Search Results (32)

Background/Objectives: Vaccination hesitancy remains a global challenge, especially after the COVID-19 pandemic. We aimed to assess the prevalence of hesitancy towards regular COVID-19 vaccinations, including booster doses (additional doses beyond the primary to sustain or improve immunity), among university students and its associated factors. Methods: We conducted a cross-sectional study involving 190 university students from Hellenic Mediterranean University in Crete, Greece. Data were collected through an electronic survey distributed from July to October 2024. The survey included socio-demographic characteristics, health status factors, prior COVID-19 infection and vaccination history (general and for COVID-19), attitudes about COVID-19 vaccination, and the Attitude Towards Adult Vaccination (ATAVAC) scale. Qualitative data were also collected by addressing themes regarding ways to overcome vaccine hesitancy. Results: The study found that 64% of participants expressed hesitancy towards receiving COVID-19 booster doses. Factors contributing to this hesitancy were female gender, current smoking, pregnancy, concerns about vaccine side effects, a lack of confidence in vaccine efficacy, COVID-19 infection history, low perceived susceptibility to infection, and reliance on media information. Additionally, increased trust in the value of adult vaccination, adhering to recommendations of treating physician/scientist opinions, and prior adherence to vaccination were positively associated with regular COVID-19 vaccinations. A thematic analysis of the qualitative data identified four key strategies to overcome student vaccine hesitancy: enhancing health literacy, validating vaccine safety through further research, alleviating pandemic-related fears, and addressing distrust in authorities and opposition to mandatory vaccination. Conclusions: Our findings provide insights into the intricate factors and barriers of COVID-19 vaccination hesitancy among university students, thus emphasizing the need for more targeted interventions. Full article

Objectives: The aim of the present study was to provide insight into potential predictors of HPV vaccination uptake and the willingness to get vaccinated. Methods: This cross-sectional study was conducted among university students using an online, anonymous, self-administered questionnaire. Vaccine hesitancy was measured according to the adult Vaccine Hesitancy Scale (aVHS). Sociodemographic characteristics, beliefs about vaccination decision-making, vaccination behavior, and willingness to receive the HPV vaccine among unvaccinated students, and sources of information about vaccinations were investigated. Results: Among the 542 sampled students, 11.1% were classified as vaccine-hesitant. About one third (31.7%) had not received the HPV vaccination. Males, older students, those who had not received the dTap-IPV booster dose, and those being discouraged from getting vaccinated by a healthcare worker were more likely not to be vaccinated. Students having one parent holding a university degree or higher were more likely to be vaccinated compared to those having parents with a high school diploma or less. Among unvaccinated students, 65.7% were willing to get vaccinated against HPV, and it was positively associated with a low aVHS score and female gender, as well as being enrolled in medical and life sciences majors. Conclusions: Suboptimal HPV vaccination uptake was observed, especially among male and older university students. Insights from the present study highlight the need to address misconceptions about HPV infection and vaccines by providing facts that can be used in conversations with individuals who may feel insecure after having heard various myths about HPV vaccination. Full article

This study focused on vaccine hesitancy and decision regret about the COVID-19 vaccine among nursing students (BScN and MScN) and Registered Nurses (RNs) in Italy. The primary aim was to describe decision regret and vaccine hesitancy among these groups and to understand what influences vaccine hesitancy. Data were collected through an e-survey conducted from March to June 2024. The Decision Regret Scale and the Adult Vaccine Hesitancy Scale were employed to assess regret and hesitancy levels, assessing trust, concerns, and compliance regarding vaccination. Among the participants, 8.64% were not vaccinated. The results indicated moderate to high levels of decision regret and diverse levels of trust, concerns, and compliance with COVID-19 vaccination. Structural equation modeling revealed that decision regret significantly predicted Trust (R² = 31.3%) and Concerns (R² = 26.9%), with lower regret associated with higher trust and lower concerns about vaccine safety. The number of COVID-19 vaccine boosters was a significant predictor of Trust and Concerns, with more boosters associated with higher trust and lower concerns. MScN students exhibited higher Compliance compared to RNs (R² = 2.9%), highlighting the role of advanced education. These findings suggest that addressing decision regret and providing comprehensive vaccine information could enhance trust and compliance. Full article

Vaccine hesitancy is an important public health issue referring to concerns about the safety and efficacy of vaccination. Within a framework, this study aimed to assess the cultural adaptation, validity, and reliability of the Greek version of the adult Vaccine Hesitancy Scale (aVHS) as well as to identify the determinants of vaccine hesitancy among a large regional population in central Greece. A cross-sectional study was conducted enrolling 300 adults who had received primary healthcare services in the Health Centers and Local Health Units of the Magnesia Region from October to December 2022. The aVHS and the Life Orientation Test-Revised (LOT-R) were used to identify vaccine hesitancy and the dispositional level of optimism, respectively. For survey translation, the procedure of forward and backward translation was followed. Also, the aVHS was tested in a pilot study with a sample of 18 responders. Construct validity and internal consistency reliability were investigated via exploratory and confirmatory factor analysis and Cronbach’s alpha coefficients, respectively. Simple and multiple linear regression analysis were used to determine predictors for vaccine hesitancy. Factor analyses indicated that the aVHS comprises two constructs (“lack of confidence” and “risk perception”) explaining 68.9% of the total variance. The Cronbach’s alpha of the total scale was 0.884, indicating its high internal consistency. Participants who lived in rural areas, had a lower annual income, and reported a lower level of optimism showed a higher lack of confidence in vaccination. On the other hand, people aged above 45 years old who had graduated from high school or elementary school and were unemployed showed greater aversion to the risks of side effects. Finally, certain socio-demographic characteristics were associated with vaccine hesitancy. Our data suggest that the aVHS is a valid and reliable instrument for measuring vaccine-related attitudes and perceptions in Greek society, providing meaningful insight into designing vaccination-related preventive interventions in the community. Full article

(1) Background: Vaccination is a cornerstone of public health strategy for mitigating the morbidity and mortality associated with seasonal influenza. However, vaccine hesitancy and misconceptions pose significant barriers to this effort, particularly in the context of the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to investigate the transfer of COVID-19 vaccine hesitancy to the influenza vaccine and to identify misconceptions about the influenza vaccine among the Saudi population in the post-COVID-19 era. (2) Methods: A web-based, cross-sectional study was conducted between February and June 2023 using a questionnaire adapted from the Adult Vaccine Hesitancy Scale (aVHS). The questionnaire was disseminated to 589 Saudi residents, aged 18 and above, with access to digital devices. Data were analyzed via logistic regression analysis to determine the associations between vaccine hesitancy, knowledge of influenza, and baseline characteristics. (3) Results: This study found that 37.7% of respondents exhibited vaccine hesitancy, while 56.7% demonstrated good knowledge about influenza. There was a significant relationship between nationality and vaccine hesitancy (p-value > 0.05), with non-Saudi respondents exhibiting higher hesitancy. Logistic regression analysis revealed significant associations between vaccine hesitancy, age, and nationality. Meanwhile, participants with higher educational qualifications showed greater knowledge about influenza. (4) Conclusions: The findings highlight an important crossover of COVID-19 vaccine hesitancy to influenza vaccines. This study underscores the need for targeted public health interventions to address misconceptions about the influenza vaccine, particularly among certain demographic groups, in order to improve influenza vaccine uptake in the post-COVID era. Full article

Despite the rigorous investigation of the phenomenon of vaccine hesitancy and refusal during the COVID-19 pandemic, the socioeconomic determinants of this phenomenon remain poorly investigated on a global scale. Following proportional quota sampling, we conducted a population-based cross-sectional study. We recruited participants on-site and online from different settings, regions, and socioeconomic strata in two Eastern Mediterranean populations, Greece and Cyprus. Our approach provided a nationwide sample (n = 576) approaching the adult population structure of the two countries, with a slight underrepresentation of men and older people. Our results indicate clear socioeconomic differences in vaccine hesitancy and vaccination coverage, consistent with wider social inequalities in health. In particular, we reveal a clear socioeconomic gradient characterized by lower vaccine hesitancy and higher vaccination coverage, with increasing educational attainment and income. Additionally, participants residing in semi-urban areas show higher vaccine hesitancy and have lower vaccination coverage than those residing in urban and rural areas. Our results could inform Public Health approaches aiming to tackle the alarming phenomenon of vaccine hesitancy by enabling the targeting of population groups who are particularly vaccine-hesitant, rendering such approaches more targeted and effective while at the same time reducing inequalities in the control and prevention of infectious diseases. Full article

Over the past decades, vaccination has proven to be largely beneficial to global health. Despite vaccine efficacy, the French population has been recently affected by more anti-vaccination attitudes and vaccine refusal, and it is therefore necessary to validate tools to study this health issue. The Vaccination Attitudes Examination scale (VAX) is a 12-item questionnaire targeting adults that assesses general attitudes towards vaccination. The aims of the study were to translate and adapt the original English version of the scale into French and to test the psychometric properties of the scale in a French-population-based sample of adults. We included 450 French speaking adults that completed the French VAX and other questionnaires to assess convergent and divergent validities. Exploratory and confirmatory factor analyses showed that the French version of the VAX replicated the factorial structure of the original scale. Moreover, it demonstrated high internal consistency, good convergent and divergent validities, and excellent temporal stability. Furthermore, scores on the scale differentiated vaccinees from non-vaccinee respondents. Results on the scale provide us with insight into factors involved in vaccine hesitancy in France, therefore allowing French authorities and policy makers to address these specific concerns and improve vaccine acceptance rates in this country. Full article

Following the rollout of a booster campaign to promote immunity against COVID-19 in China, this study aimed to assess booster hesitancy among adults who were fully vaccinated with primary doses across Zhejiang Province. Firstly, the modified 5C scale developed by a German research team was assessed for reliability and validity via a pre-survey in Zhejiang Province. Then, a 30-item questionnaire was established to conduct online and offline surveys during 10 November to 15 December 2021. Demographic characteristics and information on previous vaccination experience, vaccine type of primary doses, attitudes towards booster doses and awareness of SARS-CoV-2 infection were collected. Chi-square tests, pairwise comparison and multivariate logistic regression were performed in data analysis. In total, 4039 valid questionnaires were analyzed, with booster hesitancy of 14.81%. Dissatisfaction with previous vaccination experience of primary doses (ORs = 1.771~8.025), less confidence in COVID-19 vaccines (OR = 3.511, 95%CI: 2.874~4.310), younger age compared to the elderly aged 51–60 years old (2.382, 1.274~4.545), lower education level (ORs = 1.707~2.100), weaker awareness of social responsibility of prevention and control of COVID-19 (1.587, 1.353~1.859), inconvenience of booster vaccination (1.539, 1.302~1.821), complacency regarding vaccine efficacy as well as self-health status (1.224, 1.056~1.415) and excessive trade-offs before vaccination (1.184, 1.005~1.398) were positively associated with booster hesitancy. Therefore, intelligent means should be strengthened to optimize vaccination services. More influential experts and other significant figures should be supported to promote timely evidence-based information via various media platforms to reduce public hesitancy and increase booster uptake. Full article

Vaccination is a key public health strategy that is known to be effective in mitigating the risk of infection and severe disease. However, in the context of the COVID-19 pandemic, the percentage (<50%) of Malaysians who have received a booster for the COVID-19 vaccine has remained stagnant over a year. This study aimed to determine the prevalence of and the factors associated with hesitancy toward the second dose of booster for the COVID-19 vaccine. A web-based cross-sectional study was conducted from August to November 2022. The Oxford Vaccine Hesitancy Scale was used to assess the hesitancy toward the second dose of booster for the COVID-19 vaccine. Simple and multiple factors logistic regressions were used to determine the predictors of hesitancy. A p-value less than 0.05 was considered to be statistically significant. Data from 798 respondents were included in the analysis. The prevalence of hesitancy toward the second booster of the COVID-19 vaccine was 26.7%. The predictors of second-booster hesitancy were older age (AOR = 1.040, 95 CI = 1.022, 1.058), having received the third dose (first booster) because of instruction by the government (AOR = 2.125, 95% CI = 1.380, 3.274), concern about serious long term side effects of the vaccine (AOR = 4.010, 95% CI = 2.218, 7.250), and opinions of close friends and immediate family members that the booster is harmful (AOR = 2.201, 95% CI = 1.280, 3.785). Conversely, factors that appear to reduce vaccine booster hesitancy were acceptance of the third dose due to the high number of cases and the increasing rate of infection (AOR = 0.548, 95% CI = 0.317, 0.947), the belief that the vaccine will decrease the risk of getting the infection (AOR = 0.491, 95% CI = 0.277, 0.870), and opinions of close friends and immediate family members that the booster is helpful (AOR = 0.479, 95% CI = 0.273, 0.840). In conclusion, more than one-fifth of Malaysians were hesitant to take the second booster of the COVID-19 vaccine. This suggests that appropriate steps that increase vaccine acceptance, taking into consideration the findings of the present study, are needed to address this issue and to foster more positive attitudes toward vaccination. The survey was available in three main languages but limited to people with internet access; hence, it would likely be biased toward younger adults and social media users and exclude those with limited or no internet access, in particular older people. Therefore, the results are not representative of the Malaysian population at large and caution should be exercised when interpreting the findings. Full article

This study investigates how health literacy (HL) and trust in health information affected COVID-19 vaccine hesitancy among Chinese Hong Kong adults. A cross-sectional study was conducted in August 2022. A total of 401 participants completed the study. Participants completed a newly developed Hong Kong HL scale and self-reported their trust levels in health information from different resources. The proportions of early uptake of the first dose and booster dose of COVID-19 vaccine were 69.1% and 71.8%, respectively. The risk of delaying the first dose was higher among participants with inadequate functional HL (OR = 0.58, p = 0.015), adequate levels of two subdomains of critical HL (OR = 1.82, p = 0.013; OR = 1.91, p < 0.01), and low-level trust in health information from the government (OR = 0.57, p = 0.019). Respondents with adequate interactive HL (OR = 0.52, p = 0.014) and inadequate level of one subdomain of critical HL (OR =1.71, p = 0.039) were more likely to delay the booster dose. This negative association between critical HL and vaccination was suppressed by trust in health information from the government. This study shows that HL and trust in health information from the government are associated with COVID-19 vaccine hesitancy. Efforts should be directed at providing tailored communication strategies with regard to people’s HL and increasing public confidence in health authorities to decrease vaccine hesitancy. Full article

Adults with comorbidities have faced a high risk from COVID-19 infection. However, Western Australia experienced relatively few infections and deaths from 2020 until early 2022 compared with other OECD countries, as hard border policies allowed for wide-scale vaccination before mass infections began. This research investigated the thoughts, feelings, risk perceptions, and practices of Western Australian adults with comorbidities aged 18–60 years in regard to COVID-19 disease and COVID-19 vaccines. We conducted 14 in-depth qualitative interviews between January and April 2022, just as the disease was starting to circulate. We coded results inductively and deductively, combining the Extended Parallel Process Model (EPPM) and vaccine belief models. Non-hesitant participants believed COVID-19 vaccines were safe and effective at mitigating COVID-19′s threat and subsequently got vaccinated. Vaccine hesitant participants were less convinced the disease was severe or that they were susceptible to it; they also did not consider the vaccines to be sufficiently safe. Yet, for some hesitant participants, the exogenous force of mandates prompted vaccination. This work is important to understand how people’s thoughts and feelings about their comorbidities and risks from COVID-19 influence vaccine uptake and how mandatory policies can affect uptake in this cohort. Full article

The coronavirus (COVID-19) pandemic has emphasized a need to assess the cause of vaccine hesitancy. This study verified the reliability and validity of the Korean versions of the COVID-19 vaccine hesitancy scale and vaccine conspiracy belief scale and the correlation between them. The COVID-19 vaccine hesitancy scale, Korean COVID-19 vaccine hesitancy scale, vaccine conspiracy beliefs scale, and self-efficacy scale were the study tools. Following translation into Korean, back translation into English, content validity verification, and preliminary survey, valid samples were obtained from 400 adults aged >20 years. Exploratory factor analysis revealed that “belief” and “lack of trust” accounted for 62.4% of the total variance. The model fit index of the vaccine conspiracy beliefs scale revealed that all values were in a good range. The Korean version of the COVID-19 vaccine hesitancy scale showed a positive correlation with vaccine conspiracy beliefs (r = 0.74, p < 0.001) and a significant negative correlation with self-efficacy (r = −0.17, p < 0.001). The validity and reliability of the COVID-19 vaccine hesitancy scale and vaccine conspiracy beliefs scale were verified. The Korean versions of the two scales can contribute to programs that measure and mediate various factors influencing vaccination during the COVID-19 pandemic. Full article

Vaccination protects people from serious illness and associated complications. Conspiracy theories and misinformation on vaccines have been rampant during the COVID-19 pandemic and are considered significant drivers of vaccine hesitancy. Since vaccine hesitancy can undermine efforts to immunize the population against COVID-19 and interferes with the vaccination rate, this study aimed to ascertain the COVID-19-vaccine-related conspiracy beliefs, vaccine hesitancy, views regarding vaccine mandates, and willingness to pay for vaccines among the general population. A web-based, cross-sectional survey was conducted (April–August 2021) among the adult population in six countries (Pakistan, Saudi Arabia, India, Malaysia, Sudan, and Egypt). Participants were recruited using an exponential, non-discriminate snowball sampling method. A validated self-completed electronic questionnaire was used for the data collection. All the participants responded to questions on various domains of the study instrument, including conspiracy beliefs, vaccine hesitancy, and willingness to pay. The responses were scored according to predefined criteria and stratified into various groups. All data were entered and analyzed using SPSS version 22. A total of 2481 responses were included in the study (Pakistan 24.1%, Saudi Arabia 19.5%, India 11.6%, Malaysia 8.1%, Sudan 19.3%, and Egypt 17.3%). There was a preponderance of participants ≤40 years old (18–25 years: 55.8%, 26–40 years: 28.5%) and females (57.1%). The average score of the COVID-19 vaccine conspiracy belief scale (C19V-CBS) was 2.30 ± 2.12 (median 2; range 0–7). Our analysis showed that 30% of the respondents were found to achieve the ideal score of zero, indicating no conspiracy belief. The mean score of the COVID-19 vaccine hesitancy scale (C19V-HS) was 25.93 ± 8.11 (range: 10–50). The majority (45.7%) had C19V-HA scores of 21–30 and nearly 28% achieved a score greater than 30, indicating a higher degree of hesitancy. There was a significant positive correlation between conspiracy beliefs and vaccine hesitancy (Spearman’s rho = 0.547, p < 0.001). Half of the study population were against the vaccine mandate. Respondents in favor of governmental enforcement of COVID-19 vaccines had significantly (p < 0.001) lower scores on the C19V-CBS and C19V-HS scale. Nearly 52% reported that they would only take vaccine if it were free, and only 24% were willing to pay for COVID-19 vaccines. A high prevalence of conspiracy beliefs and vaccine hesitancy was observed in the targeted countries. Our findings highlight the dire need for aggressive measures to counter the conspiracy beliefs and factors underlying this vaccine hesitancy. Full article

In the course of 2022, an epidemic of monkeypox (MPX) arose worldwide. In order to assess the level of knowledge of the Italian adults regarding the new emerging disease, its prevention and their level of worrying and the acceptance of a possible vaccination, a web questionnaire was spread nationwide. A total of 1352 individuals (mean age 54.5 ± 13.4, 52.4% males) completed the questionnaire. Only 26. 7% of the sample were aware of the burden of the epidemic at the moment of the investigation; 47.1% were not able to identify the transmission route, nor the main symptoms (48.9%); and 54.2% were hesitant toward a possible MPXV vaccination, mainly because of a lack of confident in vaccines (38.5%). A low level of worrying about the disease was registered (mean score 2.3 ± 1.2 on a 5-point scale). In the regression analysis performed considering MPX knowledge as outcome, a lower level of knowledge was associated with higher age (OR 1.378, CI95% 0.998–1.904), working or studying in a nonhealthcare setting (OR 0.046, CI95% 0.033–0.066), being single (OR 0.624, CI95% 0.455–0.856) and having mass media as the main source of information (OR 0.332, CI95% 0.158–0.696). These findings indicate as of the time of this investigation, the communication about the MPXV epidemic was not effective in determining a good level of knowledge about the disease and its transmission among Italian adults. This highlights the need to improve risk communication strategies. Full article

Vaccination hesitancy (VH) is a phenomenon which increases the occurrence of vaccine-preventable diseases. The study tests the validity of the Multidimensional Vaccine Hesitancy Scale (MVHS) in the case of a sample of Romanian adults (n = 528; Mean_age = 30.57). The latter filled in an online cross-sectional survey. The construct validity of MVHS was assessed by using confirmatory factor analysis (CFA), the reliability was calculated by using the internal consistency, and the convergent and discriminant validity was assessed by using the composite reliability (CR), and average variance extracted (AVE). The obtained model was invariant across gender. The structural equation model was designed for predictive validity by using the partial least square method (PLS-SEM) which analyses the relation between the MVHS dimensions and the vaccination willingness. The results show support for the 8-factor structure of the scale (χ²/df = 2.48; CFI = 0.95; RMSEA = 0.053). The Cronbach’s coefficients α > 0.70; McDonald’s ω > 0.70 and CR > 0.80 have very good values. The structural equation model shows that there are more dimensions of the scale which predict vaccination hesitancy in various types of vaccines—the main predictors remain the dimensions of health risk and healthy condition. The study’s conclusion led to the idea that the MVHS is suitable for medical practice and for research on the analysis of vaccination behaviours and intentions. Full article