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1.
Nature ; 613(7945): 704-711, 2023 01.
Article in English | MEDLINE | ID: covidwho-2185935

ABSTRACT

During the COVID-19 pandemic, sizeable groups of unvaccinated people persist even in countries with high vaccine access1. As a consequence, vaccination became a controversial subject of debate and even protest2. Here we assess whether people express discriminatory attitudes in the form of negative affectivity, stereotypes and exclusionary attitudes in family and political settings across groups defined by COVID-19 vaccination status. We quantify discriminatory attitudes between vaccinated and unvaccinated citizens in 21 countries, covering a diverse set of cultures across the world. Across three conjoined experimental studies (n = 15,233), we demonstrate that vaccinated people express discriminatory attitudes towards unvaccinated individuals at a level as high as discriminatory attitudes that are commonly aimed at immigrant and minority populations3-5. By contrast, there is an absence of evidence that unvaccinated individuals display discriminatory attitudes towards vaccinated people, except for the presence of negative affectivity in Germany and the USA. We find evidence in support of discriminatory attitudes against unvaccinated individuals in all countries except for Hungary and Romania, and find that discriminatory attitudes are more strongly expressed in cultures with stronger cooperative norms. Previous research on the psychology of cooperation has shown that individuals react negatively against perceived 'free-riders'6,7, including in the domain of vaccinations8,9. Consistent with this, we find that contributors to the public good of epidemic control (that is, vaccinated individuals) react with discriminatory attitudes towards perceived free-riders (that is, unvaccinated individuals). National leaders and vaccinated members of the public appealed to moral obligations to increase COVID-19 vaccine uptake10,11, but our findings suggest that discriminatory attitudes-including support for the removal of fundamental rights-simultaneously emerged.


Subject(s)
COVID-19 Vaccines , COVID-19 , Health Knowledge, Attitudes, Practice , Internationality , Prejudice , Vaccination Refusal , Vaccination , Humans , Civil Rights/psychology , Cooperative Behavior , COVID-19/prevention & control , COVID-19/psychology , Germany , Health Knowledge, Attitudes, Practice/ethnology , Hungary , Moral Obligations , Pandemics/prevention & control , Politics , Prejudice/psychology , Prejudice/statistics & numerical data , Romania , Stereotyping , United States , Vaccination/psychology , Vaccination/statistics & numerical data , Vaccination Refusal/psychology , Vaccination Refusal/statistics & numerical data
2.
Int J Environ Res Public Health ; 19(19)2022 Sep 27.
Article in English | MEDLINE | ID: covidwho-2043759

ABSTRACT

BACKGROUND: Vaccines for COVID-19 have had a significant impact on the spread of COVID-19 infection, reducing the incidence and mortality of the infection in several countries. However, hesitancy toward this vaccine is a global health issue for the general population The Vaccine acceptance rate among patients affected with inherited metabolic disorders (IMD), as well as safety profile, has not been described. METHODS: We conducted a cross-sectional study, based on a telephone survey, investigating the COVID-19 vaccination rate, the incidence and type of adverse effects (AEs), the reasons for vaccine refusal and the effects on the underlying disease in a cohort of IMD patients followed at a single center and invited directly to vaccination by specialistic team. RESULTS: Seventy-four patients were included in the study, the median age was 23.4 years (min 12.1-max 61.7), 47% (n = 85) were females and 61% (107) were affected from impaired metabolism of phenylalanine. By October 2021, 94% (n = 163) of them had received at least one dose of the vaccine, which was, in 98% of cases, mRNA-based vaccine, given at the referral hospital in 65% of cases. Overall, 72% of patients with IMD reported AE to the vaccine: 60% after the first dose, 81% after the second. The highest rate of adverse events at the first dose was reported in patients with amino acids related disorders other than impaired phenylalanine metabolism (PKU/HPA) (88%). For the second dose, the PKU/HPA group reported the highest rate of AEs (89% of cases). There was no effect on the underlying disease or acute decompensation after the vaccine. Eleven patients (6%) were not vaccinated because they considered it dangerous. CONCLUSION: Among individuals with IMD, the vaccination rate was high, the incidence and severity of AEs were comparable to those in the general population with no effects on the disease. Direct contact with the specialist medical team, has proven to reassure patients and effectively contrast hesitancy.


Subject(s)
COVID-19 Vaccines , COVID-19 , Metabolic Diseases , Adult , Female , Humans , Male , Young Adult , COVID-19/prevention & control , COVID-19 Vaccines/administration & dosage , COVID-19 Vaccines/adverse effects , Cross-Sectional Studies , Metabolic Diseases/complications , RNA, Messenger , Vaccination/statistics & numerical data , Child , Adolescent , Middle Aged , Vaccination Refusal/statistics & numerical data
3.
PLoS One ; 17(3): e0264145, 2022.
Article in English | MEDLINE | ID: covidwho-1896446

ABSTRACT

BACKGROUND: Vaccine uptake rates have been historically low in correctional settings. To better understand vaccine hesitancy in these high-risk settings, we explored reasons for COVID-19 vaccine refusal among people in federal prisons. METHODS: Three maximum security all-male federal prisons in British Columbia, Alberta, and Ontario (Canada) were chosen, representing prisons with the highest proportions of COVID-19 vaccine refusal. Using a qualitative descriptive design and purposive sampling, individual semi-structured interviews were conducted with incarcerated people who had previously refused at least one COVID-19 vaccine until data saturation was achieved. An inductive-deductive thematic analysis of audio-recorded interview transcripts was conducted using the Conceptual Model of Vaccine Hesitancy. RESULTS: Between May 19-July 8, 2021, 14 participants were interviewed (median age: 30 years; n = 7 Indigenous, n = 4 visible minority, n = 3 White). Individual-, interpersonal-, and system-level factors were identified. Three were particularly relevant to the correctional setting: 1) Risk perception: participants perceived that they were at lower risk of COVID-19 due to restricted visits and interactions; 2) Health care services in prison: participants reported feeling "punished" and stigmatized due to strict COVID-19 restrictions, and failed to identify personal benefits of vaccination due to the lack of incentives; 3) Universal distrust: participants expressed distrust in prison employees, including health care providers. INTERPRETATION: Reasons for vaccine refusal among people in prison are multifaceted. Educational interventions could seek to address COVID-19 risk misconceptions in prison settings. However, impact may be limited if trust is not fostered and if incentives are not considered in vaccine promotion.


Subject(s)
COVID-19/prevention & control , Prisoners/psychology , Vaccination Refusal/statistics & numerical data , Adult , Alberta , Attitude , British Columbia , COVID-19/epidemiology , COVID-19/virology , Delivery of Health Care , Humans , Interviews as Topic , Male , Middle Aged , Ontario , Risk , SARS-CoV-2/isolation & purification , Social Norms , Social Responsibility , Young Adult
4.
PLoS One ; 17(3): e0264633, 2022.
Article in English | MEDLINE | ID: covidwho-1793512

ABSTRACT

BACKGROUND: In low-income countries, vaccination campaigns are lagging, and evidence on vaccine acceptance, a crucial public health planning input, remains scant. This is the first study that reports willingness to take COVID-19 vaccines and its socio-demographic correlates in Ethiopia, Africa's second most populous country. METHODS: The analysis is based on a nationally representative survey data of 2,317 households conducted in the informal economy in November 2020. It employs two logistic regression models where the two outcome variables are (i) a household head's willingness to take a COVID-19 vaccine or not, and (ii) if yes if they would also hypothetically pay (an unspecified amount) for it or not. Predictors include age, gender, education, marital status, income category, health insurance coverage, sickness due to COVID-19, chronic illness, trust in government, prior participation in voluntary activities, urban residence. RESULTS: Willingness to take the vaccine was high (88%) and significantly associated with COVID-19 cases in the family, trust in government and pro-social behavior. All other predictors such as gender, education, income, health insurance, chronic illness, urban residence did not significantly predict vaccine willingness at the 5% level. Among those willing to take the vaccine, 33% also answered that they would hypothetically pay (an unspecified amount) for it, an answer that is significantly associated with trust in government, health insurance coverage and income. CONCLUSION: The results highlight both opportunities and challenges. There is little evidence of vaccine hesitancy in Ethiopia among household heads operating in the informal economy. The role played by trust in government and pro-social behavior in motivating this outcome suggests that policy makers need to consider these factors in the planning of COVID-19 vaccine campaigns in order to foster vaccine uptake. At the same time, as the willingness to hypothetically pay for a COVID-19 vaccine seems to be small, fairly-priced vaccines along with financial support are also needed to ensure further uptake of COVID-19 vaccines.


Subject(s)
COVID-19 Vaccines/therapeutic use , COVID-19/prevention & control , Vaccination Refusal/statistics & numerical data , Adolescent , Adult , Aged , Aged, 80 and over , Attitude to Health , Cross-Sectional Studies , Ethiopia/epidemiology , Female , Humans , Immunization Programs , Income/statistics & numerical data , Male , Middle Aged , Patient Participation/psychology , Patient Participation/statistics & numerical data , Poverty , SARS-CoV-2/immunology , Vaccination , Vaccination Hesitancy/psychology , Vaccination Hesitancy/statistics & numerical data , Vaccination Refusal/psychology , Young Adult
5.
PLoS One ; 17(1): e0260949, 2022.
Article in English | MEDLINE | ID: covidwho-1648843

ABSTRACT

BACKGROUND: The UK began delivering its COVID-19 vaccination programme on 8 December 2020, with health and social care workers (H&SCWs) given high priority for vaccination. Despite well-documented occupational exposure risks, however, there is evidence of lower uptake among some H&SCW groups. METHODS: We used a mixed-methods approach-involving an online cross-sectional survey and semi-structured interviews-to gain insight into COVID-19 vaccination beliefs, attitudes, and behaviours amongst H&SCWs in the UK by socio-demographic and employment variables. 1917 people were surveyed- 1656 healthcare workers (HCWs) and 261 social care workers (SCWs). Twenty participants were interviewed. FINDINGS: Workplace factors contributed to vaccination access and uptake. SCWs were more likely to not be offered COVID-19 vaccination than HCWs (OR:1.453, 95%CI: 1.244-1.696). SCWs specifically reported uncertainties around how to access COVID-19 vaccination. Participants who indicated stronger agreement with the statement 'I would recommend my organisation as a place to work' were more likely to have been offered COVID-19 vaccination (OR:1.285, 95%CI: 1.056-1.563). Those who agreed more strongly with the statement 'I feel/felt under pressure from my employer to get a COVID-19 vaccine' were more likely to have declined vaccination (OR:1.751, 95%CI: 1.271-2.413). Interviewees that experienced employer pressure to get vaccinated felt this exacerbated their vaccine concerns and increased distrust. In comparison to White British and White Irish participants, Black African and Mixed Black African participants were more likely to not be offered (OR:2.011, 95%CI: 1.026-3.943) and more likely to have declined COVID-19 vaccination (OR:5.550, 95%CI: 2.294-13.428). Reasons for declining vaccination among Black African participants included distrust in COVID-19 vaccination, healthcare providers, and policymakers. CONCLUSION: H&SCW employers are in a pivotal position to facilitate COVID-19 vaccination access, by ensuring staff are aware of how to get vaccinated and promoting a workplace environment in which vaccination decisions are informed and voluntary.


Subject(s)
COVID-19 Vaccines/administration & dosage , COVID-19/prevention & control , Caregivers/psychology , Health Personnel/psychology , Vaccination Refusal/psychology , Vaccination/psychology , Adult , COVID-19/epidemiology , COVID-19/immunology , COVID-19 Vaccines/supply & distribution , Cross-Sectional Studies , Female , Health Knowledge, Attitudes, Practice , Humans , Male , Middle Aged , SARS-CoV-2/pathogenicity , Surveys and Questionnaires , United Kingdom/epidemiology , Vaccination Coverage/organization & administration , Vaccination Coverage/statistics & numerical data , Vaccination Refusal/statistics & numerical data
6.
PLoS One ; 17(1): e0262192, 2022.
Article in English | MEDLINE | ID: covidwho-1603690

ABSTRACT

Equal Access to the COVID-19 vaccine for all remains a major public health issue. The current study compared the prevalence of vaccination reluctance in general and COVID-19 vaccine hesitancy and social and health factors associated with intentions to receive the vaccine. A random socio-epidemiological population-based survey was conducted in France in November 2020, in which 85,855 adults participants were included in this study. We used logistic regressions to study being "not at all in favor" to vaccination in general, and being "certainly not" willing to get vaccinated against Covid-19. Our analysis highlighted a gendered reluctance toward vaccination in general but even more so regarding vaccination against COVID-19 (OR = 1.88 (95% CI: 1.79-1.97)). We also found that people at the bottom of the social hierarchy, in terms of level of education, financial resources, were more likely to refuse the COVID-19 vaccine (from OR = 1.22 (95% CI:1.10-1.35) for respondents without diploma to OR = 0.52 (95% CI:0.47-0.57) for High school +5 or more years level). People from the French overseas departments, immigrants and descendants of immigrants, were all more reluctant to the Covid-19 vaccine (first-generation Africa/Asia immigrants OR = 1.16 (95% CI:1.04-1.30)) versus OR = 2.19 (95% CI:1.96-2.43) for the majority population). Finally, our analysis showed that those who reported not trusting the government were more likely to be Covid-19 vaccine-reluctant (OR = 3.29 (95% CI: 3.13-3.45)). Specific campaigns should be thought beforehand to reach women and people at the bottom of the social hierarchy to avoid furthering social inequalities in terms of morbidity and mortality.


Subject(s)
COVID-19/prevention & control , Vaccination Hesitancy/trends , Vaccination Refusal/trends , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19/epidemiology , COVID-19 Vaccines , Cross-Sectional Studies , Female , France/epidemiology , Hostility , Humans , Intention , Male , Middle Aged , SARS-CoV-2/pathogenicity , Socioeconomic Factors , Vaccination/statistics & numerical data , Vaccination Hesitancy/psychology , Vaccination Hesitancy/statistics & numerical data , Vaccination Refusal/psychology , Vaccination Refusal/statistics & numerical data , Vaccines
7.
J Med Virol ; 93(12): 6535-6543, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1544301

ABSTRACT

Measurement of the population's general knowledge of the coronavirus vaccine is very important to improve public acceptance and decrease vaccine hesitancy in confronting the disease. This study aimed to evaluate the knowledge, attitude, and practices of the participants towards the coronavirus vaccine. Data were collected using an online survey, in the form of a structured questionnaire, conducted during April-May 2021 in Egypt, and subjects from all over Egypt participated. The questionnaire was divided into three parts to assess the knowledge and attitude regarding coronavirus. The first part was to assess participants' experience about coronavirus infection (eight items), the second was to assess the health beliefs about coronavirus and vaccine (16 items) and the third was to assess general knowledge, attitude, and practices of the participants towards vaccine (28 items). A total of 871 (465 females) participants participated, 81% of them were still committed to the precautionary measures for protection. Eighty-eight percent of them accepted to take the vaccine. Eighty-three percent of the participants answered that they will encourage family, friends, and colleagues to get the vaccine. Ninety-four percent knew that the coronavirus vaccine provides immunity against infection for a period of 6-12 months. 91.9% believed that the current infection with coronavirus is one of the main contraindications to vaccination. Eighty-nine percent believed that both pregnant women and chronic disease patients can get vaccinated and also that there is no specific age for a specific type of vaccination. Ninety-four percent of them knew that subjects taking immunosuppressive drugs should be prescribed Sinopharm, not AstraZeneca vaccine. The median score of this survey was 20/22 regarding knowledge about the coronavirus vaccine. Overall, the study participants had good knowledge about the coronavirus vaccine and accepted to take the vaccine, which indicates the highly commendable efforts to confront the coronavirus.


Subject(s)
COVID-19 Vaccines/therapeutic use , COVID-19/prevention & control , Health Knowledge, Attitudes, Practice , Patient Acceptance of Health Care/statistics & numerical data , Vaccination Refusal/statistics & numerical data , Adolescent , Adult , Egypt , Female , Humans , Male , Middle Aged , SARS-CoV-2/immunology , Surveys and Questionnaires , Vaccination/statistics & numerical data , Vaccination Refusal/psychology , Young Adult
10.
PLoS One ; 16(10): e0248325, 2021.
Article in English | MEDLINE | ID: covidwho-1496338

ABSTRACT

BACKGROUND: Since the beginning of the COVID-19 outbreak, many pharmaceutical companies have been racing to develop a safe and effective COVID-19 vaccine. Simultaneously, rumors and misinformation about COVID-19 are still widely spreading. Therefore, this study aimed to investigate the prevalence of COVID-19 misinformation among the Yemeni population and its association with vaccine acceptance and perceptions. METHODS: A cross-sectional online survey was conducted in four major cities in Yemen. The constructed questionnaire consisted of four main sections (sociodemographic data, misinformation, perceptions (perceived susceptibility, severity, and worry), and vaccination acceptance evaluation). Subject recruitment and data collection were conducted online utilizing social websites and using the snowball sampling technique. Descriptive and inferential analyses were performed using SPSS version 27. RESULTS: The total number of respondents was 484. Over 60% of them were males and had a university education. More than half had less than 100$ monthly income and were khat chewers, while only 18% were smokers. Misinformation prevalence ranged from 8.9% to 38.9%, depending on the statement being asked. Men, university education, higher income, employment, and living in urban areas were associated with a lower misinformation level (p <0.05). Statistically significant association (p <0.05) between university education, living in urban areas, and being employed with perceived susceptibility were observed. The acceptance rate was 61.2% for free vaccines, but it decreased to 43% if they had to purchase it. Females, respondents with lower monthly income, and those who believed that pharmaceutical companies made the virus for financial gains were more likely to reject the vaccination (p <0.05). CONCLUSION: The study revealed that the acceptance rate to take a vaccine was suboptimal and significantly affected by gender, misinformation, cost, and income. Furthermore, being female, non-university educated, low-income, and living in rural areas were associated with higher susceptibility to misinformation about COVID-19. These findings show a clear link between misinformation susceptibility and willingness to vaccinate. Focused awareness campaigns to decrease misinformation and emphasize the vaccination's safety and efficacy might be fundamental before initiating any mass vaccination in Yemen.


Subject(s)
COVID-19 , Disease Outbreaks , Vaccination Refusal , Vaccination , Adult , COVID-19/prevention & control , COVID-19/psychology , COVID-19 Vaccines/administration & dosage , Communication , Cross-Sectional Studies , Disease Outbreaks/prevention & control , Disease Outbreaks/statistics & numerical data , Female , Humans , Male , Socioeconomic Factors , Surveys and Questionnaires , Vaccination/psychology , Vaccination/statistics & numerical data , Vaccination Refusal/psychology , Vaccination Refusal/statistics & numerical data , Yemen/epidemiology
11.
Epidemiol Infect ; 149: e225, 2021 10 14.
Article in English | MEDLINE | ID: covidwho-1467028

ABSTRACT

Vaccine hesitancy remains a serious global threat to achieve herd immunity, and this study aimed to assess the magnitude and associated factors of coronavirus disease-19 (COVID-19) vaccine hesitancy among healthcare workers (HCWs) in Amhara regional referral hospitals. A web-based anonymised survey was conducted among 440 HCWs in the Amhara region referral hospitals. The questionnaire was designed using Google Forms and distributed using telegram and e-mail from 15 May to 10 June 2021 to the randomly selected participants in each hospital. The data were analysed with Stata 14.0 and described using frequency tables. A multivariable binary logistic regression model was fitted and model fitness was checked with the Hosmer-Lemeshow goodness of fit test. Out of 440 participants, 418 were willing to participate in the study and the mean age was about 30 years. Overall, 45.9% (n = 192) of participants reported vaccine hesitancy. After applying multivariate analysis, age ≤25 years (adjusted odds ratio (aOR) = 5.6); do not wear a mask (aOR = 2.4); not compliance with physical distancing (aOR = 3.6); unclear information by public health authorities (aOR = 2.5); low risk of getting COVID-19 infection (aOR = 2.8); and not sure about the tolerability of the vaccine (aOR = 3.76) were associated with COVID-19 vaccine hesitancy. A considerable proportion of HCWs were hesitant towards COVID-19 vaccine, and this can be tackled with the provision of clear information about the vaccine.


Subject(s)
COVID-19 Vaccines/therapeutic use , COVID-19/prevention & control , Personnel, Hospital/psychology , Vaccination Refusal/psychology , Adult , Attitude to Health , Cross-Sectional Studies , Ethiopia/epidemiology , Female , Health Status , Humans , Logistic Models , Male , Personnel, Hospital/statistics & numerical data , Physical Distancing , Risk Factors , Secondary Care Centers/statistics & numerical data , Surveys and Questionnaires , Vaccination Refusal/statistics & numerical data , Young Adult
12.
Pan Afr Med J ; 40: 10, 2021.
Article in English | MEDLINE | ID: covidwho-1449275

ABSTRACT

INTRODUCTION: healthcare workers are at higher risk of COVID-19 infection with ease of infection transmissibility to coworkers and patients. Vaccine hesitancy rates of 56% and up to 25% have been reported among healthcare workers in US and China respectively. Vaccination is known as the most effective strategy to combat infectious diseases. Acceptance of the COVID-19 vaccine plays a major role in combating the pandemic. This study assessed the sociodemographic factors associated with COVID-19 vaccine hesitancy among healthcare workers in Abia State. METHODS: a cross-sectional study among 422 healthcare workers was conducted in Abia State with an online-based questionnaire. The questionnaire extracted information on socio-demographics and willingness to take vaccine uptake. Descriptive statistics was used to calculate frequencies and proportions. Bivariate analysis was used to test the association between the socio-demographic factors and the outcome variable (vaccine hesitancy). Logistic regression was conducted to identify the predictors of COVID-19 vaccine hesitancy. The level of significance was 5%. RESULTS: mean age of the respondents was 40.6 ± 9.5 years and 67.1% were females The COVID-19 vaccine hesitancy rate was 50.5% (95%CI: 45.6%-55.3%). Socio-demographic factors included age, marital status, location of practice, profession, and income. Vaccine Hesitancy was predicted significantly by younger age (aOR=9.34, 95%CI:2.01-43.39), marital status (single) (aOR=4.97, 95%CI:1.46-16.97), lower income (aOR=2.84, 95%CI:1.32-6.08), and profession - Doctor (aOR=0.28, 95%CI:0.11-0.70), Nurse (aOR=0.31, 95%CI:0.15-0.64) and other allied health professionals (aOR=0.22, 95%CI:0.10-0.44). CONCLUSION: COVID-19 vaccine hesitancy was high among healthcare workers. Significant sociodemographic predictors influence the uptake of the COVID-19 vaccine. We recommend that the Federal and State Ministries of Health conduct awareness campaigns targeting the younger age group, singles, lower income class, and non-clinical staff.


Subject(s)
COVID-19 Vaccines/administration & dosage , Health Personnel/statistics & numerical data , Vaccination Refusal/statistics & numerical data , Vaccination/statistics & numerical data , Adult , Age Factors , COVID-19/prevention & control , Cross-Sectional Studies , Female , Humans , Income , Male , Marital Status , Middle Aged , Nigeria , Surveys and Questionnaires , Young Adult
15.
Diabetes Metab Syndr ; 15(5): 102271, 2021.
Article in English | MEDLINE | ID: covidwho-1385430

ABSTRACT

BACKGROUND AND AIMS: The survey aimed to assess COVID-19 vaccine acceptance and hesitancy rate among patients with diabetes and address barriers and beliefs that affect acceptance to take COVID-19 vaccine. METHODS: A quantitative research approach with cross-sectional design was used to collect data from March-May'2021. Saudi residents with diabetes, aged ≥18 years were included. RESULTS: Of the total 709 participants, 42.2% had family member with COVID-19, 14.7% had COVID-19, 34.0% had been with someone who had COVID-19. 34.7% of participants taken COVID-19 vaccination, 36.2% were willing to take, while 79.0% supported COVID-19 vaccine. Main reasons behind uncertainties towards vaccinations were relatively fast production, not many trials done and about genetic component. 44.6% got information about COVID-19 and vaccination through television, social media, and ministry website. On adjusting models, female gender, longer duration of diabetes and no history of influenza vaccine significantly associated with COVID vaccine uptake. CONCLUSION: Participants are willing to vaccinate but show some fear and misinformation. It is imperative that due efforts are made for increasing vaccine willingness, and availability of precise information holds key to success. Otherwise, state will have to continue to funnel in resources towards post-on-set disease management, consuming a lot more resources than preventive measures like vaccination.


Subject(s)
COVID-19 Vaccines/therapeutic use , Diabetes Mellitus/epidemiology , Vaccination Refusal , Adolescent , Adult , Aged , Aged, 80 and over , Cross-Sectional Studies , Diabetes Mellitus/psychology , Female , Health Behavior , Humans , Male , Middle Aged , Patient Acceptance of Health Care/psychology , Patient Acceptance of Health Care/statistics & numerical data , Saudi Arabia/epidemiology , Vaccination/psychology , Vaccination/statistics & numerical data , Vaccination Refusal/psychology , Vaccination Refusal/statistics & numerical data , Young Adult
16.
Travel Med Infect Dis ; 41: 102059, 2021.
Article in English | MEDLINE | ID: covidwho-1371543

ABSTRACT

BACKGROUND: Determinants of vaccine acceptance are multifactorial, complex, and in most cases, context-dependent. We determined the prevalence of COVID-19 vaccination intention (VI) and fear of its adverse effects (FAE) as well as their associated factors in Latin America and the Caribbean (LAC). METHODS: We conducted a secondary cross-sectional analysis of a database collected by the University of Maryland and Facebook. We included participants aged 18 and over from LAC surveyed, January 15 to February 1, 2021. We evaluated VI, FAE, sociodemographic characteristics, COVID-19 symptomatology, compliance with community mitigation strategies, food and economic insecurity, mental health evaluation and the influence in VI when recommended by different stakeholders. We calculated crude and adjusted prevalence ratios with their 95%CIs. RESULTS: We analyzed 472,521 responses by Latin American adults, finding a VI and FAE prevalence of 80.0% and 81.2%, respectively. We found that female and non-binary genders were associated with a lower probability of VI and a higher probability of FAE. Besides, living in a town, village or rural area and economic insecurity was associated with a higher FAE probability. The fears of becoming seriously ill, a family member becoming seriously ill from COVID-19 and having depressive symptoms were associated with a higher probability of VI and FAE. CONCLUSION: Eight out of 10 adults in LAC have VI and FAE. The factors identified are useful for the development of communication strategies to reduce FAE frequency. It is necessary to guarantee mass vaccination and support the return of economic activities.


Subject(s)
COVID-19 Vaccines/administration & dosage , COVID-19/prevention & control , Vaccination/psychology , Vaccination/statistics & numerical data , Adolescent , Adult , Aged , COVID-19/epidemiology , COVID-19/psychology , Caribbean Region/epidemiology , Cross-Sectional Studies , Female , Humans , Intention , Latin America/epidemiology , Male , Middle Aged , Patient Acceptance of Health Care/statistics & numerical data , Perception , SARS-CoV-2 , Surveys and Questionnaires , Vaccination Refusal/statistics & numerical data , Young Adult
17.
PLoS One ; 16(8): e0256496, 2021.
Article in English | MEDLINE | ID: covidwho-1369567

ABSTRACT

BACKGROUND: While vaccines ensure individual protection against COVID-19 infection, delay in receipt or refusal of vaccines will have both individual and community impacts. The behavioral factors of vaccine hesitancy or refusal are a crucial dimension that need to be understood in order to design appropriate interventions. The aim of this study was to explore the behavioral determinants of COVID-19 vaccine acceptance and to provide recommendations to increase the acceptance and uptake of COVID-19 vaccines in Bangladesh. METHODS: We employed a Barrier Analysis (BA) approach to examine twelve potential behavioral determinants (drawn from the Health Belief Model [HBM] and Theory of Reasoned Action [TRA]) of intended vaccine acceptance. We conducted 45 interviews with those who intended to take the vaccine (Acceptors) and another 45 interviews with those who did not have that intention (Non-acceptors). We performed data analysis to find statistically significant differences and to identify which beliefs were most highly associated with acceptance and non-acceptance with COVID-19 vaccines. RESULTS: The behavioral determinants associated with COVID-19 vaccine acceptance in Dhaka included perceived social norms, perceived safety of COVID-19 vaccines and trust in them, perceived risk/susceptibility, perceived self-efficacy, perceived positive and negative consequences, perceived action efficacy, perceived severity of COVID-19, access, and perceived divine will. In line with the HBM, beliefs about the disease itself were highly predictive of vaccine acceptance, and some of the strongest statistically-significant (p<0.001) predictors of vaccine acceptance in this population are beliefs around both injunctive and descriptive social norms. Specifically, Acceptors were 3.2 times more likely to say they would be very likely to get a COVID-19 vaccine if a doctor or nurse recommended it, twice as likely to say that most people they know will get a vaccine, and 1.3 times more likely to say that most close family and friends will get a vaccine. The perceived safety of vaccines was found to be important since Non-acceptors were 1.8 times more likely to say that COVID-19 vaccines are "not safe at all". Beliefs about one's risk of getting COVID-19 disease and the severity of it were predictive of being a vaccine acceptor: Acceptors were 1.4 times more likely to say that it was very likely that someone in their household would get COVID-19, 1.3 times more likely to say that they were very concerned about getting COVID-19, and 1.3 times more likely to say that it would be very serious if someone in their household contracted COVID-19. Other responses of Acceptors on what makes immunization easier may be helpful in programming to boost acceptance, such as providing vaccination through government health facilities, schools, and kiosks, and having vaccinators maintain proper COVID-19 health and safety protocols. CONCLUSION: An effective behavior change strategy for COVID-19 vaccines uptake will need to address multiple beliefs and behavioral determinants, reducing barriers and leveraging enablers identified in this study. National plans for promoting COVID-19 vaccination should address the barriers, enablers, and behavioral determinants found in this study in order to maximize the impact on COVID-19 vaccination acceptance.


Subject(s)
COVID-19/psychology , Vaccination Refusal/statistics & numerical data , Vaccination/psychology , Adult , Attitude , Bangladesh , COVID-19/prevention & control , COVID-19 Vaccines/therapeutic use , Culture , Female , Humans , Male , Middle Aged , Urban Population/statistics & numerical data , Vaccination Refusal/psychology
18.
PLoS One ; 16(8): e0256493, 2021.
Article in English | MEDLINE | ID: covidwho-1367708

ABSTRACT

In order to eliminate COVID-19, many countries provided vaccinations. However, success depends on peoples' knowledge levels and rates of acceptance. But, previous research on this topic is currently lacking in Bangladesh. This cross-sectional study aimed at to investigate Bangladeshi peoples' knowledge, acceptance, and perception of challenges regarding COVID-19 vaccines. Quantitative data were collected using an online survey (n = 1975) and face-to-face interviews (n = 2200) with a pre-tested structured questionnaire. In addition, seven open-ended interviews were conducted with health experts regarding challenges of vaccination. Binary logistic regression analyses were conducted to assess the association between explanatory and dependent variables. Effect size was estimated to understand the magnitude of relationship between two variables. Of 4175 respondents, 92.6% knew about COVID-19 vaccines, while only 37.4% believed vaccines to be effective in controlling COVID-19. Nearly 46% of respondents believed that COVID-19 vaccines have side-effects, and 16.4% of respondents believed that side-effects could be life-threatening. Only 60.5% of respondents indicated that they would receive the COVID-19 vaccine. Out of 1650 respondents (39.5%) who did not intend to receive the vaccine, 948 (57.4%) believed that they would be naturally protected. Regressions results indicated that men had higher rates of knowledge regarding the vaccine. In addition, rural respondents demonstrated lower knowledge regarding the vaccine. Furthermore, education had a significant association with knowledge of COVID-19 vaccines. Respondents with university education had more knowledge regarding the vaccine (Odds ratio, OR = 29.99; 95% confidence interval, CI 11.40-78.90, effect size 1.88; p = 0.01) and correct dosage (OR 27.34; 95% CI 15.25-49.00, effect size 1.83; p = 0.01). However, women (OR 1.16; 95% CI 0.96-1.40, effect size 0.08) and rural (OR 1.24; 95% CI 1.07-1.44, effect size 0.12; p = 0.01) respondents were more enthusiastic regarding receiving the COVID-19 vaccine. Higher educated respondents showed higher probability of receiving the vaccine. Those who believed in the effectiveness of the COVID-19 vaccine were 11.57 times more interested (OR 11.57; 95% CI 8.92-15.01, effect size 1.35; p = 0.01) in receiving the vaccine. Open-ended interviews identified several challenges toward successful COVID-19 vaccination. Mass awareness creation, uninterrupted supply, equitable distribution, and sectoral coordination were suggested to achieve at least 70% immunization across the country.


Subject(s)
COVID-19 Vaccines/therapeutic use , COVID-19/prevention & control , Vaccination/psychology , Adolescent , Adult , Aged , Bangladesh , COVID-19 Vaccines/adverse effects , Cross-Sectional Studies , Female , Health Knowledge, Attitudes, Practice , Humans , Logistic Models , Male , Middle Aged , Rural Population , Surveys and Questionnaires , Urban Population , Vaccination/statistics & numerical data , Vaccination Refusal/psychology , Vaccination Refusal/statistics & numerical data , Young Adult
19.
Expert Rev Vaccines ; 20(10): 1339-1349, 2021 10.
Article in English | MEDLINE | ID: covidwho-1352053

ABSTRACT

Vaccine hesitancy seriously hinders herd immunity. We explored the determinants of parental hesitancy to vaccinate children against Coronavirus Disease 2019 (COVID-19) in China.A population-based self-administered online questionnaire evaluating parental hesitancy in vaccinating their children against COVID-19 was conducted in Taizhou, China. Of the 2463 parents who received the invitation, 1788 (72.6%) responded to the survey.Of the repondents, 52.5% were hesitant. Mothers exhibited a greater proportion of vaccine hesitancy than fathers did (57.5% vs. 41.7%, P < 0.001). Multiple logistic regression analysis indicated that parents with children under 18 years of age (OR = 0.94, 95%CI: 0.90-0.99), lower knowledge scores about COVID-19 vaccination (Q1: OR = 1.92, 95%CI: 1.37-2.69; Q2: OR = 1.51, 95%CI: 1.10-2.08), lower awareness of the permission of vaccinating children (OR = 1.74, 95%CI: 1.36-2.23) and hesitancy to inoculate themselves (OR = 8.18, 95%CI: 6.48-10.33) were associated with parental hesitancy to inoculate their children. Results also revealed the disparity between fathers and mothers regarding associated factors.This study found that a substantial proportion of parents reported being hesitant to vaccinate children against COVID-19, implying the necessity of comprehensive assessment and health education programs for vaccination systems in China.


Subject(s)
COVID-19 Vaccines/administration & dosage , COVID-19/prevention & control , Fathers/psychology , Mothers/psychology , Vaccination Refusal/statistics & numerical data , Adolescent , Adult , Child , China , Cross-Sectional Studies , Fathers/statistics & numerical data , Female , Health Knowledge, Attitudes, Practice , Humans , Male , Middle Aged , Mothers/statistics & numerical data , Surveys and Questionnaires , Vaccination/psychology , Vaccination/statistics & numerical data
20.
Expert Rev Vaccines ; 20(9): 1185-1193, 2021 09.
Article in English | MEDLINE | ID: covidwho-1341074

ABSTRACT

BACKGROUND: As countries ramp up their COVID-19 vaccination programs, attitudes of the population remain a determining player in the success of these plans. This study analyses the factors associated with intent to vaccinate against COVID-19 in the Pakistani population. METHODOLOGY: This cross-sectional, anonymous, online survey was carried out in April 2021. Participants' demographic details, experiences relating to COVID-19 and its vaccination, and their health beliefs were inquired and divided across Health Belief Model constructs. Multivariable regression was used to determine factors associated with a No/Not sure vs Yes response for vaccination intention. RESULTS: Of the 655 respondents, 62.0% were willing to get vaccinated. Significant predictors of a less likelihood of resisting vaccination included advanced age (AOR 0.25; 95% CI 0.07-0.88), fear of contracting COVID-19 (AOR 0.47; 95% CI 0.27-0.82), hope of preventing its spread (AOR 0.30; 95% CI 0.19-0.49), and community pressure (AOR 0.22; 95% CI 0.13-0.37). Concerns about vaccine reliability (AOR 2.75; 95% CI 1.67-4.53) and religious inhibitions (AOR 2.45; 95% CI 1.34-4.48) swayed people away from vaccination. CONCLUSION: Despite a reasonably good response of Pakistanis to vaccination, factors negatively influencing their intention need to be timely addressed to control this pandemic.


Subject(s)
COVID-19 Vaccines/immunology , COVID-19/prevention & control , Mass Vaccination/psychology , Vaccination Refusal/statistics & numerical data , Vaccination/psychology , Adult , COVID-19 Vaccines/administration & dosage , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Pakistan , SARS-CoV-2/immunology , Surveys and Questionnaires , Young Adult
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