Parental Perceptions and Barriers towards Childhood COVID-19 Vaccination in Saudi Arabia: A Cross-Sectional Analysis.

Introduction: The vaccination of children against Coronavirus disease (COVID-19) is a prime area of focus around the globe and is considered a pivotal challenge during the ongoing pandemic. This study aimed to assess parents' intentions to vaccinate their children and the barriers related to pediatric COVID-19 vaccination. Methodology: An online web-based survey was conducted to recruit parents with at least one child under the age of 12 years from Saudi Arabia's Al-Jouf region. The parental intentions to vaccinate children were assessed via six items, while barriers against vaccination were assessed through seven items in validated study instrument. A 5-point Likert scale was used to record the responses of parents regarding both their intentions and barriers. Results: In total, 444 parents (28.41 ± 7.4 years, 65% females) participated in this study. Almost 90% of parents were vaccinated against COVID-19 but only 42% of parents intended to vaccinate their children. The mean intention score was 2.9 ± 1.36. More than one-third of study participants had no plan to vaccinate their children against COVID-19. The majority of the respondents agreed to vaccinate their children if vaccination was made compulsory by the government (relative index: 0.76, 73%). Out of seven potential barriers analyzed, concerns over vaccine safety and side effects were ranked highest (RII: 0.754), reported by 290 (65%) participants. In multivariate logistic regression, significant predictors of parental intention to vaccinate children were the increased education level of the parents (secondary education: OR = 3.617, p = 0.010; tertiary education: OR = 2.775, p = 0.042), COVID-19 vaccination status (vaccinated: OR = 7.062, p = 0.003), mother's involvement in decisions regarding the child's healthcare (mother: OR 4.353, p < 0.001; both father and mother: OR 3.195, p < 0.001) and parents' trust in the vaccine's safety (OR = 2.483, p = 0.022). Conclusions: This study underscored the low intention among parents to vaccinate their children against COVID-19. Vaccination intention was found to be associated with education, parents' vaccination status, the mother's involvement in healthcare decisions, and parents' trust in the vaccine's safety. On the other hand, parents' concerns over the safety and efficacy of the COVID-19 vaccine were widely reported as barriers to childhood vaccination. The health authorities should focus on addressing parental concerns about vaccines to improve their COVID-19 vaccination coverage.

Surveillance of Side Effects after Two Doses of COVID-19 Vaccines among Patients with Comorbid Conditions: A Sub-Cohort Analysis from Saudi Arabia.

Background: Individuals with underlying chronic illnesses have demonstrated considerable hesitancy towards COVID-19 vaccines. These concerns are primarily attributed to their concerns over the safety profile. Real-world data on the safety profile among COVID-19 vaccinees with comorbid conditions are scarce. This study aimed to ascertain the side-effects profile after two doses of COVID-19 vaccines among chronic-disease patients. Methodology: A cross-sectional questionnaire-based study was conducted among faculty members with comorbid conditions at a public educational institute in Saudi Arabia. A 20-item questionnaire recorded the demographics and side effects after the two doses of COVID-19 vaccines. The frequency of side effects was recorded following each dose of vaccine, and the association of the side-effects score with the demographics was ascertained through appropriate statistics. Results: A total of 204 patients with at least one comorbid condition were included in this study. A total of 24 side effects were reported after the first dose and 22 after second dose of the COVID-19 vaccine. The incidence of at least one side effect was 88.7% and 95.1% after the first and second doses of the vaccine, respectively. The frequent side effects after the first dose were pain at the injection site (63.2%), fatigue (58.8%), fever (47.5%), muscle and joint pain (38.7%), and headache (36.3%). However, pain at the injection site (71.1%), muscle and joint pain (62.7%), headache (49.5%), fever (45.6%), and stress (33.3%) were frequent after the second dose. The average side-effects score was 4.41 ± 4.18 (median: 3, IQR: 1, 6) and 4.79 ± 3.54 (median 4, IQR: 2, 6) after the first and second dose, respectively. Female gender, diabetes mellitus, hypertension, hyperlipidemia, comorbidity > 2, family history of COVID-19, and the AstraZeneca vaccine were significantly associated with higher side-effect scores. Only 35.8% of study participants were satisfied with the safety of COVID-19 vaccines. Conclusions: Our analysis showed a high proportion of transient and short-lived side effects of Pfizer and AstraZeneca vaccines among individuals with chronic illnesses. However, the side-effects profile was comparable with the safety reports of phase 3 clinical trials of these vaccines. The frequency of side effects was found to be associated with certain demographics, necessitating the need for further investigations to establish a causal relationship. The current study's findings will help instill confidence in the COVID-19 vaccines among people living with chronic conditions, overcome vaccine hesitancy, and increase vaccine coverage in this population.

Evaluation of Conspiracy Beliefs, Vaccine Hesitancy, and Willingness to Pay towards COVID-19 Vaccines in Six Countries from Asian and African Regions: A Large Multinational Analysis.

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.

Estimation of Psychological Impairment and Coping Strategies during COVID-19 Pandemic among University Students in Saudi Arabia: A Large Regional Analysis.

BACKGROUND: The COVID-19 pandemic and associated restrictive measures have substantially affected educational processes around the globe, resulting in psychological distress among students. The mental health of students in higher education is of paramount importance, and the COVID-19 pandemic has brought this vulnerable population into renewed focus. In this context, the evaluation of students' mental health at educational institutes has gained invaluable popularity during the COVID-19 pandemic. This study aimed to ascertain the psychological health and coping strategies among students from a higher education institute in Saudi Arabia. METHODS: An online study instrument was used to assess anxiety (Generalized Anxiety Disorder-7, GAD-7), depression (Patient Health Questionnaire-9, PHQ-9), post-traumatic stress disorder-PTSD (Impact of Event Scale-Revised, IES-R) and coping strategies (Brief-COPE). The severity of the psychological distress was classified as per the scoring criteria and correlated with demographics using appropriate statistical methods. RESULTS: Of 1074 students (age 21.1 ± 2.1 years), 12.9% and 9.7% had severe anxiety and depression, respectively. The mean anxiety and depression scores were 7.50 ± 5.51 and 9.31 ± 6.72, respectively. About one-third (32%) of students reported suicidal ideation, with 8.4% students having such thoughts nearly every day. The average PTSD score was 21.64 ± 17.63, where avoidance scored higher (8.10 ± 6.94) than intrusion and hyperarousal. There was no association of anxiety, depression and PTSD score with the demographics of the study participants. Religious/spiritual coping (5.43 ± 2.15) was the most adoptive coping mechanism, followed by acceptance (5.15 ± 2.10). Male students were significantly (p < 0.05) associated with active copings, instrumental support, planning, humor, acceptance and religious coping. Substance use was the least adopted coping strategy but practiced by a considerable number of students. CONCLUSIONS: The long-lasting pandemic situation, onerous protective measures and uncertainties in educational procedures have resulted in a high prevalence of psychological ailments among university students, as indicated in this study. These findings accentuate the urgent need for telepsychiatry and appropriate population-specific mental health services to assess the extent of psychological impairment and to leverage positive coping behaviors among students.

Multilevel Engagements of Pharmacists During the COVID-19 Pandemic: The Way Forward.

Severe acute respiratory syndrome caused by the novel coronavirus (SARS-CoV-2) was first reported in China in December 2019 which was later declared to be a public health emergency of international concern by the World Health Organization (WHO). This virus proved to be very contagious resulting in life-threatening respiratory intricacies posing overall public health and governance challenges. Amid the coronavirus pandemic and the unprecedented increase in healthcare demands, only inventive and adaptive practice among healthcare professionals is the need of the hour. Pharmacy services are an important mainstay in the public health and have considerable potential to combat the coronavirus disease 2019 (COVID-19) pandemic. Pharmacists working in several localities and health facilities are linked to patients either directly or indirectly. They can act swiftly in public health response such as drafting professional service guidance to pharmacists working in various healthcare facilities, ensuring effective medicine supply system, monitoring and resolving drug shortage issues, establishing and promoting remote pharmacy services, counseling the public on infection prevention basics, educating about proper use of personal protective equipment, discouraging self-medication, participating in clinical trials, small-scale manufacturing of sanitizers and disinfectants, busting the prevailing myths, and conducting drug evaluation and active surveillance. These interventions will help ease unprecedented burden on healthcare facilities during the ongoing pandemic and eventually will add value to patients and the healthcare system. The current manuscript accentuates the potential roles and activities that pharmacists can initiate in various healthcare facilities to help in relieving pressure on the overwhelmed healthcare system. The information and suggestions offered in this review could help in the restructuring of existing pharmacy services by governments, public health bodies, and policy makers in response to the COVID-19 pandemic. Moreover, this manuscript will underscore any unrealized potential among pharmacists working in various sectors including community, hospital, industry, and drug regulatory authorities.

Threat of COVID-19 Vaccine Hesitancy in Pakistan: The Need for Measures to Neutralize Misleading Narratives.

Immediately after declaring COVID-19 as a pandemic, numerous wild conspiracy theories sprouted through social media. Pakistan is quite vulnerable to such conspiracy narratives and has experienced failures of polio vaccination programs because of such claims. Recently, two well-known political figures raised conspiracy theories against COVID-19 vaccines in Pakistan, stating that COVID-19 is a grand illusion and a conspiracy against Muslim countries. This theory is much discussed in the local community, supporting COVID-19 vaccine hesitancy. We urge healthcare authorities in Pakistan to take necessary measures against such claims before they penetrate to the general community. Anti-vaccine movements could undermine efforts to end the COVID-19 pandemic. We believe that ethical and responsible behavior of mass media, a careful advisory from the Pakistan Electronic Media Regulatory Authority, stern measures from healthcare authorities, effective maneuvers to increase public awareness on COVID-19, vigorous analysis of information by data or communications scientists, and publication of counter opinions from health professionals against such theories will go a long way in neutralizing such misleading claims. Because Pakistan is experiencing a large burden of disease, with a sharp rise in confirmed cases, immediate action is of paramount importance to eradicate any potential barriers to a future COVID-19 vaccination program.