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1.
Vaccines (Basel) ; 9(11)2021 Oct 22.
Article in English | MEDLINE | ID: covidwho-1538565

ABSTRACT

BACKGROUND: Vaccines are among the most effective and cost-efficient public health interventions for promoting child health. However, uptake is considerably affected by vaccine hesitancy. An example is Malawi, with a decline in second vaccine doses and the highest cervical cancer incidence and mortality rate in Sub-Saharan Africa. Understanding vaccine hesitancy is especially important when new vaccines are introduced. This study explores factors contributing to vaccine hesitancy for routine childhood immunization and the human papillomavirus vaccine in Malawi. METHODS: The study used a cross-sectional survey design targeting caregivers of children under five years old and adolescent girls. The sample population was derived using three inclusion criteria: one district with low vaccine uptake (Dowa), one district with high vaccine uptake (Salima), and one district where human papillomavirus vaccine was piloted earlier (Zomba). A convenience sample of one primary and one secondary health facility was selected within each district, and participants were systematically included (n = 600). The measures were based on 5C scale for measuring vaccine hesitancy. Multiple regression analyses were performed to explore vaccination intention predictors. RESULTS: Confidence in vaccine safety was the strongest predictor of routine childhood immunization, followed by constraints due to everyday stress. Caregivers had lower confidence in vaccine safety and efficacy when they believed rumors and misinformation and were unemployed. Confidence was higher for those who had more trust in healthcare workers. Age, gender, religion, education, employment, belief in rumors, and trust in healthcare workers were considered predictors of vaccination intention. A husband's positive attitude (approval) increased childhood vaccination intention. For human papillomavirus, vaccination intentions were higher for those with lower education, more trust in healthcare workers, lower complacency, and a lower tendency toward calculating the benefits and risks of vaccination. Knowledge of human papillomavirus did not increase vaccination intention, but the need to attain a husband's approval did. Being a young adult and unemployed increased belief in rumors, while trust in healthcare workers reduced the belief. CONCLUSIONS: This study provides good insights into the drivers of vaccine hesitancy across different contexts in Malawi. However, further studies are necessary to understand low risk perception among elderly people and the declining trend in second vaccine doses.

2.
J Med Ethics ; 47(8): 547-548, 2021 08.
Article in English | MEDLINE | ID: covidwho-1537986

ABSTRACT

Rapid, large-scale uptake of new vaccines against COVID-19 will be crucial to decrease infections and end the pandemic. In a recent article in this journal, Julian Savulescu argued in favour of monetary incentives to convince more people to be vaccinated once the vaccine becomes available. To evaluate the potential of his suggestion, we conducted an experiment investigating the impact of payments and the communication of individual and prosocial benefits of high vaccination rates on vaccination intentions. Our results revealed that none of these interventions or their combinations increased willingness to be vaccinated shortly after a vaccine becomes available. Consequently, decision makers should be cautious about introducing monetary incentives and instead focus on interventions that increase confidence in vaccine safety first, as this has shown to be an especially important factor regarding the demand for the new COVID-19 vaccines.


Subject(s)
COVID-19 Vaccines/administration & dosage , COVID-19 Vaccines/economics , COVID-19 , Motivation , Patient Acceptance of Health Care/psychology , Vaccination/economics , Vaccination/psychology , COVID-19/prevention & control , Female , Health Education , Humans , Male , Pandemics , SARS-CoV-2
3.
Preprint in English | EuropePMC | ID: ppcovidwho-293021

ABSTRACT

Vaccines are the most powerful pharmaceutical tool to combat the COVID-19 pandemic. While the majority (about 65%) of the German population were fully vaccinated, incidence started growing exponentially in October 2021 with about 41% of recorded new cases aged twelve or above being symptomatic breakthrough infections, presumably also contributing to the dynamics. At the time, it (i) remains elusive how significant this contribution is and (ii) whether targeted non-pharmaceutical interventions (NPIs) may stop the amplification of the ongoing crisis. Here, we estimate that about 67%-76% of all new infections are caused by unvaccinated individuals, implying that only 24%-33% are caused by the vaccinated. Furthermore, we estimate 38%-51% of new infections to be caused by unvaccinated individuals infecting other unvaccinated individuals. In total, unvaccinated individuals are expected to be involved in 8-9 of 10 new infections. We further show that decreasing the transmissibility of the unvaccinated by, e.g. targeted NPIs, causes a steeper decrease in the effective reproduction number R than decreasing the transmissibility of vaccinated individuals, potentially leading to temporary epidemic control. Furthermore, reducing contacts between vaccinated and unvaccinated individuals serves to decrease R in a similar manner as increasing vaccine uptake. Taken together, our results contribute to the public discourse regarding policy changes in pandemic response and highlight the importance of combined measures, such as vaccination campaigns and contact reduction, to achieve epidemic control and preventing an overload of public health

4.
Preprint in English | EuropePMC | ID: ppcovidwho-292855

ABSTRACT

Trotz aktuell steigender Impfbereitschaft unter den Erstimpfungen ist nicht abzusehen, dass die vom RKI geforderten Impfquoten für die künftige Kontrolle des SARS-CoV-2 Virus mit den bisherigen Maßnahmen zur Steigerung der Impfbereitschaft erreicht werden können (Stand: Ende November, 2021). Daher werden in diesem Artikel drei Typen verpflichtender Regelungen vorgestellt (Terminpflicht, Beratungspflicht, Impfpflicht) und die Vorteile und Nachteile einer Impfpflicht aufgeführt. Vorteile einer Impfpflicht -Eine Impfpflicht ist sozial und stärkt das Gemeinwohl-Eine Impfpflicht kann effektiv sein-Eine Impfpflicht gegen COVID ist aktuell akzeptiert-Eine Impfpflicht kann sich positiv auf die Gesellschaft auswirken-Eine Impfpflicht kann Vertrauen stärkenNachteile einer Impfpflicht-Eine Impfpflicht entbindet nicht von der Aufklärung-Eine Impfpflicht kann psychologische Nebenwirkungen haben-Eine zielgruppenspezifische Impfpflicht könnte die Gesamt-Impfquote negativ beeinflussen-Eine Impfpflicht könnte “impffaul” machen-Eine Impfpflicht braucht begleitende Maßnahmen zur Stärkung der AkzeptanzAls Wissenschaftler:innen aus Psychologie und Gesundheitskommunikation setzen wir uns für eine informierte, evidenzbasierte Impfentscheidung ein und befürworten eine Impfpflicht nicht grundsätzlich. Aufgrund der zu erwartenden hohen gesundheitlichen und gesellschaftlichen Kosten und Belastungen, die das Fehlen einer Impfpflicht und damit eine zu niedrige Impfquote mit sich bringt, empfehlen wir jedoch nun, umgehend Beratungen über das Design, die Umsetzung, die rechtliche Grundlage und die Abfederung möglicher Folgen zu beginnen. Hierfür sollte ein interdisziplinär besetztes Expert:innen-Team herangezogen werden, in dem auch Sozial- und Verhaltenswissenschaftler:innen sowie Bürger:innen vertreten sind.

5.
Preprint in English | EuropePMC | ID: ppcovidwho-292471

ABSTRACT

To reach high vaccination rates against COVID-19, children and adolescents should be also vaccinated. To improve childhood vaccination rates and vaccination readiness, parents need to be addressed since they decide about the vaccination of their children. We adapted the 7C of vaccination readiness scale to measure parents’ readiness to vaccinate their children and evaluated the scale in a long and a short version in two studies. The study was first evaluated with a sample of N = 244 parents from the German COVID-19 Snapshot Monitoring (COSMO) and validated with N = 464 parents from the Danish COSMO. The childhood 7C scale showed acceptable to good psychometric properties in both samples and explained more than 80% of the variance in vaccination intentions. Additionally, differences in parents’ readiness to vaccinate their children against COVID-19 were strongly determined by their readiness to vaccinate themselves, explaining 64% of the variance. Vaccination readiness and intentions for children changed as a function of the children’s age explaining 93% of differences between parents in their vaccination intentions for their children. Finally, we found differences in correlations of components with self- versus childhood vaccination, as well as between the children’s age groups in the prediction of vaccination intentions. Thus, parents need to be targeted in specifically tailored ways, based on the age of their child, to reach high vaccination rates in children. The scale is publicly available in several languages (www.vaccination-readiness.com).

6.
Preprint in English | EuropePMC | ID: ppcovidwho-291666

ABSTRACT

Cultivation theory assumes that frequent exposure to certain media can lead people to perceive the real world through the lens of their preferred media. This led to the research question of whether fans of science fiction who are accustomed to seeing problem solving based on science and technology are prone to accept science- and technology-based interventions to curb the spread of the COVID-19 pandemic. An exploratory survey and a preregistered experiment (N = 1,983) found that participants who liked science fiction were more likely to trust science and to accept protective measures against COVID-19. This effect was especially visible for a Corona mobile-phone app but also extended to other behaviors. The effect was stronger for those whose genre preference was activated just before the behavioral intentions were assessed. Harnessing these preferences could improve health communication and may be useful in solving health crises, such as pandemics or the climate crisis.

7.
Euro Surveill ; 26(42)2021 10.
Article in English | MEDLINE | ID: covidwho-1485002

ABSTRACT

BackgroundDuring the COVID-19 pandemic, public perceptions and behaviours have had to adapt rapidly to new risk scenarios and radical behavioural restrictions.AimTo identify major drivers of acceptance of protective behaviours during the 4-week transition from virtually no COVID-19 cases to the nationwide lockdown in Germany (3-25 March 2020).MethodsA serial cross-sectional online survey was administered weekly to ca 1,000 unique individuals for four data collection rounds in March 2020 using non-probability quota samples, representative of the German adult population between 18 and 74 years in terms of age × sex and federal state (n = 3,910). Acceptance of restrictions was regressed on sociodemographic variables, time and psychological variables, e.g. trust, risk perceptions, self-efficacy. Extraction of homogenous clusters was based on knowledge and behaviour.ResultsAcceptance of restrictive policies increased with participants' age and employment in the healthcare sector; cognitive and particularly affective risk perceptions were further significant predictors. Acceptance increased over time, as trust in institutions became more relevant and trust in media became less relevant. The cluster analysis further indicated that having a higher education increased the gap between knowledge and behaviour. Trust in institutions was related to conversion of knowledge into action.ConclusionIdentifying relevant principles that increase acceptance will remain crucial to the development of strategies that help adjust behaviour to control the pandemic, possibly for years to come. Based on our findings, we provide operational recommendations for health authorities regarding data collection, health communication and outreach.


Subject(s)
COVID-19 , Pandemics , Adult , Communicable Disease Control , Cross-Sectional Studies , Germany/epidemiology , Humans , Pandemics/prevention & control , Perception , SARS-CoV-2 , Surveys and Questionnaires , Trust
8.
PLoS One ; 16(9): e0256660, 2021.
Article in English | MEDLINE | ID: covidwho-1398935

ABSTRACT

During the SARS-CoV-2 pandemic mobile health applications indicating risks emerging from close contacts to infected persons have a large potential to interrupt transmission chains by automating contact tracing. Since its dispatch in Germany in June 2020 the Corona Warn App has been downloaded on 25.7 Mio smartphones by February 2021. To understand barriers to download and user fidelity in different sociodemographic groups we analysed data from five consecutive cross-sectional waves of the COVID-19 Snapshot Monitoring survey from June to August 2020. Questions on the Corona Warn App included information on download, use, functionality, usability, and consequences of the app. Of the 4,960 participants (mean age 45.9 years, standard deviation 16.0, 50.4% female), 36.5% had downloaded the Corona Warn App. Adjusted analysis found that those who had downloaded the app were less likely to be female (Adjusted Odds Ratio for men 1.16 95% Confidence Interval [1.02;1.33]), less likely to be younger (Adjusted Odds Ratio for age 18 to 39 0.47 [0.32;0.59] Adjusted Odds Ratio for age 40 to 64 0.57 [0.46;0.69]), less likely to have a lower household income (AOR 0.55 [0.43;0.69]), and more likely to live in one of the Western federal states including Berlin (AOR 2.31 [1.90;2.82]). Willingness to disclose a positive test result and trust in data protection compliance of the Corona Warn App was significantly higher in older adults. Willingness to disclose also increased with higher educational degrees and income. This study supports the hypothesis of a digital divide that separates users and non-users of the Corona Warn App along a well-known health gap of education, income, and region.


Subject(s)
COVID-19/prevention & control , Contact Tracing/methods , Mobile Applications/statistics & numerical data , Smartphone/statistics & numerical data , Surveys and Questionnaires , Adult , COVID-19/epidemiology , COVID-19/virology , Cross-Sectional Studies , Female , Germany/epidemiology , Humans , Male , Middle Aged , Pandemics/prevention & control , Reproducibility of Results , SARS-CoV-2/physiology
9.
J Health Psychol ; : 13591053211044535, 2021 Sep 06.
Article in English | MEDLINE | ID: covidwho-1398812

ABSTRACT

Ending the COVID-19 pandemic will require rapid large-scale uptake of vaccines against the disease. Mandating vaccination is discussed as a suitable strategy to increase uptake. In a series of cross-sectional quota-representative surveys and two preregistered experiments conducted in Germany and the US (total N = 4629), we investigated (i) correlates of individual preferences for mandatory (vs voluntary) COVID-19 vaccination policies; (ii) potential detrimental effects of mandatory policies; and (iii) interventions potentially counteracting them. Results indicate that reactance elicited by mandates can cause detrimental effects, such as decreasing the intention to vaccinate against influenza and adhere to COVID-19 related protective measures.

10.
Int J Environ Res Public Health ; 18(17)2021 08 31.
Article in English | MEDLINE | ID: covidwho-1390609

ABSTRACT

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic is posing a global public health burden. These consequences have been shown to increase the risk of mental distress, but the underlying protective and risk factors for mental distress and trends over different waves of the pandemic are largely unknown. Furthermore, it is largely unknown how mental distress is associated with individual protective behavior. Three quota samples, weighted to represent the population forming the German COVID-19 Snapshot Monitoring study (24 March and 26 May 2020, and 9 March 2021 with >900 subjects each), were used to describe the course of mental distress and resilience, to identify risk and protective factors during the pandemic, and to investigate their associations with individual protective behaviors. Mental distress increased slightly during the pandemic. Usage of cognitive reappraisal strategies, maintenance of a daily structure, and usage of alternative social interactions decreased. Self-reported resilience, cognitive reappraisal strategies, and maintaining a daily structure were the most important protective factors in all three samples. Adherence to individual protective behaviors (e.g., physical distancing) was negatively associated with mental distress and positively associated with frequency of information intake, maintenance of a daily structure, and cognitive reappraisal. Maintaining a daily structure, training of cognitive reappraisal strategies, and information provision may be targets to prevent mental distress while assuring a high degree of individual protective behaviors during the COVID-19 pandemic. Effects of the respective interventions have to be confirmed in further studies.


Subject(s)
COVID-19 , Pandemics , Germany/epidemiology , Humans , Pandemics/prevention & control , Risk Factors , SARS-CoV-2
11.
Soc Sci Med ; 286: 114324, 2021 10.
Article in English | MEDLINE | ID: covidwho-1364477

ABSTRACT

BACKGROUND: Nighttime curfews have been discussed and implemented in many countries as a means of controlling the COVID-19 pandemic. However, there is evidence that such curfews have little or no effect on disease dynamics when other measures such as bans on gatherings or business and school closures are already in place. There are two possible explanations for this. First, nighttime curfews may elicit reactance-a feeling of anger that drives non-adherence; second, nighttime curfews may motivate people to shift activities from night to daytime, thereby increasing contact density. METHODS: A survey experiment was conducted with German participants (N = 997) to investigate public perceptions of nighttime curfews and possible detrimental effects on contact behaviors. RESULTS: Most participants perceived nighttime curfews as ineffective. The introduction of a hypothetical curfew did not affect intentions to reduce private contacts but instead elicited reactance, motivating participants to violate curfew hours or to shift a fictitious dinner meeting to an earlier time rather than cancelling it. CONCLUSIONS: When people do not support nighttime curfews or do not understand the rationale behind them, introduction of this measure may fuel the spread of the disease. For that reason, nighttime curfews should be a measure of last resort and should be accompanied by a public communication campaign explaining the importance of contact reduction during both nighttime and daylight hours.


Subject(s)
COVID-19 , Pandemics , Humans , Intention , SARS-CoV-2 , Surveys and Questionnaires
13.
Proc Natl Acad Sci U S A ; 118(34)2021 08 24.
Article in English | MEDLINE | ID: covidwho-1360224
14.
PLoS One ; 16(8): e0256113, 2021.
Article in English | MEDLINE | ID: covidwho-1357438

ABSTRACT

BACKGROUND: Separating ill or possibly infectious people from their healthy community is one of the core principles of non-pharmaceutical interventions. However, there is scarce evidence on how to successfully implement quarantine orders. We investigated a community quarantine for an entire village in Germany (Neustadt am Rennsteig, March 2020) with the aim of better understanding the successful implementation of quarantine measures. METHODS: This cross-sectional survey was conducted in Neustadt am Rennsteig six weeks after the end of a 14-day mandatory community quarantine. The sample size consisted of 562 adults (64% of the community), and the response rate was 295 adults, or 52% (33% of the community). FINDINGS: National television was reported as the most important channel of information. Contact with local authorities was very limited, and partners or spouses played a more important role in sharing information. Generally, the self-reported information level was judged to be good (211/289 [73.0%]). The majority of participants (212/289 [73.4%]) approved of the quarantine, and the reported compliance was 217/289 (75.1%). A self-reported higher level of concern as well as a higher level of information correlated positively with both a greater acceptance of quarantine and self-reported compliant behaviour. INTERPRETATION: The community quarantine presented a rare opportunity to investigate a public health intervention for an entire community. In order to improve the implementation of public health interventions, public health risk communication activities should be intensified to increase both the information level (potentially leading to better compliance with community quarantine) and the communication level (to facilitate rapport and trust between public health authorities and their communities).


Subject(s)
COVID-19/prevention & control , Communication , Health Knowledge, Attitudes, Practice , Quarantine/psychology , Adult , Aged , COVID-19/psychology , Community-Institutional Relations , Female , Germany , Humans , Male , Middle Aged , Rural Population/statistics & numerical data
15.
Curr Opin Psychol ; 43: 307-311, 2021 Aug 16.
Article in English | MEDLINE | ID: covidwho-1355588

ABSTRACT

Most vaccines not only directly protect vaccinated individuals but also provide a social benefit through community protection. Therefore, vaccination can be considered a prosocial act to protect others. We review the recent empirical evidence on (i) how prosocial concerns relate to vaccination intentions and (ii) promoting prosocial vaccination through explaining community protection or inducing concern for vulnerable others. The available evidence suggests that promoting the prosocial aspect of vaccinations could be a vaccination communication strategy to improve vaccine uptake. We point to several areas in which future research can test the boundary conditions of this approach and increase its effectiveness.

16.
Proc Natl Acad Sci U S A ; 118(32)2021 08 10.
Article in English | MEDLINE | ID: covidwho-1345646

ABSTRACT

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) rapid antigen point-of-care and home tests are available to laypeople. In four cross-sectional mixed-methods data collections conducted between December 2020 and March 2021 (n = 4,026), we showed that a majority of subjects were willing to test despite mistrust and ignorance regarding rapid tests' validity. Experimental evidence shows that low costs and access to events could increase testing intentions. Mandatory reporting and isolation after positive results were not identified as major barriers. Instead, assuming that testing and isolation can slow down the pandemic and the possibility to protect others were related to greater willingness to get tested. While we did not find evidence for risk compensation for past tests, experimental evidence suggests that there is a tendency to show less mask wearing and physical distancing in a group of tested individuals. A short communication intervention reduced complacent behavior. The derived recommendations could make rapid testing a successful pillar of pandemic management.


Subject(s)
COVID-19 Testing , COVID-19/epidemiology , Point-of-Care Systems , SARS-CoV-2 , Adolescent , Adult , Aged , Cross-Sectional Studies , False Positive Reactions , Female , Humans , Male , Middle Aged
17.
J Med Virol ; 93(12): 6456-6457, 2021 12.
Article in English | MEDLINE | ID: covidwho-1318722
18.
Appl Health Econ Health Policy ; 19(4): 619-621, 2021 07.
Article in English | MEDLINE | ID: covidwho-1306750
19.
Appl Psychol Health Well Being ; 13(4): 986-995, 2021 11.
Article in English | MEDLINE | ID: covidwho-1242146

ABSTRACT

Psychological reactance theory assumes that the restriction of valued behaviors elicits anger and negative cognitions, motivating actions to regain the limited freedom. Two studies investigated the effects of two possible restrictions affecting COVID-19 vaccination: the limitation of non-vaccination by mandates and the limitation of vaccination by scarce vaccine supply. In the first study, we compared reactance about mandatory and scarce vaccination scenarios and the moderating effect of vaccination intentions, employing a German quota-representative sample (N = 973). In the preregistered second study, we replicated effects with an American sample (N = 1394) and investigated the consequences of reactance on various behavioral intentions. Results revealed that reactance was stronger when a priori vaccination intentions were low and a mandate was introduced or when vaccination intentions were high and vaccines were scarce. In both cases, reactance increased intentions to take actions against the restriction. Further, reactance due to a mandate was positively associated with intentions to avoid the COVID-19 vaccination and an unrelated chickenpox vaccination; it was negatively associated with intentions to show protective behaviors limiting the spread of the coronavirus. Opposite intentions were observed when vaccination was scarce. The findings can help policy-makers to curb the spread of infectious diseases such as COVID-19.


Subject(s)
COVID-19 , COVID-19 Vaccines , Humans , Intention , SARS-CoV-2 , United States , Vaccination
20.
Appl Health Econ Health Policy ; 19(4): 619-621, 2021 07.
Article in English | MEDLINE | ID: covidwho-1222812
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