From COVID-19 Vaccine Hesitancy to Vaccine Acceptance: Results of a Longitudinal Survey.

OBJECTIVES: COVID-19 vaccines are widely available, but uptake is suboptimal. To develop strategies to increase vaccination rates, we sought to (1) characterize adults initially hesitant to be vaccinated for COVID-19 who later received the vaccine and (2) identify factors associated with their vaccination decision. METHODS: In January 2021, we conducted an online survey of US adults via Prolific that assessed vaccination intent, COVID-19-related knowledge and attitudes, and demographic characteristics. In May 2021, we recontacted respondents to assess vaccination status and factors influencing their vaccination decision. We used χ2 statistics and t tests to examine associations between respondents' vaccination status and their characteristics, knowledge, and attitudes. We analyzed reasons for vaccination using thematic analysis. RESULTS: Of 756 initially vaccine-hesitant respondents, 529 (70.0%) completed the follow-up survey. Nearly half of those initially not sure about vaccination (47.3%, 112 of 237) were vaccinated at follow-up, while 21.2% (62 of 292) of those initially planning not to be vaccinated were vaccinated at follow-up. Of those initially not sure, higher educational attainment, greater knowledge of COVID-19, and a doctor's recommendation were associated with vaccination. Of those initially intending not to be vaccinated, male sex, Democratic political affiliation, receipt of an influenza shot within 5 years, being more worried about COVID-19, and having greater COVID-19 knowledge were associated with increased likelihood of being vaccinated. Of 167 respondents who gave reasons for vaccination, protecting oneself and others (59.9%), practical issues (29.9%), social influences (17.4%), and vaccine safety (13.8%) were the main reasons. CONCLUSION: Providing information on the protective value of vaccination, implementing rules that make remaining unvaccinated burdensome, making vaccination easy, and providing social support may influence vaccine-hesitant adults to accept vaccination.

Impact of a physician recommendation on COVID-19 vaccination intent among vaccine hesitant individuals.

OBJECTIVE: To test the impact of varied physician recommendations on COVID-19 vaccine hesitancy. METHODS: We conducted a vignette-based experimental survey on Prolific, an online research platform. COVID-19 vaccine hesitant, adult panel members were assigned to one of five messages that varied by recommendation style (participatory vs explicit) and strategy (acknowledgement of concerns; comparison to the flu shot; statement that millions of people have already received it; emphasis on protecting others). Vaccine hesitancy was re-assessed with the question, "Would you get vaccinated at this visit?". RESULTS: Of the 752 participants, 60.1% were female, 43.4% Black, 23.6% Latino, and 33.0% White; mean age was 35.6 years. Overall, 33.1% of the initially "not sure" and 13.1% of the initially "no" participants became less hesitant following any recommendation. Among the "not sure" participants, 20.3% of those who received a participatory recommendation became less hesitant compared with 34.3%- 39.5% for the explicit recommendations. The "protect others" message was most effective among initially "no" participants; 19.8% become less hesitant, compared to 8.7% for the participatory recommendation. CONCLUSION: A physician recommendation may reduce COVID-19 vaccine hesitancy. PRACTICE IMPLICATIONS: An explicit recommendation and "protect others" message appear to be important elements of a physician recommendation for COVID-19 vaccination.

Impact of A Physician Recommendation on COVID-19 Vaccination Intent Among Vaccine Hesitant Individuals1

Objective To test the impact of varied physician recommendations on COVID-19 vaccine hesitancy. Methods We conducted a vignette-based experimental survey on Prolific, an online research platform. COVID-19 vaccine hesitant, adult panel members were assigned to one of five messages that varied by recommendation style (participatory vs explicit) and strategy (acknowledgement of concerns;comparison to the flu shot;statement that millions of people have already received it;emphasis on protecting others). Vaccine hesitancy was re-assessed with the question, “Would you get vaccinated at this visit?”. Results Of the 752 participants, 60.1% were female, 43.4% Black, 23.6% Latino, and 33.0% White;mean age was 35.6 years. Overall, 33.1% of the initially “not sure” and 13.1% of the initially “no” participants became less hesitant following any recommendation. Among the “not sure” participants, 20.3% of those who received a participatory recommendation became less hesitant compared with 34.3%-39.5% for the explicit recommendations. The “protect others” message was most effective among initially “no” participants;19.8% become less hesitant, compared to 8.7% for the participatory recommendation. Conclusion A physician recommendation may reduce COVID-19 vaccine hesitancy. Practice Implications An explicit recommendation and “protect others” message appear to be important elements of a physician recommendation for COVID-19 vaccination.

Making Statistical Sense of the Molnupiravir MOVe-OUT Clinical Trial.

Oral therapies for the early treatment of COVID-19 may prevent disease progression and health system overcrowding. A new oral therapeutic named molnupiravir has been promoted as providing an approximately 50% reduction in death or the need for hospitalization. The clinical trial evaluating this drug was stopped early at the recommendation of the Data Safety and Monitoring Board after approximately 50% of the sample had been recruited. At the point of discontinuing the trial, approximately 90% of the planned sample had been recruited and had available follow-up data accessible. We discuss issues about the study conduct, analysis, and interpretation, including 1) the authors and sponsors presented the interim analysis as the primary analysis; 2) communication between sponsors and the Data Safety and Monitoring Board was insufficient; 3) the treatment effects reverse when examining only the post-interim analysis population, and are substantially attenuated when examining the full data; 4) the choice of primary analysis is incorrect; 5) analysis of lost-to-follow-up patients favors the study drug; and 6) other known molnupiravir trials were not presented in the primary study findings. As a result of methodological and statistical concerns, it seems that external trials, separate from those supported by the sponsoring company, are required to determine the utility of this drug.

Equalizing and Widening Access to Higher Education During a Pandemic: Lessons Learned from a Multi-University Perspective

The COVID-19 pandemic caused a rapid and unprecedented shift of widening participation and outreach activities to online and remote delivery. The impact of this went beyond practitioners and the university sector;positive and negative implications are felt by stakeholders and the broader community. This shift online is discussed through the lens of a multi-university perspective, using four case studies from university outreach programs in one Australian state. The article provides a holistic view of the lessons learned and discoveries made, informing future program design and delivery. These programs include primary and secondary students, teachers, parents, guardians and carers, and work within a range of low socioeconomic and regional, rural and remote contexts. We argue that the fundamentally necessary shift online created a profound legacy and bears potential to increase accessibility (via diversity and scale), but, simultaneously, that care must be applied if substituting face-to-face engagement with that online. While this article primarily focuses on issues of value to practitioners, it also discusses important implications for academics, support staff, and university executive regarding the access and participation of underrepresented cohorts during times of mass change.

Preferences for COVID-19 vaccination information and location: Associations with vaccine hesitancy, race and ethnicity.

This study examined the association between preferences for being informed about the COVID-19 vaccine and where to receive it with vaccination intent and race/ethnicity. We conducted an online survey, oversampling Black and Latino panel members. The 1668 participants were 53.2% female, 34.8% White, 33.3% Black, and 31.8% Latino. Participants who were vaccine hesitant (answered "not sure" or "no" to vaccination intent) were more likely to prefer a conversation with their doctor compared to those who answered "yes" (25.0% and 23.4% vs 7.8%, P < .001, respectively). Among participants who responded "not sure", 61.8% prefer to be vaccinated at a doctor's office, compared with 35.2% of those who responded "yes" (P < .001). Preferred location differed by race/ethnicity (P < .001) with 67.6% of Black "not sure" participants preferring a doctor's office compared to 60.2% of Latino and 54.9% of White "not sure" participants. These findings underscore the need to integrate healthcare providers into COVID-19 vaccination programs.