Willingness to pay for a COVID-19 vaccine and its associated determinants in Iran.

Introduction: Understanding the individuals' willingness to pay (WTP) for the COVID-19 vaccine could help design policy interventions to control the COVID-19 pandemic. This study aimed to estimate the individuals' willingness to pay (WTP) for a COVID-19 vaccine and to identify its associated determinants. Methods: A cross-sectional survey was conducted on 526 Iranian adults using a web-based questionnaire. A double-bounded contingent valuation approach was used to estimate WTP for the COVID-19 vaccine. The parameters of the model were estimated based on the maximum likelihood method. Results: A considerable proportion of participants (90.87%) were willing to pay for a COVID-19 vaccine. Based on our discrete choice model, the estimated mean WTP for a COVID-19 vaccine was US$ 60.13 (CI: 56.80-63.46; p < 0.01). Having a higher perceived risk of being contaminated with COVID-19, higher average monthly income, higher education level, pre-existence of chronic diseases, previous experience of vaccination, and belonging to higher age groups were significant determinants associated with WTP for COVID-19 vaccination. Conclusion: The present study indicates a relatively high WTP and acceptance of a COVID-19 vaccine among the Iranian population. Average monthly income, risk perception, education level, the preexistence of chronic disease, and previous vaccination experience increased the likelihood of WTP for a vaccine. Subsidizing the COVID-19 vaccine for the low-income population and raising risk perception among the population should be considered in formulating vaccine-related interventions.

Just-in-Time, but Still Planned: Lessons Learned From Speeding up the Development and Implementation of an Intervention to Promote COVID-19 Vaccination in University Students.

The process of developing a behavior change intervention can cover a long time period. However, in times of need, this development process has to be more efficient and without losing the scientific rigor. In this article, we describe the just-in-time, planned development of an online intervention in the field of higher education, promoting COVID-19 vaccination among university students, just before they were eligible for being vaccinated. We demonstrate how intervention development can happen fast but with sufficient empirical and theoretical support. In the developmental process, Intervention Mapping (IM) helped with decision-making in every step. We learned that the whole process is primarily depending on the trust of those in charge in the quality of the program developers. Moreover, it is about applying theory, not about theory-testing. As there was no COVID-19-related evidence available, evidence from related fields helped as did theoretical knowledge about change processes, next to having easy access to the target population and important stakeholders for informed qualitative and quantitative research. This project was executed under unavoidable time pressure. IM helped us with systematically developing an intervention, just-in-time to positively affect vaccine acceptance among university students.

Facilitating Informed Decision Making: Determinants of University Students' COVID-19 Vaccine Uptake.

BACKGROUND: Although several COVID-19 vaccines are available, the current challenge is achieving high vaccine uptake. We aimed to explore university students' intention to get vaccinated and select the most relevant determinants/beliefs to facilitate informed decision making around COVID-19 vaccine uptake. METHODS: A cross-sectional online survey with students (N = 434) from Maastricht University was conducted in March 2021. The most relevant determinants/beliefs of students' COVID-19 vaccine intention (i.e., determinants linked to vaccination intention, and with enough potential for change) were visualized using CIBER plots. RESULTS: Students' intention to get the COVID-19 vaccine was high (80%). Concerns about safety and side effects of the vaccine and trust in government, quality control, and the pharmaceutical industry were identified as the most relevant determinants of vaccine intention. Other determinants were risk perception, attitude, perceived norm, and self-efficacy beliefs. CONCLUSION: Our study identified several determinants of COVID-19 vaccine intention (e.g., safety, trust, risk perception, etc.) and helped to select the most relevant determinants/beliefs to target in an intervention to maximize COVID-19 vaccination uptake. Concerns and trust related to the COVID-19 vaccine are the most important targets for future interventions. Other determinants that were already positive (i.e., risk perception, attitudes, perceived norms, and self-efficacy) could be further confirmed.

COVID-19 Vaccine Hesitancy: The Role of Information Sources and Beliefs in Dutch Adults.

COVID-19 vaccine hesitancy may be regarded as a new pandemic hindering the elimination of or coping with COVID-19. This study assessed reasons for COVID-19 vaccine hesitancy using the I-Change Model (ICM) by considering the role of informational and psychosocial factors. A cross-sectional online survey using a convenience sample was conducted among Dutch adults (n = 240). The questionnaire assessed information factors, predisposing factors, awareness factors, motivational factors, preparatory actions, and vaccination intention. Vaccine hesitant participants (n = 58, 24%) had lower levels of education, more often paid work, and tended to have a religion other than Catholicism. They used written media less often and tended to visit websites of public health organizations less often, but used messaging services like WhatsApp more frequently. All participants had neutral intentions towards checking information credibility. Vaccine hesitant respondents had less knowledge about vaccination, lower perceived severity of getting sick and dying of COVID-19, and reported fewer exposures to cues about the advantages of COVID-19 vaccination. They were less convinced of the emotional and rational advantages of COVID-19 vaccination and expressed more negative feelings about it. They also reported more negative social norms concerning COVID-19 vaccination, and lower self-efficacy to get vaccinated and to cope with potential side-effects. The regression model explained 58% of the variance in vaccination intention. The results suggest that strategies are needed to: 1. Reduce fake news and stimulate information checking to foster well-informed decision-making; 2. Target both rational and emotional consequences of COVID-19, in addition to strategies for optimizing levels of knowledge. Campaigns should acknowledge the perceptions of the emotional disadvantages and increase perceptions of emotional advantages of COVID-19 vaccinations, such as reducing feelings of regret, and increasing feelings of freedom and reassurance.

A Safe Return to Campus in Times of COVID-19: A Survey Study among University Personnel to Inform Decision Makers.

Halfway through 2021 in the midst of a public health crisis, a new academic year was fast approaching. Dutch universities were preparing to reopen their campuses to students and personnel in a safe manner. As the vaccination uptake was increasing and societies were slowly reopening, inviting students and personnel to campus became the next step to "the new normal". To absorb this change seamlessly, it was considered important to investigate personnel's beliefs about returning to campus and their perceptions of a safe working environment. An online survey was conducted among personnel (N = 1965) of Maastricht University, the Netherlands. University personnel's beliefs about a safe return to campus were assessed. The data were collected between 11 June and 28 June 2021. This study showed that, while most personnel (94.7%) were already vaccinated or willing to do so, not all personnel did feel safe to return to campus in September 2021. Over half of the respondents (58%) thought that the university is a safe place to return to work when the new academic year starts. However, the remainder of personnel felt unsafe or were uncertain for various reasons such as meeting in large groups or becoming infected. Moreover, when returning to campus, employees stated that they would require some time to reacclimate to their former work culture. The group who felt relatively more unsafe indicated that returning in September was too risky and that they worried about being infected. They wanted the safety guidelines to still be in force. On the other hand, the "safe" group stated safely returning to be "certainly possible" and trusted that others would still stick to the prevention guidelines. The findings led to practical recommendations for the University Board as they were preparing for organizing research and teaching for the upcoming academic year in the context of the COVID-19 pandemic. A brief intervention was developed: a webinar in which the data were linked to the board's plans for safe returning. This study demonstrates that university boards may use research among personnel to develop adequate measures promoting safety and feelings of safety among personnel in similar future situations.

Selection of determinants of students' adherence to COVID-19 guidelines and translation into a brief intervention.

BACKGROUND: When reopening universities in times of COVID-19, students still have to adhere to COVID-19 behavioral guidelines. We explored what behavioral determinants (and underlying beliefs) related to the adherence to guidelines are both relevant and changeable, as input for future interventions. METHODS: A cross-sectional online survey was conducted (Oct-Nov 2020), identifying behavioral determinants (and underlying beliefs) of university students' adherence to COVID-19-guidelines, including keeping 1.5 m distance, getting tested, and isolating (N = 255). RESULTS: Attitude, perceived norm, self-efficacy, and several beliefs (e.g., risk perception beliefs 'I am not afraid because I am young' [r = -0.33; p < .001]; attitudinal beliefs, e.g., 'I feel responsible for telling people to adhere to guidelines' [r = 0.37; p < .001]; self-efficacy beliefs, e.g., 'COVID-19-prevention guidelines are difficult to adhere to' [r = -0.30; p < .001]) were associated with intention to adhere to guidelines, and for those beliefs there was room for improvement, making them suitable as possible intervention targets. CONCLUSIONS: Students mostly adhere to COVID-19 guidelines, but there is room for improvement. Interventions need to enhance students' adherence behavior by targeting the most relevant determinants as identified in this study. Based on these findings, a small intervention was introduced targeting the determinants of students' adherence to guidelines.