Vaccine refusal risk factors among parents of children with autism spectrum disorders.

BACKGROUND: Vaccine refusal is a global trend and was announced as one of the top ten health threats in recent years. The rate of vaccine refusal (VR) among children with autism spectrum disorders (ASD) has also increased in parallel with the global trend but their vaccination behavior may differ from that of the normal population. This study aims to determine the VR rates among parents of children with ASD, to define the risk factors for developing VR, and to evaluate the parental concerns for childhood vaccinations in this susceptible population. METHODS: We conducted a 4-part survey questionnaire among parents of children with ASD, evaluating the vaccination status for both the child with ASD and their younger sibling. The vaccination uptake of the first child was accepted as the `baseline` behavior, while the following sibling`s uptake was suggested as the `current` behavior. The risk factors of VR were determined with logistic regression analysis. RESULTS: The study group included 110 parents of children with ASD (M/F:76/34) and their younger siblings (M/F:57/53). The rate of `baseline VR` was 12.7 % whereas the `current VR` was 40% (p=0.001). High socioeconomic status (relative risk [RR]: 4.4; 95% confidence interval [CI]: 1.01-16.6; p=0.04), using social media as the main source of information (RR: 7; 95% CI: 1.5-32; p= 0.01) and lack of regular well-child visits of the sibling (RR: 25; 95% CI 4.1-166; p=0.001) were determined as risk factors for VR. CONCLUSIONS: The vaccination behavior of parents changed after having a child with ASD, and thus, the younger siblings may constitute a risk group for VR. In clinical practice, pediatricians should be aware of this risk and evaluate the vaccination uptake of the younger siblings of children with ASD more carefully. Regular well-child visits and improving media literacy may be the key points to prevent VR in this susceptible population.

Are they still determining? Analysis of associations among ethnicity, gender, socioeconomic status, neighborhood factors, and COVID-19 vaccination

Introduction: This study explores associations among adult vaccination, ethnicity, gender, and socioeconomic variables such as educational attainment and income, as well as neighborhood factors. Methods: A telephone quota sample of New Jersey adults (N = 1,984) was used to text associations among proposed predictors of vaccination behaviors. Results: Our multivariate logistic regression analyses found that certain races/ethnicity, respondents' household income, and perceived safety of one's community were the strongest predictors of COVID-19 vaccination. The odds of COVID-19 vaccination were 52% lower for Black/African American respondents compared to white/Caucasian respondents (p = 0.001) and 44% lower for Hispanic/Latino respondents compared to white/Caucasian respondents (p = 0.001). Discussion: The results add new insights to public health communication research and suggest careful interventions across racial groups, considering existing racial disparities in vaccination. Copyright © 2023 Kim, Hong and Kim.

Vaccine hesitancy and post-vaccination adherence to safety measures: A mixed-method study.

Background: Despite being recognized as one of the most successful public health measures, vaccination is still considered to be unnecessary and unreliable in the context of the COVID-19 pandemic. The current study utilized a two-pronged approach in analyzing vaccine hesitancy and health behaviors after vaccination by employing a mixed-method design. Phase 1 was aimed at identifying predictors of COVID-19 vaccine hesitancy and acceptance among the Pakistani population using protection motivation theory (PMT), whereas Phase 2 was aimed at exploring the factors related to the vaccination of COVID-19. Method: A convenient sample of 1,736 individuals from the vaccine-eligible population (12 years and above) was selected to collect data on vaccine hesitancy and acceptance (Phase 1). Phase 2 of the study explored post-vaccination health behaviors, especially adherence to safety measures for COVID-19, through 23 in-depth interviews with the vaccinated population. Results: Multiple regression analyses showed that response cost is a major predictor of vaccine hesitancy (in Phase 1). In terms of the role of demographic variables, the results showed that being male (for severity: B = -0.481; threat appraisal: B = -0.737), old age (B = -0.044), not vaccinated, and not infected with COVID-19 (themselves and family members) are strongly associated with vaccination hesitancy. Results of thematic analysis in Phase 2 revealed that perceived individual experience and insensitivity toward the severity of the disease are strongly associated with a lack of adherence to safety measures of COVID-19. Faith and religious beliefs and reliance on traditional remedies are also key predictors of people's general non-compliance to health behaviors. One interesting aspect that was revealed in the analysis was the general financially and socially destabilized situation in the context of developing countries that contributed to general apathy in the pandemic situation. Conclusion: The findings of the current study may help in devising a health model for the public from the developing world to deal with future pandemic situations.

Coupled disease-vaccination behavior dynamic analysis and its application in COVID-19 pandemic.

Predicting the evolutionary dynamics of the COVID-19 pandemic is a complex challenge. The complexity increases when the vaccination process dynamic is also considered. In addition, when applying a voluntary vaccination policy, the simultaneous behavioral evolution of individuals who decide whether and when to vaccinate must be included. In this paper, a coupled disease-vaccination behavior dynamic model is introduced to study the coevolution of individual vaccination strategies and infection spreading. We study disease transmission by a mean-field compartment model and introduce a non-linear infection rate that takes into account the simultaneity of interactions. Besides, the evolutionary game theory is used to investigate the contemporary evolution of vaccination strategies. Our findings suggest that sharing information with the entire population about the negative and positive consequences of infection and vaccination is beneficial as it boosts behaviors that can reduce the final epidemic size. Finally, we validate our transmission mechanism on real data from the COVID-19 pandemic in France.

Could Belief in Fake News Predict Vaccination Behavior in the Elderly?

Willingness to get a vaccine was important during the COVID-19 pandemic. Previous studies suggest that vaccine hesitation during the pandemic could have been related to truth discernment, belief in information, exposure to misinformation, attitudes to vaccines, and conspiracy beliefs. Previous studies were mostly with younger adults, and studies with older adults are lacking. This study aimed to analyze the relationship between the trust or belief in fake online news (print news was not included), truth discernment, attitudes, and willingness to be vaccinated during the COVID-19 pandemic while controlling for some significant factors/variables that could affect vaccination in a sample of older adults. There were 504 pre-retirees and retirees participating in this study. Participants from Lithuania age ranged from 50 to 90 years old (M = 64.37, SD = 9.10), 58.3 percent were females. Results from several path models predicting the participants willingness to get a vaccine suggested that stronger conspiracy beliefs and skeptical attitudes toward vaccination would be related to lower willingness to get vaccinated. Participants who disbelieved in the headlines were already vaccinated. Therefore, it seems that discernment (the ability to distinguish which information is true and which is not) is not related to the willingness to vaccinate.

Health Belief Model (HBM) and vaccination during pandemics

Introduction: With the COVID-19 pandemic recognized as a major threat to human health, promoting vaccination is of paramount importance to public health. Objective(s): To examine the association between factors of the Health Belief Model (HBM) and intentions to be vaccinated against COVID-19, when a vaccine becomes available. Method(s): A literature review has been made through PubMed database. Result(s): The HBM dimensions "perceived barriers", "perceived benefits" and "perceived severity" were considered to be significant predictors of acceptance of vaccinations. The HBM constructs of cues to action (trust in third-party information sources), perceived severity of and susceptibility to COVID-19, and beliefs about the protection benefits of a COVID-19 vaccine, subsequently may elicit willingness to vaccinate. Individual predictors of vaccination were believing the vaccine is effective at preventing COVID-19, recalling their doctor recommending the vaccine. Common perceived barriers against vaccination included believing the vaccine could give people the virus, believing the vaccine can make individuals ill afterwards and preferring to develop immunity "naturally". Patients who delayed and refused vaccine doses were more likely to have vaccine safety concerns and perceive fewer benefits associated with vaccines. Conclusion(s): HBM is an effective tool for identifying facilitators and barriers to health behaviors. Health promotion should make use of the HBM, as the model provides a theoretically understanding of the dynamics that may enable the success of important health-related policy in the wake of COVID-19 and future pandemics and identifies the communication mechanisms that must be leveraged by governments and authorities in enforcing policy.

Determinants of vaccination behavior among university students 20 months after the COVID-19 outbreak: Results of the COVID-19 German Student Well-being Study (C19 GSWS).

Evidence indicates a higher COVID-19 vaccine hesitancy among university students due to their age and a lower risk of COVID-19 related complications compared to the general population in Germany. However, little is known about the other determinants of COVID-19 vaccination behavior for the population of German university students. This study aimed to investigate determinants of vaccination behavior in this population. The cross-sectional COVID-19 German Student Well-being Study was conducted at five German universities from October 27th to November 14th, 2021, via an online survey (n=7,267). Multiple logistic regressions were calculated to examine associations of psychological antecedents of vaccination (5Cs: confidence, complacency, constraints, calculation, collective responsibility), Critical Health Literacy in a Pandemic (CHL-P), and additional determinants (previous infection, trust in the health care system, feeling informed about the COVID-19 vaccine) and vaccination status (not vaccinated vs. fully vaccinated). All 5Cs were associated with reporting to be vaccinated, except for complacency. Regarding the CHL-P, students who felt that the current scientific knowledge about COVID-19 in terms of the policy decisions on pandemic measures was very complex had higher odds for reporting being vaccinated (OR=3.02; 95% CI: 2.26-4.04). Students who felt well informed about the COVID-19 vaccines were also more likely to report being fully vaccinated (OR=2.20; 95% CI: 1.51-3.21). Due to our finding that the 5Cs are associated with vaccination status among university students, we recommend that the different components of the 5Cs should be considered in future vaccination campaigns implemented in the university context.

Why some people do not get vaccinated against COVID-19: Social-cognitive determinants of vaccination behavior.

It is puzzling that a sizeable percentage of people refuse to get vaccinated against COVID-19. This study aimed to examine social psychological factors influencing their vaccine hesitancy. This longitudinal study traced a cohort of 2663 individuals in 25 countries from the time before COVID-19 vaccines became available (March 2020) to July 2021, when vaccination was widely available. Multilevel logistic regressions were used to examine determinants of actual COVID-19 vaccination behavior by July 2021, with country-level intercept as random effect. Of the 2663 participants, 2186 (82.1%) had been vaccinated by July 2021. Participants' attitude toward COVID-19 vaccines was the strongest predictor of both vaccination intention and subsequent vaccination behavior (p < .001). Perceived risk of getting infected and perceived personal disturbance of infection were also associated with higher likelihood of getting vaccinated (p < .001). However, religiosity, right-wing political orientation, conspiracy beliefs, and low trust in government regarding COVID-19 were negative predictors of vaccination intention and behavior (p < .05). Our findings highlight the importance of attitude toward COVID-19 vaccines and also suggest that certain life-long held convictions that predate the pandemic make people distrustful of their government and likely to accept conspiracy beliefs and therefore less likely to adopt the vaccination behavior.

As long as it circulates, we've got to keep fighting: COVID-19 and the motivation to get vaccinated.

OBJECTIVE: The first purpose of this research was to explore the relationship between goal-directed motivation and vaccination behavior. The second purpose was to find ways to motivate people to get vaccinated against COVID-19 and infectious diseases in general. RATIONALE: According to regulatory focus theory, goal-directed behavior is regulated by two motivational systems - prevention and promotion. Prevention-focused behavior is motivated by needs for security and safety, and it is associated with a strategic preference for vigilant means of goal-pursuit. Promotion-focused behavior is motivated by needs for self-development and growth, and it is associated with a strategic preference for eagerness means. Based on regulatory focus theory, this research examined the proposal that motivation in goal-pursuit and self-regulatory processes would play a central role in shaping vaccination intention and behavior. METHOD: Two studies tested the relationship between participants' self-reported intention to get vaccinated and regulatory focus. In Study 1, regulatory focus was measured as a chronic variable. In Study 2, regulatory focus was experimentally induced. RESULTS: Study 1 showed that chronic prevention focus moderated the relationship between vaccine safety concerns and vaccination intention. The higher the concerns about vaccine safety, the lower was the probability of expressing an intention to get vaccinated, and the stronger the prevention focus the stronger was the effect. Moreover, vaccine safety concerns mediated the relationship between chronic promotion focus and vaccination intention. The stronger the promotion focus, the lower was the concern over vaccine safety, and thus the higher was the probability of expressing an intention to get vaccinated. In Study 2, a situationally induced regulatory focus moderated the relationship between vaccination intention and vaccine safety concerns. As concerns about vaccine safety decreased, the intention to get vaccinated increased, and the effect was stronger for prevention compared with promotion focus. Implications for public health and health communication are discussed.

Factors Associated With the Vaccination Behavior Among COVID-19 Vaccine Hesitant College Students in Wuhan, China: A Survey Based on Social Psychological Dimension.

Background: During the COVID-19 pandemic, vaccine hesitancy (VH) on COVID-19 vaccination still exists in different populations, which has a negative impact on epidemic prevention and control. The objectives were to explore college students' willingness to vaccinate, determine the factors influencing the vaccination behavior of students with COVID-19 vaccine hesitancy, and provide a basis for improving the compliance of college students with COVID-19 vaccination. Methods: The universities in Wuhan are categorized into three levels according to their comprehensive strength and randomly sampled at each level, of which ten universities were selected. A self-designed anonymous electronic questionnaire was distributed online from May 12 to 31, 2021 to investigate the hesitancy, vaccination status, and influencing factors of COVID-19 vaccination among college students in Wuhan. Results: Of the 1,617 participants (1,825 students received the electronic questionnaire) surveyed, 19.0% reported COVID-19 vaccine hesitancy. Among the vaccine-hesitant students, 40.1% were vaccinated against COVID-19. The binary logistic regression analysis shows that families' attitudes "Uncertain" (odds ratio (OR) = 0.258 [0.132-0.503]), vaccination risk psychology (OR = 0.242 [0.079-0.747]) and wait-and-see mentality (OR = 0.171 [0.068-0.468]) are negative factors for the vaccination behavior of hesitant students, while herd mentality (OR = 7.512 [2.718-20.767]) and uncertainty of free policy's impact on vaccine trust (OR = 3.412 [1.547-7.527]) are positive factors. Conclusion: The vaccine hesitancy among college students in Wuhan was relatively high. Family support, herd mentality and free vaccination strategies can help improve vaccination among hesitant students, while vaccination risk psychology and "wait-and-see" psychology reduce the possibility of vaccination. The vaccination strategy of college students should be strengthened from the perspective of social psychological construction.

Vaccination games in prevention of infectious diseases with application to COVID-19.

Vaccination coverage is crucial for disease prevention and control. An appropriate combination of compulsory vaccination with voluntary vaccination is necessary to achieve the goal of herd immunity for some epidemic diseases such as measles and COVID-19. A mathematical model is proposed that incorporates both compulsory vaccination and voluntary vaccination, where a decision of voluntary vaccination is made on the basis of game evaluation by comparing the expected returns of different strategies. It is shown that the threshold of disease invasion is determined by the reproduction numbers, and an over-response in magnitude or information interval in the dynamic games could induce periodic oscillations from the Hopf bifurcation. The theoretical results are applied to COVID-19 to find out the strategies for protective immune barrier against virus variants.

Predictors of COVID-19 Vaccine Intention: Evidence from Chile, Mexico, and Colombia.

(1) Background: Although the evidence is consistent that vaccines for COVID-19 effectively prevent severe illness or death, the rapid development of vaccines has led to increased beliefs about possible negative consequences and conspiracy theories about the vaccine. Several factors influence whether or not people decide to be vaccinated. Some studies suggest that our perception of what significant others do and think influences our behavior. (2) Methods: This study evaluates the predictive role of beliefs about negative consequences of the COVID-19 vaccine, conspiracy beliefs about this vaccine, and social influence on the intention to vaccinate against COVID-19 in three Latin American and Caribbean countries: Chile, Mexico, and Colombia. Using convenience sampling, 2075 adults from Chile (48.3%), Mexico (27.6%), and Colombia (24.6%) participated by answering an online questionnaire with variables of interest. (3) Results: Despite the differences between countries, the results showed that the proposed model is invariant and explains between 56-66% of the COVID-19 vaccination intent. Specifically, controlling for age, socioeconomic status, political orientation, and educational level, we found that beliefs about the negative consequences of the COVID-19 vaccine were the main predictor followed by social influence. Beliefs in conspiracy theories did not predict vaccination intention (4) Conclusions: Considering these variables in campaigns to boost vaccination intention is discussed.

Effect of ontological insecurity on vaccination behavior against COVID-19: a hospital-based cross-sectional study.

OBJECTIVE: Coronavirus disease 2019 (COVID-19) has brought great uncertainty to our society and it may have disrupted people's ontological security. Consequently, this hospital-based study concerns the impact of ontological insecurity on vaccination behavior against COVID-19. STUDY DESIGN: This cross-sectional study was conducted among hospital inpatients. METHODS: A questionnaire survey addressing inpatient ontological insecurity and vaccination behavior against COVID-19 was administered in Taizhou, China. A total of 1223 questionnaires were collected; specifically, 1185 of them were credible, for a validity rate of 96.9%. RESULTS: The score of ontological insecurity was 13.27 ± 7.84, which was higher in participants who did not recommend vaccination for others than those who did (12.95 ± 8.25 vs 14.00 ± 6.78, P = 0.022). There was no difference between the vaccinated and unvaccinated groups (13.22 ± 7.96 vs 13.35 ± 7.67, P = 0.779). Lower ontological insecurity (odds ratio [OR] = 1.40, 95% confidence interval [CI]: 1.08-1.81) and being inoculated with COVID-19 vaccines (OR = 2.17, 95% CI: 1.67-2.82) were significantly associated with recommendation of COVID-19 vaccines to others after adjusting for sex, age, education, and occupation. Associations between low ontological insecurity and recommendations for COVID-19 vaccines were observed in men, adults aged 18-59 years, non-farmers, and vaccine recipients. CONCLUSIONS: This study suggests that the ontological insecurity of participants affects their behavior of recommending the COVID-19 vaccination to others rather than getting vaccinated themselves. This promotion of vaccination can be considered from the perspective of improving ontological security in China.

The COVID-19 Vaccination Behavior and Correlates in Diabetic Patients: A Health Belief Model Theory-Based Cross-Sectional Study in China, 2021.

The population with diabetes is more susceptible to severe acute respiratory syndrome-associated coronavirus (SARS-CoV)-2, and have a significantly higher coronavirus disease-2019 (COVID-19) mortality rate. Previous studies have shown low willingness for the COVID-19 vaccination, and there are limited reports on the behavior and relevance of the COVID-19 vaccination. This study aimed to determine the uptake behavior and associated factors of the COVID-19 vaccine. In our cross-sectional questionnaire-based clinical study, 645 diabetes patients affiliated with two affiliated hospitals of Changzhi Medical College completed the questionnaire between June to October 2021. The health belief model (HBM) was used in examining factors influencing vaccination behavior. After adjusting for covariates with significant differences in social background characteristics, a multivariable logistic regression was used to determine predictors related to uptake in COVID-19 vaccination. A total of 162 vaccinated and 483 unvaccinated eligible diabetic patients were recruited. Patients who believed that the COVID-19 syndrome is severe (aOR3.67, 95%CI 1.88-7.17; p < 0.001), believe that vaccination can significantly reduce the risk of SARS-Cov-2 infection (aOR3.48, 95%CI 1.80-6.73; p < 0.001), believe that vaccination is beneficial to themselves and others (aOR 4.53, 95%CI 1.71-11.99; p = 0.002), think that relatives' vaccination status has a positive impact on their vaccination behavior (aOR 5.68, 95%CI 2.83-11.39; p < 0.001), and were more likely to be vaccinated; worrying about the adverse health effects of COVID-19 vaccination (aOR 0.18, 95%CI 0.09-0.35; p < 0.001) was negatively correlated with COVID-19 vaccination behavior. Health care workers should provide targeted informative interventions based on the safety and protective effects theory of HBM to improve vaccination behavior in patients with diabetes.

Determining factors of COVID-19 vaccination uptake among elderly in Indonesia

The elderly is the most vulnerable population group during coronavirus disease 2019 (COVID-19) pandemic. Unfortunately, the vaccination uptake against COVID-19 among the seniors was considered low. This research aimed to point out the most significant factor as the recommendation for government to develop strategy in increasing COVID-19 participation among elderly. The variables are the health belief model, trust in health authorities and media, the experience regarding COVID-19, the general vaccination behaviour, and the novel contribution is the addition of the health protocol compliance as the determining factors of COVID-19 vaccination uptake action among the elderly in Indonesia. The online survey using a structured questionnaire obtained 213 respondents aged ≥55 years old. Structured equation modelling was employed to test the model. The result showed that the health belief model (β=0.296), trust in media and authorities (β=0.524), and general vaccination behaviour (β=0.319) significantly affect health protocol compliance. The health belief model (β=0.699), trust in media authorities (β=0.933), and health protocol compliance (β=0.406) significantly affected the COVID-19 vaccination uptake behaviour. This result gives the implication that the government should focus on improving the trust in media and authorities among the elderly. This action would improve the knowledge of COVID-19 and increase the vaccination coverage among the elderly. © 2022, Intelektual Pustaka Media Utama. All rights reserved.

To vaccinate or not: The relationship between conscientiousness and individual attitudes toward vaccination in real-life contexts.

Despite the availability of a safe and effective vaccine being well-recognized as a critical tool to end the COVID-19 pandemic, many individuals remain vaccine hesitant for various reasons. In the literature, one well-established finding is that skeptical attitudes towards vaccination are higher amongst individuals low in conscientiousness. However, no research is available to corroborate whether the relationship between conscientiousness and intention to vaccinate has force in real life. The present research investigated whether, in addition to self-reported conscientiousness, objectively observable index of conscientiousness behaviors is related to individual perception of vaccination. Based on self-reported data, Study 1 fully replicated prior findings that higher levels of conscientiousness are associated with more positive attitudes towards vaccination in a Chinese student sample. Using the time of arrival for an appointment as a proxy measure for conscientiousness behaviors, Study 2 revealed that non-student adults who arrived early to appointments showed stronger COVID-vaccine uptake intentions than those who arrived late to appointments. Moving beyond vaccination intention to actual behavior, Study 3 found that the arrival punctuality rates of vaccinated participants were higher than those of unvaccinated participants. Overall, our research highlights the important role of conscientiousness-related traits in individuals' COVID-19 vaccination attitudes and behavior.

Subjective health status: an easily available, independent, robust and significant predictive factor at the prometaphase of vaccination programs for the vaccination behavior of Chinese adults.

BACKGROUND: The World Health Organization (WHO) proposed COVID-19 vaccination as an emergent and important method to end the COVID-19 pandemic. Since China started vaccination programs in December 2020, vaccination has spread to provinces and municipalities nationwide. Previous research has focused on people's vaccination willingness and its influencing factors but has not examined vaccination behavior. We examine the effectiveness of psychosocial factors in predicting vaccination behavior. METHODS: A cross-sectional online survey was performed among Chinese adults on 8 May and 4 June 2021. The statistical analysis of the data included univariate analysis, receiver operator characteristics (ROC) analysis and ordinal multiclassification logistic regression model analysis. RESULTS: Of the 1300 respondents, 761 (58.5%) were vaccinated. Univariate analysis showed that a high education level and good subjective health status were protective factors for vaccination behavior, while suffering from chronic diseases was a risk factor. ROC analysis showed that subjective health status (AUC = 0.625, 95% CI: 0.594-0.656, P < 0.001) was the best predictor of vaccination behavior. Logistic regression analysis with subjective health status as a dependent variable indicated that older age, female sex, depression, neurasthenia, obsession, hypochondriasis and chronic disease were significant risk factors, while positive coping tendencies were a significant protective factor. CONCLUSION: Our study found a simple and effective marker, subjective health status, that can predict vaccination behavior. This finding can guide future epidemic prevention work.

Who Got Vaccinated for COVID-19? Evidence from Japan.

Vaccination has been critical to reducing infections and deaths during the coronavirus disease 2019 (COVID-19) pandemic. While previous studies have investigated attitudes toward taking a vaccine, studies on the determinants of COVID-19 vaccination behavior are scant. We examine what characteristics, including socioeconomic and non-economic factors, are associated with vaccination behavior for COVID-19 in Japan. We use a large nationwide online survey with approximately 10,000 participants. As of September 2021, 85% of the respondents said that they had received or would receive a COVID-19 vaccine. Employing logistic regression analysis on vaccination behavior, we found that vaccination rates are higher among those who are older, married, educated, and/or work in a large company. On the other hand, vaccination rates tend to be lower among the self-employed, younger women, and those with poor mental health. Income did not significantly correlate with vaccination. Medical workers were found to have a relatively high rate of vaccination. Although attitude towards risk and time preference were not crucial factors for vaccination, fear of infection, infection prevention behavior, and agreement with government policies on behavioral restrictions in crisis situations positively correlated with vaccination.

Regional Differences in COVID-19 Vaccine Hesitancy in December 2020: A Natural Experiment in the French Working-Age Population.

It can be assumed that higher SARS-CoV-2 infection risk is associated with higher COVID-19 vaccination intentions, although evidence is scarce. In this large and representative survey of 6007 adults aged 18-64 years and residing in France, 8.1% (95% CI, 7.5-8.8) reported a prior SARS-CoV-2 infection in December 2020, with regional variations according to an East-West gradient (p < 0.0001). In participants without prior SARS-CoV-2 infection, COVID-19 vaccine hesitancy was substantial, including 41.3% (95% CI, 39.8-42.8) outright refusal of COVID-19 vaccination. Taking into account five characteristics of the first approved vaccines (efficacy, duration of immunity, safety, country of the vaccine manufacturer, and place of administration) as well as the initial setting of the mass vaccination campaign in France, COVID-19 vaccine acceptance would reach 43.6% (95% CI, 43.0-44.1) at best among working-age adults without prior SARS-CoV-2 infection. COVID-19 vaccine acceptance was primarily driven by vaccine characteristics, sociodemographic and attitudinal factors. Considering the region of residency as a proxy of the likelihood of getting infected, our study findings do not support the assumption that SARS-CoV-2 infection risk is associated with COVID-19 vaccine acceptance.

COVID-19 Vaccination Behavior of People Living with HIV: The Mediating Role of Perceived Risk and Vaccination Intention.

The COVID-19 vaccination behavior of people living with HIV (PLWH) was examined via a cross-sectional web-based survey of PLWH aged 18 years and older. The survey was conducted from l May to 20 June 2021. The survey included social demographic information; vaccination behavior (B); and questions related to perceived usefulness (PU), perceived risk (PR), subjective norms (SNs), perceived behavior control (PBC), and behavior intention (BI). The associations between the questionnaire variables and COVID-19 vaccination behavior were assessed by calculating the descriptive data, correlation analysis, and structural equation modeling. In total, 43.71% of the 350 eligible respondents had received a COVID-19 vaccine. The differences in COVID-19 vaccination behavior according to age, gender, religious belief, marital status, income, education level, and occupation were not obvious (p > 0.05). PU had a significantly negative effect on PR (p < 0.05). PR had a significantly negative effect on BI (p < 0.05). SNs had a significantly positive effect on BI (p < 0.05). BI had a significantly positive effect on B (p < 0.05). PR fully mediated the effects of PU on BI, BI fully mediated the effects of PR on B, and BI fully mediated the effects of SNs on B (p < 0.05). Health policymakers and medical workers should provide more information about the risks of vaccine application to improve the vaccination behavior of PLWH.