Responses to a COVID-19 vaccination intervention: Qualitative analysis of 17K unsolicited SMS replies.

The development of effective interventions for COVID-19 vaccination has proven challenging given the unique and evolving determinants of that behavior. A tailored intervention to drive vaccination uptake through machine learning-enabled personalization of behavior change messages unexpectedly yielded a high volume of real-time short message service (SMS) feedback from recipients. A qualitative analysis of those replies contributes to a better understanding of the barriers to COVID-19 vaccination and demographic variations in determinants, supporting design improvements for vaccination interventions. OBJECTIVE: The purpose of this study was to examine unsolicited replies to a text message intervention for COVID-19 vaccination to understand the types of barriers experienced and any relationships between recipient demographics, intervention content, and reply type. METHOD: We categorized SMS replies into 22 overall themes. Interrater agreement was very good (all κpooled > 0.62). Chi-square analyses were used to understand demographic variations in reply types and which messaging types were most related to reply types. RESULTS: In total, 10,948 people receiving intervention text messages sent 17,090 replies. Most frequent reply types were "already vaccinated" (31.1%), attempts to unsubscribe (25.4%), and "will not get vaccinated" (12.7%). Within "already vaccinated" and "will not get vaccinated" replies, significant differences were observed in the demographics of those replying against expected base rates, all p > .001. Of those stating they would not vaccinate, 34% of the replies involved mis-/disinformation, suggesting that a determinant of vaccination involves nonvalidated COVID-19 beliefs. CONCLUSIONS: Insights from unsolicited replies can enhance our ability to identify appropriate intervention techniques to influence COVID-19 vaccination behaviors. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Media attention and Vaccine Hesitancy: Examining the mediating effects of Fear of COVID-19 and the moderating role of Trust in leadership.

Vaccination has emerged as the most cost-effective public health strategy for maintaining population health, with various social and economic benefits. These vaccines, however, cannot be effective without widespread acceptance. The present study examines the effect of media attention on COVID-19 vaccine hesitancy by incorporating fear of COVID-19 as a mediator, whereas trust in leadership served as a moderator. An analytical cross-sectional study is performed among rural folks in the Wassa Amenfi Central of Ghana. Using a questionnaire survey, we were able to collect 3079 valid responses. The Smart PLS was used to estimate the relationship among the variables. The results revealed that media attention had a significant influence on vaccine hesitancy. Furthermore, the results showed that fear of COVID-19 played a significant mediating role in the relationship between media and vaccine hesitancy. However, trust in leadership had an insignificant moderating relationship on the fear of COVID-19 and vaccine hesitancy. The study suggests that the health management team can reduce vaccine hesitancy if they focus on lessening the negative impact of media and other antecedents like fear on trust in leadership.

Assessing COVID-19 Vaccine Uptake and Effectiveness Through the North West London Vaccination Program: Retrospective Cohort Study.

BACKGROUND: On March 11, 2020, the World Health Organization declared SARS-CoV-2, causing COVID-19, as a pandemic. The UK mass vaccination program commenced on December 8, 2020, vaccinating groups of the population deemed to be most vulnerable to severe COVID-19 infection. OBJECTIVE: This study aims to assess the early vaccine administration coverage and outcome data across an integrated care system in North West London, leveraging a unique population-level care data set. Vaccine effectiveness of a single dose of the Oxford/AstraZeneca and Pfizer/BioNTech vaccines were compared. METHODS: A retrospective cohort study identified 2,183,939 individuals eligible for COVID-19 vaccination between December 8, 2020, and February 24, 2021, within a primary, secondary, and community care integrated care data set. These data were used to assess vaccination hesitancy across ethnicity, gender, and socioeconomic deprivation measures (Pearson product-moment correlations); investigate COVID-19 transmission related to vaccination hubs; and assess the early effectiveness of COVID-19 vaccination (after a single dose) using time-to-event analyses with multivariable Cox regression analysis to investigate if vaccination independently predicted positive SARS-CoV-2 in those vaccinated compared to those unvaccinated. RESULTS: In this study, 5.88% (24,332/413,919) of individuals declined and did not receive a vaccination. Black or Black British individuals had the highest rate of declining a vaccine at 16.14% (4337/26,870). There was a strong negative association between socioeconomic deprivation and rate of declining vaccination (r=-0.94; P=.002) with 13.5% (1980/14,571) of individuals declining vaccination in the most deprived areas compared to 0.98% (869/9609) in the least. In the first 6 days after vaccination, 344 of 389,587 (0.09%) individuals tested positive for SARS-CoV-2. The rate increased to 0.13% (525/389,243) between days 7 and 13, before then gradually falling week on week. At 28 days post vaccination, there was a 74% (hazard ratio 0.26, 95% CI 0.19-0.35) and 78% (hazard ratio 0.22, 95% CI 0.18-0.27) reduction in risk of testing positive for SARS-CoV-2 for individuals that received the Oxford/AstraZeneca and Pfizer/BioNTech vaccines, respectively, when compared with unvaccinated individuals. A very low proportion of hospital admissions were seen in vaccinated individuals who tested positive for SARS-CoV-2 (288/389,587, 0.07% of all patients vaccinated) providing evidence for vaccination effectiveness after a single dose. CONCLUSIONS: There was no definitive evidence to suggest COVID-19 was transmitted as a result of vaccination hubs during the vaccine administration rollout in North West London, and the risk of contracting COVID-19 or becoming hospitalized after vaccination has been demonstrated to be low in the vaccinated population. This study provides further evidence that a single dose of either the Pfizer/BioNTech vaccine or the Oxford/AstraZeneca vaccine is effective at reducing the risk of testing positive for COVID-19 up to 60 days across all age groups, ethnic groups, and risk categories in an urban UK population.

Should nurses take a COVID-19 vaccine?

The issue as to whether health care professionals have a moral obligation to take a vaccine for a communicable disease is not new. Nonetheless, this issue takes on a fresh urgency within nursing practice in the context of the present COVID-19 pandemic, i.e., is there an ethical requirement for nurses to take a COVID-19 vaccine? This paper approaches the issue by using a hypothetical example of Nurse X who has inadvertently infected Patient Y. French's (1984a) Principle of Responsive Adjustment is adapted to claim that there would be a moral expectation that Nurse X takes a COVID-19 vaccine (unless there are justifiable reasons not to). The proposition is also made that, should Nurse X not take a COVID-19 vaccine, they could be morally associated with originally infecting Patient Y.

Will Americans Get Vaccinated? Predicting COVID-19 Vaccine Uptake Rates Under Contingent Scenarios.

OBJECTIVES: Amid a pandemic, vaccines represent a promising solution for mitigating public health and economic crises, and an improved understanding of individuals' vaccination intentions is crucial to design optimal immunization campaigns. This study predicts uptake rates for different COVID-19 vaccine specifications and identifies personal characteristics that moderate an individual's responsiveness to vaccine attributes. METHODS: We developed an online survey with contingent specifications of a COVID-19 vaccine, varying in effectiveness, risks of side effects, duration of immunity, and out-of-pocket cost. Using population-averaged logit models, we estimated vaccine uptake rates that account for uncertainty, heterogeneity across respondents, and interactions between vaccine and personal characteristics. RESULTS: We obtained 3047 completed surveys. The highest uptake rate for an annual vaccine, 62%, is predicted when vaccine effectiveness is 80% to 90%, side effects are minimal, and the vaccine is provided at zero cost, with decreases seen in the uptake rate for less effective vaccines, for example, 50% for 50% to 60% effectiveness. Moreover, we found that Americans' response to vaccine effectiveness depends on their self-reported concern, that is, concerned respondents report a higher willingness to get vaccinated. Our findings also indicate that COVID-19 vaccine uptake rates decrease with vaccine cost and that responsiveness to vaccine cost is moderated by income. CONCLUSIONS: Although providing the COVID-19 vaccine at zero cost will motivate many individuals to get vaccinated, a policy focused exclusively on vaccine cost may not be enough to reach herd immunity thresholds. Although those concerned with COVID-19 will participate, further evidence is needed on how to incentivize participation among the unconcerned (43%) to prevent further pandemic spread.

Preventing the next pandemic and tackling antiscience: an interview with Peter Hotez.

This interview was conducted by Atiya Henry, Commissioning Editor of Future Microbiology. Peter J Hotez, MD, PhD is Dean of the National School of Tropical Medicine and Professor of Pediatrics and Molecular Virology & Microbiology at Baylor College of Medicine. He is an internationally recognized physician-scientist in neglected tropical diseases and vaccine development. As head of the Texas Children's Center for Vaccine Development, he leads a team and product development partnership for developing new vaccines for hookworm infection, schistosomiasis, leishmaniasis, Chagas disease and SARS/MERS/SARS-2 coronavirus. Dr Hotez has authored more than 500 original papers and is the author of four single-author books. Most recently as both a vaccine scientist and autism parent, he has led national efforts to defend vaccines and to serve as an ardent champion of vaccines going up against a growing national 'antivax' threat.

Anti-vaccine movements - a form of social activity for health care, ignorance or diversion aimed at destabilizing the health situation? Part 1. Epidemiological safety. Vaccinations - pros and cons.

INTRODUCTION: Vaccinations are a way accepted by science of preventing infectious diseases. Because of their epidemiological significance, vaccinations are considered compulsory in many countries and their evasion is penalized. Anti-vaccine movements may pose a threat to the epidemiological situation in many countries. The study presents the arguments formulated by opponents of vaccination and provides counter-arguments. MATERIAL AND METHODS: The study is based on the analysis of data stored in scientific databases, information obtained from Google, Bing and Yahoo on the Internet, as well as newspapers, magazines and opinion-forming websites. RESULTS: The slogans propagated by anti-vaccination movements are usually based on easily proven erroneous theories and lies, although there are also arguments expressing belief in the conspiracy of governments, politicians and vaccine manufacturers, or incompetence of scientists and practitioners. CONCLUSIONS: In recent years in Poland, the activity of movements against vaccination has increased significantly, and their propaganda, through its negative impact on social attitudes, threatens to destabilize the epidemiological situation. Analysis of arguments used by the opponents of vaccination suggests a lack of reliable knowledge, religious overtones (addressed to people with fundamentalist personalities), or the ill-will attitudes of anti-vaccine individuals/groups used for their own purposes. Familiarization with the arguments of anti-vaccine propaganda is necessary in order to implement effective methods of fighting such attitudes and beliefs.

Antivaccine Messages on Facebook: Preliminary Audit.

BACKGROUND: The World Health Organization lists vaccine hesitancy as one of 10 threats to global health. The antivaccine movement uses Facebook to promote messages on the alleged dangers and consequences of vaccinating, leading to a reluctance to immunize against preventable communicable diseases. OBJECTIVE: We would like to know more about the messages these websites are sharing via social media that can influence readers and consumers. What messages is the public receiving on Facebook about immunization? What content (news articles, testimonials, videos, scientific studies) is being promoted? METHODS: We proposed using a social media audit tool and 3 categorical lists to capture information on websites and posts, respectively. The keywords "vaccine," "vaccine truth," and "anti-vax" were entered in the Facebook search bar. A Facebook page was examined if it had between 2500 and 150,000 likes. Data about beliefs, calls to action, and testimonials were recorded from posts and listed under the categories Myths, Truths, and Consequences. Website data were entered in a social media audit template. RESULTS: Users' posts reflected fear and vaccine hesitancy resulting from the alleged dangers of immunization featured on the website links. Vaccines were blamed for afflictions such as autism, cancer, and infertility. Mothers shared testimonies on alleged consequences their children suffered due to immunization, which have influenced other parents to not vaccinate their children. Users denied the current measles outbreaks in the United States to be true, retaliating against the government in protests for fabricating news. CONCLUSIONS: Some Facebook messages encourage prevailing myths about the safety and consequences of vaccines and likely contribute to parents' vaccine hesitancy. Deeply concerning is the mistrust social media has the potential to cast upon the relationship between health care providers and the public. A grasp of common misconceptions can help support health care provider practice.

Vaccination strategies against COVID-19 and the diffusion of anti-vaccination views.

Misinformation is usually adjusted to fit distinct narratives and propagates rapidly through social networks. False beliefs, once adopted, are rarely corrected. Amidst the COVID-19 crisis, pandemic-deniers and people who oppose wearing face masks or quarantine have already been a substantial aspect of the development of the pandemic. With the vaccine for COVID-19, different anti-vaccine narratives are being created and are probably being adopted by large population groups with critical consequences. Assuming full adherence to vaccine administration, we use a diffusion model to analyse epidemic spreading and the impact of different vaccination strategies, measured with the average years of life lost, in three network topologies (a proximity, a scale-free and a small-world network). Then, using a similar diffusion model, we consider the spread of anti-vaccine views in the network, which are adopted based on a persuasiveness parameter of anti-vaccine views. Results show that even if anti-vaccine narratives have a small persuasiveness, a large part of the population will be rapidly exposed to them. Assuming that all individuals are equally likely to adopt anti-vaccine views after being exposed, more central nodes in the network, which are more exposed to these views, are more likely to adopt them. Comparing years of life lost, anti-vaccine views could have a significant cost not only on those who share them, since the core social benefits of a limited vaccination strategy (reduction of susceptible hosts, network disruptions and slowing the spread of the disease) are substantially shortened.

The anti-vaccination infodemic on social media: A behavioral analysis.

Vaccinations are without doubt one of the greatest achievements of modern medicine, and there is hope that they can constitute a solution to halt the ongoing COVID-19 pandemic. However, the anti-vaccination movement is currently on the rise, spreading online misinformation about vaccine safety and causing a worrying reduction in vaccination rates worldwide. In this historical time, it is imperative to understand the reasons of vaccine hesitancy, and to find effective strategies to dismantle the rhetoric of anti-vaccination supporters. For this reason, we analyzed the behavior of anti-vaccination supporters on the platform Twitter. Here we identify that anti-vaccination supporters, in comparison with pro-vaccination supporters, share conspiracy theories and make use of emotional language. We demonstrate that anti-vaccination supporters are more engaged in discussions on Twitter and share their contents from a pull of strong influencers. We show that the movement's success relies on a strong sense of community, based on the contents produced by a small fraction of profiles, with the community at large serving as a sounding board for anti-vaccination discourse to circulate online. Our data demonstrate that Donald Trump, before his profile was suspended, was the main driver of vaccine misinformation on Twitter. Based on these results, we welcome policies that aim at halting the circulation of false information about vaccines by targeting the anti-vaccination community on Twitter. Based on our data, we also propose solutions to improve the communication strategy of health organizations and build a community of engaged influencers that support the dissemination of scientific insights, including issues related to vaccines and their safety.

Beyond politics: additional factors underlying skepticism of a COVID-19 vaccine.

Even before it had been developed there had already been skepticism among the general public concerning a vaccine for COVID-19. What are the factors that drive this skepticism? While much has been said about how political differences are at play, in this article I draw attention to two additional factors that have not received as much attention: witnessing the fallibility of the scientific process play out in real time, and a perceived breakdown of the distinction between experts and non-experts.