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Article

COVID-19 Stigma and Resource Loss: Predicting Post-Traumatic Stress and Vaccine Support in Vietnam

by
David N. Sattler
1,*,
Thai D. Ngo
2,
Jennifer Ngo
3,
Cuong Nguyen
2,
Mehnaaz Sattler
4,
Ammaarah Kulshum
5,
Marisa Fernandez
6,
Ruth Hackler
1 and
Karlena Tran
1
1
Department of Psychology, Western Washington University, Bellingham, WA 98225-9172, USA
2
Tue Lam Co., Ltd., Ho Chi Minh City 700000, Vietnam
3
Kwantlen Polytechnic University, Surrey, BC V3W 2M8, Canada
4
Augustine House, Delta, BC V4K 5E6, Canada
5
Korean Women’s Association, Seattle, WA 98003, USA
6
Unity Care NW, Bellingham, WA 98225, USA
*
Author to whom correspondence should be addressed.
COVID 2025, 5(3), 33; https://doi.org/10.3390/covid5030033
Submission received: 8 December 2024 / Revised: 7 February 2025 / Accepted: 24 February 2025 / Published: 28 February 2025
(This article belongs to the Section COVID Public Health and Epidemiology)
Versions Notes

Abstract

Public health officials reported increases in stigma, discrimination, and verbal and physical abuse during the coronavirus (COVID-19) pandemic. This study, conducted in Vietnam, examined how stigma, fear of the virus, self-protective behaviors, and threats to and loss of resources during the pandemic were associated with post-traumatic stress and belief in vaccine effectiveness. Participants were 380 persons (237 women, 129 men, 14 unreported) who completed measures assessing demographics, stigma experienced during the pandemic, resource loss, fear about becoming infected with the virus, self-protective actions to avoid illness, post-traumatic stress, and belief in COVID-19 vaccination effectiveness. Hierarchical multiple regression showed post-traumatic stress was positively associated with COVID-19 stigma personal experience, minimizing the COVID-19 threat, personal characteristic and support resource loss, perceived susceptibility to illness, and fear of COVID-19. Vaccine support was positively associated with age, COVID-19 stigma personal experience, and self-protective behaviors to avoid illness, and negatively associated with number of people known who died due to the virus. The findings support the hypotheses and extend conservation of resources stress theory. The findings underscore the importance of promptly addressing stigma, enhancing public education, and addressing barriers to receiving the vaccine.

1. Introduction

“Lock the virus, not your heart…. It’s on us to bring out the best in humanity”.
—World Health Organization Regional Office for South-East Asia
Public health officials worldwide reported increases in stigma, discrimination, and verbal and physical abuse during the coronavirus (COVID-19) pandemic [1,2]. Harassment and threats were directed at people perceived as associated with virus spread, health care professionals, those who had close contact with others or had contracted the virus, Asians (based on reports the virus originated in China), and persons from minority groups [1,3,4,5]. Stigma can adversely influence physical and mental health, serve as a barrier that limits access to resources and services that promote physical and mental health, and foster inequalities [6].
Stigma is a social process that involves devaluing, demeaning, discriminating, and labeling as a result of the perception that society views a characteristic or trait as a threat or which it has rejected [7,8]. Stigma is associated with a variety of adverse outcomes. Stigma can increase psychological distress and social isolation, lower self-esteem, and perpetuate stereotypes. Individuals may distance themselves from others due to concerns about being devalued or discredited [6]. Further, stigma can reduce access to or use of services and resources that promote mental and physical health, and foster inequalities [6]. For example, the expectation or fear of becoming a target of stigma may prevent people from taking a COVID-19 test due to concerns of testing positive, disclosing test results to close contacts, and seeking treatment [9].
Perceived and actual threats to and loss of resources (e.g., health, employment, income, feelings of hope, ability to provide and receive social support) as a result of virus spread may exacerbate hardships brought on by stigma. Conservation of resources stress theory provides a useful framework for understanding how stigma and threats to or loss of resources may be associated with psychological distress [10,11]. According to the theory, people endeavor to obtain, sustain, and safeguard valuable resources. Resources offer safety and stability, are essential for acquiring or sustaining other resources, and act as a buffer against the loss of other assets. When valued resources are jeopardized or lost, individuals may experience stress. The theory identifies four types of resources: condition (e.g., social support, employment), personal characteristic (e.g., self-esteem, hope), energy (e.g., time), and objects (e.g., physical possessions) [11]. Notably, stigma can create resource loss spirals wherein the loss or threat of loss in one resource area leads to the loss or threat of loss in other areas. For example, the loss of personal characteristic resources (e.g., loss of hope or sense of optimism) due to being devalued may lead to the loss of condition resources (e.g., decreased social interaction) and object resources (e.g., loss of employment). The theory also proposes that investment of resources can enhance the availability of resources when recovering from resource loss and safeguard against subsequent resource threats. Consequently, individuals with robust and diversified resources are likely to recover more swiftly and be less vulnerable to the negative impact of resource loss, whereas those with fewer resources are more likely to face additional losses and challenges in recovering from resource loss [10,12].
A review of the PsycINFO database shows few studies have examined COVID-19 stigma in Vietnam or other countries, or its connection to mental health and vaccine acceptance. In Vietnam, one of the few studies examining stigma reported that health care workers experienced increased stigma in the early stages of the pandemic [13]. A study conducted in Mongolia, India, and the United States revealed that COVID-19 stigma was associated with post-traumatic stress, and post-traumatic stress was associated with fear of contracting the virus, blaming others for virus spread, and resource loss during the pandemic [14]. Post-traumatic stress is a mental health condition that can develop after experiencing or witnessing a traumatic event or life threat. Symptoms include reliving the event through memories or nightmares, avoiding situations that activate memories of the event, and increased arousal [15]. Studies also suggest that COVID-19 stigma is associated with stress, sleep disturbances, depression, anxiety, and feelings of embarrassment [2,14,16].
In Vietnam, public health organizations took swift action to address COVID-19 virus spread and reduce the likelihood of resource loss. They recommended citizens engage in COVID-19 virus protective behaviors, including wearing masks in crowded and enclosed locations, hand washing, and receiving the COVID-19 vaccine to protect against serious illness [5]. Importantly, prior to COVID-19, Vietnam enhanced its public health infrastructure as a result of lessons learned during the 2002 SARS outbreak, including maintaining a national public health emergency operations center and public health surveillance programs, which facilitated COVID-19 monitoring and response [17]. Vietnam pursued a zero-COVID strategy for approximately one and one-half years during the pandemic, through September 2021, which included lockdowns, contact tracing, social distancing, and closing entry into the country for most individuals [12,18]. Between January 25, 2020 (near the start of the COVID-19 pandemic) and March 31, 2023 (approximately one month before the World Health Organization declared an end to the COVID-19 public health emergency globally), the World Health Organization reported that in Vietnam, there were 11,527,301 COVID-19 cases confirmed by laboratory testing in all 63 provinces and 43,186 deaths. In this time period, 265,987,159 doses of COVID-19 vaccine had been administered, with 91.9% of the Vietnamese public receiving the first dose and 87.5% receiving the second dose [5].
The present study addresses the lacuna of COVID-19 stigma research by examining the associations among COVID-19 stigma, fear of the virus, threats to and loss of resources, and self-protective behaviors (which could minimize resource loss) with post-traumatic stress and belief the COVID-19 vaccine would provide protection (and thus reduce the potential for resource loss) in Vietnam. In consideration of conservation of resources stress theory and research discussed above, we expected that (a) stigma experienced during the pandemic, resource loss, and fear of infection would be positively associated with post-traumatic stress, and (b) stigma would be positively associated with belief in COVID-19 vaccine effectiveness.

2. Method

2.1. Participants

The participants were 380 persons (237 women, 129 men, 14 unreported; age: M = 28.50, SD = 13.23, range: 18–85 years) in Hanoi, Hue, and Ho Chi Minh City, Vietnam. Their education level was primary (3%), some secondary (3%), secondary (6%), some college (52%), college (35%), and unreported (1%). About one-quarter (25.5%) lived in areas on the outskirts of the city, about one-third (30.8%) were in suburban areas, and less than half (43.7%) lived in the central city areas. These proportions reflect the fact that fewer people live in areas outside of the central city areas. Participants in central city and suburban locations reported higher education levels than did those in the outskirts areas, χ2(8, N = 380) = 26.77, p < 0.001. Most were single (68%), followed by married (26%), divorced/separated (3%), other situation (3%), and unreported (2%).

2.2. Assessment Instruments

Participants completed the following measures:
COVID-19 Stigma. Five items assessed personal experience with COVID-19 stigma [14]. Examples of items include “People have avoided me because they think I have the coronavirus” and “My friends or family have excluded me because they think I have the coronavirus”. Participants used a 5-point scale (1 = not at all to 5 = very much) to indicate their answers.
Resource Loss. Eighteen items examined threat to or loss of resources due to COVID-19 [14,19]. Examples include “Adequate food”, “Money for living expenses”, “Optimism”, and “Feeling I have control over my life”. Participants used a 5-point scale (0 = no loss to 4 = great loss) to indicate their answers.
COVID-19 Fear. Five items from the Fear of the COVID-19 scale assessed fear and anxiety about contracting COVID-19 [20]. Examples include “I am afraid of getting the coronavirus” and “I am afraid of losing my life or becoming seriously ill because of the coronavirus”. Participants used a 5-point scale (1 = not at all to 5 = very much) to indicate their answers.
Susceptibility to Illness. Two items written by the authors assessed feeling susceptible to illness. An example is “Feeling that I am susceptible to colds, flu, and diseases that spread from people to other people”. Participants used a 5-point scale (1 = not at all to 5 = very much) to indicate their answers. Reliability was excellent, α = 0.87.
Self-Protective Behaviors to Avoid Illness. Six items from the COVID-19 Clean and Contain Scale assessed performing self-protective behaviors to prevent contracting COVID-19 [21]. Examples include “Using hand sanitizer that contains at least 60% alcohol when soap and water are not available” and “Avoiding touching my eyes, nose, and mouth with unwashed hands”. Participants used a 5-point scale (1 = never to 5 = always) to indicate their answers.
Experience of others with COVID-19. Participants indicated the number of people they know who contracted COVID-19, became severely ill, and died.
Minimize Threat of COVID-19. Four items written by the authors assessed minimizing risks of COVID-19. Examples of items include “People should be able to travel on airplanes and buses with no restrictions for the coronavirus” and “It is more important to keep businesses open in my community than to prevent the spread of the virus”. Participants used a 5-point scale (1 = not at all to 5 = very much) to indicate their answers.
Post-traumatic Stress. The 6-item Abbreviated PTSD Checklist asked about symptoms experienced in the past month [22]. Examples include “Repeated, disturbing, and unwanted memories of the coronavirus pandemic” and “Feeling irritable”. Participants used a 5-point scale (1 = not at all to 5 = very much) to indicate their answers.
Vaccine Effectiveness. One item assessed vaccine effectiveness: “I believe the coronavirus vaccine will protect me from the coronavirus”. Participants used a 5-point scale (1 = not at all to 5 = very much) to indicate their answer.
Demographics. Participants checked a response to indicate their gender identity, age, education, and the number of people they live with.

2.3. Procedure

To translate the questionnaire into Vietnamese, we followed the committee approach, which the first author has successfully used to translate measures examining post-traumatic stress into Thai, Mongolian, Bahasa Indonesia, Tagalog, Spanish, and Tongan [14,19,23,24,25]. The second author translated the questionnaire and the third author and two research assistants reviewed the translation. Edits were made as appropriate. The first author trained research assistants in questionnaire administration and research ethics. The research assistants read the items to the participants, who indicated they were clear and understandable.
The sampling procedure for this cross-sectional study involved selecting participants in the central city, suburban, and outskirt areas of Hanoi, Hue, and Ho Chi Minh City. In each area, we identified comparable neighborhoods, selected every other residence in these neighborhoods, and asked one individual in each household to participate. The criteria for inclusion were being at least 18 years of age and living in the home. Due to time limitations, we were not able to return if no one was home.
Most individuals agreed to participate, yielding a response rate of 88%. “Response rate is the chief index of data quality in a survey because it defines the extent of possible bias from nonresponses” [26]; a response rate of 60% or greater indicates higher quality data [26,27,28]. It took approximately 20 min to complete the survey. Participants completed the survey about one month before the World Health Organization declared the end of the COVID-19 public health emergency globally, and within a one-month period.

2.4. Data Analytic Plan

We first conducted a principal component factor analysis on the resource loss scale with varimax rotation and assessed factor reliability for all scales. We then conducted hierarchical regression analyses to examine the factors associated with post-traumatic stress and belief in COVID-19 vaccine effectiveness. Based on conservation of resources stress theory and a prior study examining COVID-19 stigma in Mongolia, India, and the United States and other disaster research [14,19], we first entered individual characteristics (e.g., gender, age) and location type (city center, suburban, outskirt areas), followed by stigma experiences and COVID-19 experiences.

3. Results

3.1. Factor Analysis and Scale Reliability

A principal component factor analysis with varimax rotation was performed on the 18 resource loss items. Three factors with eigenvalues greater than one and factor loadings greater than 0.55 emerged. Factor 1 assessed personal characteristic and support resource loss. Items (factor loadings in parentheses) include feeling independent (0.79), companionship (0.76), family stability (0.74), support from co-workers (0.74), intimacy with at least one friend (0.74), hope (0.73), sense of optimism (0.71), and feeling my life has meaning or purpose (0.67). Factor 2 assessed energy loss. Items include free time (0.83), adequate home furnishings (0.79), time for adequate sleep (0.78), and personal transportation (0.55). Factor 3 assessed basic living and survival loss (α = 0.80). Items include money for living expenses (0.77), adequate income (0.75), and adequate food (0.62). Reliability for the resource loss factors was very good to excellent: personal characteristic and support resource loss (α = 0.92), energy resource loss (α = 0.81), and basic living and survival loss (α = 0.80).
Reliability for other scales was very good to excellent: COVID-19 stigma personal experience (α = 0.85), COVID-19 fear (α = 0.88), post-traumatic stress (α = 0.88), minimizing threat of COVID-19 (α = 0.84), and self-protective behaviors (α = 0.89).

3.2. Predicting Post-Traumatic Stress

Table 1 presents the correlation matrix. Table 2 presents the hierarchical regression analysis and shows the predictor variables explained 61% of the variance in post-traumatic stress during the COVID-19 pandemic, F(16, 295) = 30.75, p < 0.001. Post-traumatic stress was positively associated with COVID-19 stigma personal experience, minimizing the COVID-19 threat, personal characteristic and support resource loss, perceived susceptibility to illness, and fear of COVID-19.

3.3. Predicting Belief in Vaccine Effectiveness

Table 2 shows that in the hierarchical regression analysis, the predictor variables explained 17% of the variance in belief of COVID-19 vaccine effectiveness, F(16, 299) = 5.22, p < 0.001. Vaccine support was positively associated with age, COVID-19 stigma personal experience, and self-protective behaviors to avoid illness; and negatively associated with the number of people known who died due to the virus.

4. Discussion

The findings support the hypotheses and extend conservation of resources stress theory. Experiencing COVID-19 stigma, minimizing the threat of COVID-19, losing personal characteristic and support resources (e.g., sense of optimism, companionship), perceived susceptibility to illness, fear of contracting COVID-19, and home location in an urban area were associated with post-traumatic stress. These predictor variables explained 61% of the variance in post-traumatic stress. Further, belief in vaccine effectiveness was positively associated with COVID-19 stigma experience and COVID-19 self-protective behaviors, and negatively associated with knowing people who died as a result of the virus. Personal experience with stigma and personal characteristic and social support resource loss accounted for the largest percentage of variance associated with post-traumatic stress. The finding that posttraumatic stress was greater for people living in city urban areas underscores the connection between population density and heightened exposure to virus spread, and the need for effective public health measures. Education level was not associated with either post-traumatic stress or vaccine acceptance. These finding support and extend studies examining COVID-19 stigma in Mongolia, India, and the United States to Vietnam [14]. Further, the findings support conservation of resource stress theory and its application to the COVID-19 pandemic [10].
The public health response to minimize virus spread and protect life by initiating quarantines (e.g., limiting or closing businesses and schools for months at a time) decreased exposure to the virus, but in some cases may have inadvertently contributed to resource loss spirals in other areas, such as social support and employment [10,29]. This may explain, in part, the association of personal characteristic and social support resource loss with post-traumatic stress. Importantly, community resilience in Vietnam may have been strengthened as a result of the public health response, which included transparency, communication, collective unity, and considered practices and values of tam giao, which involve the harmonious coexistence of Buddhism, Taoism, and Confucianism through cultural integration [17]. Future research examining community resilience and the role of tam giao is warranted.
The findings support and extend Trinh et al. who, through interviews with 38 individuals in Vietnam, show that some people at the beginning of the pandemic interpreted contact tracing—a procedure to identify where the virus was spreading within a community—as indicating people were intentionally spreading the virus. However, this view evolved over time as people came to interpret risk of exposure as largely due to environmental conditions [30]. Importantly, Trinh et al. suggest that public health agencies should be mindful of the manner in which information and public policies are presented in order to minimize or avoid the possibility that they “unintentionally [create] conditions for stigma to flourish” (p. 1).
The findings have important public health implications. Additional outreach and public education are needed to address stigma, health, and mental health, including the adverse consequences of stigma. Accurate information is essential in addressing stigma and discrimination, given that dis/misinformation can generate false beliefs and misunderstanding [31]. Enhanced efforts to educate citizens about information source accuracy is warranted. For example, to inform readers that information is credible, established media outlets might prominently note their professional journalism practices. Users of social media could be provided with additional options to filter unwanted content, including misleading or fake news. Information by known people (e.g., family members, friends, co-workers) is an important source of information, and enhanced efforts to develop recommendations regarding how to verify information from secondary sources are warranted. Because social media platforms are constantly changing, public health agencies might enhance outreach efforts concerning ways to determine information accuracy.
Enhancing community resources to reduce and prevent stigma and promote coping and healing are warranted. Communities could bolster efforts to highlight commonalities among all citizens, the importance of community and caring for one another, empathy, and being a good neighbor. Importantly, mental health resources should be made available to help people resolve issues regarding stigma. Research is needed to identify which types of support would be most effective in promoting safety, health, and stability—viz., Maslow’s hierarchy of needs, including physiological need, love and belonging, safety need, esteem, and self-actualization. Research is also needed to examine how the pandemic may have affected family dynamics and resources, including mother or father and child interactions [32]. For example, in the Netherlands, elementary-aged students experienced decreased proficiency in math, spelling, and reading, and proficiency was influenced, in part, by parent education level [33]. How might diminished family resources and associated stress influence child rearing styles and attachment development? Longitudinal studies are needed to examine long-term consequences of COVID-19 stress and resource loss and their association with disease, relationship quality (e.g., marriages, friends, family), and life expectancy.
There are a few limitations to the study. The sample was cross-sectional and the findings may not generalize to all persons in Vietnam. We were not able to return to approximately 13% of homes with no one home. However, the response rate of 88% was excellent; a response rate of 60% or greater is a metric of higher quality data [26,27,28]. We do not know the degree to which responses may have been influenced by social desirability or differ based on whether participants completed surveys on their own or with assistance as this variable was not coded. Longitudinal studies are needed to better understand the long-term consequences of COVID-19 stress, stigma, and resource loss.

5. Conclusions

Prompt action is needed to address stigma-related experiences and resource loss, particularly in personal characteristic and social support, and to understand their central roles as contributors to post-traumatic stress. Public health agencies should consider these critical issues in developing and executing response plans. Importantly, these considerations underscore the necessity for continued research to inform interventions, policies, and support systems that address the multifaceted challenges posed by pandemics on psychological well-being.

Author Contributions

Conceptualization, D.N.S., T.D.N. and A.K.; Methodology, D.N.S. and T.D.N.; Investigation, J.N. and C.N.; Analysis, D.N.S.; Data curation, D.N.S., M.F. and R.H., Original draft preparation, D.N.S., T.D.N., J.N., M.S., A.K. and K.T.; Review and editing, D.N.S., T.D.N., J.N., M.S., A.K., M.F., R.H. and K.T. All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding.

Institutional Review Board Statement

This study was approved by the Human Subjects Research Committee at Western Washington University on 2 February 2023.

Informed Consent Statement

Informed consent was obtained from all subjects involved in the study.

Data Availability Statement

The data presented in this study are available upon request from the corresponding author.

Acknowledgments

We thank the participants for participating in the study.

Conflicts of Interest

Mr. Thai D. Ngo and Mr. Cuong Nguyen are affiliated to Tue Lam Co., Ltd., Ho Chi Minh City, Vietnam. The authors declare no conflict of interest.

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Table 1. Correlations among variables.
Table 1. Correlations among variables.
Variable12345678910111213141516
1. Gender —
2. Age0.04—
3. Education0.08−0.27 b—
4. Number people live with0.020.15 b−0.12 a—
5. Stigma experience−0.21 b−0.040.050.07—
6. Minimize threat−0.20 b−0.09−0.010.070.51 b—
7. Personal characteristic & support−0.13 a−0.31 b0.16 b−0.020.53 b0.43 b—
8. Energy−0.17 b−0.15 b0.040.050.60 b0.53 b0.62 b—
9. Basic survival0.05−0.25 b0.16 b−0.10 a0.31 b0.29 b0.62 b0.43 b—
10. Know people, COVID−0.060.06−0.05−0.06−0.070.00−0.07−0.070.00—
11. Know people, severely ill 0.07−0.020.020.050.00−0.10−0.03−0.070.000.34 b—
12. Know people, died0.000.040.080.060.07−0.18 b−0.01−0.050.000.12 a0.40 b—
13. Personal susceptibility to illness0.020.12 a−0.03−0.090.43 b0.36 b0.37 b0.35 b0.25 b0.060.05−0.03—
14. Fear of COVID0.11 a0.18 b0.18 b0.000.43 b0.30 b0.28 b0.24 b0.23 b0.040.11 a−0.030.54 b—
15. Self-protective behaviors0.100.12 a0.12 a−0.050.060.080.11 a0.030.17 b0.10 a0.09−0.080.31 b0.41 b
16. Post-traumatic stress−0.04−0.14 b−0.080.050.64 b0.45 b0.69 b0.56 b0.47 b−0.050.030.020.54 b0.46 b0.23 b
17. Vaccine effectivenesss−0.040.17 b−0.060.000.14 a0.09−0.08−0.04−0.070.040.01−0.050.18 b0.070.19 b0.4
Note: a = p < 0.05. b = p < 0.01.
Table 2. Predicting post-traumatic stress and belief in vaccine effectiveness during the COVID-19 pandemic in Vietnam.
Table 2. Predicting post-traumatic stress and belief in vaccine effectiveness during the COVID-19 pandemic in Vietnam.
Post-Traumatic StressVaccine Effectiveness
VariableMSDBSE BβAdj. R2BSE BβAdj. R2
Post-traumatic Stress2.400.97
Belief in Vaccine Effectiveness3.502.35
Step 1: Demographics 0.01 0.11 d
 Gender 0.650.48−0.030.11−0.02 −0.090.14−0.04
 Age28.4913.23−0.010.00−0.09 0.030.000.34 d
 Education4.140.900.080.060.08 −0.070.07−0.05
 Number People Live With4.571.960.020.030.05 −0.030.03−0.05
Step 2: Location Type 0.03 b 0.11
Step 3: Stigma 0.43 d 0.12 a
 Experience2.201.010.530.050.57 d 0.140.080.12 a
 Minimize Threat1.880.910.190.050.17 c 0.020.090.02
Step 4: Resource Loss 0.57 d 0.13
 Personal Characteristic and Support2.321.020.410.050.43 d −0.060.10−0.05
 Energy1.830.940.030.050.03 −0.150.10−0.11
 Basic Survival2.720.990.060.050.06 0.110.090.08
Step 5: Illness Concerns 0.61 d 0.13
 Know People Who Contracted COVID23.8646.680.000.00−0.04 0.000.000.07
 Know People Severely Ill due to COVID4.4310.200.000.000.03 0.010.010.08
 Know People Died due to COVID0.641.540.020.030.03 −0.100.05−0.13 a
 Personal Susceptibility to Illness2.551.190.130.040.16 d 0.010.070.01
 Fear of COVID3.021.080.110.040.13 c 0.010.080.01
Step 6: Self-protective Behaviors3.820.96 0.61 0.18 d
Note: a = p < 0.054, b = p < 0.05, c = p < 0.01, d = p < 0.001. B = unstandardized beta. SE B = standard error for the unstandardized beta. Β = standardized beta. Adj. R2 = adjusted R-squared.
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Sattler, D.N.; Ngo, T.D.; Ngo, J.; Nguyen, C.; Sattler, M.; Kulshum, A.; Fernandez, M.; Hackler, R.; Tran, K. COVID-19 Stigma and Resource Loss: Predicting Post-Traumatic Stress and Vaccine Support in Vietnam. COVID 2025, 5, 33. https://doi.org/10.3390/covid5030033

AMA Style

Sattler DN, Ngo TD, Ngo J, Nguyen C, Sattler M, Kulshum A, Fernandez M, Hackler R, Tran K. COVID-19 Stigma and Resource Loss: Predicting Post-Traumatic Stress and Vaccine Support in Vietnam. COVID. 2025; 5(3):33. https://doi.org/10.3390/covid5030033

Chicago/Turabian Style

Sattler, David N., Thai D. Ngo, Jennifer Ngo, Cuong Nguyen, Mehnaaz Sattler, Ammaarah Kulshum, Marisa Fernandez, Ruth Hackler, and Karlena Tran. 2025. "COVID-19 Stigma and Resource Loss: Predicting Post-Traumatic Stress and Vaccine Support in Vietnam" COVID 5, no. 3: 33. https://doi.org/10.3390/covid5030033

APA Style

Sattler, D. N., Ngo, T. D., Ngo, J., Nguyen, C., Sattler, M., Kulshum, A., Fernandez, M., Hackler, R., & Tran, K. (2025). COVID-19 Stigma and Resource Loss: Predicting Post-Traumatic Stress and Vaccine Support in Vietnam. COVID, 5(3), 33. https://doi.org/10.3390/covid5030033

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