Qualitative assessment of COVID-19 vaccination acceptance among healthcare workers in Pima County.

In the Spring of 2021, the COVID-19 vaccination was authorized for emergency use by the Food and Drug Administration. Healthcare workers (HCWs) are one of the most trusted sources of information for vaccination choices. However, HCWs at this time appeared to continue to have lower rates of COVID-19 vaccination uptake than expected in Arizona. The objective of this study was to examine factors that play a role in the vaccination decision-making process among Arizona HCWs. Between January and April 2021, 18 semi-structured interviews were conducted among physicians, emergency medical technicians and long-term care nurses in Pima County. The informed consent process was completed for each participant. The interview guide was informed by the Increasing Vaccination model to collect information on vaccination decision-making. A codebook was developed using an inductive approach. Coding and analysis was conducted using the software MAXQDA. Participants were primarily male (11/18, 61%) and white (11/18, 61%). Three participants identified as Hispanic. Initial themes that emerged included: mixed opinions concerning the innovations in COVID-19 vaccine development, access-related barriers, issues related to distribution inequities, concerns about misinformation and conspiracy theories, and dialogue concerning the benefits of requiring mandatory vaccination. The results gathered from this study indicate that there continues to be hesitancy among some healthcare professionals in Pima County. These results will be used to help Arizonan Health Departments promote rollout of novel vaccines more effectively through targeting relevant vaccination decision-making factors among HCWs.

Racial/ethnic disparities in influenza risk perception and vaccination intention among Pima County residents in Arizona.

While influenza cases in Arizona have nearly tripled since 2018, vaccination rates continue to lag. Statewide, Hispanics and African Americans had the lowest vaccination rates despite having higher influenza infection rates than Whites. Given Arizona's racial influenza vaccination disparity and the general increase in vaccination hesitancy due to COVID-19, the purpose of this study was to better understand the influences of seasonal influenza vaccination in Arizona during the COVID-19 pandemic using qualitative methods. Findings from this study revealed that many participants were motivated to get the influenza vaccine to protect their family and close friends. The heightened concern for COVID-19 prompted some Hispanic/Latino focus group discussion participants to consider getting vaccinated. However, many Hispanic/Latino participants also expressed that they stopped getting influenza vaccine due to negative vaccination experiences or concern about sickness following immunization. African American participants primarily discussed receiving the vaccine as part of their routine health visit. Compared to other races, more White participants believed that vaccination was unimportant because they were healthy, and the people they interacted with never got sick. Distinct factors influence risk perception and vaccination intention across different racial/ethnic groups. Effective interventions can account for these factors and be tailored to the target population to maximize vaccination uptake.

Moral framing in health promotion: lessons from an Indonesian case study.

OBJECTIVE: In this article we illuminate the important, yet typically underreported, role played by moral framing in public health messaging. We present case studies from West Java, Indonesia to demonstrate how moral framing is used to motivate health volunteers and to promote behavior change in line with government health policies. METHODS: We used qualitative research including participant observation, job shadowing, interviews and focus groups with health promotion workers and community members. Findings were analyzed using thematic and discourse analysis. RESULTS: We identified three moral frameworks typically used to encourage shifts in normative health practices in Indonesia: Islamic values, right to health, and evidence-based public health policy, represented as indicative of modernity. Health workers tailor these moral frameworks to audiences in their health promotion work. While the immediate goal is to meet health performance targets, the broader goal is to generate forms of health citizenship commensurate with Indonesia's political environment of democratic decentralization. CONCLUSION AND LESSONS: COVID-19 presents an opportune moment for the public health community to reevaluate the power of moral framing in health messaging, and how it can be used both as a compelling means of establishing community norms toward the common good, as seen in our Indonesia case study, and also as a mechanism used by counterpublics to challenge these norms and appeal to alternative values and versions of reality.