ABSTRACT
This paper addresses the just distribution of vaccines against the SARS-CoV- 2 virus and sets forth an ethical framework that prioritises frontline and essential workers, people at high risk of severe disease or death, and people at high risk of infection. Section I makes the case that vaccine distribution should occur at a global level in order to accelerate development and fair, efficient vaccine allocation. Section II puts forth ethical values to guide vaccine distribution including helping people with the greatest need, reducing health disparity, saving the most lives and promoting narrow social utility. It also responds to objections which claim that earlier years have more value than later years. Section III puts forth a practical ethical framework to aid decision-makers and compares it with alternatives. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
ABSTRACT
We studied the factors that influence attitudes toward the COVID-19 vaccine by testing 1872 people across 29 provinces in China. We investigated an individual trait (responsibilism) and two situational factors (a descriptive norm and an injunctive norm). Responsibilism is a version of collectivism that emphasizes tight social ties and responsibilities in close relationships. Responsibilism and perceptions of strong social norms predicted acceptance of the COVID-19 vaccine. The data also revealed an interplay between responsibilism and social norms. People high in responsibilism accepted the vaccine regardless of social norms. But people low in responsibilism were wary of the vaccine, unless they perceived strong injunctive norms. These findings contribute to the research on psychological factors behind vaccine hesitancy. The findings could help provide a roadmap for public health efforts to encourage vaccines. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
ABSTRACT
Background: Since it was declared a global pandemic in March 2020, Coronavirus Disease 2019 (COVID-19) has claimed over one million lives in the United States. Since COVID-19 vaccine rollout efforts began in Baltimore City, Maryland in December 2020, approximately 63.4% of all residents have been fully vaccinated (i.e., received their first and second doses in a two-dose series or received a single-dose vaccine). Despite efforts to implement equitable vaccine distribution in Baltimore City, prominent disparities in COVID-19 vaccine uptake persist, with poorer, predominantly Black neighborhoods frequently reporting lower levels of vaccine uptake than affluent, predominantly White neighborhoods. Guided by key principles of community-based participatory research, this dissertation explores community experiences with COVID-19 vaccines and develops a core outcome set (COS), inclusive of community-important outcomes, for use in studies evaluating the safety, efficacy, and implementation of COVID-19 vaccines. Methods: In March 2022, semi-structured interviews were held with vaccinated and unvaccinated Black residents of a community in Baltimore City reporting 40% vaccination uptake. Data were analyzed using inductive thematic analysis with subsequent subgroup analyses and thematic network analyses. To assess the extent to which outcomes measured in COVID-19 vaccine studies published between December 2019 and March 2022 aligned with factors of vaccine hesitancy, a systematic literature review (SLR) was conducted. Results from the qualitative analyses and the SLR informed the development of a candidate list of outcomes used in the first round of a Delphi study held in June 2020. After two rounds of Delphi survey distribution, a face-to-face consensus meeting was held with community members and community health workers to prioritize outcomes of interest to all relevant stakeholders and finalize the COS. Results: Thematic analysis yielded four emergent themes relating to COVID-19 vaccine uptake decision making: (I) Safety and efficacy of vaccines, (II) Perceived importance of COVID-19 vaccines in relation to pre-existing community needs, divided into two subthemes, a) Environmental injustice and (b) Personal health concerns, (III) Access to trustworthy, understandable information, and (IV) Physical access to vaccines. Participants acknowledged that physical access to COVID-19 vaccines was not a major barrier to uptake, however finding trustworthy and understandable information about the safety and efficacy of the vaccines were common areas of concern. Of all primary outcomes (N=20) identified in the 56 articles included in the SLR, 85% (n=17) corresponded with factors of vaccine hesitancy. The final COS included 19 outcomes across four "domains:" "Is the vaccine safe?";"Does the vaccine work in my body?";"Does the vaccine work in the community?";and "Outcomes identified during consensus meeting." Conclusion: The findings from this dissertation suggest that although community-important outcomes related to safety and efficacy of vaccines are often addressed in clinical studies, outcomes measuring institutional trust, economic and health impacts, community acceptance of the vaccines, and trustworthiness of vaccine information are underutilized in studies of vaccine implementation. As these social factors function as barriers to vaccine uptake, particularly among underserved communities, they should be regarded as indicators of equitable access to COVID-19 vaccines. The findings from this dissertation provide a framework with which public health researchers can begin to rethink measures of equity in vaccine rollout efforts. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
ABSTRACT
INTRODUCTION: The COVID-19 vaccine is the most essential tool for altering the pandemic's trajectory. The pandemic's control is complicated by society's unwillingness to vaccinate. The aim of this cross-sectional study was to assess patients with hematological malignancies and their attitudes regarding COVID-19 immunization and to investigate COVID-19 anxiety in this susceptible population. METHODS: In this cross-sectional study, 165 patients with hematological malignancies were included. COVID-19 anxiety was evaluated with the coronavirus anxiety scale (CAS), and COVID-19 vaccine attitude was evaluated with the Vaccine Attitudes Review (VAX) scale. RESULTS: The mean CAS score was 2.42 (0-17). There were 22 (13%) participants with a mean CAS score of ≥ 9. Half of the participants had a CAS score of 0. The CAS score was higher in females (p = 0.023). Similarly, it was significantly higher in patients who were not in remission for hematological malignancy and who received active chemotherapy (p = 0.010). The mean VAX score was 49.07 ± 8.76 (27-72). Most of the participants (64%) had a neutral attitude toward the COVID-19 vaccination. In a survey of 165 patients, 55% said that they were skeptical about vaccination safety, and 58% said that they were concerned about unintended side effects. In addition, 90% expressed moderate concerns about commercial profiteering. Natural immunity was preferred by 30% of the participants. There was no statistically significant correlation between CAS scores and the Vaccine Attitudes Review (VAX) scale. CONCLUSION: This study draws attention to the level of anxiety in patients with hematological malignancies during the COVID-19 pandemic. Negative attitudes toward the COVID-19 vaccine are worrisome for at-risk patient groups. We think that patients with hematological malignancies should be informed to eliminate their hesitations about COVID-19 vaccines.
ABSTRACT
Objectives: COVID-19 vaccination misinformation on YouTube can have negative effects on users. Some, after being exposed to such misinformation, may search online for information that either debunks or confirms it. This study's objective is to examine the impact of YouTube videos spreading misinformation about COVID-19 vaccination and the influencing variables, as well as subsequent information seeking and its effect on attitudes toward vaccination. Methods: In this observational and survey study, we used a three-group pre-test and post-tests design (N = 106 participants). We examined the effects of YouTube videos containing misinformation about COVID-19 vaccination on attitudes toward vaccination via surveys, employed screen recordings with integrated eye tracks to examine subsequent online information searches, and again surveyed participants to examine the effects of the individual searches on their attitudes. Results: Receiving misinformation via video tended to have negative effects, mostly on unvaccinated participants. After watching the video, they believed and trusted less in the effectiveness of the vaccines. Internet searches led to more positive attitudes toward vaccination, regardless of vaccination status or prior beliefs. The valences of search words entered and search duration were independent of the participants' prior attitudes. Misinforming content was rarely selected and perceived (read). In general, participants were more likely to perceive supportive and mostly neutral information about vaccination. Conclusion: Misinformation about COVID-19 vaccination on YouTube can have a negative impact on recipients. Unvaccinated citizens in particular are a vulnerable group to online misinformation; therefore, it is important to take action against misinformation on YouTube. One approach could be to motivate users to verify online content by doing their own information search on the internet, which led to positive results in the study.
ABSTRACT
BACKGROUND: Although vaccination is one of the critical interventions to address global health issues, inadequate vaccination rates has become an international challenge. Vaccine hesitancy is the key to affecting inadequate vaccination rates. According to the WHO SAGE working group's definition, vaccine hesitancy refers to delaying or refusing vaccination and has been ranked as one of the top 10 health threats. There has yet to be a scale that evaluates vaccination attitudes among Chinese adults. However, an attitude quantity, the adult vaccination attitude scale, has been developed to assess adult vaccination attitudes and reasons for vaccine hesitancy. OBJECTIVE: The Adult Attitudes to Vaccination Scale (ATAVAC) was initially developed by Professor Zoi Tsimtsiou et al. This study aimed to analyze the structure of the Chinese version of the ATAVAC and explore the relationship between adult vaccination attitudes, e-health literacy, and medical distrust. METHODS: After obtaining author permission for the initial scales, the study was translated using the Brislin back-translation method. 693 adults were enrolled to the study. To validate this hypothesis, participants finished the socio-demographic questionnaire, the Chinese version of the ATAVAC, the electronic Health Literacy Scale (e-HEALS) and the Medical Mistrust Index (MMI). The exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to examine the underlying structure of the factors of the Chinese version of the Adult Vaccination Attitude Scale and to measure its reliability and validity. RESULTS: The Cronbach's alpha coefficient for the Chinese version of the ATAVAC was 0.885, with Cronbach's alpha coefficients ranging from 0.850 to 0.958 for each dimension. The content validity index was 0.90, and the retest reliability was 0.943. The exploratory factor analysis (EFA) supported the 3-factor structure of the translation instrument, and the scale had good discriminant validity. The confirmatory factor analysis (CFA) revealed a degree of freedom of 1.219, a model fit index (GFI) of 0.979, a normative fit index (NFI) of 0.991, a Tucker-Lewis index (TLI) of 0.998, a comparability index (CFI) of 0.998 and a root mean square error of approximation (RMSEA) of 0.026. CONCLUSION: The results show that the Chinese version of the ATAVAC has demonstrated good reliability and validity. Hence, it can be used as an effective tool to assess vaccination attitudes among Chinese adults.
Subject(s)
Attitude , Trust , Humans , Adult , Reproducibility of Results , Psychometrics/methods , Translating , Surveys and QuestionnairesABSTRACT
In December 2019, Wuhan, China, experienced a highly infectious disease outbreak described as an acute respiratory virus caused by a novel coronavirus strain (COVID-19) (Ruiz & Bell, 2021) that spread quickly worldwide. By mid-October 2020, the total number of confirmed cases and loss of life had surpassed 38 million, with the United States (US) accounting for 7.8 million cases of the disease and over 216,000 deaths (John Hopkins University, 2020). The United States had the highest prevalence rate of COVID-19 worldwide. The coronavirus pandemic (COVID-19) has significantly impacted the United States, particularly New York City, and State, with a high mortality rate. This study aimed to explore the factors that influenced people's perceptions of COVID-19 vaccines and how those perceptions may have influenced decisions between vaccinated and unvaccinated people. Participants (n = 120) were sent an online survey using the Pandemic Subjective Perception (PSP) scale, which was tested based on a previous study by Pelletier (2021). (PsycInfo Database Record (c) 2023 APA, all rights reserved)
ABSTRACT
BACKGROUND: The Immunisation Register of Australia reports that childhood vaccination rates in some regional areas are below herd immunity levels. This is a concern for the health and well-being of society, as regions with low vaccination rates have an increased risk of disease outbreaks. OBJECTIVE: This study explored psychological motivators as predictors of anti-vaccination attitudes amongst parents living on the Sunshine Coast (Queensland), Australia. METHODS: A cross-sectional survey design explored anti-vaccination attitudes, conspiratorial thinking, psychological reactance, trust in government and magical beliefs about health in 1050 parents (968 mothers). RESULTS: The predictor variables significantly accounted for 42% of the variance in parental anti-vaccination attitudes. The strongest predictor of anti-vaccination attitudes was lower levels of trust in government. CONCLUSION: The findings contribute to understanding of psychological factors motivating anti-vaccine attitudes in Australian parents. The findings may help inform health communication campaign effectiveness in their alignment with individual underlying motivations.
ABSTRACT
Human papillomavirus (HPV) vaccination is an effective public health tool to decrease the rates of HPV-related cancers in our communities. Vaccine hesitancy can undermine this effort, and interventions are needed to inform and assist individuals/parents in decision-making to receive vaccines. The COVID-19 pandemic and newly developed vaccines have increased attention and made families hesitant about vaccines. Receiving a provider's strong recommendation for the vaccine is one of the strongest predictors of HPV vaccine uptake. However, not all providers have the knowledge and skills to provide the best approach for families and patients. The primary communication method has been the presumptive approach. However, this may not work well with vaccine-hesitant individuals. Would another evidence-based approach, such as motivational interviewing (MI), improve vaccine uptake? A study analysis showed that the presumptive strategy remains proven;however, the MI communication strategy was less proven. However, an evidence-based intervention, DOSE HPV, endorsed by the National Cancer Institute showed promise. This DNP project implemented a quality improvement project in a public immunization clinic using the DOSE HPV model as a framework. The project purpose aimed to improve HPV vaccination rates in individuals aged 11-24 years. Staff participants received education on HPV 101 and two communication strategies, presumptive and MI approaches. The project data demonstrated a 5% increase in vaccine uptake for those aged 11-12 years and staff participants rated the educational presentation favorably. This DNP project potentially may be duplicated to include other vaccines, especially the COVID vaccine or other applications changing health behavior. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
ABSTRACT
COVID-19 vaccinations have been mandated for most healthcare professionals providing direct patient care, but there are a group of nonmandated healthcare professionals who have been hesitant to receive the vaccine. Given prolonged hesitancy among key health professionals charged with providing direct patient care, it is crucial to understand why they are hesitant;their apprehension may impact the pool of professionals available to provide direct patient care. This is a cross-sectional quantitative study that included an online survey. The health belief model served as the theoretical framework. The research questions addressed whether there is an association between type of patient care and COVID-19 vaccination intent among nonvaccinated health care professionals. The independent variables were the type of care provided, and the dependent variable was intent to receive the COVID-19 vaccine. Data was collected using Survey Monkey. Participants were recruited through Facebook, Instagram, LinkedIn, Amazon's M-Turk, and flyers that were distributed in the local community. A total of 385 participants completed the survey. Multivariable logistic regression showed there was not a statistically significant association between the type of patient care provided and intent to receive the COVID-19 vaccine, even when modified by professional practice degree, years of education, and race/ethnicity. The information revealed within this study has implications for positive social change by helping public health officials create initiatives that can improve COVID-19 vaccination uptake among nonmandated healthcare professionals. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
ABSTRACT
Vaccination has been the most successful tool in the fight against the COVID-19 pandemic. Given this success, during mass vaccination campaigns many countries resolved to relax other protective measures such as enforced social (or physical) distancing. However, the continued viral evolution of SARS-CoV-2 raises concerns that vaccine resistance will emerge. Several variants, such as Delta or Omicron, are already partially resistant to current vaccines. Therefore, we sought to quantify the probability of the emergence of vaccine resistance, given the speed and penetrance of vaccination campaigns and given the dynamic social distancing applied (which allows a fixed number of new infections per day to determine the strength of the distancing measures). (PsycInfo Database Record (c) 2023 APA, all rights reserved)
ABSTRACT
The COVID-19 pandemic has wreaked havoc across the world. Public health efforts to combat the disease and return life to normalcy largely rests upon COVID-19 vaccination distribution and uptake. Thus, it is critical to examine factors that predict people's intentions to vaccinate. This study explored predictors of intention to vaccinate against COVID-19 among demographic and personal factors, health behaviors and beliefs, COVID-19-specific beliefs, and trust in physicians, using a sample of U.S. adults. We employed bivariate correlations and hierarchical regression to analyze the data. We found that the strongest predictors are political orientation, trust in physicians, subjective norms, and prior flu shot uptake. These associations suggest that individuals who held more liberal political views, expressed higher levels of trust in their primary care provider, perceived stronger social pressure to vaccinate against COVID-19, and received a flu shot during the previous flu season, had a stronger intention to vaccinate against COVID-19. Based on our results, we suggest that public health efforts to increase vaccination uptake for COVID-19 vaccines focus on addressing political orientation (conservatism), involve primary care providers, emphasize vaccination as the norm (and not the exception), and use information about previous flu vaccinations to target vaccination campaigns.
ABSTRACT
SARS-CoV-2, better known as COVID-19, has impacted all people globally. In the United States, the impact of COVID-19 has been extremely devastating for American Indian and Alaska Native populations. Historically, this resilient population has been battling numerous epidemics since first contact with European colonizers. These epidemics, coupled with COVID-19, have led to a deadly syndemic for American Indians and Alaska Natives. Understanding what cultural, societal and individual factors are involved in health decisions can help mitigate the impact of COVID-19 and better inform policies. This dissertation used a mixed-method approach to examine 1) what cultural, societal, and individual factors can predict COVID-19 vaccine intent (Chapter 2 & 3) and 2) to understand the phenomenology of tribal COVID-19 policies and tribal governmental actions implemented in response to the pandemic (Chapter 4). Results demonstrate that ethnic identity, age, education, smoking status, type of employment, handwashing behaviors and a belief that traditions can prevent COVID-19 infection were all predictive of COVID-19 vaccine intent. Furthermore, results show that tribes relied heavily on federal recommendations and traditional values when implementing strategies to keep their communities safe. Tribes with limited infrastructure had a more challenging time disseminating policy to their members, but others found that social media was an effective medium for policy dissemination. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
ABSTRACT
This dissertation investigated vaccine-related content on two dominant social networks, Facebook and Twitter, and explored how this content could influence vaccine decision making. First, Study 1 included a framing analysis of paid vaccine advertisements collected from the Facebook Ad Library during the first two months of the COVID-19 pandemic. Overarching frames included: support for vaccines;dual benefits, including individual and community protection;presentation of information;and the necessity for liberty in medical choices (anti-vaccine frame). COVID-19 specific frames included: 1) vaccine development and the politicization of the COVID-19 pandemic, and 2) COVID-19 as a backdrop to illustrate the need for other vaccines. Study 2 included a thematic analysis of tweets utilizing the #DoctorsSpeakUp hashtag, which was designed by physicians to collectively promote vaccines on Twitter but was hijacked by anti-vaccine advocates. Through the lens of counterpublic sphere theory, analysis revealed that the hashtag hijacking by a scientific counterpublic was successful, and the majority of tweets were oriented against vaccines. Five overarching themes emerged in anti-vaccine hijacked tweets, including: personal experience with vaccine injury, profits over people, a lack of liability, a perception that doctors were uninformed, and "We are the Herd." Finally, Study 3 included interviews with vaccine-accepting mothers to understand their perceptions of paid vaccine advertisements on Facebook, identified in Study 1, through the lens of Source Credibility Theory. Thematic analysis revealed five themes related to current ads, including: one-sided pro-vaccine advertisements;"you can't tell me what to do;" the perception of an underlying agenda;the need for more scientific data-driven information;and a sense of confusion and lack of clarity related to ad elements. Relevant credibility cues included sponsor, context, image selection, wording, and spokesperson of each advertisement. Overall, the three studies revealed key findings, including the politicization of vaccines and vaccine-related messaging on social media, the need for neutral, credible sources and medical provider buy-in, the need for a change in message emphasis from community to personal health, and recommendations for the best platform and strategy to promote vaccines on social networks. Practical and theoretical implications for advertising practitioners and public health communicators were provided. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
ABSTRACT
INTRODUCTION: The objective of this study is to characterize the associations between demographic, attitudinal, and leadership factors with COVID-19 vaccination rates, vaccination intentions among those not vaccinated, and attitudes about vaccination safety, effectiveness, and importance. METHODS: A serial cross-sectional anonymous online survey was administered to soldiers at two large U.S. Army Divisions located in the Southwestern region of the U.S. at two different time points (April-May 2021 [Time 1; T1] N = 24,629; July-August 2021 [Time 2; T2] N = 21,116). Binary logistic regressions were used to assess demographic and attitudinal predictors of vaccination receipt and vaccination intent. Multinomial logistic regressions were used to assess demographic and leadership predictors of endorsement of three vaccination attitudes concerning effectiveness, safety, and importance. RESULTS: Approximately 43% of soldiers reported that they received a COVID-19 vaccine at T1, increasing to 67% at T2. Soldiers who agreed with three separate statements on vaccination effectiveness, safety, or importance were more likely to indicate that they intended to get the vaccination at both time points. Soldiers who reported that their immediate supervisor encouraged soldiers to get a COVID-19 vaccine were more likely to indicate that the vaccination was effective, safe, or important at both time points. DISCUSSION: Negative attitudes about COVID-19 vaccines were prevalent and correlated with less intention to get a vaccination. However, prioritizing leadership engagement around the importance of vaccinations may be a simple but widely effective intervention point to increase future vaccine uptake following the development of novel vaccines to future COVID-19 variants.
ABSTRACT
BACKGROUND: Instruments designed to assess individual differences in predispositions towards vaccination are useful in predicting vaccination-related outcomes. Despite their importance, there is relatively little evidence regarding the conditions under which these instruments are more predictive. The current research was designed to improve the ability of these kinds of instruments to predict vaccination advocacy by considering the certainty associated with the responses to vaccination scales. METHOD: Across two studies, participants completed the Beliefs about Medicines Questionnaire BMQ scale (Study 1) or the Vaccination Attitudes Examination (VAX) scale (Study 2). The certainty participants had in their responses to each scale was either measured (Study 1) or manipulated (Study 2). Intentions to advocate in favor of vaccination served as the criterion measure in both studies. RESULTS: As expected, the scales significantly predicted vaccination advocacy, contributing to enhancing the predictive validity of the instruments used in the studies. Most relevant, certainty moderated the extent to which these scales predicted vaccination advocacy, with greater consistency between the initial scores and the subsequent advocacy willingness obtained for those with higher certainty. CONCLUSIONS: Certainty can be useful to predict when the relationship between vaccination-related cognitions (i.e., beliefs or attitudes) and advocacy willingness is likely to be stronger.
ABSTRACT
In 2020 editor-in-chief (Andrew Malekoff) issued a special call for papers for group work stories on pandemic 2020. Among the 28 stories accepted for the series there were 16 from India, 9 from the United States, 2 from Canada and 1 from Israel. General submissions from the U.S., Canada and Israel were typical for the journal. Atypical are submissions from India. Rather than publish the stories in one special issue of the Journal, he decided to spread them out over several issues through 2022. In the course of organizing the special series (with a December 2021 deadline) he continued communication with a few of the authors from India, with particular interest and concern in the deteriorating situation as 2021 unfolded. Although the present commentary is not about group work per se, it is an update by Ajay Saini, Nancy and Andrew Malekoff on the current state of affairs in India, with some contrast to the situation in the U.S., that offers continuing context for the stories in the series. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
ABSTRACT
Vaccinations, conspiracy theories, and celebrities are all popular topics in contemporary society. Anti-vaccination attitudes and conspiratorial beliefs, especially, have emerged as more prevalent against the backdrop of the 2020 election and Covid-19 pandemic. Martinez-Berman et al. (2020), collected data on these topics prior to the emergence of the Covid-19 pandemic and found a positive relationship between anti-vaccination attitudes and celebrity admiration. Further, there were positive relationships between conspiratorial beliefs and dimensions of celebrity admiration. In this study, we replicated and extended this work to a university-aged sample, to document anti-vaccination attitudes and conspiratorial beliefs at a different time of the Covid-19 pandemic, and to conduct a validity check of the single-item Belief in Conspiracy Theories scale with a more sophisticated measure of conspiratorial belief, the General Conspiratorial Belief (GCB) scale. We discovered overall attitudes toward vaccinations to be similar to those in the prior study. However, participants in our study reported lower mistrust of vaccinations and greater concern for future effects of vaccinations than participants in the previous study. In contrast to the results of the prior study, we found that interest in celebrities was not a significant predictor of vaccination attitudes. We discussed the results in the context of the replication and extension nature of the project and present goals for future research into the relationships among the key variables. © NAJP.
ABSTRACT
OBJECTIVE: Vaccination is the primary way to mitigate the COVID-19 pandemic. Vaccine hesitancy and refusal are one of the most important challenges against to reach herd immunity. The aim of this study is to examine the reasons for not getting vaccinated and the attitudes toward vaccines by people in Turkiye, who were not vaccinated, even though a COVID-19 vaccine was available for them. METHODS: This cross-sectional study is conducted in Eyupsultan district of Istanbul. The study population is 12,540. A questionnaire consisted of three sections as sociodemographic characteristics, attitudes toward COVID-19 vaccines, and Vaccination Attitudes Examination (VAX) scale was used. Among the sample size, participation rate is 69.4%. RESULTS: About 50.2% of the participants (n=259) are male, 80.3% are married, 13.1% are university graduates, and 44.0% are working in a job. About 32.8% of the participants have COVID-19 history. About 34.4% of the participants stated that they would be vaccinated against COVID-19. Although those who define themselves as vaccine refuser are 5.4%, those who still refuse to be vaccinated for COVID-19 are 20.1%. In addition to this, those who are hesitant about COVID-19 vaccines are 45.6%. The most frequently preferred vaccine is comirnaty (41.7%). About 13.1% of the participants stated that "if we had a domestic COVID-19 vaccine, I would have it." The most common sources of information about vaccines are television with 78.4%, and health workers are in the last place with 14.7%. "Concerns about side effects" are the most frequently cited (85.9%) reason for not vaccinating. The mean score of the VAX scale is 42.34±10.93, and the "mistrust of vaccine benefit" is higher among primary school graduates than other educational status groups (p=0.001). CONCLUSION: Anti-vaccination attitudes have increased with the COVID-19 vaccines during pandemic. Our study is valuable in terms of examining the reasons of individuals who have not gotten vaccinated even though they had no access problems. Prominent concerns of the population should be approached seriously. Otherwise, vaccine hesitancy can be a decisive factor that would prevent the success of the struggle against pandemic.
ABSTRACT
People hold different anti-vaccination attitudes. Having an understanding of how these attitudes have changed prior to and during the COVID-19 pandemic is critical for combatting anti-vaccination attitudes and increasing vaccine intention and uptake. Data were collected from different samples in the United States at three time points prior to (n = 840) and four time points during (n = 1543) the pandemic. All participants completed a multi-dimensional measure of anti-vaccination attitudes (VAX Scale) through an online platform. Results showed that, when it comes to vaccines, worries about unforeseen side effects, concerns about commercial profiteering, and preference for natural immunity were higher during the COVID-19 pandemic than they were prior to it. However, mistrust of vaccine benefit was lower during the COVID-19 pandemic than prior to it. These differences were found even after controlling for the potential effects of participant sex, education, socioeconomic status, age, and race/ethnicity. Additionally, worries about unforeseen side effects, concerns about commercial profiteering, and preference for natural immunity increased linearly alongside the persistence of COVID-19; whereas, mistrust of vaccine benefit showed no change. Although it might be intuitive to emphasize vaccines' effectiveness to increase uptake, the public's trust in vaccine effectiveness did not appear to be the major concern. Thus, public health efforts to increase uptake of vaccines should also focus on reducing concerns about potential side effects from the vaccine, tempering the attention on financial benefits to pharmaceutical companies, and rebuffing the overreliance on natural immunity.