-K.; McNeil, E.B.; Tang, A.; Wong, S.Y.S.; Kwok, K.O. Revisiting Vaccine Hesitancy in Residential Care Homes for the Elderly for Pandemic Preparedness: A Lesson from COVID-19. Vaccines 2023, 11, 1700. https://doi.org/10.3390/vaccines11111700
Leung CLK, Wei WI, Li K-K, McNeil EB, Tang A, Wong SYS, Kwok KO. Revisiting Vaccine Hesitancy in Residential Care Homes for the Elderly for Pandemic Preparedness: A Lesson from COVID-19. Vaccines. 2023; 11(11):1700. https://doi.org/10.3390/vaccines11111700
Chicago/Turabian StyleLeung, Cyrus Lap Kwan, Wan In Wei, Kin-Kit Li, Edward B. McNeil, Arthur Tang, Samuel Yeung Shan Wong, and Kin On Kwok. 2023. "Revisiting Vaccine Hesitancy in Residential Care Homes for the Elderly for Pandemic Preparedness: A Lesson from COVID-19" Vaccines 11, no. 11: 1700. https://doi.org/10.3390/vaccines11111700