How Portuguese Health Entities Used Social Media to Face the Public Health Emergency during COVID-19 Disease.

BACKGROUND: During the COVID-19 pandemic, social media became an important and easily accessible source of information to keep the population informed. In this study, we explored how Portuguese health entities used social media during the public health emergency caused by COVID-19 disease. METHODS: A retrospective study on Portuguese public health entities' communication with the public using social media platforms was performed. Data were retrieved from Facebook, Instagram, and Twitter. All retrieved posts were analyzed, and the engagement of the public was calculated. A thematic analysis of all COVID-19-related posts was conducted. RESULTS: The analysis of each social media platform revealed that during the COVID-19 pandemic, health entities reinforced their presence on social media platforms. The most published posts were related to "epidemiological context" and "encouragement to take actions" to avoid the spread of COVID-19. High engagement frames were not associated with the most frequently published posts. CONCLUSIONS: Although health entities have reinforced their presence on social media platforms, they do not take full advantage of these platforms to improve health literacy.

Unravelling the drivers behind COVID-19 vaccination hesitancy and refusal among teachers: A nationwide study.

This study aims to assess the determinants of the coronavirus disease 2019 (COVID-19) vaccination hesitancy and refusal (VHR) among teachers, from pre-school to higher education, through an online survey. A logistic regression analysis was used to determine the adjusted odds ratio (OR) of the independent variables (perceptions, knowledge, and attitudes) per 1-point increase in the Likert scale, and VHR. Concerns about the vaccines' efficacy and safety increase the risk of VHR (OR = 6.97, 95 %CI: 4.82-10.09 and OR = 8.71, 95 %CI: 5.52-13.73, respectively). Higher risk perceptions of getting infected (1/OR = 3.94, 95 %CI: 2.93-5.29), trust in the effectiveness of vaccines in reducing this risk or protecting against suffering complications (OR = 3.52, 95 %CI: 2.72-4.55 and OR = 10.94, 95 %CI: 7.16-16.68, respectively), and higher trust levels on the information transmitted regarding COVID-19 vaccination, are associated to lower VHR. As VHR appears to be highly influenced by perceptions, knowledge, and attitudes, it is crucial to promote and design interventions targeted to transforming these determinants.

What determines health professionals' COVID-19 vaccine hesitancy? A nationwide study.

INTRODUCTION: To contain the COVID-19 pandemic, higher vaccination rates are essential. However, as vaccine hesitancy is a reality, it is important to understand what drives health professionals to refuse getting vaccinated against COVID-19, who have been in the frontline of this pandemic since its beginning and may be key actors to improve vaccine coverage among their patients. PURPOSE: This study aims to assess the factors associated with vaccine hesitancy (VH) among health professionals (physicians, nurses, pharmacists and dentists). METHODS: A nationwide cross-sectional study was conducted through an online survey, with 890 Portuguese health professionals. A logistic regression analysis was used to determine the adjusted odds ratio (OR) of the independent variables (perceptions, knowledge and attitudes) per 1-point increase in the Likert scale and VH. RESULTS: Complacency, communications, confidence and convenience were strongly associated with VH probability. Concerns about vaccines' efficacy (ORPhysicians  = 8.33, 95% CI: 4.51-15.36) and safety (ORNurses  = 11.07, 95% CI: 4.12-29.77) increase the risk of VH on all health professional groups. A reduction of VH probability is associated with higher risk perceptions of getting infected (1/ORNurses  = 2.76, 95% CI: 1.52-5.02) and suffering complications (1/ORNurses  = 33.72, 95% CI: 8.48-134.13), higher confidence in the effectiveness of COVID-19 vaccines (1/ORDentists  = 12.29, 95% CI: 2.91-51.89), risk perception of getting infected if vaccinated (1/ORPhysicians  = 14.92, 95% CI: 6.85-32.50), risk of suffering from complications after getting vaccinated, and higher trust levels on the information transmitted by competent authorities (1/ORDentists  = 17.76, 95% CI: 3.83-82.22). CONCLUSIONS: To reduce COVID-19 VH, which appears to be highly influenced by perceptions, knowledge and attitudes, it is essential to promote interventions directed to transforming these potentially modifiable determinants.

Perceptions, knowledge and attitudes about COVID-19 vaccine hesitancy in older Portuguese adults.

BACKGROUND: Coronavirus 2019 (COVID-19) has become a public-health emergency of international concern. Most efforts to contain the spread and transmission of the virus rely on campaigns and interventions targeted to reduce Vaccine Hesitancy and Refusal (VHR). OBJECTIVE: this study aims to assess the major factors associated with VHR in the older population in Portugal. METHODS: a nation-wide cross-sectional study was conducted in the older Portuguese population (≥65 years old) through computer-assisted telephone interviewing. Logistic regression was used to determine the adjusted odds ratio (OR) of the independent variables (perceptions, knowledge and attitudes) and of the outcome (VHR). RESULTS: the response rate was 60.1% (602/1,001). Perceptions, knowledge and attitudes were strongly associated with VHR probability. A 1-point Likert scale increase in concerns about the vaccines' efficacy and safety increased the risk of VHR by 1.96 (95% confidence interval [CI]: 1.40-6.28) and 3.13 (95%CI: 2.08-8.22), respectively. A reduction of VHR probability for 'reliability of the information released by social media' (OR = 0.34, 95%CI: 0.16-0.70) and for 'trust in national and international competent authorities' (OR = 0.34, 95%CI: 0.17-0.69) is also observed per 1-point increase. CONCLUSIONS: as VHR seems to be strongly associated with perceptions, knowledge and attitudes, the design and promotion of vaccination campaigns/educational interventions specifically targeted at changing these potentially modifiable determinants may help to tackle COVID-19 VHR and achieve a wider vaccine coverage.