Search Results (335)

COVID-19 vaccine hesitancy (VH), like attitudes towards other vaccines, is a critical global public health concern. Despite numerous studies covering psychological, sociodemographic, and other determinants of vaccine acceptance, resistance, and hesitance, few studies have reported these factors among students, particularly in politically unstable settings like Ukraine. This cross-sectional, descriptive, and quantitative study assesses hesitancy towards COVID-19 vaccines, utilizing the 5Cs Model. Among 936 respondents surveyed in 2023, 64% received at least one shot of the COVID-19 vaccine (acceptant), 11% were still considering getting vaccinated (hesitant), and 25% refused vaccination (resistant). Vaccination behavior is significantly associated with the 5Cs. Higher collective responsibility significantly increased acceptance and reduced resistance, while higher constraints lowered the chances of being either acceptant or resistant. Confidence protected against resistance. Complacency, counterintuitively, reduced odds of resistance, pointing to differences between passive hesitancy and active refusal. Male gender and sources of information and misinformation influenced confidence. Collective responsibility was positively associated with official sources and negatively with conspiracy beliefs. Complacency increased with official sources, while constraints and calculation were least explained by predictors. Practical barriers should be tackled through improved accessibility and fostering collective responsibility via targeted communication strategies. These findings provide actionable insights for policymakers, healthcare providers, and academic institutions to enhance vaccine uptake among university students, particularly in crisis settings. Full article

COVID-19 vaccine hesitancy in Pakistan is a barrier to optimal vaccine uptake and has been situated within a context of hesitancy towards other vaccines. A mixed-methods study was conducted during the initial COVID-19 vaccine roll-out in 2021 in four union councils in Peshawar, consisting of a cross-sectional survey, eight focus group discussions (FGDs) with community members and eight in-depth interviews with healthcare workers (HCWs) to assess perceptions toward vaccines. Multivariable logistic regression was used to assess factors associated with COVID-19 vaccine hesitancy. Of 400 survey participants, 57.3% were vaccine acceptant and 42.8% vaccine hesitant. Just over half (56.8%) perceived COVID-19 vaccines to be safe. Most (88%) reported trust in HCWs to provide accurate vaccine information. FGDs revealed that women received less information about the vaccine compared to men and cultural restrictions were barriers even for those willing to be vaccinated. Correlates of vaccine acceptance included male sex (aOR 2.25; 95% CI 1.29–3.91), age 50 years or greater (aOR 1.74; 95% CI 1.19–6.31), social network support (e.g., vaccine acceptance among an individual’s social network) in receiving COVID-19 vaccines (aOR 2.38; 95% CI 1.45–3.89), community concern about COVID-19 spread (aOR 2.84; 95% CI 1.73–4.66), and trust in HCWs to provide vaccine information (aOR 3.47; 95% CI 1.62–7.42). Future vaccine promotion should prioritize engaging community leaders, sharing transparent information, combatting misinformation and rumors, and implementing household-based interventions especially targeting the importance of vaccination among women and young people to increase uptake. Full article

Introduction: COVID-19 and influenza are viruses that have been major causes of morbidity and mortality worldwide. While a combination vaccine for these two viruses is currently in development, little is known about public perceptions and attitudes towards such a vaccine. Therefore, we have aimed to conduct a scoping review to evaluate the attitudes and reasons for the acceptance/rejection of a combination COVID-19 and influenza vaccination. Material and Methods: Our review has followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR) guidelines. Search terms included those on COVID-19, influenza, and combination vaccines. Searches were conducted in a total of 10 different databases, as follows: Embase, Global Health, Google Scholar, CINAHL, Medline, Scopus, ScienceDirect, PubMed, PsycINFO, and Web of Science. Results: Searches across all databases produced a total of 1763 results, of which five studies were deemed to be eligible for this review. Data from included studies encompassed a total of 20,581 participants across 14 countries. Generally, participants had favorable views towards a combination vaccine. However, attitudes varied by region, demographics, and prior vaccine exposure. Reasons provided for accepting a combination vaccine include low cost, reasonable effectiveness, fewer injections, and higher safety. However, reasons for rejection of a potential combination vaccine include a potential lack of evidence and studies regarding its effectiveness and a fear of possible side effects. Conclusions: There are generally positive attitudes and perceptions towards a combination vaccination for COVID-19 and influenza, and there are also specific segments of populations that may show hesitancy towards such a vaccine. Vaccination delivery programs should clearly demonstrate that these vaccines are safe and must concurrently address false rumors and misinformation. Ensuring that as many people as possible can receive the vaccination without barriers via equity in access should be a public health priority. It is also important to recognize the limitations of this work, especially that the review was limited to five studies, the majority of which were cross-sectional and relied on self-reporting. Full article

Background/Objectives: Influenza vaccination plays a crucial role in reducing morbidity and mortality among older adults; however, uptake remains suboptimal, particularly in the post-COVID-19 pandemic. In many settings, countries have not recovered their influenza vaccine coverage rates to the same level as pre-COVID. Therefore, this scoping review systematically identified the behavioral and social drivers (BeSD) influencing influenza vaccination among older adults using the BeSD framework. Methods: A systematic search across five databases included quantitative, qualitative, and mixed-methods studies involving individuals aged 60 years and older. Data were charted across four BeSD domains: thinking and feeling, social processes, motivation, and practical issues. Results: Thirty-nine studies from 24 countries were included. Key barriers encompassed safety concerns, misinformation, financial burdens, logistical challenges, and cultural and language barriers. While motivation was positively associated with vaccination intentions, the transition from intention to behavior remains underexplored, and practical issues have received comparatively limited research attention. Conclusions: These findings underscore the need for multifaceted, behaviorally informed interventions and greater inclusion of under-resourced settings to support equitable influenza vaccination strategies for healthy aging. Full article

Background: Vaccines have eradicated deadly diseases, yet vaccine hesitancy persists, leading to reduced uptake. Some individuals, mistrustful of healthcare providers, may turn to tools like ChatGPT for information. We evaluated ChatGPT’s responses to common vaccine hesitancy questions. Methods: Infectious disease physicians compiled 15 frequently encountered questions relating to vaccine hesitancy, focusing on concerns about efficacy, adverse effects, and cultural or religious issues, and submitted them to ChatGPT on 18 October 2023. Two independent physicians assessed the responses for factual accuracy and alignment with recommendations from the U.S. Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices (ACIP). Results: A representative selection of responses is shown. ChatGPT consistently provided fact-based, reassuring responses. For instance, it accurately addressed the benefits of male HPV vaccination; however, it failed to consider ACIP’s age-specific recommendations and individual sexual health factors. While correcting mRNA vaccine misconceptions, it did not mention the availability of non-mRNA COVID-19 vaccines. It also lacked depth in discussing religious objections, deferring users to faith leaders and providers. Conclusions: ChatGPT provides generally accurate information and may be a useful adjunct in addressing vaccine hesitancy. With refinement, it could complement public health efforts to improve vaccine confidence and counter misinformation. Full article

Examining public attitudes towards COVID-19 vaccination is crucial for understanding the global effort to combat the ongoing pandemic. Social media platforms such as YouTube play a significant role in the dissemination of information and misinformation about the vaccine, making it imperative to analyze user comments to gain insights into vaccine perceptions. Analyzing the Philippines case is particularly significant as it provides insights into the attitudes towards COVID-19 vaccination in a country that has been heavily impacted by the pandemic. The current study investigates the discourse surrounding vaccine hesitancy in comments on YouTube videos announcing the COVID-19 vaccination campaign by the Philippines national TV channels and its impact on engagement levels. A total of 741 YouTube comments were analyzed, with 80% exhibiting vaccine-hesitant related discourse. The results indicate that those with negative attitudes towards COVID-19 vaccination exhibit higher engagement levels than those supporting vaccination (p < 0.05). Additionally, the most commonly used themes in vaccine-hesitant posts were “ingredients”, “health department control”, “pharmaceutical interest”, and “adverse effects”. Moreover, 134 sources were identified among the posts, with vaccine-hesitant posts utilizing more sources than supportive vaccine posts (p < 0.001). The most significant information sources utilized in the posts were related to other YouTube users, politicians, clinicians, and scientific papers. Finally, a total of 890 discourses were coded, with the most frequently used discourse types among vaccine-hesitant posts being negationist, institutional, preventive, political, and pharmaceutical. These findings offer valuable insights into the nature and prevalence of vaccine hesitancy discourse on social media platforms and its impact on public engagement. This study highlights the importance of targeted communication strategies and the provision of accurate information from reliable sources in addressing vaccine hesitancy. Full article

During the COVID-19 pandemic, social media platforms emerged as both vital information sources and conduits for the rapid spread of propaganda and misinformation. However, existing studies often rely on single-label classification, lack contextual sensitivity, or use models that struggle to effectively capture nuanced propaganda cues across multiple categories. These limitations hinder the development of robust, generalizable detection systems in dynamic online environments. In this study, we propose a novel deep learning (DL) framework grounded in fine-tuning the RoBERTa model for a multi-label, multi-class (ML-MC) classification task, selecting RoBERTa due to its strong contextual representation capabilities and demonstrated superiority in complex NLP tasks. Our approach is rigorously benchmarked against traditional and neural methods, including, TF-IDF with n-grams, Conditional Random Fields (CRFs), and long short-term memory (LSTM) networks. While LSTM models show strong performance in capturing sequential patterns, our RoBERTa-based model achieves the highest overall accuracy at 88%, outperforming state-of-the-art baselines. Framed within the diffusion of innovations theory, the proposed model offers clear relative advantages—including accuracy, scalability, and contextual adaptability—that support its early adoption by Information Systems researchers and practitioners. This study not only contributes a high-performing detection model but also delivers methodological and theoretical insights for combating propaganda in digital discourse, enhancing resilience in online information ecosystems. Full article

In the digital era, social media proliferation accelerates rumor dissemination. During public health emergencies, such misinformation intensifies social harm. Studying the influencing factors of online rumor refutation behavior thus becomes crucial. This study uses the stimulus–organism–response (SOR) theory as an analysis framework, based on the perspective of information sources and integrating group norms as a moderating factor, to explore the psychological processes affecting Chinese university students’ online rumor refuting in public health emergencies. Against the backdrop of the COVID-19 pandemic, a questionnaire survey was conducted on 1017 respondents, and the collected data were analyzed using the structural equation modeling research method. The results indicate that both online and offline information seeking positively influence university students’ fear of contracting the COVID-19 virus. University students’ fear positively influences their engagement in online rumor refuting. Notably, fear mediates the link between online and offline information seeking and online rumor refuting. Additionally, group norms help strengthen the connection between university students’ fear and their involvement in online refuting rumors. These results provide theoretical explanations and practical guidance for university students to refute rumors online. Full article

Informational divergence emerged as a significant phenomenon during the COVID-19 health crisis. This period was characterized by information overload and changes in the communication of public health recommendations and policies by authorities and media outlets. This study examines the impact of such divergence on the population’s mental health, focusing on primary emotions expressed in comments across digital ecosystems. A media EMIC approach was used to analyze digital ecosystems during March and April 2020. Data were collected from Twitter, YouTube, Instagram, official press websites, and internet forums, yielding 3,456,387 communications. These were filtered to extract emotion-expressing content, resulting in 106,261 communications. Communications were categorized into primary emotions (anger, disgust, joy, fear, and sadness) using an exclusionary emotion assignment procedure. Analysis techniques included polarity and term frequency calculation, content analysis using Natural Language Understanding, emotion intensity measurement using IBM Watson Analytics, and data reliability assessment using the ISMA-OWA operator. The findings suggest that exposure to informational divergence from governments, health organizations, and media negatively affected mental health, evidenced by sadness, fear, disgust, and anger, which are associated with elevated levels of stress, anxiety, and information fatigue. In contrast, information perceived as reflecting coordination, support, and solidarity elicited positive emotional responses, particularly joy. Full article

Background: Resistance to vaccinations continues to pose a considerable challenge to attaining widespread vaccination, especially among the college student demographic, who are pivotal in championing public health initiatives. This systematic review investigates the elements that influence reluctance to receive the COVID-19 vaccine among university students globally. Utilizing the WHO’s 3C model, which encompasses confidence, complacency, and convenience, this review seeks to pinpoint the main factors and suggest focused strategies to address them. Methods: Following the PRISMA guidelines, we conducted a systematic search in PubMed, Medline, Web of Science, Scopus, Embase, and Global Health. Eligible studies were cross-sectional, peer-reviewed, and examined COVID-19 vaccine hesitancy among college students. Covidence was used for screening, and data were synthesized narratively using the 3C model. Results: Sixty-seven studies (n = 88,345 participants) from 25 countries were included in this study. Confidence factors were the most influential, with fear of side effects (87.18%) and doubts about efficacy (72.4%) as primary concerns. Complacency factors included a low perceived risk of infection (34.9%) and a preference for alternative preventive measures (52.3%). Convenience barriers involved financial costs (58.1%) and difficulty accessing vaccination centers (40.3%). Subgroup analyses revealed variations by academic discipline and geographic region, with medical students showing hesitancy despite their health knowledge. Conclusions: COVID-19 vaccine hesitancy among college students is primarily driven by safety concerns, misinformation, and accessibility barriers. Addressing hesitancy requires transparent risk communication, policy-driven accessibility improvements, and tailored educational interventions. These findings can inform strategies to enhance vaccine uptake among young adults and contribute to broader efforts in pandemic preparedness. Full article

The COVID-19 pandemic intensified concerns about misinformation, sparking interest in the field of infodemiology, which examines the spread and impact of information on public health perceptions. This research examines how geographic location influenced COVID-19 discourse across 10 Italian cities by analyzing geographically tagged Twitter data. Our network analysis of 4792 high-degree nodes identifies key information spreaders and community structures, while spatiotemporal mapping reveals regional variations in information patterns and influential narratives. Results demonstrate significant geographic and cultural influences on public discourse. In Milan and Rome, economic and political narratives dominated, suggesting targeted messaging about economic recovery and government transparency. Southern regions like Naples require trust-building through community-led initiatives addressing cultural health beliefs. The study identified a clear dichotomy among influencers: established public figures provided evidence-based information, while another group cultivated followings through conspiracy theories, creating echo chambers for skeptical views. This research informs strategies for location-specific information campaigns, helping public health agencies combat misinformation more effectively. Findings emphasize the need for context-specific interventions that consider geographic, cultural, and socioeconomic factors to enhance community resilience during health emergencies. Full article

Maternal immunization is a key strategy for protecting pregnant individuals and newborns from infectious diseases. This review examines the mechanisms and benefits of maternal immunization, with a focus on transplacental IgG transfer and immune system interactions. We provide an overview of current recommendations and the safety and efficacy profiles of maternal vaccines, including influenza, tetanus–diphtheria–acellular pertussis (Tdap), respiratory syncytial virus (RSV), COVID-19, and hepatitis B. Additionally, we analyze the barriers to maternal immunization, such as misinformation, vaccine hesitancy, and disparities in healthcare access, while exploring potential strategies to overcome these challenges through targeted educational initiatives, improved provider communication, and policy-driven interventions aimed at increasing vaccine confidence and accessibility. Finally, this review highlights recent innovations and future directions in maternal immunization, including emerging vaccines for Group B Streptococcus and cytomegalovirus. Expanding immunization programs and advancing research on maternal–fetal immunity are essential to optimizing vaccination strategies, improving public health outcomes, and reducing the global burden of infectious diseases. Full article

During the COVID-19 pandemic, vaccination hesitancy (VH) posed an equally unexpected and significant obstacle to the effectiveness of public health interventions. VH has not only the potential to stir up public unrest, but it may also impede the success of entire immunization programs and thus prevent the attainment of herd immunity. This cross-sectional, quantitative, and descriptive study examined VH and vaccination behavior (VB) among 3486 university students in Ghana, using a standardized self-administered questionnaire based on the 5Cs model among other relevant variables. The findings confirm a significant VH and a VB influenced by both sociodemographic factors, such as gender (OR: 1.45; [CI: 1.26–1.67]), study program (OR: 0.55; [CI: 0.47–0.64]), and ethnicity (OR: 1.31; [CI: 1.12–1.52]) and also four of the 5Cs, i.e., Confidence (OR:1.56; [CI: 1.45–1.68]), Constraints (OR: 0.83; [CI: 0.78–0.87]), Calculation (OR:0.85; [CI: 0.78–0.92]), and Collective Responsibility (OR:1.27; [CI: 1.16–1.38]), yet not Complacency, nor religion. Notably, VH was further shaped by previous vaccine experience, information sources, vaccine attributes, stance on vaccine passport, and conspiracy beliefs, with misinformation from unofficial sources playing a key role. The multiple regression models explained 11% to 34% of the variance in the 5Cs, indicating varying degrees of explanatory power for each factor influencing VB and eventually also VH. This study highlights the urgent need for targeted public health interventions, such as integrating vaccine education into university orientation programs, streamlining vaccination processes, and leveraging influencers for trust-building campaigns. Full article

Background: The COVID-19 pandemic highlighted the vulnerability of immunocompromised individuals, including liver transplant recipients (LTRs), who often exhibit reduced vaccine immunogenicity. While initial vaccine doses and subsequent boosters improved immune response, LTRs were prioritized for vaccination. Studies have shown increased antibody response after each booster dose. Vaccine hesitancy, defined as delayed or refused vaccination despite availability, poses a public health challenge, often fueled by misinformation. This study aimed to evaluate anti-spike antibody responses in vaccinated LTRs after two initial doses and at least one booster, also assessing adherence to subsequent doses. Methods: We conducted a retrospective observational study at a transplant center in Milan, Italy, between January 2021 and December 2023. LTRs who had received four or more doses of mRNA vaccines (Pfizer or Moderna) were included. Anti-spike antibody levels were measured 60–80 days after each dose. Data on vaccination status were collected in January 2024. Statistical analysis was performed to compare antibody responses and identify predictive factors. Results: LTRs showed a significant increase in anti-spike antibody responses after the first booster compared to the second dose with a trend versus a further increase following the fourth dose in a subgroup of the patients receiving two booster doses. However, adherence to booster doses decreased over time. In LTRs, predictors of a weaker response after the second dose were chronic kidney disease and metabolic etiology at transplant. Conclusions: The study highlighted that in LTRs, multiple doses of the COVID-19 vaccine led to a continuous increase in anti-spike antibody responses. The progressive decline in adherence of LTRs “to further booster doses” should be related to the fact that after the spread of vaccination programs worldwide, COVID-19 is still a current infection, but it is much less severe than before. Full article

The rapid emergence of infectious disease outbreaks has underscored the urgent need for effective communication tools to manage public health crises. Artificial Intelligence (AI)-based chatbots have become increasingly important in these situations, serving as critical resources to provide immediate and reliable information. This review examines the role of AI-based chatbots in public health emergencies, particularly during infectious disease outbreaks. By providing real-time responses to public inquiries, these chatbots help disseminate accurate information, correct misinformation, and reduce public anxiety. Furthermore, AI chatbots play a vital role in supporting healthcare systems by triaging inquiries, offering guidance on symptoms and preventive measures, and directing users to appropriate health services. This not only enhances public access to critical information but also helps alleviate the workload of healthcare professionals, allowing them to focus on more complex tasks. However, the implementation of AI-based chatbots is not without challenges. Issues such as the accuracy of information, user trust, and ethical considerations regarding data privacy are critical factors that need to be addressed to optimize their effectiveness. Additionally, the adaptability of these chatbots to rapidly evolving health scenarios is essential for their sustained relevance. Despite these challenges, the potential of AI-driven chatbots to transform public health communication during emergencies is significant. This review highlights the importance of continuous development and the integration of AI chatbots into public health strategies to enhance preparedness and response efforts during infectious disease outbreaks. Their role in providing accessible, accurate, and timely information makes them indispensable tools in modern public health emergency management. Full article