Special Issue "Vaccines: Uptake and Equity in Times of the COVID-19 Pandemic"

A special issue of Vaccines (ISSN 2076-393X). This special issue belongs to the section "COVID-19 Vaccines and Vaccination".

Deadline for manuscript submissions: 30 November 2021.

Special Issue Editor

Prof. Dr. Barbara Rath
E-Mail Website
Guest Editor
Department of Public Health, Vienna Vaccine Safety Initiative, Berlin, Germany
Interests: vaccine safety; vaccine communication and education; influenza and other respiratory viruses; pediatric infectious diseases

Special Issue Information

Dear Colleagues,

As societies and, more specifically, healthcare delivery systems have reorganized and adapted during the COVID-19 pandemic, there has been a de-emphasis in many important healthcare activities, including routine life-course immunizations. Childhood and booster immunizations have been disrupted or delayed in some instances. Drops in vaccination rates risk long-term consequences, and it is possible that loss of vaccine protection may disproportionately impact vulnerable and disadvantaged populations.  

It is unclear at this moment whether measures to improve vaccine uptake prior to the COVID-19 pandemic will now be sustained or whether they need to be adjusted. At the same time, vaccine providers need to familiarize themselves with the best ways to generate catch-up programs and new ways to serve their communities in these unprecedented times.

With procurement mechanisms evolving around pandemic vaccines—including vaccines still in development to protect from SARS-CoV2—new questions will arise around scalability, equity, and access. These considerations will add to the existing challenges in vaccine uptake.

Experts disagree on the impact of a prospective pandemic vaccine on overall vaccine acceptance in the wider community. At the same time, simultaneous improvements in diagnostics, antibody treatments, and antivirals may also influence the sense of urgency to vaccinate.

This Special Issue invites subject matter experts on vaccines, public health, bioethics, vaccine research and development, anthropology, global health, risk analysis, economics, clinical medicine, basic science, and information technology to weigh in on this timely topic. We seek original manuscripts, reviews, position papers, and contributions from basic and clinical science, modeling/epidemiology, and the humanities that will provide novel ideas and scientific evidence to this important discussion. Lessons learned from the past and current health crises for pandemic preparedness in the future should also be considered.

Prof. Dr. Barbara Rath
Editorial Board Member

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Vaccines is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2000 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Vaccines
  • pandemic preparedness
  • COVID-19
  • SARS-CoV2
  • influenza
  • Ebola
  • HIV/AIDS
  • antiviral therapy
  • epidemic
  • antibodies
  • vaccine confidence
  • risk communication
  • vaccine hesitancy
  • public health
  • modeling

Published Papers (17 papers)

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Research

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Article
Disparities in COVID-19 Vaccination among Low-, Middle-, and High-Income Countries: The Mediating Role of Vaccination Policy
Vaccines 2021, 9(8), 905; https://doi.org/10.3390/vaccines9080905 - 14 Aug 2021
Viewed by 629
Abstract
Inequity in the access to and deployment of the coronavirus disease 2019 (COVID-19) vaccines has brought about great challenges in terms of resolving the pandemic. Aiming to analyze the association between country income level and COVID-19 vaccination coverage and explore the mediating role [...] Read more.
Inequity in the access to and deployment of the coronavirus disease 2019 (COVID-19) vaccines has brought about great challenges in terms of resolving the pandemic. Aiming to analyze the association between country income level and COVID-19 vaccination coverage and explore the mediating role of vaccination policy, we conducted a cross-sectional ecological study. The dependent variable was COVID-19 vaccination coverage in 138 countries as of May 31, 2021. A single-mediator model based on structural equation modeling was developed to analyze mediation effects in different country income groups. Compared with high-income countries, upper-middle- (β = −1.44, 95% CI: −1.86–−1.02, p < 0.001), lower-middle- (β = −2.24, 95% CI: −2.67–−1.82, p < 0.001), and low- (β = −4.05, 95% CI: −4.59–−3.51, p < 0.001) income countries had lower vaccination coverage. Vaccination policies mediated 14.6% and 15.6% of the effect in upper-middle- (β = −0.21, 95% CI: −0.39–−0.03, p = 0.020) and lower-middle- (β = −0.35, 95% CI: −0.56–−0.13, p = 0.002) income countries, respectively, whereas the mediation effect was not significant in low-income countries (β = −0.21, 95% CI: −0.43–0.01, p = 0.062). The results were similar after adjusting for demographic structure and underlying health conditions. Income disparity remains an important cause of vaccine inequity, and the tendency toward “vaccine nationalism” restricts the functioning of the global vaccine allocation framework. Stronger mechanisms are needed to foster countries’ political will to promote vaccine equity. Full article
(This article belongs to the Special Issue Vaccines: Uptake and Equity in Times of the COVID-19 Pandemic)
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Article
The Long and Winding Road: Uptake, Acceptability, and Potential Influencing Factors of COVID-19 Vaccination in Austria
Vaccines 2021, 9(7), 790; https://doi.org/10.3390/vaccines9070790 - 15 Jul 2021
Viewed by 1194
Abstract
Acceptance of the COVID-19 vaccine will play a crucial role in combating the current pandemic. Vaccine rollouts have started in most countries. To reach the desirable vaccine coverage and to enhance its uptake, it is imperative to assess vaccine hesitancy. Methods: To assess [...] Read more.
Acceptance of the COVID-19 vaccine will play a crucial role in combating the current pandemic. Vaccine rollouts have started in most countries. To reach the desirable vaccine coverage and to enhance its uptake, it is imperative to assess vaccine hesitancy. Methods: To assess the current vaccine acceptability in Austria and its influencing factors, an online survey was created and comprised fifteen questions segmented into a sociodemographic part and the acceptance and influencing factors of the approval of the COVID-19 vaccine. Results: In total, 70% of the 1350 respondents thought that the COVID-19 vaccine is an effective way to prevent and control the virus, while 13% disagreed and 17% were uncertain. Further, 71% approved the rapid development and rollout of the vaccine, while 55% were willing to accept the vaccine as soon as it became available, 18% did not want to get the vaccine, 17% wanted to delay, and 10% were already vaccinated. Conclusions: The results show a generally positive attitude towards the new COVID-19 vaccine. The doctor’s recommendation greatly influences the decision-making process, and tailored vaccine information can support a higher vaccine coverage. Full article
(This article belongs to the Special Issue Vaccines: Uptake and Equity in Times of the COVID-19 Pandemic)
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Article
Efficiency in COVID-19 Vaccination Campaigns—A Comparison across Germany’s Federal States
Vaccines 2021, 9(7), 788; https://doi.org/10.3390/vaccines9070788 - 14 Jul 2021
Viewed by 682
Abstract
Vaccination programs are considered a central pillar of the efforts to stop COVID-19. However, vaccine doses are scarce and several organizational and logistical obstacles, such as the timing of and reserves for second shots and delivery failures, apparently slow down vaccination roll-outs in [...] Read more.
Vaccination programs are considered a central pillar of the efforts to stop COVID-19. However, vaccine doses are scarce and several organizational and logistical obstacles, such as the timing of and reserves for second shots and delivery failures, apparently slow down vaccination roll-outs in several countries. Moreover, it is an open question as to where vaccines are administered as efficiently as possible (vaccination centers, hospitals, doctor’s offices, pharmacists, etc.). The first aim of our study was to systematically evaluate the efficiency of a country’s vaccination campaign. The second aim was to analyze how the integration of doctors’ offices into a campaign that formerly relied only on vaccination centers affected the speed of that campaign. Using data on vaccine deliveries and vaccinations given in Germany, we find considerable differences across federal states in terms of efficiency, defined as the ability to administer the most vaccinations out of a given number of available doses. Back-of-the-envelope calculations for January to May 2021 show that vaccinations would have been 3.4–6.9% higher if all federal states had adopted a similar ratio between vaccinations given and vaccines stored, as the most efficient states did. This corresponds to 1.7–3.3% of Germany’s total population. In terms of our second research goal, we find evidence that the integration of doctors’ offices into the vaccination campaign significantly increased the ratio of vaccinations administered out of a given stock of vaccine doses. On average, there appears to be a structural break in this ratio after doctors’ offices were integrated into the vaccination campaign on 5 April 2021. On average, an additional 11.6 out of 100 available doses were administered each week compared to the period prior to that date. We conclude that there are considerable regional differences in the efficiency of the vaccination roll-out. Systematic efficiency analyses are one step to detecting inefficiencies and to identify best practices that can be adopted to eventually speed up the vaccination roll-out in a country. Full article
(This article belongs to the Special Issue Vaccines: Uptake and Equity in Times of the COVID-19 Pandemic)
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Article
Predictors of COVID-19 Vaccine Hesitancy: Socio-Demographics, Co-Morbidity, and Past Experience of Racial Discrimination
Vaccines 2021, 9(7), 767; https://doi.org/10.3390/vaccines9070767 - 09 Jul 2021
Cited by 2 | Viewed by 1772
Abstract
The goal of this study is to explore predictors of COVID-19 vaccine hesitancy, including socio-demographic factors, comorbidity, risk perception, and experience of discrimination, in a sample of the U.S. population. We used a cross-sectional online survey study design, implemented between 13–23 December 2020. [...] Read more.
The goal of this study is to explore predictors of COVID-19 vaccine hesitancy, including socio-demographic factors, comorbidity, risk perception, and experience of discrimination, in a sample of the U.S. population. We used a cross-sectional online survey study design, implemented between 13–23 December 2020. The survey was limited to respondents residing in the USA, belonging to priority groups for vaccine distribution. Responses were received from 2650 individuals (response rate 84%) from all 50 states and Puerto Rico, American Samoa, and Guam. The five most represented states were California (13%), New York (10%), Texas (7%), Florida (6%), and Pennsylvania (4%). The majority of respondents were in the age category 25–44 years (66%), male (53%), and working in the healthcare sector (61%). Most were White and non-Hispanic (66%), followed by Black and non-Hispanic (14%) and Hispanic (8%) respondents. Experience with racial discrimination was a predictor of vaccine hesitancy. Those reporting racial discrimination had 21% increased odds of being at a higher level of hesitancy compared to those who did not report such experience (OR = 1.21, 95% C.I. 1.01–1.45). Communication and logistical aspects during the COVID-19 vaccination campaign need to be sensitive to individuals’ past-experience of racial discrimination in order to increase vaccine coverage. Full article
(This article belongs to the Special Issue Vaccines: Uptake and Equity in Times of the COVID-19 Pandemic)
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Article
Willingness to Receive the COVID-19 and Seasonal Influenza Vaccines among the Saudi Population and Vaccine Uptake during the Initial Stage of the National Vaccination Campaign: A Cross-Sectional Survey
Vaccines 2021, 9(7), 765; https://doi.org/10.3390/vaccines9070765 - 08 Jul 2021
Cited by 1 | Viewed by 696
Abstract
This study aimed to assess the willingness to receive the coronavirus disease 2019 (COVID-19) and seasonal influenza vaccines and vaccine uptake during the early stage of the national vaccination campaign in Saudi Arabia. A cross-sectional online survey was conducted among adult Saudis between [...] Read more.
This study aimed to assess the willingness to receive the coronavirus disease 2019 (COVID-19) and seasonal influenza vaccines and vaccine uptake during the early stage of the national vaccination campaign in Saudi Arabia. A cross-sectional online survey was conducted among adult Saudis between 20 January and 20 March 2021. The questionnaire addressed vaccine hesitancy, perceived risk, willingness, and vaccine uptake. Approximately 39% of the participants expressed vaccine hesitancy, and 29.8% and 24% felt highly vulnerable to contracting COVID-19 and seasonal influenza, respectively. The majority (59.5%) were willing to receive the COVID-19 vaccine, although only 31.7% were willing to receive the flu vaccine. Adjusted analysis showed that vaccine hesitancy (OR 0.34, 95% CI 0.27–0.43) and the perception of being at high risk (OR 2.78, 95% CI 1.68–4.60) independently affected the intention to be vaccinated. Vaccine hesitancy was similar among those who were willing to be vaccinated (29.8%) and those who had already been vaccinated (33.1%). The perceived risk was significantly higher among those who had been vaccinated (48.1%) than among those who were willing to be vaccinated but had not yet been vaccinated (29.1%). In conclusion, the acceptance of the COVID-19 vaccine in Saudi Arabia is high. Saudis who received the vaccine had a similar level of vaccine hesitancy and a higher level of perceived risk. Full article
(This article belongs to the Special Issue Vaccines: Uptake and Equity in Times of the COVID-19 Pandemic)
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Article
Antivaccine Movement and COVID-19 Negationism: A Content Analysis of Spanish-Written Messages on Twitter
Vaccines 2021, 9(6), 656; https://doi.org/10.3390/vaccines9060656 - 15 Jun 2021
Cited by 2 | Viewed by 1086
Abstract
During the COVID-19 pandemic, different conspiracies have risen, with the most dangerous being those focusing on vaccines. Today, there exists a social media movement focused on destroying the credibility of vaccines and trying to convince people to ignore the advice of governments and [...] Read more.
During the COVID-19 pandemic, different conspiracies have risen, with the most dangerous being those focusing on vaccines. Today, there exists a social media movement focused on destroying the credibility of vaccines and trying to convince people to ignore the advice of governments and health organizations on vaccination. Our aim was to analyze a COVID-19 antivaccination message campaign on Twitter that uses Spanish as the main language, to find the key elements in their communication strategy. Twitter data were retrieved from 14 to 28 December using NodeXL software. We analyzed tweets in Spanish, focusing on influential users, most influential tweets, and content analysis of tweets. The results revealed ordinary citizens who ‘offer the truth’ as the most important profile in this network. The content analysis showed antivaccine tweets (31.05%) as the most frequent. The analysis of anti-COVID19 tweets showed that attacks against vaccine safety were the most important (79.87%) but we detected a new kind of message presenting the vaccine as a means of manipulating the human genetic code (8.1%). We concluded that the antivaccine movement and its tenets have great influence in the COVID-19 negationist movement. We observed a new topic in COVID-19 vaccine hoaxes that must be considered in our fight against misinformation. Full article
(This article belongs to the Special Issue Vaccines: Uptake and Equity in Times of the COVID-19 Pandemic)
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Article
Hesitancy towards COVID-19 Vaccination among Healthcare Workers: A Multi-Centric Survey in France
Vaccines 2021, 9(6), 547; https://doi.org/10.3390/vaccines9060547 - 22 May 2021
Cited by 4 | Viewed by 1623
Abstract
Vaccination programs against COVID-19 are being scaled up. We aimed to assess the effects of vaccine characteristics on vaccine hesitancy among healthcare workers in a multi-center survey conducted within French healthcare facilities from 1 December 2020 to 26 March 2021. We invited any [...] Read more.
Vaccination programs against COVID-19 are being scaled up. We aimed to assess the effects of vaccine characteristics on vaccine hesitancy among healthcare workers in a multi-center survey conducted within French healthcare facilities from 1 December 2020 to 26 March 2021. We invited any healthcare workers naïve of COVID-19 vaccination to complete an online self-questionnaire. They reported on their socio-demographic characteristics, as well as their perception and beliefs towards vaccination. We measured their willingness to get vaccinated in eight scenarios for candidates’ vaccines presented sequentially (1 to 4-point scale). Candidates’ vaccines varied for efficacy (25%, 50%, 100%), length of immunization (1 year or lifetime), frequency (<1/100, <1/10,000), and severity (none, moderate, severe) of adverse events. We analyzed 4349 healthcare workers’ responses with interpretable questionnaires. The crude willingness to get vaccinated was 53.2% and increased over time. We clustered the trajectories of responses using an unsupervised classification algorithm (k-means) and identified four groups of healthcare workers: those willing to get vaccinated in any scenario (18%), those not willing to get vaccinated at all (22%), and those hesitating but more likely to accept (32%) or reject (28%) the vaccination depending on the scenario. In these last two subgroups, vaccine acceptance was growing with age, educational background and was higher among men with condition. Compared to an ideal vaccine candidate, a 50% reduced efficacy resulted in an average drop in acceptance by 0.8 (SD ± 0.8, −23.5%), while it was ranging from 1.4 (SD ± 1.0, −38.4%) to 2.1 (SD ± 1.0, −58.4%) in case of severe but rare adverse event. The acceptance of a mandatory immunization program was 29.6% overall and was positively correlated to the willingness to get vaccinated, ranging from 2.4% to 60.0%. Even if healthcare workers represent a heterogeneous population, most (80%) could accept the vaccination against COVID-19. Their willingness to get the vaccine increased over time and as immunization programs became available. Among hesitant professionals, the fear of adverse events was the main concern. Targeted information campaigns reassuring about adverse events may increase vaccine coverage, in a population with a strong opinion about mandatory immunization programs. Full article
(This article belongs to the Special Issue Vaccines: Uptake and Equity in Times of the COVID-19 Pandemic)
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Article
What Arguments against COVID-19 Vaccines Run on Facebook in Poland: Content Analysis of Comments
Vaccines 2021, 9(5), 481; https://doi.org/10.3390/vaccines9050481 - 10 May 2021
Cited by 2 | Viewed by 4999
Abstract
Social media allow anti-vaxxers to quickly spread misinformation and false statements. This situation may lead to an increase in vaccine hesitancy. We wanted to characterize what arguments against COVID-19 vaccines run on Facebook in Poland. We analyzed Facebook comments related to the five [...] Read more.
Social media allow anti-vaxxers to quickly spread misinformation and false statements. This situation may lead to an increase in vaccine hesitancy. We wanted to characterize what arguments against COVID-19 vaccines run on Facebook in Poland. We analyzed Facebook comments related to the five events of the introduction of COVID-19 vaccines—announcements of the efficacy of the Pfizer-BioNTech (09.11.2020), Moderna (16.11.2020), and AstraZeneca (23.11.2020) vaccines, registration of the Pfizer-BioNTech vaccine by the European Medicines Agency (21.12.2020), and the first vaccination in Poland (27.12.2020). We collected the comments from fanpages of the biggest Polish media and then established their main anti-vaccine themes. We found that the negative arguments about COVID-19 vaccines can be divided into 12 categories. Seven of them are universal and also apply to other vaccines but five are new and COVID-19’ specific. The frequency of arguments from a given category varied over time. We also noticed that, while the comments were mostly negative, the reactions were positive. Created codebook of anti-vaccine COVID-19 arguments can be used to monitor the attitude of society towards COVID-19 vaccines. Real-time monitoring of social media is important because the popularity of certain arguments on Facebook changes rapidly over time. Full article
(This article belongs to the Special Issue Vaccines: Uptake and Equity in Times of the COVID-19 Pandemic)
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Article
COVID-19 Vaccination Intent and Willingness to Pay in Bangladesh: A Cross-Sectional Study
Vaccines 2021, 9(5), 416; https://doi.org/10.3390/vaccines9050416 - 21 Apr 2021
Cited by 9 | Viewed by 1913
Abstract
This article reports the intent to receive a SARS-COV-2 vaccine, its predictors and willingness to pay in Bangladesh. We carried out an online cross-sectional survey of 697 adults from the general population of Bangladesh in January 2021. A structured questionnaire was used to [...] Read more.
This article reports the intent to receive a SARS-COV-2 vaccine, its predictors and willingness to pay in Bangladesh. We carried out an online cross-sectional survey of 697 adults from the general population of Bangladesh in January 2021. A structured questionnaire was used to assess vaccination intent. The questionnaire included sociodemographic variables and health belief model constructs which may predict vaccination intent. Among the participants, 26% demonstrated a definite intent, 43% probable intent, 24% probable negative, and 7% a definite negative intention. Multivariable logistic regression analyses suggest an association between definite intent and previous COVID-19 infection (OR: 2.86; 95% CI: 1.71–4.78), perceiving COVID-19 as serious (OR: 1.93; 1.04–3.59), the belief that vaccination would make them feel less worried about catching COVID-19 (OR: 4.42; 2.25–8.68), and concerns about vaccine affordability (OR: 1.51; 1.01–2.25). Individuals afraid of the side effects (OR: 0.34; 0.21–0.53) and those who would take the vaccine if the vaccine were taken by many others (OR: 0.44; 0.29–0.67) are less likely to have a definite intent. A definite negative intent is associated with the concern that the vaccine may not be halal (OR: 2.03; 1.04–3.96). Furthermore, 68.4% are willing to pay for the vaccine. The median amount that they are willing to pay is USD 7.08. The study findings reveal that the definite intent to receive the SARS-CoV-2 vaccination among the general population varies depending on their COVID-19-related health beliefs and no significant association was found with sociodemographic variables. Full article
(This article belongs to the Special Issue Vaccines: Uptake and Equity in Times of the COVID-19 Pandemic)
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Article
Willingness of Taiwan’s Healthcare Workers and Outpatients to Vaccinate against COVID-19 during a Period without Community Outbreaks
Vaccines 2021, 9(3), 246; https://doi.org/10.3390/vaccines9030246 - 12 Mar 2021
Cited by 16 | Viewed by 1934
Abstract
To control the spread of the novel coronavirus disease 2019 (COVID-19), COVID-19 vaccination has been quickly developed. However, the COVID-19 pandemic will not be controlled if the COVID-19 vaccination uptake willingness is low. Therefore, the study aim was to explore the COVID-19 vaccination [...] Read more.
To control the spread of the novel coronavirus disease 2019 (COVID-19), COVID-19 vaccination has been quickly developed. However, the COVID-19 pandemic will not be controlled if the COVID-19 vaccination uptake willingness is low. Therefore, the study aim was to explore the COVID-19 vaccination uptake willingness among the outpatient population and healthcare workers in Taiwan during the worldwide pandemic period without community outbreaks. A cross-sectional survey was conducted among healthcare workers (HCWs; n = 500; mean age = 32.96 years) of National Cheng Kung University Hospital (NCKUH) and outpatients (n = 238; mean age = 34.43 years) arriving at NCKUH. We used an online survey conducted between September 24 and 21 November 2020, for healthcare workers, and between 27 October and 31 December 2020, for the outpatient sample. Information regarding willingness to receive vaccination, willingness to rapid test, fear of COVID-19, risk perception, and preventive behaviors was collected in both samples; information regarding willingness to care for patients was collected in healthcare workers. Willingness to receive vaccination was the main variable in the present study; willingness to rapid test, willingness to care for patients, fear of COVID-19, risk perception, and preventive behaviors were the secondary variables in the study. The factors associated with vaccination willingness were identified through logistic regression analysis. The participants’ willingness to receive vaccination was low for both healthcare workers (23.4%) and the outpatient sample (30.7%). Similarly, their willingness to take rapid tests was low (23.6% for healthcare workers and 28.6% for outpatient sample). Risk perception (crude odds ratio (COR) = 1.29; 95% confidence interval (CI) = 1.03, 1.63), willingness to take rapid test (COR = 9.24; 95% CI = 5.76, 14.83), and preventive COVID-19 infection behaviors (COR = 2.32; 95% CI = 1.52, 3.56) were significant factors explaining the healthcare workers’ willingness to receive vaccination. Willingness to take a rapid test (COR = 8.91; 95% CI = 4.71, 16.87) and preventive COVID-19 infection behaviors (COR = 1.69; 95% CI = 1.09, 2.60) were significant factors explaining the outpatient sample’s willingness to receive vaccination. Willingness to vaccinate against COVID-19 among HCWs and outpatients is low due to the relatively safe status of COVID-19 infection in Taiwan. These findings can help policymakers advocate for the effectiveness of and provide transparent information on COVID-19 vaccination uptake in a country/region with a relatively safe COVID-19 outbreak status. Full article
(This article belongs to the Special Issue Vaccines: Uptake and Equity in Times of the COVID-19 Pandemic)
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Article
COVID-19 Vaccine Acceptance among Health Care Workers in the United States
Vaccines 2021, 9(2), 119; https://doi.org/10.3390/vaccines9020119 - 03 Feb 2021
Cited by 67 | Viewed by 10054
Abstract
Background: Acceptance of the COVID-19 vaccine will play a major role in combating the pandemic. Healthcare workers (HCWs) are among the first group to receive vaccination, so it is important to consider their attitudes about COVID-19 vaccination to better address barriers to widespread [...] Read more.
Background: Acceptance of the COVID-19 vaccine will play a major role in combating the pandemic. Healthcare workers (HCWs) are among the first group to receive vaccination, so it is important to consider their attitudes about COVID-19 vaccination to better address barriers to widespread vaccination acceptance. Methods: We conducted a cross sectional study to assess the attitude of HCWs toward COVID-19 vaccination. Data were collected between 7 October and 9 November 2020. We received 4080 responses out of which 3479 were complete responses and were included in the final analysis. Results: 36% of respondents were willing to take the vaccine as soon as it became available while 56% were not sure or would wait to review more data. Only 8% of HCWs do not plan to get vaccine. Vaccine acceptance increased with increasing age, education, and income level. A smaller percentage of female (31%), Black (19%), Lantinx (30%), and rural (26%) HCWs were willing to take the vaccine as soon as it became available than the overall study population. Direct medical care providers had higher vaccine acceptance (49%). Safety (69%), effectiveness (69%), and speed of development/approval (74%) were noted as the most common concerns regarding COVID-19 vaccination in our survey. Full article
(This article belongs to the Special Issue Vaccines: Uptake and Equity in Times of the COVID-19 Pandemic)
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Article
Vaccination Criteria Based on Factors Influencing COVID-19 Diffusion and Mortality
Vaccines 2020, 8(4), 766; https://doi.org/10.3390/vaccines8040766 - 15 Dec 2020
Cited by 2 | Viewed by 1714
Abstract
SARS-CoV-2 is highly contagious, rapidly turned into a pandemic, and is causing a relevant number of critical to severe life-threatening COVID-19 patients. However, robust statistical studies of a large cohort of patients, potentially useful to implement a vaccination campaign, are rare. We analyzed [...] Read more.
SARS-CoV-2 is highly contagious, rapidly turned into a pandemic, and is causing a relevant number of critical to severe life-threatening COVID-19 patients. However, robust statistical studies of a large cohort of patients, potentially useful to implement a vaccination campaign, are rare. We analyzed public data of about 19,000 patients for the period 28 February to 15 May 2020 by several mathematical methods. Precisely, we describe the COVID-19 evolution of a number of variables that include age, gender, patient’s care location, and comorbidities. It prompts consideration of special preventive and therapeutic measures for subjects more prone to developing life-threatening conditions while affording quantitative parameters for predicting the effects of an outburst of the pandemic on public health structures and facilities adopted in response. We propose a mathematical way to use these results as a powerful tool to face the pandemic and implement a mass vaccination campaign. This is done by means of priority criteria based on the influence of the considered variables on the probability of both death and infection. Full article
(This article belongs to the Special Issue Vaccines: Uptake and Equity in Times of the COVID-19 Pandemic)
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Article
Is a COVID-19 Vaccine Likely to Make Things Worse?
Vaccines 2020, 8(4), 761; https://doi.org/10.3390/vaccines8040761 - 14 Dec 2020
Cited by 3 | Viewed by 2879
Abstract
In order to limit the disease burden and economic costs associated with the COVID-19 pandemic, it is important to understand how effective and widely distributed a vaccine must be in order to have a beneficial impact on public health. To evaluate the potential [...] Read more.
In order to limit the disease burden and economic costs associated with the COVID-19 pandemic, it is important to understand how effective and widely distributed a vaccine must be in order to have a beneficial impact on public health. To evaluate the potential effect of a vaccine, we developed risk equations for the daily risk of COVID-19 infection both currently and after a vaccine becomes available. Our risk equations account for the basic transmission probability of COVID-19 (β) and the lowered risk due to various protection options: physical distancing; face coverings such as masks, goggles, face shields or other medical equipment; handwashing; and vaccination. We found that the outcome depends significantly on the degree of vaccine uptake: if uptake is higher than 80%, then the daily risk can be cut by 50% or more. However, if less than 40% of people get vaccinated and other protection options are abandoned—as may well happen in the wake of a COVID-19 vaccine—then introducing even an excellent vaccine will produce a worse outcome than our current situation. It is thus critical that effective education strategies are employed in tandem with vaccine rollout. Full article
(This article belongs to the Special Issue Vaccines: Uptake and Equity in Times of the COVID-19 Pandemic)
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Review

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Review
COVID-19 Vaccine Donations—Vaccine Empathy or Vaccine Diplomacy? A Narrative Literature Review
Vaccines 2021, 9(9), 1024; https://doi.org/10.3390/vaccines9091024 - 15 Sep 2021
Viewed by 558
Abstract
Introduction: Vaccine inequality inflames the COVID-19 pandemic. Ensuring equitable immunization, vaccine empathy is needed to boost vaccine donations among capable countries. However, damaging narratives built around vaccine donations such as “vaccine diplomacy” could undermine nations’ willingness to donate their vaccines, which, in turn, [...] Read more.
Introduction: Vaccine inequality inflames the COVID-19 pandemic. Ensuring equitable immunization, vaccine empathy is needed to boost vaccine donations among capable countries. However, damaging narratives built around vaccine donations such as “vaccine diplomacy” could undermine nations’ willingness to donate their vaccines, which, in turn, further exacerbate global vaccine inequality. However, while discussions on vaccine diplomacy are on the rise, there is limited research related to vaccine diplomacy, especially in terms of its characteristics and effects on vaccine distribution vis-à-vis vaccine empathy. Thus, to bridge the research gap, this study aims to examine the defining attributes of vaccine diplomacy and its potential effects on COVID-19 immunization, particularly in light of vaccine empathy. Methods: A narrative review was conducted to shed light on vaccine diplomacy’s defining attributes and effects in the context of COVID-19 vaccine distribution and dissemination. Databases such as PubMed and Medline were utilized for literature search. Additionally, to ensure up-to-date insights are included in the review, validated reports and reverse tracing of eligible articles’ reference lists in Google Scholar have also been conducted to locate relevant records. Results: Vaccine empathy is an individual or a nation’s capability to sympathize with other individuals or nations’ vaccine wants and needs, whereas vaccine diplomacy is a nation’s vaccine efforts that aim to build mutually beneficial relationships with other nations ultimately. Our findings show that while both vaccine empathy and vaccine diplomacy have their strengths and weaknesses, they all have great potential to improve vaccine equality, particularly amid fast-developing and ever-evolving global health crises such as COVID-19. Furthermore, analyses show that, compared to vaccine empathy, vaccine diplomacy might be a more sustainable solution to improve vaccine donations mainly because of its deeper and stronger roots in multilateral collaboration and cooperation. Conclusion: Similar to penicillin, automated external defibrillators, or safety belts amid a roaring global health disaster, COVID-19 vaccines are, essentially, life-saving consumer health products that should be available to those who need them. Though man-made and complicated, vaccine inequality is nonetheless a solvable issue—gaps in vaccine distribution and dissemination can be effectively addressed by timely vaccine donations. Overall, our study underscores the instrumental and indispensable role of vaccine diplomacy in addressing the vaccine inequality issue amid the COVID-19 pandemic and its potentials for making even greater contributions in forging global solidarity amid international health emergencies. Future research could investigate approaches that could further inspire and improve vaccine donations among capable nations at a global scale to advance vaccine equity further. Full article
(This article belongs to the Special Issue Vaccines: Uptake and Equity in Times of the COVID-19 Pandemic)
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Review
COVID-19 Vaccine Hesitancy—A Scoping Review of Literature in High-Income Countries
Vaccines 2021, 9(8), 900; https://doi.org/10.3390/vaccines9080900 - 13 Aug 2021
Cited by 2 | Viewed by 1727
Abstract
Vaccine hesitancy forms a critical barrier to the uptake of COVID-19 vaccine in high-income countries or regions. This review aims to summarize rates of COVID-19 hesitancy and its determinants in high-income countries or regions. A scoping review was conducted in Medline®, [...] Read more.
Vaccine hesitancy forms a critical barrier to the uptake of COVID-19 vaccine in high-income countries or regions. This review aims to summarize rates of COVID-19 hesitancy and its determinants in high-income countries or regions. A scoping review was conducted in Medline®, Embase®, CINAHL®, and Scopus® and was reported in accordance with the PRISMA-SCr checklist. The search was current as of March 2021. Studies which evaluated COVID-19 vaccine hesitancy and its determinants in high-income countries (US$12,536 or more GNI per capita in 2019) were included. Studies conducted in low, lower-middle, and upper-middle income countries or regions were excluded. Factors associated with vaccine hesitancy were grouped into four themes (vaccine specific, individual, group, or contextual related factors). Of 2237 articles retrieved, 97 articles were included in this review. Most studies were conducted in U.S. (n = 39) and Italy (n = 9). The rates of vaccine hesitancy across high-income countries or regions ranged from 7–77.9%. 46 studies (47.4%) had rates of 30% and more. Younger age, females, not being of white ethnicity and lower education were common contextual factors associated with increased vaccine hesitancy. Lack of recent history of influenza vaccination, lower self-perceived risk of contracting COVID-19, lesser fear of COVID-19, believing that COVID-19 is not severe and not having chronic medical conditions were most frequently studied individual/group factors associated with increased vaccine hesitancy. Common vaccine-specific factors associated with increased vaccine hesitancy included beliefs that vaccine are not safe/effective and increased concerns about rapid development of COVID-19 vaccines. Given the heterogeneity in vaccine hesitancy definitions used across studies, there is a need for standardization in its assessment. This review has summarized COVID-19 vaccine hesitancy determinants that national policymakers can use when formulating health policies related to COVID-19 vaccination. Full article
(This article belongs to the Special Issue Vaccines: Uptake and Equity in Times of the COVID-19 Pandemic)
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Review
Current State of the First COVID-19 Vaccines
Vaccines 2021, 9(1), 30; https://doi.org/10.3390/vaccines9010030 - 08 Jan 2021
Cited by 17 | Viewed by 6167
Abstract
SARS CoV-2 and its associated disease COVID-19 has devastated the world during 2020. Masks and social distancing could be efficient if done by large proportions of the population, but pandemic fatigue has decreased their efficacy. Economic shut downs come with large price tags [...] Read more.
SARS CoV-2 and its associated disease COVID-19 has devastated the world during 2020. Masks and social distancing could be efficient if done by large proportions of the population, but pandemic fatigue has decreased their efficacy. Economic shut downs come with large price tags and cannot be a long term solution either. The announcements by three vaccine manufacturers in November that their vaccines are 90% or more effective has given hope to at least those in the population who plan to get vaccinated as soon as a scientifically and medically sound vaccine becomes available. This review summarizes the underlying design strategies and current status of development of the nine vaccines that were in phase III trial on 8 November 2020. Contracts between vaccine manufacturing companies and governments aim at distributing the vaccine to a large part of the world population. Questions remain how the temperature sensitive mRNA vaccines will be transported and/or stored and how vaccination will be prioritized within each country. Additionally, current contracts do not cover all countries, with a serious gap in Africa and South America. The second part of this review will detail current distribution plans and remaining challenges with vaccine accessibility and acceptance. Full article
(This article belongs to the Special Issue Vaccines: Uptake and Equity in Times of the COVID-19 Pandemic)
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Project Report
Changing Attitudes toward the COVID-19 Vaccine among North Carolina Participants in the COVID-19 Community Research Partnership
Vaccines 2021, 9(8), 916; https://doi.org/10.3390/vaccines9080916 - 17 Aug 2021
Viewed by 620
Abstract
Coronavirus Disease-2019 (COVID-19) vaccine acceptance is variable. We surveyed participants in the COVID-19 Community Research Partnership from 17 December 2020 to 13 January 2021 to assess vaccine receptiveness. Vaccine uptake was then monitored until 15 May 2021; 20,232 participants responded to the receptiveness [...] Read more.
Coronavirus Disease-2019 (COVID-19) vaccine acceptance is variable. We surveyed participants in the COVID-19 Community Research Partnership from 17 December 2020 to 13 January 2021 to assess vaccine receptiveness. Vaccine uptake was then monitored until 15 May 2021; 20,232 participants responded to the receptiveness survey with vaccination status accessed in 18,874 participants via daily follow-up surveys (participants not completing daily surveys ≥30 days to 15 May 2021, were excluded). In the initial survey, 4802 (23.8%) were vaccine hesitant. Hesitancy was most apparent in women (Adjusted RR 0.93, p < 0.001), Black Americans (Adjusted RR 1.39, 1.41, 1.31 to non-Hispanic Whites, Other, and Hispanic or Latino, respectively p < 0.001), healthcare workers (Adjusted RR 0.93, p < 0.001), suburbanites (ref. Urban Adjusted RR 0.85, 0.90 to urban and rural dwellers, respectively, p < 0.01), and those previously diagnosed with COVID-19 (RR 1.20, p < 0.01). Those <50 years were also less accepting of vaccination. Subsequent vaccine uptake was 99% in non-hesitant participants. For those who were unsure, preferred not to answer, or answered “no”, vaccination rates were 80% (Adjusted RR 0.86, p < 0.0001), 78% (Adjusted RR 0.83, p < 0.0001), and 52.7% (Adjusted RR 0.65, p < 0.0001), respectively. These findings suggest that initial intent did not correlate with vaccine uptake in our cohort. Full article
(This article belongs to the Special Issue Vaccines: Uptake and Equity in Times of the COVID-19 Pandemic)
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