ABSTRACT
TITLE: Enfermedad de Steinert y rechazo de la actuación médica.
Subject(s)
COVID-19/complications , Myotonic Dystrophy/psychology , Treatment Refusal/psychology , COVID-19/diagnosis , COVID-19/diagnostic imaging , COVID-19/therapy , COVID-19 Serological Testing , Cognition Disorders/etiology , Cognition Disorders/psychology , Female , Humans , Lung/diagnostic imaging , Middle Aged , Myotonic Dystrophy/complications , Quality of Life , SARS-CoV-2/immunology , Vertebrobasilar Insufficiency/etiologyABSTRACT
Importance: Ensuring widespread uptake of available COVID-19 vaccinations, each with different safety and efficacy profiles, is essential to combating the unfolding pandemic. Objective: To test communication interventions that may encourage the uptake of less-preferred vaccines. Design, Setting, and Participants: This online survey was conducted from March 24 to 30, 2021, using a nonprobability convenience sample of Canadian citizens aged 18 years or older, with quota sampling to match 2016 Canadian Census benchmarks on age, gender, region, and language. Respondents completed a 2-by-2-by-2 factorial experiment with random assignment of brand (AstraZeneca or Johnson & Johnson), information about the vaccine's effectiveness against symptomatic infection (yes or no), and information about the vaccine's effectiveness at preventing death from COVID-19 (yes or no) before being asked about their willingness to receive their assigned vaccine and their beliefs about its effectiveness. Exposures: Respondents were randomly assigned a vaccine brand (AstraZeneca or Johnson & Johnson) and information about the vaccine's effectiveness against symptomatic COVID-19 infection (yes or no) and at preventing death from COVID-19 (yes or no). Main Outcomes and Measures: Respondents' self-reported likelihood of taking their assigned vaccine if offered (response categories: very likely, somewhat likely, not very likely, or not at all likely, scaled 0-1) and their beliefs about their assigned vaccine's effectiveness (response categories: very effective, somewhat effective, not very effective, or not at all effective, scaled 0-1) were measured. Results: A total of 2556 Canadian adults responded to the survey (median [IQR] age, 50 [34-63] years; 1339 women [52%]). The self-reported likelihood of taking an assigned AstraZeneca or Johnson & Johnson vaccine was higher for respondents given information about their assigned vaccine's effectiveness at preventing death from COVID-19 (b, 0.04; 95% CI, 0.01 to 0.06) and lower among those given information about its overall effectiveness at preventing symptomatic transmission (b, -0.03; 95% CI, -0.05 to 0.00), compared with those who were not given the information. Perceived effectiveness was also higher among those given information about their assigned vaccine's effectiveness at preventing death from COVID-19 (b, 0.03; 95% CI, 0.01 to 0.05) and lower among those given information about their assigned vaccine's overall efficacy at preventing symptomatic infection (b, -0.05; 95% CI, -0.08 to -0.03), compared with those who were not given this information. The interaction between these treatments was neither substantively nor statistically significant. Conclusions and Relevance: These findings suggest that providing information on the effectiveness of less-preferred vaccines at preventing death from COVID-19 is associated with more confidence in their effectiveness and less vaccine-specific hesitancy. These results can inform public health communication strategies to reduce hesitancy toward specific COVID-19 vaccines.
Subject(s)
COVID-19 Vaccines/therapeutic use , COVID-19/prevention & control , Health Education/methods , Patient Acceptance of Health Care/psychology , Treatment Refusal/psychology , Vaccination/psychology , Adult , COVID-19/psychology , Canada , Female , Humans , Middle Aged , Patient Acceptance of Health Care/statistics & numerical data , Persuasive Communication , Self Report , Treatment Refusal/statistics & numerical data , Vaccination/statistics & numerical dataSubject(s)
COVID-19 Vaccines/administration & dosage , COVID-19/prevention & control , Treatment Refusal/psychology , Treatment Refusal/statistics & numerical data , Vaccination/ethics , Vaccination/psychology , Vaccination/statistics & numerical data , Adult , Aged , Aged, 80 and over , Female , Humans , India , Male , Middle Aged , Public Health/statistics & numerical data , SARS-CoV-2Subject(s)
COVID-19 Vaccines , COVID-19/prevention & control , Politics , Public Opinion , Risk Assessment/methods , Treatment Refusal/psychology , Treatment Refusal/statistics & numerical data , Trust , Administrative Personnel , Age Distribution , COVID-19/epidemiology , COVID-19/immunology , COVID-19 Vaccines/administration & dosage , COVID-19 Vaccines/adverse effects , COVID-19 Vaccines/immunology , COVID-19 Vaccines/supply & distribution , Child , Drug Approval , Drug Industry , Europe/epidemiology , Federal Government , Health Policy , HumansSubject(s)
COVID-19 Testing/standards , COVID-19/diagnosis , COVID-19/epidemiology , Mass Screening/standards , Personal Autonomy , COVID-19/transmission , COVID-19 Testing/ethics , Decision Making , Health Services Accessibility , Humans , Informed Consent/psychology , Informed Consent/standards , Mass Screening/ethics , Personal Protective Equipment/standards , SARS-CoV-2 , Treatment Refusal/ethics , Treatment Refusal/psychology , United States/epidemiologyABSTRACT
Despite vast improvements in global vaccination coverage during the last decade, there is a growing trend in vaccine hesitancy and/or refusal globally. This has implications for the acceptance and coverage of a potential vaccine against COVID-19. In the United States, the number of children exempt from vaccination for "philosophical belief-based" non-medical reasons increased in 12 of the 18 states that allowed this policy from 2009 to 2017 (1). Meanwhile, the overuse and misuse of antibiotics, especially in young children, have led to increasing rates of drug resistance that threaten our ability to treat infectious diseases. Vaccine hesitancy and antibiotic overuse exist side-by-side in the same population of young children, and it is unclear why one modality (antibiotics) is universally seen as safe and effective, while the other (vaccines) is seen as potentially hazardous by some. In this review, we consider the drivers shaping the use of vaccines and antibiotics in the context of three factors: individual incentives, risk perceptions, and social norms and group dynamics. We illustrate how these factors contribute to the societal and individual costs of vaccine underuse and antimicrobial overuse. Ultimately, we seek to understand these factors that are at the nexus of infectious disease epidemiology and social science to inform policy-making.
Subject(s)
COVID-19 Vaccines/economics , COVID-19/economics , COVID-19/prevention & control , Treatment Refusal/psychology , Treatment Refusal/statistics & numerical data , Vaccination/economics , Vaccination/statistics & numerical data , Anti-Infective Agents/administration & dosage , Anti-Infective Agents/economics , COVID-19 Vaccines/administration & dosage , Humans , SARS-CoV-2 , United States/epidemiologyABSTRACT
In the light of the COVID-19 pandemic, anti-vaccine sentiments have been on the rise, with a recent seminal study on the development of anti-vaccine views in social media even making its way into Nature Communications. Yet, with the current scientific consensus being in overwhelming agreement over the safety and efficacy of vaccines, many scientists lose their grasp on the fears, concerns, and arguments that the opposition may hold. This paper discusses and evaluates vaccine-hesitant individuals on a socioeconomic, historical, and philosophical landscape. It also provides an analysis of common argumentative patterns and the psychological impact that these arguments may have on undecided individuals. The discussion also explores why anti-vaccine sentiments are on the rise, and how members of the scientific and medical community require a more structured approach to communicating key arguments. This is particularly important if vaccination rates and herd immunity are to be sustained. No longer is it sufficient to win arguments based on a factual and scientific basis, but rather scientists and medical practitioners have to focus on conveying confidence and reassurance on both an informative and emotional level to those with doubts and fears.
Subject(s)
Coronavirus Infections/prevention & control , Health Knowledge, Attitudes, Practice , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Treatment Refusal/psychology , Vaccination/psychology , Betacoronavirus , COVID-19 , COVID-19 Vaccines , Coronavirus Infections/psychology , Humans , Pneumonia, Viral/psychology , SARS-CoV-2 , Social Media , Vaccines , Viral VaccinesABSTRACT
BACKGROUND: Coronavirus disease 2019 (COVID-19) was declared a pandemic in March 2020. Several prophylactic vaccines against COVID-19 are currently in development, yet little is known about people's acceptability of a COVID-19 vaccine. METHODS: We conducted an online survey of adults ages 18 and older in the United States (n = 2,006) in May 2020. Multivariable relative risk regression identified correlates of participants' willingness to get a COVID-19 vaccine (i.e., vaccine acceptability). RESULTS: Overall, 69% of participants were willing to get a COVID-19 vaccine. Participants were more likely to be willing to get vaccinated if they thought their healthcare provider would recommend vaccination (RR = 1.73, 95% CI: 1.49-2.02) or if they were moderate (RR = 1.09, 95% CI: 1.02-1.16) or liberal (RR = 1.14, 95% CI: 1.07-1.22) in their political leaning. Participants were also more likely to be willing to get vaccinated if they reported higher levels of perceived likelihood getting a COVID-19 infection in the future (RR = 1.05, 95% CI: 1.01-1.09), perceived severity of COVID-19 infection (RR = 1.08, 95% CI: 1.04-1.11), or perceived effectiveness of a COVID-19 vaccine (RR = 1.46, 95% CI: 1.40-1.52). Participants were less likely to be willing to get vaccinated if they were non-Latinx black (RR = 0.81, 95% CI: 0.74-0.90) or reported a higher level of perceived potential vaccine harms (RR = 0.95, 95% CI: 0.92-0.98). CONCLUSIONS: Many adults are willing to get a COVID-19 vaccine, though acceptability should be monitored as vaccine development continues. Our findings can help guide future efforts to increase COVID-19 vaccine acceptability (and uptake if a vaccine becomes available).
Subject(s)
Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Health Knowledge, Attitudes, Practice , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Vaccination/psychology , Adolescent , Adult , Betacoronavirus/drug effects , Betacoronavirus/immunology , Betacoronavirus/pathogenicity , COVID-19 , COVID-19 Vaccines , Coronavirus Infections/immunology , Coronavirus Infections/psychology , Coronavirus Infections/virology , Cross-Sectional Studies , Humans , Immunogenicity, Vaccine , Male , Middle Aged , Patient Compliance/psychology , Patient Compliance/statistics & numerical data , Patient Safety , Pneumonia, Viral/immunology , Pneumonia, Viral/virology , Risk Assessment/trends , SARS-CoV-2 , Treatment Refusal/psychology , Treatment Refusal/statistics & numerical data , United States/epidemiology , Viral Vaccines/administration & dosageABSTRACT
BACKGROUND/AIM: Coronavirus-19 (COVID-19) pandemic outbreak is currently having a huge impact on medical resource allocation. Breast Cancer (BC) patients are concerned both with BC treatment and COVID-19. This study aimed to estimate the impact of anxiety among patients, caused by the spreading of COVID-19. PATIENTS AND METHODS: Between the 16th of January and the 20th of March 2020, we retrospectively enrolled 160 patients. Eighty-two patients with a suspected breast lesion (SBL) were divided into two groups: PRE-COVID-19-SBL and POST-COVID-19-SBL. Seventy-eight BC patients were divided into PRE-COVID-19-BC and POST-COVID-19-BC. Patient characteristics including age, marital status, SBL/BC diameter, personal and family history of BC, clinical stage and molecular subtype were recorded. Procedure Refusal (PR) and Surgical Refusal (SR) were also recorded with their reason. RESULTS: BC and SBL analysis showed no difference in pre-treatment characteristics (p>0.05). Both POST-COVID-19-SBL and POST-COVID-19-BC groups showed higher rates of PR and SR (p=0.0208, p=0.0065 respectively). Infection risk represented primary reason for refusal among POST-COVID-19 patients. CONCLUSION: COVID-19-related anxiety could affect patients' decision-making process.
Subject(s)
Anxiety/psychology , Biopsy, Large-Core Needle/psychology , Breast Neoplasms/psychology , Coronavirus Infections/psychology , Decision Making , Elective Surgical Procedures/psychology , Fear/psychology , Mastectomy/psychology , Pneumonia, Viral/psychology , Treatment Refusal/psychology , Aged , Aged, 80 and over , Anxiety/etiology , Attitude to Health , Biopsy, Large-Core Needle/methods , Breast Neoplasms/diagnostic imaging , Breast Neoplasms/pathology , Breast Neoplasms/surgery , COVID-19 , Female , Humans , Italy , Mammography , Middle Aged , Pandemics , Retrospective Studies , Socioeconomic Factors , Ultrasonography, Mammary , VacuumABSTRACT
COVID-19 has been officially declared as a pandemic by the WHO. Italy was the first European country to be strongly affected by this outbreak. All elective and health promotion activities were reduced. Accordingly, Italian Breast Units and breast cancer (BC) screening programs scaled down significantly their activities. The aim of this study was to evaluate measures that could potentially reduce the clinical impact of COVID-19 on BC patients. Temporary recommendations are needed that could assist specialists in preventing COVID-19 infection and optimizing resources for diagnosis and treatment of BC patients.