Prevalence and risk factors of adverse effects after the first COVID-19 booster dose: evidence from Greece. Prevalencia y factores de riesgo de efectos adversos tras la primera dosis de refuerzo de COVID-19: Datos procedentes de Grecia

Background In general, COVID-19 vaccines are safe and effective, but minor adverse effects are common. However, adverse effects have not been measured in several countries including Greece. Objective: To estimate the prevalence of adverse effects after the first COVID-19 booster dose, and to identify possible risk factors. Material and methods: We conducted a cross-sectional study with a convenience sample in Greece during November 2022. We measured several adverse effects after the booster dose, such as fatigue, headaches, fever, chills, nausea, etc. We considered gender, age, chronic disease, self-assessment of health status, COVID-19 diagnóstico, and self-assessment of COVID-19 course as possible predictors of adverse effects. Results: In our sample, 96% developed at least one adverse effect. Half of the participants (50.2%) developed one to five adverse effects, 35.9% developed six to ten adverse effects, and 9.5% developed 11 to 16 adverse effects. Mean number of adverse effects was 5.5. The most frequent adverse effects were pain at the injection site (84.3%), fatigue (70.8%), muscle pain (61%), swelling at the injection site (55.2%), headache (49.8%), fever (42.9%), and chills (41%). Females developed more adverse effects than males (p < 0.001). The prevalence of adverse effects of COVID-19 vaccines was statistically significant and positively associated with the severity of COVID-19 among COVID-recovered individuals (p < 0.05). Moreover, younger age was associated with increased adverse effects (p < 0.001). Conclusions: Almost all participants in our study developed minor adverse effects after the booster dose. Female gender, COVID-19 patients with worse clinical course, and younger individuals experienced more often adverse effects.

Predictors of second COVID-19 booster dose or new COVID-19 vaccine hesitancy among nurses: A cross-sectional study.

AIMS AND OBJECTIVES: To assess the levels of second COVID-19 booster dose/new COVID-19 vaccine hesitancy among nurses and explore the potential predictors of vaccine hesitancy. BACKGROUND: COVID-19 full vaccination seems to be highly effective against highly contagious variants of SARS-CoV-2. Healthcare workers are at high-risk group since they have experienced high levels of COVID-19-associated morbidity and mortality. DESIGN: An on-line cross-sectional study was carried out in Greece in May 2022, using a self-administered questionnaire. METHODS: The study population included nurses in healthcare services who were fully vaccinated against COVID-19 at the time of study. We considered socio-demographic characteristics, COVID-19-related variables, and attitudes toward COVID-19 vaccination and pandemic as potential predictors of vaccine hesitancy. We applied the STROBE checklist in our study. RESULTS: Among 795 nurses, 30.9% were hesitant toward a second booster dose or a new COVID-19 vaccine. Independent predictors of hesitancy included lower educational level, absence of a chronic condition, good/very good self-perceived physical health, lack of flu vaccination during 2021, front-line nurses that provided healthcare to COVID-19 patients, nurses that had not been diagnosed with COVID-19 and nurses that had at least one relative/friend that has died from COVID-19. Moreover, increased compliance with hygiene measures, increased fear of a second booster dose/new COVID-19 vaccine and decreased trust in COVID-19 vaccination were associated with increased hesitancy. CONCLUSIONS: Our study shows that a significant percentage of nurses are hesitant toward a second booster dose/new COVID-19 vaccine. This initial hesitancy could be a barrier to efforts to control the COVID-19 pandemic. RELEVANCE TO CLINICAL PRACTICE: Nurses' role during the COVID-19 pandemic is essential since they are the front-line healthcare workers empowering the public with their passion and empathy. There is a need to communicate COVID-19 vaccine science in a way that is accessible to nurses in order to decrease COVID-19 vaccine hesitancy. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Prevalence and risk factors of adverse effects after the first COVID-19 booster dose: evidence from Greece.

Background: In general, COVID-19 vaccines are safe and effective, but minor adverse effects are common. However, adverse effects have not been measured in several countries including Greece. Objective: To estimate the prevalence of adverse effects after the first COVID-19 booster dose, and to identify possible risk factors. Material and methods: We conducted a cross-sectional study with a convenience sample in Greece during November 2022. We measured several adverse effects after the booster dose, such as fatigue, headaches, fever, chills, nausea, etc. We considered gender, age, chronic disease, self-assessment of health status, COVID-19 diagnóstico, and self-assessment of COVID-19 course as possible predictors of adverse effects. Results: In our sample, 96% developed at least one adverse effect. Half of the participants (50.2%) developed one to five adverse effects, 35.9% developed six to ten adverse effects, and 9.5% developed 11 to 16 adverse effects. Mean number of adverse effects was 5.5. The most frequent adverse effects were pain at the injection site (84.3%), fatigue (70.8%), muscle pain (61%), swelling at the injection site (55.2%), headache (49.8%), fever (42.9%), and chills (41%). Females developed more adverse effects than males (p < 0.001). The prevalence of adverse effects of COVID-19 vaccines was statistically significant and positively associated with the severity of COVID-19 among COVID-recovered individuals (p < 0.05). Moreover, younger age was associated with increased adverse effects (p < 0.001). Conclusions: Almost all participants in our study developed minor adverse effects after the booster dose. Female gender, COVID-19 patients with worse clinical course, and younger individuals experienced more often adverse effects.

Antecedentes: En general, las vacunas COVID-19 son seguras y eficaces, pero son frecuentes los efectos adversos leves. Sin embargo, los efectos adversos no se han medido en varios países, entre ellos Grecia. Objetivo: Estimar la prevalencia de efectos adversos tras la primera dosis de refuerzo de COVID-19 e identificar posibles factores de riesgo. Métodos: Realizamos un estudio transversal con una muestra de conveniencia en Grecia durante noviembre de 2022. Se midieron varios efectos adversos tras la dosis de refuerzo, fatiga, dolores de cabeza, fiebre, escalofríos, náuseas, etc. Consideramos el sexo, la edad, la enfermedad crónica, la autoevaluación del estado de salud, el diagnóstico de COVID-19 y la autoevaluación del curso de COVID-19 como posibles predictores de los efectos adversos. Resultados: En nuestra muestra, el 96% desarrolló al menos un efecto adverso. La mitad de los participantes (50,2%) desarrollaron de uno a cinco efectos adversos, el 35,9% desarrollaron de seis a diez efectos adversos, y el 9,5% desarrollaron de 11 a 16 efectos adversos. La media de efectos adversos fue de 5,5. Los efectos adversos más frecuentes fueron dolor en el punto de inyección (84,3%), fatiga (70,8%), dolor muscular (61%), hinchazón en el punto de inyección (55,2%), cefalea (49,8%), fiebre (42,9%) y escalofríos (41%). Las mujeres presentaron más efectos adversos que los hombres (p < 0,001). La prevalencia de los efectos adversos de las vacunas COVID-19 fue estadísticamente significativa y se asoció positivamente con la gravedad de COVID-19 entre los individuos recuperados de COVID (p < 0,05). Además, la menor edad se asoció con mayores efectos adversos (p < 0,001). Conclusiones: Casi todos los participantes en nuestro estudio desarrollaron efectos adversos menores tras la dosis de refuerzo. El sexo femenino, los pacientes de COVID-19 con peor evolución clínica y los individuos más jóvenes experimentaron efectos adversos con mayor frecuencia.

The Impact of COVID-19 Pandemic on Palliative Care Services as Perceived by Healthcare Professionals: A Systematic Review

Background: The Covid-19 pandemic stretched healthcare systems' capacity, imposed the reorganization and reprioritization of services under the burden of scarce resources, and altered the traditional way that care was provided. Palliative care, though designed to address complex needs such as relief from severe suffering, difficult decision making and complicated grief was not an exception;its holistic approach of care was seriously challenged due to infection spread restrictions. Objective: To review the impact on palliative care services from healthcare professionals' perspective. Methodology: A systematic review according to the Preferred Reporting Items for Systematic Review and MetaAnalysis (PRISMA) was conducted via PubMed in October 2022. Eligibility criteria included original studies that had used a qualitative, quantitative, or mixed design approach to evaluate the impact on services, delivery of care, and emotional status of palliative healthcare professionals. Results: Out of 2040 initial records, 32 studies were included in the review coming from various countries and settings with representative participation of multidisciplinary palliative care teams' members. Reported impacts concerned organizational aspects and provision of services, altered delivery of care, and implications for the mental health of involved staff. Increased workload, visiting restrictions, use of Personal Protective Equipment, and remote contact were perceived as factors compromising the quality of care provided and impeding palliative healthcare professionals from fulfilling their holistic care role. Moral distress was the most exacerbated emotional impact. Conclusions: Despite the important role that palliative care can play during a health crisis, this was not always adequately reflected on pandemic plans. In the era of the Covid-19, Palliative care entered a phase of change;whether this fact may compromise or accelerate its evolvement depends on how lessons learned will be used in future planning.

Predictors of COVID-19 Vaccination Uptake and Reasons for Decline of Vaccination: A Systematic Review

Background: Various COVID-19 vaccines with proven safety and effectiveness are available now but vaccine hesitancy remains a public threat. COVID-19 vaccines uptake appears to have an essential role in the successful control of the COVID-19 pandemic. Objective: To examine predictors of COVID-19 vaccination uptake and reasons for decline of vaccination. Methods: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines for this systematic review. We searched Medline, PubMed, Web of Science, Scopus, ProQuest, CINAHL, and a preprint service (medRxiv). We used the following key-words: vaccin·, COVID-19, and uptake. We included all types of studies (quantitative, qualitative, and mixed methods) reporting COVID-19 vaccination uptake. The review protocol was registered with PROSPERO (CRD42021267460). Results: Twelve studies met the inclusion and exclusion criteria. COVID-19 vaccination uptake ranged from 28.6% to 98% in the general population, while among healthcare workers ranged from 33.3% to 94.5%, and among patients ranged from 36% to 80%. The main predictors of COVID-19 vaccination uptake were male gender, white race, older age, higher socioeconomic status, higher self-perceived COVID-19 vulnerability, increased information about COVID-19 vaccines, and chronic illness. The most important reasons for decline of vaccination were concerns about the safety and effectiveness of vaccines, illness, medication, pregnancy, fertility, breastfeeding, religious reasons, ethical reasons, previous COVID-19 diagnosis, self-estimation that COVID-19 is not a severe disease, and limited knowledge about the vaccines. Conclusions: Several factors affect COVID-19 vaccination uptake, while various reasons affect people's decision to refuse to take a COVID-19 vaccine. These findings are essential to further enhance our understanding of COVID-19 vaccination uptake and design specific interventions. Given the high prevalence of COVID-19 vaccine hesitancy, our findings have major implications for the delivery of COVID-19 vaccination programmes in the public with special attention to people who are undecided or unlikely to take a COVID-19 vaccine.

Psychosocial Predictors of COVID-19 Vaccine Uptake among Pregnant Women: A Cross-Sectional Study in Greece.

An understanding of the factors associated with the COVID-19 vaccine uptake in pregnant women is paramount to persuade women to get vaccinated against COVID-19. We estimated the vaccination rate of pregnant women against COVID-19 and evaluated psychosocial factors associated with vaccine uptake among them. We conducted a cross-sectional study with a convenience sample. In particular, we investigated socio-demographic data of pregnant women (e.g., age, marital status, and educational level), COVID-19 related variables (e.g., previous COVID-19 diagnosis and worry about the side effects of COVID-19 vaccines), and stress due to COVID-19 (e.g., danger and contamination fears, fears about economic consequences, xenophobia, compulsive checking and reassurance seeking, and traumatic stress symptoms about COVID-19) as possible predictors of COVID-19 vaccine uptake. Among pregnant women, 58.6% had received a COVID-19 vaccine. The most important reasons that pregnant women were not vaccinated were doubts about the safety and effectiveness of the COVID-19 vaccines (31.4%), fear that COVID-19 vaccines could be harmful to the fetus (29.4%), and fear of adverse side effects of COVID-19 vaccines (29.4%). Increased danger and contamination fears, increased fears about economic consequences, and higher levels of trust in COVID-19 vaccines were related with vaccine uptake. On the other hand, increased compulsive checking and reassurance seeking and increased worry about the adverse side effects of COVID-19 vaccines reduced the likelihood of pregnant women being vaccinated. An understanding of the psychosocial factors associated with increased COVID-19 vaccine uptake in pregnant women could be helpful for policy makers and healthcare professionals in their efforts to persuade women to get vaccinated against COVID-19. There is a need for targeted educational campaigns to increase knowledge about COVID-19 vaccines and reduce vaccine hesitancy in pregnancy.

Predictors of COVID-19 Vaccine Uptake in Teachers: An On-line Survey in Greece.

COVID-19 vaccines are safe at a very high rate and protect against severe disease, hospitalization, and mortality. Schools are workplaces with high transmissibility of coronavirus and teachers are at risk of infection. The study aimed to find out the predictors of COVID-19 vaccine uptake in teachers. An on-line cross-sectional survey with a convenience sample was conducted, in Greece, during December 2021. We collected demographic data of teachers and we measured their attitudes towards COVID-19 vaccination and the pandemic. The sample included 513 teachers. The majority of them was vaccinated against COVID-19 (85.8%). The most important reasons for teachers' decline in COVID-19 vaccination were their concerns about safety, effectiveness and the side effects of COVID-19 vaccine. Also, furthermore they were characterized by strong self-assessment that they will not be infected by the COVID-19, and self-assessment that the COVID-19 vaccination will be useless for those who have already been diagnosed with COVID-19. After multivariable analysis, we found that increased age (OR 1.08, 95% CI 1.02-1.14, p = 0.011), and trust in COVID-19 vaccination (OR 2.57, 95% CI 2.07-3.18, p < 0.001) were related with an increased probability of a COVID-19 vaccine uptake. Also, teachers who lived with elderly people or vulnerable groups (OR 4.81, 95% CI 1.55-14.89, p = 0.006) during the COVID-19 pandemic, demonstrated greater probability to take COVID-19 vaccine. The study highlighted the need for reliable and accurate public information on both the risks of coronavirus infection and the vaccines' safety and efficacy.

COVID-19-Related Burnout and Intention of Fully Vaccinated Individuals to Get a Booster Dose: The Mediating Role of Resilience.

Because an annual COVID-19 booster vaccine appears to be required to control the pandemic, identifying the factors that influence individuals' decision to receive a booster dose is critical. Thus, our goal was to quantify the influence of COVID-19-related burnout on vaccination intention and to investigate the role of resilience in mediating the link between burnout and intention. We conducted a cross-sectional study with a convenience sample during October 2022. We used the COVID-19 burnout scale and the Brief Resilience Scale. The study sample included 1256 people who had received their primary COVID-19 vaccination. Among the participants, 34.1% reported being very likely to be vaccinated with a booster dose. COVID-19-related burnout was found to be inversely connected with vaccination intention. Moreover, our results suggested that resilience not only had a positive direct effect on vaccination intention but also mediated the relationship between burnout and vaccination intention. Although our study had limitations, such as a convenience sample and information bias, we demonstrate the critical role of resilience in reducing the impact of COVID-19-related burnout on the vaccination intention. Policymakers should develop and implement initiatives to address the issues of COVID-19-related burnout and enhance booster adoption by strengthening psychosocial resources such as resilience.

Social Support Mediates the Relationship between COVID-19-Related Burnout and Booster Vaccination Willingness among Fully Vaccinated Nurses.

COVID-19 booster doses for high-risk groups such as nurses are necessary to reduce the impacts of the pandemic and promote public health. We examined the relationship between COVID-19-related burnout and booster vaccination willingness among nurses, and we assessed whether social support can buffer this relationship. We conducted a cross-sectional study with 963 fully vaccinated nurses working in healthcare settings in Greece. We used the multidimensional scale of perceived social support to measure social support and the COVID-19 burnout scale to measure COVID-19-related burnout. We measured vaccination willingness with a scale from 0 (extremely unlikely to take a booster dose) to 10 (extremely likely). Among nurses, 37.1% reported being very likely to be vaccinated, 34.4% reported being uncertain about their likelihood of vaccination, and 28.6% reported being very unlikely to be vaccinated with a booster dose. We found that COVID-19-related burnout reduced vaccination willingness, while social support functioned as a partial mediator of this relationship. In conclusion, nurses who experienced burnout were less likely to accept a booster dose. Furthermore, increasing nurses' social support reduced the negative effects of burnout, resulting in improved booster vaccination willingness. Immunization awareness programs should be implemented in order to address nurses' concerns and support booster doses.

Predictors of Seasonal Influenza Vaccination Willingness among High-Risk Populations Three Years after the Onset of the COVID-19 Pandemic.

High-risk populations are at increased risk of severe influenza-related illness, hospitalization, and death due to influenza. The aim of our study was to assess the willingness of high-risk populations to take the influenza vaccine for the 2022-2023 season, and to investigate the factors associated with such willingness. We conducted a cross-sectional study in Greece in September 2022 using a convenience sample. We considered demographic characteristics, COVID-19-related variables, resilience, social support, anxiety, depression, and COVID-19-related burnout as potential predictors. Among participants, 39.4% were willing to accept the seasonal influenza vaccine, 33.9% were unwilling, and 26.8% were hesitant. Multivariable analysis identified that increased age and increased family support were associated with increased influenza vaccination willingness. Moreover, participants that have received COVID-19 booster doses were more willing to accept the influenza vaccine. In contrast, adverse effects because of COVID-19 vaccination and exhaustion due to measures against COVID-19 reduced influenza vaccination willingness. We found that the intention of high-risk populations to receive the influenza vaccine was low. Our study contributes to an increased understanding of the factors that affect vaccination willingness. Public health authorities could use this information to update vaccination programs against influenza. Emphasis should be given on safety and effectiveness issues.

Seasonal Influenza Vaccine Intention among Nurses Who Have Been Fully Vaccinated against COVID-19: Evidence from Greece.

Seasonal influenza continues to be a significant public health issue causing hundreds of thousands of deaths annually. Nurses are a priority risk group for influenza vaccination and a high vaccine uptake rate among them is crucial to protect public health. Thus, the aim of our study was to estimate the levels of influenza vaccine acceptance, as well as its determinants, among nurses for the 2022/2023 season. We conducted a cross-sectional study with a convenience sample in Greece. We collected data via an online survey in September 2022. Most of the nurses in the study possessed a MSc/PhD diploma (56.2%) and had previously been infected by SARS-CoV-2 (70.3%). Among nurses, 57.3% were willing to accept the influenza vaccine, 19% were hesitant, and 23.7% were unwilling. Older age, higher levels of perceived support from significant others, and higher COVID-19-related physical exhaustion were positively related to influenza vaccination intention. In contrast, more side effects because of COVID-19 vaccination and higher levels of exhaustion due to measures taken against COVID-19 were negatively associated with vaccination intention. Since the influenza vaccination acceptance rate among nurses was moderate, policymakers should develop and implement measures tailored specifically to nurses in the context of the COVID-19 pandemic to decrease vaccine hesitancy.

Cross-sectional assessment of predictors for COVID-19 vaccine uptake: an online survey in Greece Evaluación transversal de los factores predictivos de la aceptación de la vacuna contra la COVID-19: Encuesta online en Grecia

Objective To estimate the percentage of the general population vaccinated against the COVID-19 and to investigate the factors associated with COVID-19 vaccine uptake. Material and methods We conducted an online cross-sectional study in Greece during August 2021. We included individuals over 18 years of age. Independent variables included socio-demographic data of the participants and attitudes towards COVID-19 vaccination and pandemic. Our outcome variable was COVID-19 vaccination status, measured through “yes/no” answers. Results Most participants had been vaccinated against the COVID-19 (87.8%). Multivariate analysis identified that increased age and a higher level of education were associated with an increased likelihood of COVID-19 vaccination. Also, participants working in health services, participants without a previous COVID-19 diagnóstico, and those with previous seasonal influenza vaccination history had a greater probability to take a COVID-19 vaccine. Additionally, increased self-perceived severity of COVID-19, knowledge regarding COVID-19, and trust in COVID-19 vaccines and scientists were associated with COVID-19 vaccine uptake. On the other hand, the likelihood of vaccination was lower for participants who were more concerned about the side effects of COVID-19 vaccination. Conclusions Understanding the factors affecting individuals' decision to take a COVID-19 vaccine is essential to improve the COVID-19 vaccination coverage rate. Policymakers and scientists should scale up their efforts to increase the COVID-19 vaccination rate among specific population groups such as young people, people with a low level of education, etc.

COVID-19 Vaccine Uptake among Healthcare Workers: A Systematic Review and Meta-Analysis.

The vaccine-induced immunity of healthcare workers (HCWs) is crucial to controlling the COVID-19 pandemic. Therefore, we conducted a systematic review and meta-analysis to assess the COVID-19 vaccine uptake among HCWs worldwide and to identify predictors of vaccination. We searched Scopus, Web of Science, Medline, PubMed, ProQuest, CINAHL, and medRxiv up to 25 August 2022. We applied the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. We found 25 studies including 491,624 vaccinated HCWs, while the full sample included 555,561 HCWs. The overall proportion of vaccinated HCWs was 77.3%. Vaccine uptake for studies that were conducted in North America (85.6%) was higher than the proportion for studies that were conducted in Asia (79.5%), Europe (72.8%), and Africa (65.6%). The overall prevalence of COVID-19 vaccine uptake was 83.6% and 77.4% for physicians and nurses, respectively. Older age, white race, physicians' profession, seasonal influenza vaccine, direct COVID-19 patient care, and confidence in COVID-19 vaccine safety and effectiveness were positive predictors of vaccine uptake, while history of SARS-CoV-2 infection was a negative predictor. Deep understanding of the factors that influence HCWs' decisions to receive a COVID-19 vaccine is critical to implementing tailored communication strategies for HCWs who are at risk for not getting vaccinated.

Predictors of Real-World Parents' Acceptance to Vaccinate Their Children Against the COVID-19.

Background: As the COVID-19 pandemic continues to threaten public health, the vaccination of children against the disease appears to be a key factor to control the pandemic. Our aim was to investigate the prevalence of parents who have vaccinated their children against the COVID-19 and the factors influencing this decision. Materials and Methods: We conducted a web-based cross-sectional study in Greece during the first week of September 2021. The study questionnaire was distributed through social media and a convenience sample was obtained. Only parents with children aged 12-17 years old could participate in the study. We collected socio-demographic data of parents and we measured their attitudes towards vaccination and COVID-19 pandemic. Results: Study population included 656 parents. Regarding vaccination, 27.1% of parents had their children vaccinated against the COVID-19, while almost all children had a complete vaccination history (98.9%). The most important reasons for decline of COVID-19 vaccination were doubts about the safety and effectiveness of COVID-19 vaccines (45.3%) and fear of side effects (36.6%). Regarding the information about the COVID-19 vaccines, parents showed more trust in family doctors than in scientists and the government. We found that increased parents' age, increased trust in COVID-19 vaccines, and positive attitude of parents towards vaccination had a positive effect on children's vaccination. Conclusions: Understanding the factors influencing parents' decision to vaccinate their children against the COVID-19 is crucial to increase the COVID-19 vaccination coverage rate. Implementation of public health policies is necessary to spread knowledge about COVID-19 vaccines and to regain vaccine confidence.

Decreased Hospital Visits and Increased Mortality Rate in Emergency Department during the COVID-19 Pandemic: Evidence from Albania.

Objective: To investigate the hospital visits and mortality rate during the COVID-19 in emergency department of Vlora regional hospital in Albania and to compare with the three previous years (2017-2019). Methods: Secondary data of patients that visited emergency department of Vlora Regional hospital Albania (largest hospital in the south of the country), since January 1, 2017 till December 31, 2020. This is a retrospective study. We used the hard copy of the patients' health register records. The data extraction was conducted during March 2021 till June 2021. Eligible were all patients admitted and recorded in the registry of the emergency department. The causes of admission were categorized in 14 different disease categories. All registered patients admitted to the Vlora regional hospital were included in the study. Results: Study population included 44,917 patients during 2017-2020. Mean age of patients was 51.5 years, while 53.6% were females. The highest number of patients was in 2017 (n=12,407) and the lowest in 2020 (n=9,266). Increase of patients presented with cardiovascular, psychiatric and renal/urinary tract was observed in 2020 in comparison to 2019. Patients decreased over time with an average annual percent decrease of 7% (p-value=0.22). Joinpoint analysis revealed that mortality rate increased over time with an average annual percent increase of 34.3% (95% confidence interval=42.7% to 214.8%, p-value=0.27). Conclusions: The number of patients visiting emergency department decreased while mortality rate increased. Educating and raising awareness of patient to seek medical assistance should be a key objective of health policy makers and health personnel.

Cross-sectional assessment of predictors for COVID-19 vaccine uptake: an online survey in Greece.

Objective: To estimate the percentage of the general population vaccinated against the COVID-19 and to investigate the factors associated with COVID-19 vaccine uptake. Material and methods: We conducted an online cross-sectional study in Greece during August 2021. We included individuals over 18 years of age. Independent variables included socio-demographic data of the participants and attitudes towards COVID-19 vaccination and pandemic. Our outcome variable was COVID-19 vaccination status, measured through "yes/no" answers. Results: Most participants had been vaccinated against the COVID-19 (87.8%). Multivariate analysis identified that increased age and a higher level of education were associated with an increased likelihood of COVID-19 vaccination. Also, participants working in health services, participants without a previous COVID-19 diagnóstico, and those with previous seasonal influenza vaccination history had a greater probability to take a COVID-19 vaccine. Additionally, increased self-perceived severity of COVID-19, knowledge regarding COVID-19, and trust in COVID-19 vaccines and scientists were associated with COVID-19 vaccine uptake. On the other hand, the likelihood of vaccination was lower for participants who were more concerned about the side effects of COVID-19 vaccination. Conclusions: Understanding the factors affecting individuals' decision to take a COVID-19 vaccine is essential to improve the COVID-19 vaccination coverage rate. Policymakers and scientists should scale up their efforts to increase the COVID-19 vaccination rate among specific population groups such as young people, people with a low level of education, etc.

Objetivo: Calcular el porcentaje de población general vacunada contra la COVID-19 e investigar los factores asociados a la aceptación de dicha vacuna. Material y métodos: Realizamos un estudio transversal online en Grecia durante el mes de agosto de 2021, en el que incluimos a individuos mayores de 18 años de edad. Las variables independientes incluyeron los datos sociodemográficos de los participantes y las actitudes hacia la vacunación y la pandemia de COVID-19. Nuestra variable del resultado fue la situación de vacunación contra la COVID-19, medida mediante respuestas "sí/no". Resultados: La mayoría de los participantes habían sido vacunados contra la COVID-19 (87,8%). El análisis multivariante identificó que el incremento de la edad y el mayor nivel educativo estaban asociados a un aumento de la probabilidad de vacunarse contra la COVID-19. De igual modo, los participantes que trabajaban en servicios sociales, aquellos participantes sin un diagnóstico previo de COVID-19, y aquellos con historial previo de vacuna contra la gripe estacional tenían una mayor probabilidad de vacunarse contra la COVID-19. Además, el incremento de la gravedad autopercibida de la COVID-19, el conocimiento sobre la enfermedad, y la confianza en las vacunas contra la COVID-19 y en los científicos estuvieron asociados a la aceptación de la vacuna. Por otro lado, la probabilidad de vacunarse fue menor en los participantes más preocupados de los efectos secundarios de la vacuna contra la COVID-19. Conclusiones: Comprender los factores que afectan a la decisión de los individuos sobre la vacunación contra la COVID-19 es fundamental para mejorar la tasa de cobertura de dicha vacunación. Los responsables políticos y los científicos deberán redoblar sus esfuerzos para incrementar la tasa de vacunación contra la COVID-19 entre los grupos de población específicos tales como la gente joven, las personas con un bajo nivel educativo, etc.

First COVID-19 Booster Dose in the General Population: A Systematic Review and Meta-Analysis of Willingness and Its Predictors.

The emergence of breakthrough infections and new highly contagious variants of SARS-CoV-2 threaten the immunization in individuals who had completed the primary COVID-19 vaccination. This systematic review and meta-analysis investigated, for the first time, acceptance of the first COVID-19 booster dose and its associated factors among fully vaccinated individuals. We followed the PRISMA guidelines. We searched Scopus, Web of Science, Medline, PubMed, ProQuest, CINAHL and medrxiv from inception to 21 May 2022. We found 14 studies including 104,047 fully vaccinated individuals. The prevalence of individuals who intend to accept a booster was 79.0%, while the prevalence of unsure individuals was 12.6%, and the prevalence of individuals that intend to refuse a booster was 14.3%. The main predictors of willingness were older age, flu vaccination in the previous season, and confidence in COVID-19 vaccination. The most important reasons for decline were adverse reactions and discomfort experienced after previous COVID-19 vaccine doses and concerns for serious adverse reactions to COVID-19 booster doses. Considering the burden of COVID-19, a high acceptance rate of booster doses could be critical in controlling the pandemic. Our findings are innovative and could help policymakers to design and implement specific COVID-19 vaccination programs in order to decrease booster vaccine hesitancy.

Investigating the Impact of the Covid-19 Pandemic on the Economy and the Corresponding Entrepreneurship Support Measures in Europe.

Covid-19 pandemic continues to cause great losses in human lives and adverse consequences in many sectors of the EU economy. The aim of the paper is to evaluate the effects of the pandemic in small and medium-sized enterprises (SMEs), in culture - entertainment industry and to investigate the effectiveness of the corresponding entrepreneurship support measures have been taken. This review was conducted based on related articles that were published during the years 2020-2021, using the online databases of Google Scholar, Science Direct, Elsevier, PubMed, OECD, IOBE. A total of 16 eligible studies were included in this literature review. EU authorities have launched measures, setting up policy and funding instruments to mobilize the economy. The impact of these measures is of great significance for many EU countries and sectors. However, measures taken for small and medium-sized enterprises, tourism and culture were not evaluated effectively to get the sectors back on track. Those measures were effective in short term and were insufficient to boost the recovery of the EU economy in long term. Since Covid-19 still exists, the fear of a recurrence is fed back. Long-term support measures need to be re-evaluated and new strategies must be established, that will set, sustainability criteria for companies, according to future investment and development policies.

Predictors of Willingness of the General Public to Receive a Second COVID-19 Booster Dose or a New COVID-19 Vaccine: A Cross-Sectional Study in Greece.

Given the concerns of waning immunity from the primary COVID-19 vaccines and the first booster dose, we conducted an online cross-sectional study in May 2022 to investigate willingness to receive a second COVID-19 booster dose or a new COVID-19 vaccine and its associated factors. Overall, 62% of the participants were willing to be vaccinated, 25.8% were unsure, and 12.3% were unwilling to be vaccinated. The main reasons against accepting a second COVID-19 booster dose/new COVID-19 vaccine were concerns about the side effects and the effectiveness and the opinion that further vaccination is unnecessary. Males, younger individuals, participants without a previous COVID-19 diagnosis, and those with good/very good self-perceived physical health were significantly more frequently willing to receive a second COVID-19 booster dose or a new COVID-19 vaccine. Additionally, increased fear of the COVID-19, increased trust in COVID-19 vaccinations, and decreased fear of a second booster dose or a new COVID-19 vaccine was associated with increased willingness. Our results show some hesitancy and unwillingness toward further COVID-19 vaccination and indicate that the fear of COVID-19 and trust in COVID-19 vaccination affects public opinion.