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2.
J Manag Care Spec Pharm ; 27(9-a Suppl): S4-S13, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1431199

ABSTRACT

BACKGROUND: Reducing the extra burden COVID-19 has on people already facing disparities is among the main national priorities for the COVID-19 vaccine rollout. Early reports from states releasing vaccination data by race show that White residents are being vaccinated at significantly higher rates than Black residents. Public health efforts are being targeted to address vaccine hesitancy among Black and other minority populations. However, health care interventions intended to reduce health disparities that do not reflect the underlying values of individuals in underrepresented populations are unlikely to be successful. OBJECTIVE: To identify key factors underlying the disparities in COVID-19 vaccination. METHODS: Primary data were collected from an online survey of a representative sample of the populations of the 4 largest US states (New York, California, Texas, and Florida) between August 10 and September 3, 2020. Using latent class analysis, we built a model identifying key factors underlying the disparities in COVID-19 vaccination. RESULTS: We found that individuals who identify as Black had lower rates of vaccine hesitancy than those who identify as White. This was true overall, by latent class and within latent class. This suggests that, contrary to what is currently being reported, Black individuals are not universally more vaccine hesitant. Combining the respondents who would not consider a vaccine (17%) with those who would consider one but ultimately choose not to vaccinate (11%), our findings indicate that more than 1 in 4 (28%) persons will not be willing to vaccinate. The no-vaccine rate is highest in White individuals and lowest in Black individuals. CONCLUSIONS: Results suggest that other factors, potentially institutional, are driving the vaccination rates for these groups. Our model results help point the way to more effective differentiated policies. DISCLOSURES: No funding was received for this study. The authors have nothing to disclose.


Subject(s)
African Americans/statistics & numerical data , COVID-19 Vaccines/administration & dosage , COVID-19/prevention & control , Vaccination Refusal/ethnology , Adult , Female , Humans , Male , Middle Aged , SARS-CoV-2 , United States
6.
Front Immunol ; 12: 558270, 2021.
Article in English | MEDLINE | ID: covidwho-1291750

ABSTRACT

The arrival of the COVID-19 vaccine has been accompanied by increased discussion of vaccine hesitancy. However, it is unclear if there are shared patterns between general vaccine hesitancy and COVID-19 vaccine rejection, or if these are two different concepts. This study characterized rejection of a hypothetical COVID-19 vaccine, and compared patterns of association between general vaccine hesitancy and COVID-19 vaccine rejection. The survey was conducted online March 20-22, 2020. Participants answered questions on vaccine hesitancy and responded if they would accept the vaccine given different safety and effectiveness profiles. We assessed differences in COVID-19 rejection and general vaccine hesitancy through logistic regressions. Among 713 participants, 33.0% were vaccine hesitant, and 18.4% would reject a COVID-19 vaccine. Acceptance varied by effectiveness profile: 10.2% would reject a 95% effective COVID-19 vaccine, but 32.4% would reject a 50% effective vaccine. Those vaccine hesitant were significantly more likely to reject COVID-19 vaccination [odds ratio (OR): 5.56, 95% confidence interval (CI): 3.39, 9.11]. In multivariable logistic regression models, there were similar patterns for vaccine hesitancy and COVID-19 vaccine rejection by gender, race/ethnicity, family income, and political affiliation. But the direction of association flipped by urbanicity (P=0.0146, with rural dwellers less likely to be COVID-19 vaccine rejecters but more likely to be vaccine hesitant in general), and age (P=0.0037, with fewer pronounced differences across age for COVID-19 vaccine rejection, but a gradient of stronger vaccine hesitancy in general among younger ages). During the COVID-19 epidemic's early phase, patterns of vaccine hesitancy and COVID-19 vaccine rejection were relatively similar. A significant minority would reject a COVID-19 vaccine, especially one with less-than-ideal effectiveness. Preparations for introducing the COVID-19 vaccine should anticipate substantial hesitation and target concerns, especially among younger adults.


Subject(s)
COVID-19 Vaccines , Vaccination Refusal , Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Rural Population , Surveys and Questionnaires , United States , Urban Population , Vaccination Refusal/ethnology , Vaccination Refusal/psychology , Vaccines , Young Adult
8.
Isr J Health Policy Res ; 10(1): 33, 2021 05 27.
Article in English | MEDLINE | ID: covidwho-1244924

ABSTRACT

Israel, the UK, the USA, and some other wealthier countries lead in the implementation of COVID-19 vaccine mass vaccination programmes. Evidence from these countries indicates that their ethnic minorities could be as disproportionately disadvantaged in COVID-19 vaccines roll-out as they were affected by COVID-19-related serious illnesses. Their disadvantage is linked to their lower social status and fewer social goods compared with dominant population groups.Albeit limited by methodology, early studies attribute lower uptake of COVID-19 amongst ethnic minorities to the wider determinants of vaccine uptake, hesitancy or lack of vaccine confidence, including lower levels of trust and greater concerns about vaccine safety. Early sentinel studies are needed in all early adopter countries.One emerging theme among those of reproductive age in minority communities concerns a worry regarding COVID-19 vaccine's potential adverse effect on fertility. Respected professional groups reassure this is not a credible rationale. Drug and vaccine regulators use understandable, cautious and conditional language in emergency licencing of new gene-based vaccines. Technical assessments on whether there is any potential genotoxicity or reproductive toxicity should be more emphatic.From a public health perspective, sentinel studies should identify such community concerns and act early to produce convincing explanations and evidence. Local public health workforces need to be diverse, multiskilled, and able to engage well with minorities and vulnerable groups. The local Directors of Public Health in the UK are based in each local government area and have a remit and opportunity to stimulate speedy action to increase vaccine uptake.During the rapid Pandemic Pace of the vaccines roll-out, extra efforts to minimise uptake variations are likely to achieve improvements in the next year or two. We expect variations will not disappear however, given that underlying inequalities persist in less inclusive social systems.


Subject(s)
COVID-19 Vaccines/administration & dosage , COVID-19/prevention & control , Vaccination Refusal/psychology , Vaccination/psychology , /psychology , Humans , Immunization Programs/organization & administration , Israel , Minority Groups/psychology , Minority Groups/statistics & numerical data , Public Health , Trust , United Kingdom , United States , Vaccination/statistics & numerical data , Vaccination Refusal/ethnology
11.
J Perinat Med ; 49(6): 678-685, 2021 Jul 27.
Article in English | MEDLINE | ID: covidwho-1204143

ABSTRACT

OBJECTIVES: To explore attitudes to COVID-19 vaccination among perinatal women. METHODS: A nationwide online, cross-sectional survey was conducted in Qatar from 15th October 2020 to 15th November 2020 with voluntary participation open to all adult residents. Of the respondents, the population group for this study comprised the 341 pregnant and breastfeeding participants. The survey utilized a composite questionnaire incorporating a validated instrument to measure vaccine attitudes. The responses were recorded and analysed with statistical analysis being performed with SPSS software. Outcome measures included intentions towards vaccination and potential factors influencing vaccine hesitancy (contextual factors, vaccine specific concerns and group/individual influences). RESULTS: Perinatal women exhibited a vaccine hesitancy rate of 25% towards COVID-19 immunisation. The main concerns of the group were of infection risks and main factor determining vaccine hesitancy was of vaccine specific safety concerns. Previous vaccine "acceptors" showed vaccine hesitancy to COVID-19 immunisation. A third of the group cited non availability of the vaccine as a concern. CONCLUSIONS: COVID-19 vaccine trials amongst pregnant and lactating women have lagged behind those for general populations and this has compounded concerns around safety in this special group. Perinatal women constitute a vulnerable group and play an important role in vaccination of wider family members. This study highlights the need for trials and data for COVID-19 vaccine in this group to be able to achieve appreciable numbers needed for herd immunity and ultimately control of the pandemic.


Subject(s)
COVID-19 Vaccines , Perinatal Care , Vaccination Refusal/ethnology , Adult , Cross-Sectional Studies , Female , Humans , Pregnancy , Qatar , Vaccination Refusal/psychology , Young Adult
12.
J Community Health ; 46(5): 1013-1019, 2021 10.
Article in English | MEDLINE | ID: covidwho-1173958

ABSTRACT

Willingness and reasons to be vaccinated against COVID-19 were examined among 26,324 respondents who completed a survey on willingness and questions related to Confidence in vaccine safety, Complacency about the disease, Convenience of vaccination, tendency to Calculate risks versus benefits, and Concern for protecting others. Willingness to be vaccinated differed by age (p < 0.001), by race and ethnicity (p < 0.001) and by level of education (p < 0.001). Willingness generally increased with age and education. Asians were most willing to be vaccinated, followed by non-Hispanic Whites, Hispanics, and non-Hispanic Blacks (p < 0.001). Occupational groups differed in willingness (p < 0.001). Retired and students were more willing than all others (p < 0.001) followed by disabled or unemployed, healthcare workers, and educators. First Responders were least willing to be vaccinated (p < 0.001) followed by construction, maintenance and landscaping, homemakers, housekeeping, cleaning and janitorial workers, and retail and food service. The strongest predictor of willingness was confidence with the safety of the vaccine (r = 0.723, p < 0.001), followed by concern with protecting others by being vaccinated (r = 0.574, p < 0.001), and believing COVID-19 was serious enough to merit vaccination (r = 0.478, p < 0.00). Using multiple regression, confidence in safety was the strongest predictor for all groups. Protecting others was strongest for 13 of 15 demographic groups and 8 of 11 occupational groups. College educated, non-Hispanic Whites, first responders, construction, maintenance and landscape workers, housekeeping, cleaning and janitorial workers all gave greater weight to complacency about the disease. These results can help in designing programs to combat vaccine hesitancy.


Subject(s)
COVID-19/prevention & control , Vaccination Refusal/ethnology , Vaccination Refusal/psychology , Vaccination/statistics & numerical data , Adolescent , Adult , Age Distribution , Aged , Aged, 80 and over , COVID-19/epidemiology , COVID-19/psychology , Female , Humans , Male , Middle Aged , SARS-CoV-2 , Sex Distribution , Surveys and Questionnaires , United States/epidemiology , Vaccination Refusal/statistics & numerical data
13.
PLoS Biol ; 19(3): e3001167, 2021 03.
Article in English | MEDLINE | ID: covidwho-1121937

ABSTRACT

As the vaccines against COVID are slowly becoming available, we need to consider the paradox of why so many people of color are dying from the disease yet cannot get the vaccinations. Concerns focus on vaccine refusal but lack of access is the bigger problem.


Subject(s)
African Americans/psychology , COVID-19/ethnology , Racism/psychology , Vaccination Refusal/ethnology , COVID-19/epidemiology , COVID-19/psychology , COVID-19 Vaccines/metabolism , COVID-19 Vaccines/pharmacology , Humans , Pandemics , SARS-CoV-2/isolation & purification , United States/epidemiology , Vaccination/methods , Vaccination/psychology , Vaccination Refusal/psychology , Vaccination Refusal/trends
16.
HEC Forum ; 33(1-2): 143-154, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1037319

ABSTRACT

The year 2020 has yielded twin crises in the United States: a global pandemic and a public reckoning with racism brought about by a series of publicized instances of police violence toward Black men and women. Current data indicate that nationally, Black Americans are three times more likely than White Americans to contract Covid-19 (with further variance by state), a pattern that underscores the more general phenomenon of health disparity among Black and White Americans (Oppel et al. in The New York Times 2020; APM Research Lab Staff in APM Research Lab 2020). Once exposed, Black Americans are twice as likely to die of the virus. Unsurprisingly, Black Americans report higher levels of fear of Covid-19 than their White peers, but they also report higher levels of hesitancy toward a Covid-19 vaccine. This paper explores why this apparent discrepancy exists. It also provides practical recommendations for how government and public health leaders might address vaccine hesitancy in the context of the twin crises of 2020.


Subject(s)
African Americans , COVID-19 Vaccines/administration & dosage , COVID-19/ethnology , COVID-19/prevention & control , Racism , Vaccination Refusal/ethnology , COVID-19/epidemiology , Communicable Disease Control , Female , Humans , Male , Pandemics/prevention & control , SARS-CoV-2 , Social Justice , Trust , United States/epidemiology
17.
Nat Commun ; 12(1): 29, 2021 01 04.
Article in English | MEDLINE | ID: covidwho-1007632

ABSTRACT

Identifying and understanding COVID-19 vaccine hesitancy within distinct populations may aid future public health messaging. Using nationally representative data from the general adult populations of Ireland (N = 1041) and the United Kingdom (UK; N = 2025), we found that vaccine hesitancy/resistance was evident for 35% and 31% of these populations respectively. Vaccine hesitant/resistant respondents in Ireland and the UK differed on a number of sociodemographic and health-related variables but were similar across a broad array of psychological constructs. In both populations, those resistant to a COVID-19 vaccine were less likely to obtain information about the pandemic from traditional and authoritative sources and had similar levels of mistrust in these sources compared to vaccine accepting respondents. Given the geographical proximity and socio-economic similarity of the populations studied, it is not possible to generalize findings to other populations, however, the methodology employed here may be useful to those wishing to understand COVID-19 vaccine hesitancy elsewhere.


Subject(s)
COVID-19 Vaccines , COVID-19/prevention & control , Patient Acceptance of Health Care/psychology , SARS-CoV-2/immunology , Vaccination/psychology , Adolescent , Adult , Aged , COVID-19/psychology , Female , Health Knowledge, Attitudes, Practice , Humans , Ireland , Male , Middle Aged , Pandemics/prevention & control , Surveys and Questionnaires , United Kingdom , Vaccination Refusal/ethnology , Vaccination Refusal/psychology , Vaccination Refusal/statistics & numerical data , Young Adult
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