Special Issue "COVID-19 Vaccine Acceptance and Uptake: Insights from Behavioural and Social Sciences"

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

Deadline for manuscript submissions: 31 January 2023 | Viewed by 66898

Special Issue Information

Dear Colleagues,

It is well known that it is not enough to simply have safe and effective vaccines in order to achieve high vaccination coverage. Indeed, vaccine hesitancy is a global problem, and behavioural sciences are key to understanding, informing, and guiding research on the acceptance and uptake of COVID-19 vaccines.

This Special Issue will gather research focusing on insights from behavioural and social sciences applied to the context of COVID-19 vaccines. Theoretical contributions, reviews and meta-analyses, and original reports are all welcomed.

Example of issues of interest include (but are not limited to): interventions to promote vaccines (e.g., nudges, inoculation or pre-bunking, presumptive communication, prosocial appeals, motivational interviewing); risk perception, confidence and trust in relation to vaccine safety, vaccine acceptance and vaccine uptake; restoring confidence after vaccine pause; decision-making processing; gaps between intentions and actual behaviours; decision making in specific contexts where evidence is lacking (e.g., pregnant women); factors involved in the decision to participate in vaccine clinical trials.

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 submissions that pass pre-check are 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 2200 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

  • COVID-19 vaccine hesitancy
  • COVID-19 vaccine acceptance
  • behavioural sciences
  • social sciences
  • decision making
  • vaccine confidence
  • risk perception
  • risk communication
  • public health

Published Papers (48 papers)

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Article
The Relationship between COVID-19 Protection Behaviors and Pandemic-Related Knowledge, Perceptions, Worry Content, and Public Trust in a Turkish Sample
Vaccines 2022, 10(12), 2027; https://doi.org/10.3390/vaccines10122027 (registering DOI) - 27 Nov 2022
Viewed by 58
Abstract
Background: This study aimed to explore the effect of knowledge, COVID-19-related perceptions, and public trust on protective behaviors in Turkish people. Methods: Data were collected from an online survey (Turkish COVID-19 Snapshot Monitoring) conducted between July 2020 and January 2021. The recommended protective [...] Read more.
Background: This study aimed to explore the effect of knowledge, COVID-19-related perceptions, and public trust on protective behaviors in Turkish people. Methods: Data were collected from an online survey (Turkish COVID-19 Snapshot Monitoring) conducted between July 2020 and January 2021. The recommended protective behaviors (hand cleaning, wearing a face mask, and physical distancing) to prevent COVID-19 were examined. The impacts of the following variables on protective behaviors were investigated using logistic regression analysis: knowledge, cognitive and affective risk perception, pandemic-related worry content, public trust, conspiracy thinking, and COVID-19 vaccine willingness. Results: Out of a total of 4210 adult respondents, 13.8% reported nonadherence to protection behavior, and 86.2% reported full adherence. Males and young (aged 18–30 years) people tend to show less adherence. Perceived self-efficacy, susceptibility, and correct knowledge were positively related to more adherence to protective behavior. Perceptual and emotional factors explaining protective behavior were perceived proximity, stress level, and worrying about the relatives who depended on them. Trust in health professionals and vaccine willingness were positive predictors, while conspiracy thinking and acquiring less information (<2, daily) were negative predictors. Unexpectedly, trust in the Ministry of Health showed a weak but negative association with protection behavior. Conclusions: Perceived stress, altruistic worries, and public trust seem to shape protection behaviors in addition to individuals’ knowledge and cognitive risk perception in respondents. Males and young people may have a greater risk for nonadherence. Reliable, transparent, and culture-specific health communication that considers these issues is required. Full article
Article
“Maternal Vaccination Greatly Depends on Your Trust in the Healthcare System”: A Qualitative Study on the Acceptability of Maternal Vaccines among Pregnant Women and Healthcare Workers in Barcelona, Spain
Vaccines 2022, 10(12), 2015; https://doi.org/10.3390/vaccines10122015 (registering DOI) - 25 Nov 2022
Viewed by 150
Abstract
The World Health Organization (WHO) identified vaccine hesitancy as one of the top 10 threats to global health in 2019. Health promotion and education have been seen to improve knowledge and uptake of vaccinations in pregnancy. This qualitative study was conducted based on [...] Read more.
The World Health Organization (WHO) identified vaccine hesitancy as one of the top 10 threats to global health in 2019. Health promotion and education have been seen to improve knowledge and uptake of vaccinations in pregnancy. This qualitative study was conducted based on phenomenology, a methodological approach to understand first-hand experiences, and grounded theory, an inductive approach to analyse data, where theoretical generalisations emerge. Data were collected through semi-structured interviews with pregnant women attending antenatal care services and healthcare workers (HCWs) in Barcelona, Spain. Interviews were audio-recorded, transcribed, and coded, and notes were taken. Inductive thematic analysis was performed, and data were manually coded. Pertussis was reported as the most trusted vaccine among pregnant women due to its long-standing background as a recommended vaccine in pregnancy. The influenza vaccine was regarded as less important since it was perceived to cause mild disease. The COVID-19 vaccine was the least trustworthy for pregnant women due to uncertainties about effectiveness, health effects in the mid- and long-term, the fast development of the vaccine mRNA technology, and the perceptions of limited data on vaccine safety. However, the necessity to be vaccinated was justified by pregnant women due to the exceptional circumstances of the COVID-19 pandemic. The recommendations provided by HCW and the established relationship between the HCW, particularly midwives, and pregnant women were the main factors affecting decision-making. The role of mass media was perceived as key to helping provide reliable messages about the need for vaccines during pregnancy. Overall, vaccines administered during pregnancy were perceived as great tools associated with better health and improved quality of life. Pregnancy was envisioned as a vulnerable period in women’s lives that required risk–benefits assessments for decision-making about maternal vaccinations. A holistic approach involving the community and society was considered crucial for health education regarding maternal vaccines in support of the work conducted by HCWs. Full article
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Article
Rapid Protocol Development, Study Startup and Enrolment of a Prospective Study of COVID-19 Vaccination for Patients with Cancer: A Collaborative Approach
Vaccines 2022, 10(12), 2003; https://doi.org/10.3390/vaccines10122003 - 24 Nov 2022
Viewed by 138
Abstract
Background: COVID-19 is an unprecedented global health emergency. It has been highly disruptive for patients with cancer, both due to an increased burden of severe illness and due to pressure on healthcare systems. COVID-19 vaccination has been an important public health measure for [...] Read more.
Background: COVID-19 is an unprecedented global health emergency. It has been highly disruptive for patients with cancer, both due to an increased burden of severe illness and due to pressure on healthcare systems. COVID-19 vaccination has been an important public health measure for this patient group. Aim: The aim of this study was to describe the rapid design and startup of a multicentre study of COVID-19 vaccine response for vulnerable patients with cancer. Study startup: We set up a multicentre prospective observational study of COVID-19 vaccination response for Australian patients with cancer. Due to intensive collaboration between health services, the funding body and laboratories, we were able to develop a protocol and enrol the first patient within 52 days of the initial study proposal. Rapid startup was further enabled by prompt availability of funding and by high-level engagement of institutional review boards, allowing expedited review. Study enrolment: We rapidly enroled more than 500 patients, 80% within 4 months of study opening. Engagement and follow-up were maintained throughout the course of up to five serial vaccination doses. Conclusion: Our study is an example of intensive collaboration inspired by the COVID-19 pandemic and may serve as an example of an agile research response to real-time public health challenges. Full article
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Article
Strengthening the Link between Vaccine Predispositions and Vaccine Advocacy through Certainty
Vaccines 2022, 10(11), 1970; https://doi.org/10.3390/vaccines10111970 - 20 Nov 2022
Viewed by 277
Abstract
Background. Instruments designed to assess individual differences in predispositions towards vaccination are useful in predicting vaccination-related outcomes. Despite their importance, there is relatively little evidence regarding the conditions under which these instruments are more predictive. The current research was designed to improve the [...] Read more.
Background. Instruments designed to assess individual differences in predispositions towards vaccination are useful in predicting vaccination-related outcomes. Despite their importance, there is relatively little evidence regarding the conditions under which these instruments are more predictive. The current research was designed to improve the ability of these kinds of instruments to predict vaccination advocacy by considering the certainty associated with the responses to vaccination scales. Method. Across two studies, participants completed the Beliefs about Medicines Questionnaire BMQ scale (Study 1) or the Vaccination Attitudes Examination (VAX) scale (Study 2). The certainty participants had in their responses to each scale was either measured (Study 1) or manipulated (Study 2). Intentions to advocate in favor of vaccination served as the criterion measure in both studies. Results. As expected, the scales significantly predicted vaccination advocacy, contributing to enhancing the predictive validity of the instruments used in the studies. Most relevant, certainty moderated the extent to which these scales predicted vaccination advocacy, with greater consistency between the initial scores and the subsequent advocacy willingness obtained for those with higher certainty. Conclusions. Certainty can be useful to predict when the relationship between vaccination-related cognitions (i.e., beliefs or attitudes) and advocacy willingness is likely to be stronger. Full article
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Article
Assessment of COVID-19 Anxiety Levels and Attitudes to COVID-19 Vaccine among Older Adults in Poland: A Pilot Study
Vaccines 2022, 10(11), 1918; https://doi.org/10.3390/vaccines10111918 - 13 Nov 2022
Viewed by 272
Abstract
Background: The fear of being infected with the SARS-CoV-2 has become widespread, especially among older adults. Information campaigns to promote mass vaccination against COVID-19 are a key element in controlling and preventing the spread of the COVID-19 pandemic. However, their success primarily depends [...] Read more.
Background: The fear of being infected with the SARS-CoV-2 has become widespread, especially among older adults. Information campaigns to promote mass vaccination against COVID-19 are a key element in controlling and preventing the spread of the COVID-19 pandemic. However, their success primarily depends on vaccination coverage in a given population. The aim of this study was to assess the severity of COVID-19 anxiety and attitudes towards COVID-19 vaccines among older adults in Poland. Methods: This pilot study was conducted among a total of 127 older participants, including 108 students (85%) of Third Age Universities in Bialystok and 19 patients (15%) of the Department and Clinic of Geriatrics of the Hospital of the Ministry of Internal Affairs and Administration in Bialystok. The study used a diagnostic survey based on an author-designed questionnaire and four standardized psychometric tools: The Fear of COVID-19 Scale (FCV-19S), Coronavirus Anxiety Scale (CAS), The Drivers of COVID-19 Vaccination Acceptance Scale (DrVac-COVID19S), and Scale to Measure the Perception of SARS-CoV-2 Vaccines Acceptance (The VAC-COVID-19 Scale). Results: COVID-19 vaccination coverage in the study group was 88.2%, with three doses in most cases. We found a negative vaccination status only in women taking part in the study. Men scored significantly higher on DrVac-COVID19S and its Value subscale, and markedly lower on FCV-19S. We did not observe significant differences in the scales’ scores between age groups. Respondents recruited from the Third Age Universities had significantly higher scores than geriatric clinic patients in the Knowledge subscale of DrVac-COVID19S. In the case of FCV-19S, no correlation with the results obtained in other scales used in the study was found. Additionally, no correlation was found between CAS scores and the following scales: DrVac-COVID19S (total), DrVac-COVID19S Knowledge (K) subscale, DrVac-COVID19S Autonomy (A) subscale and VAC-COVID-19-Scale-positive subscale. The other scales were strongly correlated with each other—the correlations were statistically significant. Conclusions: Subjective COVID-19 anxiety in the study group was moderate. Seniors were more likely to show positive vaccine attitudes, as confirmed by the percentage of respondents vaccinated against COVID-19 with at least one dose. However, there is still a percentage of unvaccinated individuals in the population of seniors; therefore, measures should be taken to motivate this age group and encourage preventive vaccination against COVID-19. Furthermore, representative studies on COVID-19 anxiety and attitudes towards the COVID-19 vaccine among Polish seniors are needed to determine a more precise prevalence of these phenomena and potential correlations on a national level. Full article
Article
A Social Cognitive Theory Approach to Understanding Parental Attitudes and Intentions to Vaccinate Children during the COVID-19 Pandemic
Vaccines 2022, 10(11), 1876; https://doi.org/10.3390/vaccines10111876 - 07 Nov 2022
Viewed by 327
Abstract
The distribution of the COVID-19 vaccine represents a path towards global health after a worldwide pandemic. Yet, the U.S. response to the vaccination rollout has been politically polarized. The aim of this paper is to contribute to the understanding of the contextual factors [...] Read more.
The distribution of the COVID-19 vaccine represents a path towards global health after a worldwide pandemic. Yet, the U.S. response to the vaccination rollout has been politically polarized. The aim of this paper is to contribute to the understanding of the contextual factors that influence parents’ attitudes towards health officials and their intention to vaccinate children, focusing on communication behaviors, personal factors, and geographic locations. We use Bandura’s triadic reciprocal determinism (TRD) model which posits reciprocal influence between personal factors, environmental factors, and behaviors. We found that personal factors (having younger children and identifying as Republican partisans), and the behavioral factor of conservative news use were significantly related to more negative attitudes towards health officials and lower vaccination intentions. Conversely, Democrats and liberal news use were significantly related to warmer attitudes and greater vaccination intentions. The environmental factor of geographic location across four states with different partisan dynamics was not significantly related to attitudes and behavioral intentions. Results from a post-hoc analysis show that news media use and partisanship were the strongest correlates of parents’ attitudes towards health officials. This evidence points to the politicization of the COVID-19 vaccine being a key consideration regarding vaccine uptake. Full article
Article
Prevalence and Factors Associated with Caregivers’ Hesitancy in Immunizing Dependent Older Adults with COVID-19 Vaccines: A Cross-Sectional Survey
Vaccines 2022, 10(10), 1748; https://doi.org/10.3390/vaccines10101748 - 19 Oct 2022
Viewed by 379
Abstract
Background: Coronavirus disease 2019 (COVID-19) vaccinations have been proven to prevent hospitalization and mortality. However, some caregivers may be hesitant to authorize COVID-19 vaccination of people under their care. Our study aimed to evaluate factors associated with caregiver hesitancy to authorize vaccination of [...] Read more.
Background: Coronavirus disease 2019 (COVID-19) vaccinations have been proven to prevent hospitalization and mortality. However, some caregivers may be hesitant to authorize COVID-19 vaccination of people under their care. Our study aimed to evaluate factors associated with caregiver hesitancy to authorize vaccination of dependent older adults. Method: We conducted a cross-sectional telephone survey of vaccine hesitancy among caregivers of dependent older patients in the geriatric clinic of Ramathibodi Hospital. Caregivers were contacted and interviewed by trained interviewers from 20 June to 25 July 2021. Results: The study enrolled 318 participants with a mean age of 55.9 years. The majority of the participants were the patients’ children (86.5%). In total, 39.9% of participants were hesitant to authorize COVID-19 vaccination of the older adults under their care. Factors associated with caregiver vaccine hesitation were uneasiness, anxiety, agitation, sadness, and worry in association with social distancing, refusal to receive a COVID-19 vaccine, and concern about vaccine manufacturers. Conclusion: The prevalence of caregiver hesitancy to allow older adults to undergo COVID-19 vaccination was relatively high, and several factors associated with this vaccine hesitancy were identified. These findings may aid efforts toward COVID-19 vaccination of dependent older adults. Full article
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Article
Intolerance of Uncertainty and Attitudes towards Vaccination Impact Vaccinal Decision While Perceived Uncertainty Does Not
Vaccines 2022, 10(10), 1742; https://doi.org/10.3390/vaccines10101742 - 18 Oct 2022
Viewed by 326
Abstract
The COVID-19 pandemic illustrated that intolerance of uncertainty (IU) can hinder problem-solving and lead to avoidance of ambiguous situations. Furthermore, people tend to lack confidence in decisions made in ambiguous contexts. We wanted to investigate the impact of IU on intentions to get [...] Read more.
The COVID-19 pandemic illustrated that intolerance of uncertainty (IU) can hinder problem-solving and lead to avoidance of ambiguous situations. Furthermore, people tend to lack confidence in decisions made in ambiguous contexts. We wanted to investigate the impact of IU on intentions to get vaccinated, to vaccinate one’s children, and to recommend the vaccine in situations with varying degrees of perceived uncertainty. We first conducted a pretest to select six scenarios with different levels of perceived uncertainty. In the core study, 485 participants answered for each of the six scenarios whether they would get vaccinated, vaccinate their children (or imagine doing so, for individuals without children), and whether they would recommend the vaccine. They also completed the IUS-12 (Intolerance of Uncertainty scale) and the VAX (Vaccination Attitudes Examination). Results showed that perceived uncertainty did not influence our measures, but the IUS-12 and VAX predicted the difference in score between the most and least uncertain scenarios. An indirect effect of the IUS-12 on decision confidence through the VAX was found, but with no direct effect. We conclude that, even if future studies should refine these results, Public Policies should be more focused on factors such as IU and attitudes toward vaccination. Full article
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Article
Acceptance, Hesitancy, and Refusal in Anti-COVID-19 Vaccination: A Cluster Analysis Aiming at the Typology behind These Three Concepts
Vaccines 2022, 10(9), 1496; https://doi.org/10.3390/vaccines10091496 - 08 Sep 2022
Viewed by 1703
Abstract
This paper presents the findings of a study aiming at an innovative typology of attitudes towards COVID-19 vaccination. The proposed typology tries to go beyond the common sociological studies who divide the public into three categories: pro-vaxxers, anti-vaxxers, and hesitants. Our purpose is [...] Read more.
This paper presents the findings of a study aiming at an innovative typology of attitudes towards COVID-19 vaccination. The proposed typology tries to go beyond the common sociological studies who divide the public into three categories: pro-vaxxers, anti-vaxxers, and hesitants. Our purpose is obtaining a more complex typology using cluster analysis. The article is based on a nation-wide survey conducted in Romania. The sample of the survey was statistically representative to the population of Romania and was composed of 1002 participants. A k-means algorithm for classifying cases was used to identify how the studied population structures itself when it comes to attitudes towards COVID-19 vaccination. We see hesitancy as an expression of concern or doubt about the value or safety of the vaccination, but also as fear or dis(trust) in the authorities, or as disinterest. We found out that the Romanian public falls into three categories regarding the attitude towards COVID-19 vaccination: the “non-fanatical” pro-vaxxers, the anti-vaxxers, and those without a clear opinion (uninterested and/or undecided). What we usually call “vaccine hesitancy” can be found, depending on motivation or type of hesitancy, in both of the last two clusters. Full article
Article
COVID-19 Vaccine Booster Dose Willingness among Patients with Inflammatory Bowel Disease on Infliximab and Vedolizumab: A Cross-Sectional Study
Vaccines 2022, 10(8), 1166; https://doi.org/10.3390/vaccines10081166 - 22 Jul 2022
Viewed by 607
Abstract
Background: Vaccination has been effective in preventing COVID-19 infections and related mortality. However, waning immunity after two-dose vaccination prompted health authorities to recommend a third dose of COVID-19 vaccine to boost immunity. The aim of our study was to assess willingness to receive [...] Read more.
Background: Vaccination has been effective in preventing COVID-19 infections and related mortality. However, waning immunity after two-dose vaccination prompted health authorities to recommend a third dose of COVID-19 vaccine to boost immunity. The aim of our study was to assess willingness to receive a third (booster) dose among patients with inflammatory bowel disease (IBD). Methods: A cross-sectional study was performed at an IBD tertiary care center. Patients were recruited at the infusion room from 1 January 2022 to 31 March 2022. The primary outcome was the prevalence of a third (booster) dose of the BNT162b2 vaccine in infliximab- or vedolizumab-treated patients with IBD. The secondary outcome evaluated whether the prevalence of a third (booster) dose of the BNT162b2 vaccine differed based on type of COVID-19 vaccine, gender, age, type of biologic therapy, and citizenship. Results: In total, 499 patients with IBD were included in this study. The median age was 34.5 years, and 60% had ulcerative colitis (UC). Among the study participants, 302 (60.5%) patients were vaccinated with BNT162b2, and 197 (39.5%) were vaccinated with ChAdOx1 nCoV-19. Of the total number of participants, 400 (80.2%) were receiving infliximab, and 99 (19.8%) were receiving vedolizumab. Overall, 290 (58.1%) of the included patients were willing to receive the third (booster) dose. Patients vaccinated with BNT162b2 were more likely to be willing to receive a booster dose compared to patients vaccinated with ChAdOx1 nCoV-19 (201 (66.5%) vs. 103 (52.0%), p = 0.014). Infliximab-treated patients were more likely to be willing to receive a booster dose compared to patients receiving vedolizumab (310 (77.5%) vs. 62 (62.6%), p = 0.002). There was no statistical difference in willingness to receive a booster dose in terms of age, nationality, or gender. Conclusions: The percentage of patients with IBD willing to receive or having already received a third (booster) dose of BNT162b2 vaccine was lower compared to the general population. In addition, patients who received two doses of BNT162b2 vaccines were more likely to be willing to receive a third (booster) dose compared to patients who received ChAdOx1 nCoV-19. Patients treated with infliximab were more likely to be willing to receive a third (booster) dose of COVID-19 vaccine. Full article
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Article
Attitudes to Vaccine Mandates among Late Adopters of COVID-19 Vaccines in Zimbabwe
Vaccines 2022, 10(7), 1090; https://doi.org/10.3390/vaccines10071090 - 07 Jul 2022
Cited by 1 | Viewed by 760
Abstract
Despite sufficient supply, <25% of the population in sub-Saharan Africa has received at least one dose of COVID-19 vaccine. Vaccine mandates have previously been effective in increasing vaccine uptake. Attitudes to COVID-19 vaccine mandates and vaccines for children in African populations are not [...] Read more.
Despite sufficient supply, <25% of the population in sub-Saharan Africa has received at least one dose of COVID-19 vaccine. Vaccine mandates have previously been effective in increasing vaccine uptake. Attitudes to COVID-19 vaccine mandates and vaccines for children in African populations are not well understood. We surveyed late-adopters presenting for COVID-19 vaccination one year after program initiation in Zimbabwe. Logistic regression models were developed to evaluate factors associated with attitudes to mandates. In total, 1016 adults were enrolled; 690 (67.9%) approved of mandating vaccination for use of public spaces, 686 (67.5%) approved of employer mandates, and 796 (78.3%) approved of mandating COVID-19 vaccines for schools. Individuals of lower economic status were twice as likely as high-income individuals to approve of mandates. Further, 743 (73.1%) participants indicated that they were extremely/very likely to accept vaccines for children. Approval of vaccine mandates was strongly associated with perceptions of vaccine safety, effectiveness, and trust in regulatory processes that approved vaccines. Vaccine hesitancy is an important driver of low vaccine coverage in Africa and can be mitigated by vaccine mandates. Overall, participants favored vaccine mandates; however, attitudes to mandates were strongly associated with level of education and socioeconomic status. Full article
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Article
Anti-SARS-CoV-2 Vaccination Campaign: Risk Perception, Emotional States, and Vaccine Hesitancy in a Sample of Adolescents’ Vaccinated Parents in Southern Italy
Vaccines 2022, 10(6), 958; https://doi.org/10.3390/vaccines10060958 - 16 Jun 2022
Cited by 1 | Viewed by 625
Abstract
Background: The international strategic plan for COVID-19 vaccines remains the practical option for the protection of health. However, vaccine hesitancy remains an obstacle to full population vaccination, with rapid developments in COVID-19 vaccines and concerns about efficacy acting as influencing factors. Aim: The [...] Read more.
Background: The international strategic plan for COVID-19 vaccines remains the practical option for the protection of health. However, vaccine hesitancy remains an obstacle to full population vaccination, with rapid developments in COVID-19 vaccines and concerns about efficacy acting as influencing factors. Aim: The present study investigated the perception of vaccine hesitancy among parents of adolescents in order to explore the reasons and related emotional states. Methods: In January–March 2022, an online questionnaire was administered to a sample of parents who brought their children to the vaccine center of a local health unit, ASL Salerno (Campania, Italy). Results: The participants were 1105 parents (F = 64.6%; mean age = 47.37 years, SD = 7.52) of adolescents (F = 47.6%; mean age = 14.83 years, SD = 1.72). All parents had received the COVID-19 vaccine. Regarding the vaccination schedule, 46.8% believed that children receive more vaccinations than they should; 25.1% believed that it is better to develop immunity rather than get vaccinated; 41.2% believed that their child could have side effects; 29.6% were very concerned that vaccines were unsafe, while 35.3% believed vaccines do not prevent disease; 21.5% were very reluctant about pediatric vaccines; and 23.8% did not trust the information received. Conclusions: In order to increase vaccination and reduce the prevalence of vaccine hesitancy, it is essential to support the value of vaccination among all parents and make information more accessible and usable through competent pediatricians. Full article
Article
Impact of Vaccine and Immunity Passports in the Context of COVID-19: A Time Series Analysis in Overseas France
Vaccines 2022, 10(6), 852; https://doi.org/10.3390/vaccines10060852 - 26 May 2022
Cited by 1 | Viewed by 2330
Abstract
(1) Background: By summer 2021, overseas France turned COVID-19 vaccine and immunity certificates into passports to open travel bubbles. Subsequently, its territories set French records for both COVID-19 and 6-month excess all-cause mortality. (2) Methods: Official time series were collected to compare time [...] Read more.
(1) Background: By summer 2021, overseas France turned COVID-19 vaccine and immunity certificates into passports to open travel bubbles. Subsequently, its territories set French records for both COVID-19 and 6-month excess all-cause mortality. (2) Methods: Official time series were collected to compare time correlations between air traffic and COVID-19 transmission and mortality in overseas France, before and after the implementation of immunity passports. (3) Results: Air traffic initially had a reversed relationship with COVID-19, which transitioned into a leader–follower relationship with the introduction of immunity passports. Essentially, air traffic increased 16 days before COVID-19 cases increased (r = 0.61) and 26 days before deaths increased (r = 0.31) in Martinique, 26 days (r = 0.72) and 40 days (r = 0.82) before in Guadeloupe, and 29 days (r = 0.60) and 31 days (r = 0.41) before in Réunion upon introduction of immunity passports. Moreover, air traffic became as correlated as community transmission to COVID-19 mortality in Guadeloupe. (4) Conclusions: Since the introduction of immunity passports, air traffic has been pacesetting COVID-19 within one month for transmission, and within an additional two weeks for mortality in overseas France. Responding to WHO’s call for real-world evidence, this study suggests that COVID-19 passports are not commensurate with health system goals. Full article
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Article
Serious Underlying Medical Conditions and COVID-19 Vaccine Hesitancy: A Large Cross-Sectional Analysis from Australia
Vaccines 2022, 10(6), 851; https://doi.org/10.3390/vaccines10060851 - 26 May 2022
Cited by 3 | Viewed by 1070
Abstract
As COVID-19 vaccinations became available and were proven effective in preventing serious infection, uptake amongst individuals varied, including in medically vulnerable populations. This cross-sectional multi-site study examined vaccine uptake, hesitancy, and explanatory factors amongst people with serious and/or chronic health conditions, including the [...] Read more.
As COVID-19 vaccinations became available and were proven effective in preventing serious infection, uptake amongst individuals varied, including in medically vulnerable populations. This cross-sectional multi-site study examined vaccine uptake, hesitancy, and explanatory factors amongst people with serious and/or chronic health conditions, including the impact of underlying disease on attitudes to vaccination. A 42-item survey was distributed to people with cancer, diabetes, or multiple sclerosis across ten Australian health services from 30 June to 5 October 2021. The survey evaluated sociodemographic and disease-related characteristics and incorporated three validated scales measuring vaccine hesitancy and vaccine-related beliefs generally and specific to their disease: the Oxford COVID-19 Vaccine Hesitancy Scale, the Oxford COVID-19 Vaccine Confidence and Complacency Scale and the Disease Influenced Vaccine Acceptance Scale-Six. Among 4683 participants (2548 [54.4%] female, 2108 [45.0%] male, 27 [0.6%] other; mean [SD] age, 60.6 [13.3] years; 3560 [76.0%] cancer, 842 [18.0%] diabetes, and 281 [6.0%] multiple sclerosis), 3813 (81.5%) self-reported having at least one COVID-19 vaccine. Unvaccinated status was associated with younger age, female sex, lower education and income, English as a second language, and residence in regional areas. Unvaccinated participants were more likely to report greater vaccine hesitancy and more negative perceptions toward vaccines. Disease-related vaccine concerns were associated with unvaccinated status and hesitancy, including greater complacency about COVID-19 infection, and concerns relating to vaccine efficacy and impact on their disease and/or treatment. This highlights the need to develop targeted strategies and education about COVID-19 vaccination to support medically vulnerable populations and health professionals. Full article
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Article
Missed Opportunities for Vaccination and Associated Factors among Children Attending Primary Health Care Facilities in Cape Town, South Africa: A Pre-Intervention Multilevel Analysis
Vaccines 2022, 10(5), 785; https://doi.org/10.3390/vaccines10050785 - 16 May 2022
Viewed by 743
Abstract
Despite the substantial efforts at ensuring universal access to routine immunisation services among children in South Africa, major gaps in immunisation coverage remain. This study assessed the magnitude of missed opportunities for vaccination (MOV) and associated factors among children aged 0–23 months attending [...] Read more.
Despite the substantial efforts at ensuring universal access to routine immunisation services among children in South Africa, major gaps in immunisation coverage remain. This study assessed the magnitude of missed opportunities for vaccination (MOV) and associated factors among children aged 0–23 months attending primary health care (PHC) facilities in Cape Town. We used multilevel binomial logistic regression models to explore individual and contextual factors associated with MOV, with children aged 0–23 months at Level 1, nested within PHC facilities (Level 2). A total of 674 children and their caregivers were enrolled. MOV prevalence was 14.1%, ranging from 9.1% to 18.9% across sub-districts. Dose-specific MOV prevalence was highest for the second dose of measles vaccine (9.5%) and lowest for the first dose of rotavirus vaccine (0.6%). The likelihood of a child experiencing MOV was significantly associated with caregivers’ low level of education (Odds ratio (OR) = 3.53, 95% credible interval (CrI): 1.13–11.03), recent receipt of immunisation messages (OR = 0.46, 95%CrI: 0.25–0.87), shared immunisation decision making by both parents (OR = 0.21, 95%CrI: 0.07–0.62) and health facility staff number (OR = 0.18, 95%CrI: 0.06–0.61). The burden of MOV among children in Cape Town is influenced by individual and contextual factors, which provide important opportunities for quality improvement and broader strategies to improve routine immunisation service delivery. Full article
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Article
COVID-19 Vaccine Hesitancy among Behavioral Risk Takers
Vaccines 2022, 10(5), 767; https://doi.org/10.3390/vaccines10050767 - 12 May 2022
Cited by 1 | Viewed by 741
Abstract
The COVID-19 pandemic has emerged as a major public health issue, with vaccines serving as a vital preventive strategy to lower the global burden. Yet, despite national and local mandates, key sectors of the population continue to demonstrate lower compliance rates. In the [...] Read more.
The COVID-19 pandemic has emerged as a major public health issue, with vaccines serving as a vital preventive strategy to lower the global burden. Yet, despite national and local mandates, key sectors of the population continue to demonstrate lower compliance rates. In the United States, young adults have the lowest vaccination rates among the adult population. The goal of our study was to utilize the largest state-health survey to assess the key determinants of such hesitancy in order to create targeted interventions for the most at-risk groups to ensure equitable outcomes in disease prevention. We utilized the latest available California Health Interview Survey, a population-based complex probability survey, to evaluate determinants of vaccine hesitancy among young adults. Survey-weighted descriptive statistics, bivariate statistics, and multivariable logistic regression analyses were conducted. All statistical tests used p less than 0.05 to determine statistical significance. A total of 1203 respondents, representative of 4,027,462 young adults (ages 18–25 years) were included in our study. Our primary findings note that 24% of participants reported they would not be willing to take the COVID-19 vaccination. Prevalence of vaccine hesitancy was also significantly higher among young adults who were current smokers (including electronic cigarettes), when compared to non-current smokers (36% vs. 22%). Further, the highest prevalence was also noted among young adults who identified as African-American (51%), had a high school degree or less (34%), those who were overweight or obese (28%), and reported a poor health status (22%). Multivariable regression analysis demonstrated that current smokers, as compared to non-current smokers, had more than double the odds of reporting COVID-19 vaccine hesitancy. African-American young adults or young adults with a high school degree or less were both independently associated with at least a three-fold increase in vaccine hesitancy. Participants with psychological distress, however, were more likely to be accepting of the vaccine. Public health efforts to improve vaccine compliance need targeted efforts, including building trust in the healthcare system for African-Americans and promoting easier access and knowledge of vaccines among those with a high school degree or less, as well as young-adults who are currently smoking, with such efforts targeting behavioral interventions focused on risk aversion. Full article
Article
Second Wave of the Study of Taiwanese Caregivers of Children with ADHD in the COVID-19 Pandemic: Intentions to Vaccinate Their Children for COVID-19, and Related Factors
Vaccines 2022, 10(5), 753; https://doi.org/10.3390/vaccines10050753 - 11 May 2022
Viewed by 686
Abstract
The second wave of the Study of Taiwanese Caregivers of Children with Attention-Deficit/Hyperactivity Disorder (ADHD) in the COVID-19 Pandemic was conducted at the time of a severe COVID-19 outbreak. The aims of this study were to compare the level of the intentions of [...] Read more.
The second wave of the Study of Taiwanese Caregivers of Children with Attention-Deficit/Hyperactivity Disorder (ADHD) in the COVID-19 Pandemic was conducted at the time of a severe COVID-19 outbreak. The aims of this study were to compare the level of the intentions of caregivers of children with ADHD to vaccinate their children between the first and second waves of study, as well as to examine the COVID-19 pandemic and non-COVID-19 pandemic factors related to caregivers’ intentions. In total, 252 caregivers of children with ADHD completed the structured questionnaires, including the Drivers of COVID-19 Vaccination Acceptance Scale; the Risk Perception of the COVID-19 Scale; caregivers’ Difficulties in Asking Their Children to Adopt Self-Protective Behavior Scale; the Brief Symptom Rating Scale; the Parental Bonding Instrument; the Swanson, Nolan, and Pelham version IV Scale; and the questionnaires for the intentions to vaccinate their children and child’s medication use for treating ADHD. The results demonstrated that 82.5% of caregivers reported their willingness to vaccinate their children definitely or under doctors’ recommendation; the level of intentions to vaccinate significantly increased compared with that of caregivers in the first wave of the study. Caregivers’ drivers of COVID-19 vaccination uptake, namely, values, impact, and autonomy but not knowledge; being male caregivers; being caregivers of girls; and the older age of the children were positively associated with caregiverscaregivers’ intentions. The specific intervention programs for enhancing caregivers’ intentions should be specified according to the sex and age of caregivers and of the children with ADHD. The Drivers of COVID-19 Vaccination Uptake should be also the target of intervention for enhancing caregivers’ intentions through strengthening caregivers’ acceptance of the COVID-19 vaccines’ values, positive impact and autonomy to vaccinate their children. Full article
Article
Adverse Mentions, Negative Sentiment, and Emotions in COVID-19 Vaccine Tweets and Their Association with Vaccination Uptake: Global Comparison of 192 Countries
Vaccines 2022, 10(5), 735; https://doi.org/10.3390/vaccines10050735 - 08 May 2022
Cited by 1 | Viewed by 1609
Abstract
Background: Many countries show low COVID-19 vaccination rates despite high levels of readiness and delivery of vaccines. The public’s misperceptions, hesitancy, and negative emotions toward vaccines are psychological factors discouraging vaccination. At the individual level, studies have revealed negative perceptual/behavioral outcomes of [...] Read more.
Background: Many countries show low COVID-19 vaccination rates despite high levels of readiness and delivery of vaccines. The public’s misperceptions, hesitancy, and negative emotions toward vaccines are psychological factors discouraging vaccination. At the individual level, studies have revealed negative perceptual/behavioral outcomes of COVID-19 information exposure via social media where misinformation and vaccine fear flood. Objective: This study extends research context to the global level and investigates social media discourse on the COVID-19 vaccine and its association with vaccination rates of 192 countries in the world. Methods: COVID-19 vaccine tweets were compared by country in terms of (1) the number per million Twitter users, (2) mentions of adverse events—death, side-effects, blood clots, (3) negative sentiment (vs. positive), and (4) fear, sadness, or anger emotions (vs. joy). Artificial intelligence (AI) was adopted to classify sentiment and emotions. Such tweets and covariates (COVID-19 morbidity and mortality rates, GDP, population size and density, literacy rate, democracy index, institutional quality, human development index) were tested as predictors of vaccination rates in countries. Results: Over 21.3 million COVID-19 vaccine tweets posted between November 2020 and August 2021 worldwide were included in our analysis. The global average of COVID-19 vaccine tweets mentioning adverse events was 2% for ‘death’, 1.15% for ‘side-effects’, and 0.80% for ‘blood clots’. Negative sentiment appeared 1.90 times more frequently than positive sentiment. Fear, anger, or sadness appeared 0.70 times less frequently than joy. The mention of ‘side-effects’ and fear/sadness/anger emotions appeared as significant predictors of vaccination rates, along with the human development index. Conclusions: Our findings indicate that global efforts to combat misinformation, address negative emotions, and promote positive languages surrounding COVID-19 vaccination on social media may help increase global vaccination uptakes. Full article
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Article
Factors Influencing the Acceptance of COVID-19 Vaccines in a Country with a High Vaccination Rate
Vaccines 2022, 10(5), 681; https://doi.org/10.3390/vaccines10050681 - 25 Apr 2022
Cited by 5 | Viewed by 917
Abstract
Control of the COVID-19 pandemic largely depends on the effectiveness of the vaccination process. An understanding of the factors that underlie the willingness to accept vaccination contributes pivotal information to controlling the pandemic. We analyzed the association between the willingness to accept the [...] Read more.
Control of the COVID-19 pandemic largely depends on the effectiveness of the vaccination process. An understanding of the factors that underlie the willingness to accept vaccination contributes pivotal information to controlling the pandemic. We analyzed the association between the willingness to accept the available COVID-19 vaccines and vaccine determinants amidst the Chilean vaccination process. Individual-level survey data was collected from 744 nationally representative respondents and multivariate regression models were used to estimate the association between outcome and explanatory variables. We found that trust in COVID-19 vaccines, scientists, and medical professionals significantly increased the willingness to: accept the vaccines and booster doses, as well as annual vaccinations and the vaccination of children. Our results are critical to understanding the acceptance of COVID-19 vaccines in the context of a country with one of the world’s highest vaccination rates. We provide useful information for decision-making and policy design, in addition to establishing guidelines regarding how to effectively explain vaccination programs to citizens. Full article
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Article
COVID-19 Vaccine Hesitancy among Arab Americans
Vaccines 2022, 10(4), 610; https://doi.org/10.3390/vaccines10040610 - 14 Apr 2022
Cited by 3 | Viewed by 865
Abstract
(1) Background: Coronavirus disease-2019 (COVID-19) vaccines have a significant impact on reducing morbidity and mortality from infection. However, vaccine hesitancy remains an obstacle in combating the pandemic. The Arab American (AA) population is understudied; thus, we aimed to explore COVID-19 attitudes within this [...] Read more.
(1) Background: Coronavirus disease-2019 (COVID-19) vaccines have a significant impact on reducing morbidity and mortality from infection. However, vaccine hesitancy remains an obstacle in combating the pandemic. The Arab American (AA) population is understudied; thus, we aimed to explore COVID-19 attitudes within this community. (2) Methods: This was a cross-sectional study. An anonymous online survey was distributed to members of different AA associations and to the community through the snowball method. (3) Results: A total of 1746 participants completed the survey. A total of 92% of respondents reported having received at least one dose of a COVID-19 vaccine. A total of 73% reported willingness to receive a booster, and 72% plan to give their children the vaccine. On multivariate analysis, respondents were more likely to be vaccine-hesitant if they were hesitant about receiving any vaccine in general. They were less likely to be vaccine-hesitant if they were immigrants, over the age of 40, up to date on their general vaccination and if they believed that COVID-19 vaccines are safe and effective in preventing an infection. The belief that all vaccines are effective at preventing diseases was also associated with lower hesitancy. (4) Conclusions: This sample of AAs have higher vaccination rates and are more willing to vaccinate their children against COVID-19 when compared to the rest of the population. However, a reemergence of hesitancy might be arising towards the boosters. Full article
Article
Perceived COVID-19 Vaccine Pressure in the Caribbean: Exploring a New Stressor–Strain Phenomenon in the Pandemic
Vaccines 2022, 10(2), 238; https://doi.org/10.3390/vaccines10020238 - 03 Feb 2022
Cited by 1 | Viewed by 907
Abstract
This research introduced the new construct of ‘perceived COVID-19 vaccine pressure’ (i.e., the psychological strain associated with societal demands on vaccine taking) and examined the initial psychometric properties of a newly proposed measure. The study surveyed 411 Barbadian respondents to examine their level [...] Read more.
This research introduced the new construct of ‘perceived COVID-19 vaccine pressure’ (i.e., the psychological strain associated with societal demands on vaccine taking) and examined the initial psychometric properties of a newly proposed measure. The study surveyed 411 Barbadian respondents to examine their level of perceived COVID-19 vaccine pressure using an online survey modality. The results revealed strong and robust psychometric properties for the scale and its unidimensionality. Younger and employed respondents as well as those working in the tourism and hospitality and government (public) sectors experienced the greatest internalised vaccine pressure relative to other respondent groups. Only initial/preliminary evidence of the scale’s validity and reliability was revealed by this cross-sectional study. A follow-up study (using CFA on a new sample) is needed to provide stronger evidence for its validity and reliability. Understanding the dynamics of perceived or internalised vaccine pressure might help explain the positive or negative effects of societal pressure and its implications for vaccine hesitancy and other vaccine-related attitudes and behaviours. The study is the first to conceptually discuss and empirically examine the mental health strain occasioned by societal demands placed on individuals to take a COVID-19 vaccine. Full article
Article
What Determines Vaccine Hesitancy: Recommendations from Childhood Vaccine Hesitancy to Address COVID-19 Vaccine Hesitancy
Vaccines 2022, 10(1), 80; https://doi.org/10.3390/vaccines10010080 - 06 Jan 2022
Cited by 5 | Viewed by 1581
Abstract
Vaccine hesitancy is a prevalent and ongoing issue. However, due to the COVID-19 pandemic, additional attention has been brought to the topic of vaccine hesitancy. Vaccine hesitancy is a threat to the population’s health globally. This article aims to acquire insights from previous [...] Read more.
Vaccine hesitancy is a prevalent and ongoing issue. However, due to the COVID-19 pandemic, additional attention has been brought to the topic of vaccine hesitancy. Vaccine hesitancy is a threat to the population’s health globally. This article aims to acquire insights from previous literature to determine what works to increase vaccine uptake and how we can apply this knowledge to increase COVID-19 vaccine uptake. Research has focused chiefly on childhood vaccination and the hesitancy of caregivers. After conducting an extensive literature review, we have created a conceptual model of indicators that influence vaccine uptake for health providers and caregivers, which can also be used for vaccine recipients. Overall, the reasons for vaccine hesitancy are complex; therefore, a multifaceted approach is needed to address it. Understanding the factors that affect vaccine hesitancy will aid in addressing hesitancy and, in turn, lead to an increase in vaccine uptake. Full article
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Article
COVID-19 Vaccine Hesitancy among Patients with Inflammatory Bowel Disease Receiving Biologic Therapies in Kuwait: A Cross-Sectional Study
Vaccines 2022, 10(1), 55; https://doi.org/10.3390/vaccines10010055 - 31 Dec 2021
Cited by 4 | Viewed by 1004
Abstract
Background: COVID-19 vaccinations have been shown to be effective in reducing risk of severe infection, hospitalization, and death. They have also been shown to be safe and effective in patients with inflammatory bowel disease (IBD) who are receiving biologic therapies. In this study, [...] Read more.
Background: COVID-19 vaccinations have been shown to be effective in reducing risk of severe infection, hospitalization, and death. They have also been shown to be safe and effective in patients with inflammatory bowel disease (IBD) who are receiving biologic therapies. In this study, we aimed to evaluate the prevalence of vaccination among patients receiving biologic therapies for IBD. Methods: A single-center prospective cross-sectional study conducted at a tertiary care inflammatory bowel disease center in Kuwait. Data from patients with inflammatory bowel disease (IBD) who attended the gastroenterology infusion clinic from 1 June 2021 until 31 October 2021 were retrieved. Patients who received infliximab or vedolizumab at least six weeks before recruitment were included. The primary outcome was prevalence of COVID-19 vaccination. The secondary outcome was to assess whether prevalence of COVID-19 vaccination differed based on sex, age, type of biologic therapy and nationality. Results: The total number of inflammatory bowel disease (IBD) patients enrolled in the study was 280 (56.0% male and 44.0% female). Of the total, 112 (40.0%) patients were diagnosed with ulcerative colitis and 168 (60.0%) with Crohn’s disease. The number of ulcerative colitis patients who were vaccinated was 49 (43.8%) and the number of Crohn’s disease patients who were vaccinated was 68 (40.5%). The median age was 33.2 years and BMI was 24.8 kg/m2. With respect to the total number of patients, 117 (41.8%) were vaccinated with either BNT162b2 or ChAdOx1 nCoV-19 and 163 (58.2%) were not vaccinated. Female patients were more likely to receive the vaccine compared to male patients (83.0% vs. 63.8%, p < 0.001). In addition, patients above the age 50 were more likely to receive the vaccine than patients below the age of 50 (95.6% vs. 31.2% p < 0.001). Expatriates were more likely to receive the vaccine than citizens (84.8% vs. 25.0%, p < 0.001). There was no statistical difference between patients on infliximab and vedolizumab with regard to prevalence of vaccination (40.0% vs 48.0%, p = 0.34). Conclusion: The overall prevalence of COVID-19 vaccination among patients with inflammatory bowel disease (IBD) on biologic therapies was lower than that of the general population and world health organization (WHO) recom-mendation. Female patients, patients above the age of 50, and expatriates were more likely to receive the vaccine. Physicians should reinforce the safety and efficacy of COVID-19 vaccines among patients, especially IBD patients on biologic therapies, who express hesitancy towards them. Full article
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Article
Acceptability of the COVID-19 Vaccine among Adults in Saudi Arabia: A Cross-Sectional Study of the General Population in the Southern Region of Saudi Arabia
Vaccines 2022, 10(1), 41; https://doi.org/10.3390/vaccines10010041 - 29 Dec 2021
Cited by 7 | Viewed by 844
Abstract
Vaccines afford protection against infectious diseases. However, a sizeable part of the population refuse vaccinations and continue to dispute the evidence supporting vaccinations. The objective of this study was to determine the prevalence of COVID-19 vaccination uptake and its determinants among the Saudi [...] Read more.
Vaccines afford protection against infectious diseases. However, a sizeable part of the population refuse vaccinations and continue to dispute the evidence supporting vaccinations. The objective of this study was to determine the prevalence of COVID-19 vaccination uptake and its determinants among the Saudi population in the southern region of Saudi Arabia. A cross-sectional survey studied COVID-19 vaccine acceptance in adults in Saudi Arabia, targeting the general population in the southwestern region. Data were collected through an online survey questionnaire tool. All data were analysed using SPSS version 23.0. The majority (57.29%) of the participants were willing to receive the new COVID-19 vaccine, whereas almost 64% believed it is necessary to take the COVID-19 vaccine to protect oneself and that the vaccine is safe, efficient and effective. The data showed that perceived risk of COVID-19 (p = 0.015), history of previous vaccination against seasonal influenza (p = 0.000), and trust in the healthcare system (p = 0.025) were significant predictors for COVID-19 vaccine acceptance. We conclude that participants’ trust in the healthcare system, perceived risk of contracting COVID-19, and history of previous vaccination against seasonal influenza were significant predictors for COVID-19 vaccine acceptance. Knowing the acceptance rates for the COVID-19 vaccination can aid state agencies, medical practitioners, and other entities in reducing the impact of vaccine avoidance. Full article
Article
The Role of Risk Perception in Students’ COVID-19 Vaccine Uptake: A Longitudinal Study
Vaccines 2022, 10(1), 22; https://doi.org/10.3390/vaccines10010022 - 24 Dec 2021
Cited by 7 | Viewed by 1927
Abstract
Since COVID-19 vaccine uptake was found to be especially low among young adults, the present study investigated COVID-19 risk perception as predictor of COVID-19 vaccination intention and actual COVID-19 vaccine uptake among this age group. More specifically, it was tested whether cognitive risk [...] Read more.
Since COVID-19 vaccine uptake was found to be especially low among young adults, the present study investigated COVID-19 risk perception as predictor of COVID-19 vaccination intention and actual COVID-19 vaccine uptake among this age group. More specifically, it was tested whether cognitive risk perception predicts vaccination uptake successively via affective risk perception and vaccination intention. In total, 680 students (65.9% female) between 17 and 28 years participated in this longitudinal online study. COVID-19 cognitive and affective risk perception, COVID-19 vaccination intention, and actual COVID-19 vaccine uptake were measured in t1: November/December 2020, t2: March 2021, and t3: June/July 2021, respectively. The mediation analysis revealed a significant indirect effect of perceived severity at t1 on vaccine uptake at t3 via worry at t1 and vaccination intention at t2. Stronger perceptions of perceived severity of COVID-19 were related to more worry about COVID-19, which led to a higher vaccination intention, which, in turn, increased the chance of COVID-19 vaccine uptake. To increase vaccine uptake among young adults it might be fruitful to emphasize the severity of COVID-19. However, one should take into account that tapping into fear works best when messages also include efficacy statements. Full article
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Article
Factors Influencing Australian Healthcare Workers’ COVID-19 Vaccine Intentions across Settings: A Cross-Sectional Survey
Vaccines 2022, 10(1), 3; https://doi.org/10.3390/vaccines10010003 - 21 Dec 2021
Cited by 5 | Viewed by 2096
Abstract
Healthcare workers’ COVID-19 vaccination coverage is important for staff and patient safety, workforce capacity and patient uptake. We aimed to identify COVID-19 vaccine intentions, factors associated with uptake and information needs for healthcare workers in Victoria, Australia. We administered a cross-sectional online survey [...] Read more.
Healthcare workers’ COVID-19 vaccination coverage is important for staff and patient safety, workforce capacity and patient uptake. We aimed to identify COVID-19 vaccine intentions, factors associated with uptake and information needs for healthcare workers in Victoria, Australia. We administered a cross-sectional online survey to healthcare workers in hospitals, primary care and aged or disability care settings (12 February–26 March 2021). The World Health Organization Behavioural and Social Drivers of COVID-19 vaccination framework informed survey design and framing of results. Binary regression results adjusted for demographics provide risk differences between those intending and not intending to accept a COVID-19 vaccine. In total, 3074 healthcare workers completed the survey. Primary care healthcare workers reported the highest intention to accept a COVID-19 vaccine (84%, 755/898), followed by hospital-based (77%, 1396/1811) and aged care workers (67%, 243/365). A higher proportion of aged care workers were concerned about passing COVID-19 to their patients compared to those working in primary care or hospitals. Only 25% felt they had sufficient information across five vaccine topics, but those with sufficient information had higher vaccine intentions. Approximately half thought vaccines should be mandated. Despite current high vaccine rates, our results remain relevant for booster programs and future vaccination rollouts. Full article
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Article
COVID-19 Vaccination Acceptance among Health Science Students in Morocco: A Cross-Sectional Study
Vaccines 2021, 9(12), 1451; https://doi.org/10.3390/vaccines9121451 - 08 Dec 2021
Cited by 4 | Viewed by 1440
Abstract
While students in the health sciences occupy pivotal roles in the Moroccan COVID-19 response and vaccination campaigns, factors associated with COVID-19 vaccine acceptability among students have not been reported. This study aimed to determine the willingness and identify predictive attitudes and beliefs of [...] Read more.
While students in the health sciences occupy pivotal roles in the Moroccan COVID-19 response and vaccination campaigns, factors associated with COVID-19 vaccine acceptability among students have not been reported. This study aimed to determine the willingness and identify predictive attitudes and beliefs of COVID-19 vaccine acceptance among health science students in Morocco. A cross-sectional, self-administered online questionnaire was conducted among students of the Mohammed VI University of Health Sciences in Casablanca, Morocco in January 2021. In total, 1272 students participated. Univariate and multivariate logistic regression models were used to calculate odds ratios and 95% confidence intervals. Overall, 26.9% of participants reported being willing to receive the COVID-19 vaccine. Between genders, male students were more likely to accept the vaccine. Regarding individual attitudes and beliefs about COVID-19 infection, students with greater confidence in COVID-19 information, and higher perceived likelihood and perceived severity of infection were more likely to be willing to get the vaccine. Concerning a COVID-19 vaccine, students who reported lower levels of perceived harm and higher levels of perceived vaccine effectiveness were more willing to get vaccinated. Our findings help guide future efforts to tailor communication and identify strategies to increase COVID-19 vaccine uptake among students. Full article
Article
Perceptions towards COVID-19 Vaccines and Willingness to Vaccinate in Nepal
Vaccines 2021, 9(12), 1448; https://doi.org/10.3390/vaccines9121448 - 07 Dec 2021
Cited by 2 | Viewed by 1972
Abstract
Vaccination is the most effective preventive measure of COVID-19 available at present, but its success depends on the global accessibility of vaccines and the willingness of people to be vaccinated. As the vaccination rollouts are increasing worldwide, it is important to assess public [...] Read more.
Vaccination is the most effective preventive measure of COVID-19 available at present, but its success depends on the global accessibility of vaccines and the willingness of people to be vaccinated. As the vaccination rollouts are increasing worldwide, it is important to assess public perception and willingness towards vaccination, so that the aim of mass vaccination will be successful. This study aimed to understand public perception towards COVID-19 vaccines and their willingness to get vaccinated in Nepal. This cross-sectional online survey was conducted among 1196 residents of Nepal in August 2021; most of the participants of this online survey were young adults (18–47 years) with university-level education. A total of 64.5% (771/1196) of the participants perceived COVID-19 vaccines to be safe and risk-free, while 68.6% (820/1196) agreed that vaccination would be efficient in the fight against this pandemic. Most of the participants (841/1196, 70.3%) disagreed that people are getting COVID-19 vaccines easily in Nepal, while they agree with the prioritization of older adults and healthcare workers for vaccination. A total of 61.1% (731/1196) of the participants had received at least one dose of the vaccine. Among the unvaccinated, 93.3% (434/465) were willing to get vaccinated when their turn came. The higher confidence of younger adults in vaccines and the vaccination process is encouraging, as that can help educate others who are hesitant or are not positive towards the idea of receiving vaccines. Dissemination of correct and current information, acquisition of enough doses of vaccines, and equitable distribution of vaccines will be required to achieve successful completion of the COVID-19 vaccination campaign in Nepal. Full article
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Article
COVID-19 Vaccination in Patients with Pulmonary Arterial Hypertension and Chronic Thromboembolic Pulmonary Hypertension: Safety Profile and Reasons for Opting against Vaccination
Vaccines 2021, 9(12), 1395; https://doi.org/10.3390/vaccines9121395 - 25 Nov 2021
Cited by 4 | Viewed by 1266
Abstract
The incidence of COVID-19 infection in patients with pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) is similar to that in the general population, but the mortality rate is much higher. COVID-19 vaccination is strongly recommended for PAH/CTEPH patients. The aim [...] Read more.
The incidence of COVID-19 infection in patients with pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) is similar to that in the general population, but the mortality rate is much higher. COVID-19 vaccination is strongly recommended for PAH/CTEPH patients. The aim of our cross-sectional study was to identify reasons why PAH/CTEPH patients refused vaccination against COVID-19. Moreover, we assessed the safety profile of approved COVID-19 vaccines in PAH/CTEPH patients. We examined 261 patients (164 PAH patients and 97CTEPH patients) with a median age of 60 (18–92) years, 62% of which were female. Sixty-one patients (23%) refused to be vaccinated. The main reason for unwillingness to be vaccinated was anxiety about adverse events (AEs, 61%). Age and fear of COVID-19 in the univariate analysis and age ≥60 years in the multivariate regression analysis were factors that impacted willingness to be vaccinated (OR = 2.5; p = 0.005). AEs were reported in 61% of vaccinated patients after the first dose and in 40.5% after the second dose (p = 0.01). The most common reported AEs were pain at the injection site (54.5%), fever (22%), fatigue (21%), myalgia (10.5%), and headache (10%). A lower percentage of AEs was reported in older patients (OR = 0.3; p = 0.001). The COVID-19 vaccines are safe for PAH/CTEPH patients. The results obtained in this study may encourage patients of these rare but severe cardio-pulmonary diseases to get vaccinated against COVID-19. Full article
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Article
Determinants of COVID-19 Vaccine Acceptance among the Adult Population of Bangladesh Using the Health Belief Model and the Theory of Planned Behavior Model
Vaccines 2021, 9(12), 1393; https://doi.org/10.3390/vaccines9121393 - 25 Nov 2021
Cited by 31 | Viewed by 4239
Abstract
Vaccination is undoubtedly one of the most effective strategies to halt the COVID-19 pandemic. The current study aimed to investigate the acceptance of COVID-19 vaccination and its associated factors using two health behavior change frameworks: the Health Belief Model (HBM) and the Theory [...] Read more.
Vaccination is undoubtedly one of the most effective strategies to halt the COVID-19 pandemic. The current study aimed to investigate the acceptance of COVID-19 vaccination and its associated factors using two health behavior change frameworks: the Health Belief Model (HBM) and the Theory of Planned Behavior (TPB). A total of 639 Bangladeshi adults (mean age: 24 years) participated in a cross-sectional online study between July and August 2021. The questionnaire covered questions regarding vaccine intentions, sociodemographic features, health status, perceived trust in/satisfaction with health authorities, reasons for vaccine hesitancy, and factors related to the health behavior change frameworks. Hierarchical logistic regression was employed to determine associations between these predictors and vaccine acceptance. The intention to get a COVID-19 vaccination was expressed among 85% of the participants. In fully adjusted models, students and respondents with more normal body weights reported higher intentions to get vaccinated. Respondents were also more likely to seek vaccination if they reported greater levels of perceived susceptibility, benefits, and cues to action, as well as lower levels of barriers and self-efficacy. Fear of future vaccine side effects was the most common reason for COVID-19 vaccine hesitancy and was expressed by 94% of the vaccine-hesitant respondents. These factors should be considered by health authorities in Bangladesh and perhaps other countries when addressing the plateauing COVID-19 vaccination rates in many populations. Full article
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Investigating the Influence of Vaccine Literacy, Vaccine Perception and Vaccine Hesitancy on Israeli Parents’ Acceptance of the COVID-19 Vaccine for Their Children: A Cross-Sectional Study
Vaccines 2021, 9(12), 1391; https://doi.org/10.3390/vaccines9121391 - 24 Nov 2021
Cited by 17 | Viewed by 2106
Abstract
Vaccination is currently the most effective strategy for combating COVID-19. COVID-19 vaccines were introduced to the adult population in Israel in early December 2020 and have been available for children aged 12–15 since June 2021. Our study aimed at assessing the influence of [...] Read more.
Vaccination is currently the most effective strategy for combating COVID-19. COVID-19 vaccines were introduced to the adult population in Israel in early December 2020 and have been available for children aged 12–15 since June 2021. Our study aimed at assessing the influence of vaccine literacy, perception, hesitancy, and behavior on Israeli parents’ intentions to have their children vaccinated. Using an anonymous online questionnaire, we recruited 520 parents; 70.4% of the parents indicated that they would get their children vaccinated. The participants’ COVID-19 vaccination status was the only socio-demographic factor significantly associated with COVID-19 vaccination acceptability (OR = 32.89; 95%CI = [13.11, 82.54]). The most common sources of information regarding the COVID-19 vaccine were health-care providers and the Internet. Parents who intend to vaccinate their children had higher mean levels of vaccine literacy (2.99 ± 0.47 vs. 3.07 ± 0.44 respectively, p = 0.06), more positive perception of the vaccine (mean scores of 2.26 ± 0.75 vs. 3.44 ± 0.68 respectively, p < 0.001), and lower perceived vaccine hesitancy (7.53 ± 2.37 vs. 4.68 ± 2.71 respectively, p < 0.001) than parents who do not intend to do so. Vaccine behavior was measured using the 5C model of psychological antecedents. All 5C components were significantly correlated with parents’ willingness to vaccinate their children. Understanding of parents’ willingness to have their children receive the COVID-19 vaccine and the barriers to and facilitators of the vaccination is crucial, as vaccination of children aged 5–11 has recently been approved by the FDA. Providing the population with reliable information regarding the COVID-19 vaccine is an important measure in the attempt to increase COVID-19 vaccine acceptance. Full article
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Impact of Anxiety on Readiness for COVID-19 Vaccination among Polish Nursing Undergraduate Students: Nationwide Cross-Sectional Study
Vaccines 2021, 9(12), 1385; https://doi.org/10.3390/vaccines9121385 - 24 Nov 2021
Cited by 3 | Viewed by 1030
Abstract
The COVID-19 pandemic had a huge impact on the mental health of people around the world, and it increased the level of fear of infection and anxiety about the consequences of the disease caused by the SARS-CoV-2 virus. We examined the relationship between [...] Read more.
The COVID-19 pandemic had a huge impact on the mental health of people around the world, and it increased the level of fear of infection and anxiety about the consequences of the disease caused by the SARS-CoV-2 virus. We examined the relationship between the level of anxiety among nursing students and their knowledge about COVID-19 vaccination. In addition, we explored the correlations among the level of anxiety, knowledge about vaccination, and the willingness to vaccinate against COVID-19. A total of 790 undergraduate nursing students participated in the study. The results demonstrated that the level of anxiety among the surveyed nursing students was low; 40% of the study participants did not report any anxiety at all, 30% reported mild anxiety, 20% reported moderate anxiety, and 9% reported severe anxiety. At the time of the study, 77.2% of the participants were already vaccinated against COVID-19. Student knowledge about vaccination against COVID-19 was high and anxiety levels were low, with no direct correlation between the knowledge of vaccination and the severity of anxiety. Full article
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Data-Driven Decision Making and Proactive Citizen–Scientist Communication: A Cross-Sectional Study on COVID-19 Vaccination Adherence
Vaccines 2021, 9(12), 1384; https://doi.org/10.3390/vaccines9121384 - 24 Nov 2021
Cited by 1 | Viewed by 1469
Abstract
Due to the severe impact of COVID-19 on public health, rollout of the vaccines must be large-scale. Current solutions are not intended to promote an active collaboration between communities and public health researchers. We aimed to develop a digital platform for communication between [...] Read more.
Due to the severe impact of COVID-19 on public health, rollout of the vaccines must be large-scale. Current solutions are not intended to promote an active collaboration between communities and public health researchers. We aimed to develop a digital platform for communication between scientists and the general population, and to use it for an exploratory study on factors associated with vaccination readiness. The digital platform was developed in Latvia and was equipped with dynamic consent management. During a period of six weeks 467 participants were enrolled in the population-based cross-sectional exploratory study using this platform. We assessed demographics, COVID-19-related behavioral and personal factors, and reasons for vaccination. Logistic regression models adjusted for the level of education, anxiety, factors affecting the motivation to vaccinate, and risk of infection/severe disease were built to investigate their association with vaccination readiness. In the fully adjusted multiple logistic regression model, factors associated with vaccination readiness were anxiety (odds ratio, OR = 3.09 [95% confidence interval 1.88; 5.09]), feelings of social responsibility (OR = 1.61 [1.16; 2.22]), and trust in pharmaceutical companies (OR = 1.53 [1.03; 2.27]). The assessment of a large number of participants in a six-week period show the potential of a digital platform to create a data-driven dialogue on vaccination readiness. Full article
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Article
Vaccinating against COVID-19: The Correlation between Pro-Vaccination Attitudes and the Belief That Our Peers Want to Get Vaccinated
Vaccines 2021, 9(11), 1366; https://doi.org/10.3390/vaccines9111366 - 20 Nov 2021
Cited by 8 | Viewed by 6579
Abstract
This study verifies whether there is a strong correlation between the pro-vaccination, against COVID-19 attitude of the respondents and their belief that most of those around them want to be vaccinated against COVID-19. For this purpose, we analyzed data from a sociological survey [...] Read more.
This study verifies whether there is a strong correlation between the pro-vaccination, against COVID-19 attitude of the respondents and their belief that most of those around them want to be vaccinated against COVID-19. For this purpose, we analyzed data from a sociological survey conducted in April 2021 in Romania. The sample size was of 1001 respondents, the selection process was randomized and the population included in the sample is representative of the socio-demographic structure of Romania. The tool used to collect the data was CATI (telephonic interview). In order to test the existence of these correlations we performed the following tests: Chi-Square test, Kendall τ, Spearman ρ tests and Freeman’s z-test. The pro-vaccination attitude strongly correlates with the perception of subjects that their primary group accepts vaccination and even correlates with the perception that the general public is rather pro-vaccination. The vaccination decision is closely linked to the social relations system and the rules of the community in which the subject lives. In this paper we discuss the correlation between attitude and belief, not the existence of a causal relation between the two of them. Full article
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Article
Recommending COVID-19 Vaccines to Patients: Practice and Concerns of Frontline Family Doctors
Vaccines 2021, 9(11), 1319; https://doi.org/10.3390/vaccines9111319 - 13 Nov 2021
Cited by 5 | Viewed by 1071
Abstract
Background: Recommendation from doctors is a well-recognized motivator toward vaccine uptake. Family doctors are in the prime position to advise the public on COVID-19 vaccination. We studied the practice and concerns of frontline family doctors concerning COVID-19 vaccination recommendations to patients. Methods [...] Read more.
Background: Recommendation from doctors is a well-recognized motivator toward vaccine uptake. Family doctors are in the prime position to advise the public on COVID-19 vaccination. We studied the practice and concerns of frontline family doctors concerning COVID-19 vaccination recommendations to patients. Methods: We conducted a cross-sectional online survey of all family doctors in the Hong Kong College of Family Physicians between June and July 2021. Their practice of making COVID-19 recommendation to patients was assessed. Based on the Health Belief Model, factors associated with doctors’ recommendation practices were explored and examined. Multivariate logistic regression models were used to investigate the factors, including COVID-19 vaccine attributes, associated with doctors’ practices in making recommendations. Their own vaccination status and psychological antecedents to vaccine hesitancy were measured. Results: A total of 312 family doctors responded (a 17.6% response rate). The proportion of doctors who had received COVID-19 vaccines was 90.1%. The proportion of doctors who would recommend all patients without contraindications for the vaccination was 64.4%. The proportion of doctors who would proactively discuss COVID-19 vaccines with patients was 52.9%. Multivariate logistic regression analysis showed that doctors’ own COVID-19 vaccination status was the strongest predictor of family doctors making a recommendation to patients (aOR 12.23 95% CI 3.45–43.33). Longer duration of practice, willingness to initiate the relevant discussion with patients and less worry about vaccine side effects on chronic illness patients were the other factors associated with making a COVID-19 vaccination recommendation. Conclusions: Family doctors should be encouraged to get vaccinated themselves and initiate discussions with patients about COVID-19 vaccines. Vaccine safety data on patients with chronic illness, training and guidelines for junior doctors may facilitate the COVID-19 vaccination recommendation practices of family doctors. Full article
Article
COVID-19 Vaccination Behavior of People Living with HIV: The Mediating Role of Perceived Risk and Vaccination Intention
Vaccines 2021, 9(11), 1288; https://doi.org/10.3390/vaccines9111288 - 06 Nov 2021
Cited by 1 | Viewed by 953
Abstract
The COVID-19 vaccination behavior of people living with HIV (PLWH) was examined via a cross-sectional web-based survey of PLWH aged 18 years and older. The survey was conducted from l May to 20 June 2021. The survey included social demographic information; vaccination behavior [...] Read more.
The COVID-19 vaccination behavior of people living with HIV (PLWH) was examined via a cross-sectional web-based survey of PLWH aged 18 years and older. The survey was conducted from l May to 20 June 2021. The survey included social demographic information; vaccination behavior (B); and questions related to perceived usefulness (PU), perceived risk (PR), subjective norms (SNs), perceived behavior control (PBC), and behavior intention (BI). The associations between the questionnaire variables and COVID-19 vaccination behavior were assessed by calculating the descriptive data, correlation analysis, and structural equation modeling. In total, 43.71% of the 350 eligible respondents had received a COVID-19 vaccine. The differences in COVID-19 vaccination behavior according to age, gender, religious belief, marital status, income, education level, and occupation were not obvious (p > 0.05). PU had a significantly negative effect on PR (p < 0.05). PR had a significantly negative effect on BI (p < 0.05). SNs had a significantly positive effect on BI (p < 0.05). BI had a significantly positive effect on B (p < 0.05). PR fully mediated the effects of PU on BI, BI fully mediated the effects of PR on B, and BI fully mediated the effects of SNs on B (p < 0.05). Health policymakers and medical workers should provide more information about the risks of vaccine application to improve the vaccination behavior of PLWH. Full article
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Article
Differences in Sources of Information, Risk Perception, and Cognitive Appraisals between People with Various Latent Classes of Motivation to Get Vaccinated against COVID-19 and Previous Seasonal Influenza Vaccination: Facebook Survey Study with Latent Profile Analysis in Taiwan
Vaccines 2021, 9(10), 1203; https://doi.org/10.3390/vaccines9101203 - 19 Oct 2021
Cited by 2 | Viewed by 1360
Abstract
The present study aimed (1) to identify distinct latent classes of motivation to get vaccinated against coronavirus disease 2019 (COVID-19) and previous seasonal influenza vaccination among people in Taiwan and (2) to examine the roles of sources of information, risk perception, and cognitive [...] Read more.
The present study aimed (1) to identify distinct latent classes of motivation to get vaccinated against coronavirus disease 2019 (COVID-19) and previous seasonal influenza vaccination among people in Taiwan and (2) to examine the roles of sources of information, risk perception, and cognitive appraisals of vaccination against COVID-19 in these classes. We recruited 1047 participants through a Facebook advertisement. The participants’ motivation to get vaccinated against COVID-19, previous seasonal influenza vaccination, sources of information about COVID-19 vaccination, risk perception of COVID-19, and cognitive appraisals of vaccination against COVID-19 were determined. We examined the participants’ motivation for COVID-19 vaccination and previous seasonal influenza vaccination through latent profile analysis. Four latent classes of motivation were identified: participants with high motivation for COVID-19 vaccination and high seasonal influenza vaccination, those with high motivation for COVID-19 vaccination but low seasonal influenza vaccination, those with low motivation for COVID-19 vaccination but high seasonal influenza vaccination, and those with low motivation for COVID-19 vaccination and low seasonal influenza vaccination. Compared with participants in the latent class of high motivation for COVID-19 vaccination and high seasonal influenza vaccination, those in the other three latent classes had lower levels of positive appraisals of COVID-19 vaccination; participants in the latent class of low motivation for COVID-19 vaccination and low seasonal influenza vaccination had lower risk perception of COVID-19 and were also less likely to obtain information about COVID-19 vaccination from the internet, friends, and family members. The various motivations and behaviors for vaccination, sources of information, risk perception, and cognitive appraisals of vaccination against COVID-19 should be considered in intervention programs aiming to increase people’s motivation to get vaccinated against COVID-19. Full article
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Article
Predicting COVID-19 Vaccination Intention: The Determinants of Vaccine Hesitancy
Vaccines 2021, 9(10), 1161; https://doi.org/10.3390/vaccines9101161 - 11 Oct 2021
Cited by 19 | Viewed by 3346
Abstract
Do people want to be vaccinated against COVID-19? Herd immunity is dependent on individuals’ willingness to be vaccinated since vaccination is not mandatory. Our main goal was to investigate people’s intention to be vaccinated and their intentions to vaccinate their children. Moreover, we [...] Read more.
Do people want to be vaccinated against COVID-19? Herd immunity is dependent on individuals’ willingness to be vaccinated since vaccination is not mandatory. Our main goal was to investigate people’s intention to be vaccinated and their intentions to vaccinate their children. Moreover, we were interested in understanding the role of the personal characteristics, psychological factors, and the lockdown context on that decision. Therefore, we conducted an online survey during the lockdown in Portugal (15 January 2021 until 14 March 2021). Participants completed a socio-demographic questionnaire, questions about their intentions of being vaccinated, concerns about the vaccine, a COVID-19 attitudes and beliefs scale, a COVID-19 vaccine attitudes and beliefs scale, and the Domain-Specific Risk-Taking (DOSPERT) Scale. Our results showed that from the 649 participants, 63% of the participants reported being very likely to have the vaccine, while 60% reported being very likely to vaccinate their children. We conducted two linear regression models, explaining 65% of the variance for personal vaccination and 56% of the variance for children vaccination. We found that the COVID-19 vaccine general beliefs and attitudes were the main determinants of vaccination intention. Additionally, our proposed artificial neural network model was able to predict with 85% accuracy vaccination intention. Thus, our results suggest that psychological factors are an essential determinant of vaccination intention. Thus, public policy decision makers may use these insights for predicting vaccine hesitancy and designing effective vaccination communication strategies. Full article
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Article
Vaccine Refusal in the Czech Republic Is Associated with Being Spiritual but Not Religiously Affiliated
Vaccines 2021, 9(10), 1157; https://doi.org/10.3390/vaccines9101157 - 10 Oct 2021
Cited by 12 | Viewed by 1308
Abstract
A strong reduction in the deleterious effects of the COVID-19 pandemic can be achieved by vaccination. Religiosity and spirituality (R/S) may play an important role in vaccine acceptance. However, evidence is lacking for the associations with religious conspiracy theories (RCT) in a non-religious [...] Read more.
A strong reduction in the deleterious effects of the COVID-19 pandemic can be achieved by vaccination. Religiosity and spirituality (R/S) may play an important role in vaccine acceptance. However, evidence is lacking for the associations with religious conspiracy theories (RCT) in a non-religious environment. This study investigated the associations between R/S and RCT about COVID-19 vaccination and the links of R/S with vaccine refusal and hesitancy. A sample of Czech adults (n = 459) participated in the survey. We measured R/S, RCT, religious fundamentalism, and COVID-19 vaccination intentions. We found spirituality to be significantly associated with RCT belief, with odds ratios (OR) of 2.12 (95% confidence interval [CI] 1.42–3.19). A combination of R/S groups revealed that spirituality with non-religious affiliation was associated with higher beliefs in RCT, with ORs from 3.51 to 7.17. Moreover, associations were found between spirituality with non-religious affiliation [OR 2.22(1.33–7.76)] with vaccine refusal. Our findings showed associations of spirituality and religious fundamentalism with RCT about COVID-19 vaccination. Furthermore, spirituality was linked to a higher possibility of vaccine refusal. Understanding these associations may help prevent the development of RCT and negative impact of spirituality on vaccine intentions and contribute to the effectiveness of the vaccination process. Full article
Article
Attitudes and Intentions toward COVID-19 Vaccination among Spanish Adults: A Descriptive Cross-Sectional Study
Vaccines 2021, 9(10), 1135; https://doi.org/10.3390/vaccines9101135 - 04 Oct 2021
Viewed by 1090
Abstract
Vaccination against SARS-CoV-2 is postulated as the most effective measure to control the COVID-19 pandemic. However, the use of other protection measures is necessary to efficiently combat the spread of the virus. The aim of the present study was to determine the attitudes [...] Read more.
Vaccination against SARS-CoV-2 is postulated as the most effective measure to control the COVID-19 pandemic. However, the use of other protection measures is necessary to efficiently combat the spread of the virus. The aim of the present study was to determine the attitudes and intentions toward COVID-19 vaccination among non-regular social media users in Spain and to analyze how these factors could condition the acceptance of other personal protective measures once an individual has received the COVID-19 vaccine. A cross-sectional design was used in this work. In total, 719 subjects, ≥18 years old and of both sexes, were recruited from primary public healthcare centers to self-complete a questionnaire between March and April 2021. The majority of participants had a positive attitude toward vaccination and showed high levels of intention to be vaccinated. Likewise, except those participants who considered the vaccine to be the most effective measure to fight the COVID-19 pandemic, the rest of the participants highlighted the importance of continuing to limit social interactions and/or wearing masks even after being vaccinated. Since vaccination can create a perception of total immunity against SARS-CoV-2, it is necessary that healthcare staff organize effective awareness campaigns on the importance of maintaining personal protective measures until vaccination coverage is greater. Full article
Article
Factors Related to Caregiver Intentions to Vaccinate Their Children with Attention-Deficit/Hyperactivity Disorder against COVID-19 in Taiwan
Vaccines 2021, 9(9), 983; https://doi.org/10.3390/vaccines9090983 - 02 Sep 2021
Cited by 9 | Viewed by 1037
Abstract
The aims of this study were to examine the proportion of caregivers who were hesitant to vaccinate their children with attention-deficit/hyperactivity disorder (ADHD) against coronavirus disease 2019 (COVID-19) and the factors related to caregiver intentions to vaccinate their children against COVID-19. In total, [...] Read more.
The aims of this study were to examine the proportion of caregivers who were hesitant to vaccinate their children with attention-deficit/hyperactivity disorder (ADHD) against coronavirus disease 2019 (COVID-19) and the factors related to caregiver intentions to vaccinate their children against COVID-19. In total, 161 caregivers of children with ADHD were recruited in this study. The caregivers completed an online questionnaire to provide data regarding their intention to vaccinate their children against COVID-19, concerns about the effectiveness and safety of vaccines, unfavorable family attitudes toward vaccines, and children’s medication use for ADHD and comorbid psychopathology. The factors related to caregiver intentions to vaccinate their child were examined using linear regression analysis. The results indicated that 25.5% of caregivers were hesitant to vaccinate their children with ADHD, and 11.8% refused to vaccinate their children against COVID-19. The caregivers’ concerns about the safety of vaccines and children’s regular use of medication for ADHD were negatively associated with caregiver intentions to vaccinate, whereas the children’s comorbid conduct or oppositional defiant problems were positively associated with the caregiver intentions to vaccinate. An intervention that enhances caregiver intentions to vaccinate their children with ADHD against COVID-19 by addressing the related factors found in this study is warranted. Full article
Communication
Willingness to Get the COVID-19 Vaccine among Residents of Slum Settlements
Vaccines 2021, 9(9), 951; https://doi.org/10.3390/vaccines9090951 - 26 Aug 2021
Cited by 11 | Viewed by 1720
Abstract
Slum residents are more vulnerable to COVID-19 infection. Without a specific treatment, vaccination became the main strategy against COVID-19. In this study, we determined the rate and factors associated with the willingness to get vaccinated against COVID-19 among slum residents and their main [...] Read more.
Slum residents are more vulnerable to COVID-19 infection. Without a specific treatment, vaccination became the main strategy against COVID-19. In this study, we determined the rate and factors associated with the willingness to get vaccinated against COVID-19 among slum residents and their main reasons associated with the vaccine intention. The study was conducted in Pau da Lima, a slum community in Salvador Brazil. In total, 985 residents were interviewed. Among them 66.0% (650/985) were willing to get vaccinated, 26.1% (257/985) were hesitant to take the vaccine and 7.9% (78/285) were not sure. The main reasons cited for vaccine hesitancy or being unsure were concerns about vaccine efficacy and potential side effects. In contrast, the main reasons cited for wanting the vaccine were the high incidence of COVID-19 cases and participants’ self-perception of their own health history. Multivariate analysis identified that COVID-19 vaccine hesitancy was associated with younger age and low social capital, summarized as low perceived importance of vaccination to protect one’s family, friends and community. Slum residents have been less willing to vaccinate than the general population. Social capital presents a critical opportunity in the design of communication campaigns to increase COVID-19 vaccine acceptance in slum settings. Full article
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Article
The Credibility of Health Information Sources as Predictors of Attitudes toward Vaccination—The Results from a Longitudinal Study in Poland
Vaccines 2021, 9(8), 933; https://doi.org/10.3390/vaccines9080933 - 23 Aug 2021
Cited by 5 | Viewed by 1159
Abstract
Background: The research focused on the relationships between attitudes towards vaccination and the trust placed in different sources of information (science, experts and the information available on the Internet) before and during COVID-19. Method: A longitudinal design was applied with the first measurement [...] Read more.
Background: The research focused on the relationships between attitudes towards vaccination and the trust placed in different sources of information (science, experts and the information available on the Internet) before and during COVID-19. Method: A longitudinal design was applied with the first measurement in February 2018 (N = 1039). The second measurement (N = 400) was carried out in December 2020 to test if the pandemic influenced the trust in different sources of information. Results: The final analyses carried out on final sample of 400 participants showed that there has been no change in trust in the Internet as a source of knowledge about health during the pandemic. However, the trust in science, physicians, subjective health knowledge, as well as the attitude towards the vaccination has declined. Regression analysis also showed that changes in the level of trust in physicians and science were associated with analogous (in the same direction) changes in attitudes toward vaccination. The study was also focused on the trust in different sources of health knowledge as possible predictors of willingness to be vaccinated against SARS-nCoV-2. However, it appeared that the selected predictors explained a small part of the variance. This suggests that attitudes toward the new COVID vaccines may have different sources than attitudes toward vaccines that have been known to the public for a long time. Full article

Review

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Review
Global COVID-19 Vaccine Acceptance: A Systematic Review of Associated Social and Behavioral Factors
Vaccines 2022, 10(1), 110; https://doi.org/10.3390/vaccines10010110 - 12 Jan 2022
Cited by 35 | Viewed by 2726
Abstract
COVID-19 vaccines have met varying levels of acceptance and hesitancy in different parts of the world, which has implications for eliminating the COVID-19 pandemic. The aim of this systematic review is to examine how and why the rates of COVID-19 vaccine acceptance and [...] Read more.
COVID-19 vaccines have met varying levels of acceptance and hesitancy in different parts of the world, which has implications for eliminating the COVID-19 pandemic. The aim of this systematic review is to examine how and why the rates of COVID-19 vaccine acceptance and hesitancy differ across countries and continents. PubMed, Web of Science, IEEE Xplore and Science Direct were searched between 1 January 2020 and 31 July 2021 using keywords such as “COVID-19 vaccine acceptance”. 81 peer-reviewed publications were found to be eligible for review. The analysis shows that there are global variations in vaccine acceptance among different populations. The vaccine-acceptance rates were the highest amongst adults in Ecuador (97%), Malaysia (94.3%) and Indonesia (93.3%) and the lowest amongst adults in Lebanon (21.0%). The general healthcare workers (HCWs) in China (86.20%) and nurses in Italy (91.50%) had the highest acceptance rates, whereas HCWs in the Democratic Republic of Congo had the lowest acceptance (27.70%). A nonparametric one-way ANOVA showed that the differences in vaccine-acceptance rates were statistically significant (H (49) = 75.302, p = 0.009*) between the analyzed countries. However, the reasons behind vaccine hesitancy and acceptance were similar across the board. Low vaccine acceptance was associated with low levels of education and awareness, and inefficient government efforts and initiatives. Furthermore, poor influenza-vaccination history, as well as conspiracy theories relating to infertility and misinformation about the COVID-19 vaccine on social media also resulted in vaccine hesitancy. Strategies to address these concerns may increase global COVID-19 vaccine acceptance and accelerate our efforts to eliminate this pandemic. Full article
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Review
Determinants of Obtaining COVID-19 Vaccination among Health Care Workers with Access to Free COVID-19 Vaccination: A Cross-Sectional Study
Vaccines 2022, 10(1), 39; https://doi.org/10.3390/vaccines10010039 - 29 Dec 2021
Cited by 1 | Viewed by 1038
Abstract
Introduction: Despite global efforts to contain the illness, COVID-19 continues to have severe health, life, and economic repercussions; thus, maintaining vaccine development is mandatory. Different directions concerning COVID-19 vaccines have emerged as a result of the vaccine’s unpredictability. Aims: To study the determinants [...] Read more.
Introduction: Despite global efforts to contain the illness, COVID-19 continues to have severe health, life, and economic repercussions; thus, maintaining vaccine development is mandatory. Different directions concerning COVID-19 vaccines have emerged as a result of the vaccine’s unpredictability. Aims: To study the determinants of the attitudes of healthcare workers (HCWs) to receiving or refusing to receive the vaccine. Methods: The current study adopted an interviewed questionnaire between June and August 2021. A total of 341 HCWs currently working at Assiut University hospitals offered to receive the vaccine were included. Results: Only half of the HCWs (42%) accepted the COVID-19 vaccine. The most common reason that motivated the HCWs was being more susceptible than others to infection (71.8%). On other hand, the common reasons for refusing included: previously contracted the virus (64.8%); did not have time (58.8%); warned by a doctor not to take it (53.8%). Nearly one-third of nonaccepting HCWs depended on television, the Internet, and friends who refused the vaccine for information (p < 0.05). In the final multivariate regression model, there were six significant predictors: sex, job category, chronic disease, being vaccinated for influenza, and using Assiut University hospital staff and the Ministry of Health as sources of information (p < 0.05). Conclusion: Misinformation and negative conceptions are still barriers against achieving the desired rate of vaccination, especially for vulnerable groups such as HCWs. Full article
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Review
Ending the Pandemic: How Behavioural Science Can Help Optimize Global COVID-19 Vaccine Uptake
Vaccines 2022, 10(1), 7; https://doi.org/10.3390/vaccines10010007 - 22 Dec 2021
Cited by 5 | Viewed by 1681
Abstract
Governments, public health officials and pharmaceutical companies have all mobilized resources to address the COVID-19 pandemic. Lockdowns, social distancing, and personal protective behaviours have been helpful but have shut down economies and disrupted normal activities. Vaccinations protect populations from COVID-19 and allow a [...] Read more.
Governments, public health officials and pharmaceutical companies have all mobilized resources to address the COVID-19 pandemic. Lockdowns, social distancing, and personal protective behaviours have been helpful but have shut down economies and disrupted normal activities. Vaccinations protect populations from COVID-19 and allow a return to pre-pandemic ways of living. However, vaccine development, distribution and promotion have not been sufficient to ensure maximum vaccine uptake. Vaccination is an individual choice and requires acceptance of the need to be vaccinated in light of any risks. This paper presents a behavioural sciences framework to promote vaccine acceptance by addressing the complex and ever evolving landscape of COVID-19. Effective promotion of vaccine uptake requires understanding the context-specific barriers to acceptance. We present the AACTT framework (Action, Actor, Context, Target, Time) to identify the action needed to be taken, the person needed to act, the context for the action, as well as the target of the action within a timeframe. Once identified a model for identifying and overcoming barriers, called COM-B (Capability, Opportunity and Motivation lead to Behaviour), is presented. This analysis identifies issues associated with capability, opportunity and motivation to act. These frameworks can be used to facilitate action that is fluid and involves policy makers, organisational leaders as well as citizens and families. Full article

Other

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Brief Report
High Stress Levels and Trust toward the Government Are Associated with More Positive Attitudes toward COVID-19 Vaccines among French Students: A Pilot Study
Vaccines 2022, 10(9), 1377; https://doi.org/10.3390/vaccines10091377 - 24 Aug 2022
Cited by 2 | Viewed by 460
Abstract
Mistrust in COVID-19 vaccines may hinder vaccination campaigns. We looked at cognitive determinants of vaccination intentions against COVID-19. We were interested in (i) the effects of stress and (ii) the effects of self-protection systems on attitudes and intentions to get COVID-19 vaccines. We [...] Read more.
Mistrust in COVID-19 vaccines may hinder vaccination campaigns. We looked at cognitive determinants of vaccination intentions against COVID-19. We were interested in (i) the effects of stress and (ii) the effects of self-protection systems on attitudes and intentions to get COVID-19 vaccines. We conducted an online observational pilot study with 203 participants and used self-report questionnaires to assess perceived stress and vulnerability to disease, beliefs about a dangerous world, pandemic-related stressors, living conditions, attitudes and intentions toward the vaccines and trust in government management of the COVID-19 pandemic. The participants reporting high levels of trust in government and high levels of stress were more likely to have positive attitudes toward COVID-19 vaccines, although these two effects are at least partially independent of each other. We discuss how to improve the communication around COVID-19 vaccine policies. Full article
Brief Report
Educational Inequalities in COVID-19 Vaccination: A Cross-Sectional Study of the Adult Population in the Lazio Region, Italy
Vaccines 2022, 10(3), 364; https://doi.org/10.3390/vaccines10030364 - 25 Feb 2022
Cited by 3 | Viewed by 890
Abstract
Several studies reported socioeconomic inequalities during the COVID-19 pandemic. We aimed at investigating educational inequalities in COVID-19 vaccination on 22 December 2021. We used the cohort of all residents in the Lazio Region, Central Italy, established at the beginning of the pandemic to [...] Read more.
Several studies reported socioeconomic inequalities during the COVID-19 pandemic. We aimed at investigating educational inequalities in COVID-19 vaccination on 22 December 2021. We used the cohort of all residents in the Lazio Region, Central Italy, established at the beginning of the pandemic to investigate the effects of COVID-19. The Lazio Region has 5.5 million residents, mostly distributed in the Metropolitan Area of Rome (4.3 million inhabitants). We selected those aged 35 years or more who were alive and still residents on 22 December 2021. The cohort included data on sociodemographic, health characteristics, COVID-19 vaccination (none, partial, or complete), and SARS-CoV-2 infection. We used adjusted logistic regression models to analyze the association between level of education and no vaccination. We investigated 3,186,728 subjects (54% women). By the end of 2021, 88.1% of the population was fully vaccinated, and 10.3% were not vaccinated. There were strong socioeconomic inequalities in not getting vaccinated: compared with those with a university degree, residents with a high school degree had an odds ratio (OR) of 1.29 (95% confidence interval, CI, 1.27–1.30), and subjects with a junior high or primary school attainment had an OR = 1.41 (95% CI: 1.40–1.43). Since a comprehensive vaccination against COVID-19 could help reduce socioeconomic inequalities raised with the pandemic, further efforts in reaching the low socioeconomic strata of the population are crucial. Full article
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Planned Papers

The below list represents only planned manuscripts. Some of these manuscripts have not been received by the Editorial Office yet. Papers submitted to MDPI journals are subject to peer-review.

Title: QUI CUSTODIET IPSOS CUSTODES? OBLIGATIONS AND RIGHTS OF PARENTS AND CHILDREN IN ITALY
Author:
Highlights: Sars-Cov-2; vaccine; social responsibility; children; public health; vaccine strategies; parental consent.

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