For the greater good? Bereidheid van ouders om hun kinderen van 5 tot 11 jaar te vaccineren tegen corona

We explored parent's intention to vaccinate their children aged 5–11 against corona and factors influencing this. A survey, including open and closed questions, was distributed among parents (N = 214, 57,8% female) at booster vaccination locations in Rotterdam. The survey was subdivided in three categories: background variables of the participant (parent), background variables of his/her children, determinants of vaccination-intentions and information needs. Results show that 43% of the parents intended to vaccinate their children. Parents attitude towards vaccination was ambivalent, they rated the likelihood for children to get infected with corona relatively high and the severity of corona for children relatively low. The response to potential harmful effects of the vaccine were ambivalent as well. Attitude was the strongest correlate of vaccination-intention and mediated the effects of likelihood, severity and harmfulness. Most parents would take the decision together with the partner, but also with the child. The open questions showed that the most common reason to vaccinate the child was to protect the child or others. Reasons mentioned for not vaccinating the child were mostly worries regarding side-effects and doubts about the added value of vaccinating children. In the discussion, communication and intervention options to enhance vaccination intentions are described. Samenvatting: We hebben onderzocht wat de bereidheid van ouders is om hun kinderen van 5 tot 11 jaar te laten vaccineren tegen corona en factoren die hieraan bijdragen. Op boostervaccinatielocaties in Rotterdam is aan ouders (N = 214, 57,8 % vrouw) een vragenlijst uitgedeeld met open en gesloten vragen. De vragenlijst was onderverdeeld in drie categorieën: achtergrondvariabelen van de deelnemer (ouder), achtergrondvariabelen van zijn/haar kinderen, en determinanten van vaccinatiebereidheid en informatiebehoeften. De resultaten laten zien dat 43,0 % van de ouders bereid was hun kinderen te vaccineren. Ouders hadden een ambivalente attitude ten aanzien van vaccineren, en schatten de kans op corona bij kinderen relatief hoog en de ernst van corona bij kinderen relatief laag in. De visie op schadelijkheid van het vaccin was ambivalent. Attitude was de sterkste voorspeller van vaccinatie-intentie en medieerde de effecten van kans, ernst en schadelijkheid. Veel ouders zouden de beslissing met de partner, maar ook met het kind nemen. In de open vragen gaven ze als redenen om het kind wel te vaccineren vooral dat ze het kind of anderen wilden beschermen. Redenen om het kind niet te vaccineren waren vooral zorgen over bijwerkingen en twijfel over de meerwaarde van het vaccineren van kinderen. De beschouwing beschrijft communicatie- en interventiemogelijkheden om vaccinatiebereidheid te bevorderen.

One-Year Follow-Up of Seroprevalence of SARS-CoV-2 Infection and Anxiety among Health Workers of a French Cancer Center: The PRO-SERO-COV Study.

Infection of SARS-CoV-2 among health workers (HWs) in contact with cancer patients has been a major issue since the beginning of the pandemic. We aimed to assess the serological immune status of SARS-CoV-2 infection among these HWs. A prospective cohort study was initiated in the comprehensive cancer center of the Nouvelle-Aquitaine region (NA, France). Volunteer HWs working on March 2020 without active infection or symptoms of COVID-19 completed a self-questionnaire and had a blood test at inclusion, at 3 and 12 months. Positive serological status of SARS-CoV-2 infection was defined by anti-nucleocapsid antibodies and/or IgG anti-spike antibodies, except at 12 months due to vaccine. Half of the HWs were included (N = 517) and 89% were followed for three months (N = 500) and one year (N = 462). Seroprevalence of SARS-CoV-2 infection was 3.5% (95% CI: 1.9-5.1), 6.2% (95% CI: 4.1-8.3), and 10% (95% CI: 7.2-12.7) on June-September 2020, September 2020-January 2021, and June-October 2021, respectively. At 12 months, 93.3% had detectable antibodies with 80% vaccinated in the first three months of vaccine availability. The COVID-19-free policy of the institution, respect for barrier gestures, high and early vaccination of HWs, and low prevalence of SARS-CoV-2 in NA may explain the low rate of seropositivity among the HWs of the Institut Bergonié.

COVID-19 vaccine hesitancy: A Systematic review of cognitive determinants.

Background: Although mass vaccination is considered one of the most effective public health strategies during the pandemic, in the COVID-19 era, many people considered vaccines unnecessary and, or doubted the effectiveness of the COVID-19 vaccine. This review aimed to tabulate cognitive causes of COVID-19 vaccination hesitancy, which may help public health policymakers overcome the barriers to mass vaccinations in future pandemics. Methods: For this systematic review, studies pertaining to COVID-19 vaccine hesitancy published up to June 2022 were retrieved from six online databases (Cochrane Library, Google Scholar Medline through PubMed, Scopus, and Web of Science). Inclusion criteria were the studies conducted on people who had a delay in accepting or refusing COVID-19 vaccines, reported the impact of cognitive determinants on vaccine hesitancy, and were written in English in the timeframe of 2020-2022. Results: This systematic review initially reviewed 1171 records. From these 91 articles met the inclusion criteria. The vaccination hesitation rate was 29.72% on average. This systematic review identified several cognitive determinants influencing vaccination hesitancy. Lack of confidence and complacency were the most frequent factors that predicted vaccine hesitancy. Conclusion: The identified prevailing cognitive determinants for COVID-19 vaccine hesitancy indicated that using initiative and effective communication strategies would be a determinant factor in building people's trust in vaccines during the pandemic and mass vaccinations.

COVID-19 vaccine hesitancy, vaccination, and mental health: A national study among U.S. parents.

The COVID-19 pandemic led to increased mental health concerns among parents. Emerging studies have shown links between COVID-19 vaccine hesitancy and psychological distress, including among parents. The primary aim of this study was to extend these emerging findings by examining the role of COVID-19 vaccine hesitancy in mental health functioning in a national sample of U.S. parents, accounting for the effects of COVID-19 vaccination status and underlying medical conditions increasing COVID-19 risk. A nationally representative sample of U.S. parents (N = 796) completed a cross-sectional survey between February-April 2021, including measures of depressive, anxiety, and COVID-19 acute stress symptoms; COVID-19 vaccination status; underlying medical conditions increasing COVID-19 risk; and COVID-19 vaccine hesitancy. The sample consisted of 51.8% fathers, Mage=38.87 years, 60.3% Non-Hispanic white, 18.1% Hispanic/Latinx, 13.2% Non-Hispanic Black/African American, 5.7% Asian, and 2.8% Other Race. Hierarchical regression models adjusted for demographic covariates revealed that greater COVID-19 vaccination hesitancy and presence of an underlying medical condition were consistently associated with higher levels of depressive, anxiety, and COVID-19 acute stress symptoms among parents. Having had at least one COVID-19 vaccination dose was associated with greater levels of COVID-19 acute stress, but was not associated with depressive or anxiety symptoms. Results add new evidence from the U.S. in support of the link between COVID-19 vaccine hesitancy and psychological distress, point to the potential utility of behavioral health care workers in helping reduce vaccine hesitancy, and provide tentative data suggesting that COVID-19 vaccination for parents alone may not have provided mental health relief.

COVID-19 Vaccination Hesitancy among Youths in Soweto, South Africa.

In combatting COronaVIrus Disease 2019 (COVID-19), immunization is the most prominent strategy. However, vaccination hesitancy-meaning delays in accepting or denying inoculation regardless of availability-has been identified as an essential threat to global health. Attitudes and perceptions play a pivotal role in vaccine acceptability. Meanwhile, uptake in South Africa's rollout has been particularly disappointing among youths. For that reason, we explored attitudes and perceptions of COVID-19 in 380 youths in Soweto and Thembelihle, South Africa, between April and June 2022. A staggering hesitancy rate of 79.2 percent was recorded (301/380). We found negative attitudes and confounded perceptions of COVID-19 to be fueled by medical mistrust and misinformation, with online channels as the main sources of non- and counterfactual claims stemming mostly from unregulated social media popular with youths. Understanding its underpinnings-and enhancing means of curbing vaccine hesitancy-will be paramount in boosting uptake in South Africa's immunization program, particularly among youths.

Determinants of Vaccination and Willingness to Vaccinate against COVID-19 among Pregnant and Postpartum Women during the Third Wave of the Pandemic: A European Multinational Cross-Sectional Survey.

With COVID-19 vaccination hesitancy at around 50% in the obstetric population, it is critical to identify which women should be addressed and how. Our study aimed to assess COVID-19 vaccination willingness among pregnant and postpartum women in Europe and to investigate associated determinants. This study was a cross-sectional, web-based survey conducted in Belgium, Norway, Switzerland, The Netherlands, and United Kingdom (UK) in June-August 2021. Among 3194 pregnant women, the proportions of women vaccinated or willing to be vaccinated ranged from 80.5% in Belgium to 21.5% in Norway. The associated characteristics were country of residence, chronic illness, history of flu vaccine, trimester of pregnancy, belief that COVID-19 is more severe during pregnancy, and belief that the COVID-19 vaccine is effective and safe during pregnancy. Among 1659 postpartum women, the proportions of women vaccinated or willing to be vaccinated ranged from 86.0% in the UK to 58.6% in Switzerland. The associated determinants were country of residence, chronic illness, history of flu vaccine, breastfeeding, and belief that the COVID-19 vaccine is safe during breastfeeding. Vaccine hesitancy in the obstetric population depends on medical history and especially on the opinion that the vaccine is safe and on the country of residence.

Global Misinformation Spillovers in the Vaccination Debate Before and During the COVID-19 Pandemic: Multilingual Twitter Study.

BACKGROUND: Antivaccination views pervade online social media, fueling distrust in scientific expertise and increasing the number of vaccine-hesitant individuals. Although previous studies focused on specific countries, the COVID-19 pandemic has brought the vaccination discourse worldwide, underpinning the need to tackle low-credible information flows on a global scale to design effective countermeasures. OBJECTIVE: This study aimed to quantify cross-border misinformation flows among users exposed to antivaccination (no-vax) content and the effects of content moderation on vaccine-related misinformation. METHODS: We collected 316 million vaccine-related Twitter (Twitter, Inc) messages in 18 languages from October 2019 to March 2021. We geolocated users in 28 different countries and reconstructed a retweet network and cosharing network for each country. We identified communities of users exposed to no-vax content by detecting communities in the retweet network via hierarchical clustering and manual annotation. We collected a list of low-credibility domains and quantified the interactions and misinformation flows among no-vax communities of different countries. RESULTS: The findings showed that during the pandemic, no-vax communities became more central in the country-specific debates and their cross-border connections strengthened, revealing a global Twitter antivaccination network. US users are central in this network, whereas Russian users also became net exporters of misinformation during vaccination rollout. Interestingly, we found that Twitter's content moderation efforts, in particular the suspension of users following the January 6 US Capitol attack, had a worldwide impact in reducing the spread of misinformation about vaccines. CONCLUSIONS: These findings may help public health institutions and social media platforms mitigate the spread of health-related, low-credibility information by revealing vulnerable web-based communities.

Effect of a mobile app chatbot and an interactive small-group webinar on COVID-19 vaccine intention and confidence in Japan: a randomised controlled trial.

INTRODUCTION: We investigated the effect of social media-based interventions on COVID-19 vaccine intention (VI) and confidence in Japan. METHODS: We conducted a three-arm randomised controlled trial between 5 November 2021 and 9 January 2022 during a low incidence (<1000/day) of COVID-19 in Japan in the midst of the second and the third waves. Japanese citizens aged ≥20 who had not received any COVID-19 vaccine and did not intend to be vaccinated were randomly assigned to one of the following three groups: (1) a control group, (2) a group using a mobile app chatbot providing information on COVID-19 vaccines and (3) a group using interactive webinars with health professionals. VI and predefined Vaccine Confidence Index (VCI) measuring confidence in the importance, safety and effectiveness were compared before and after the interventions under intention-to-treat principle. Logistic regression models were used to investigate the effect of each intervention on postintervention VI and changes of VCI compared with control. RESULTS: Among 386 participants in each group, 359 (93.0%), 231 (59.8%) and 207 (53.6%) completed the postsurvey for the control, chatbot and webinar groups, respectively. The average duration between the intervention and the postsurvey was 32 days in chatbot group and 27 days in webinar group. VI increased from 0% to 18.5% (95% CI 14.5%, 22.5%) in control group, 15.4% (95% CI 10.8%, 20.1%) in chatbot group and 19.7% (95% CI 14.5%, 24.9%) in webinar group without significant difference (OR for improvement=0.8 (95% CI 0.5, 1.3), p=0.33 between chatbot and control, OR=1.1 (95% CI 0.7, 1.6), p=0.73 between webinar and control). VCI change tended to be larger in chatbot group compared with control group without significant difference (3.3% vs -2.5% in importance, OR for improvement=1.3 (95% CI 0.9, 2.0), p=0.18; 2.5% vs 1.9% in safety, OR=1.1 (95% CI 0.7, 1.9), p=0.62; -2.4% vs -7.6% in effectiveness, OR=1.4 (95% CI 0.9, 2.1), p=0.09). Improvement in VCI was larger in webinar group compared with control group for importance (7.8% vs -2.5%, OR=1.8 (95% CI 1.2, 2.8), p<0.01), effectiveness (6.4% vs -7.6%, OR=2.2 (95% CI 1.4, 3.4), p<0.01) and safety (6.0% vs 1.9%, OR=1.6 (95% CI 1.0, 2.6), p=0.08). CONCLUSION: This study demonstrated that neither the chatbot nor the webinar changed VI importantly compared with control. Interactive webinars could be an effective tool to change vaccine confidence. Further study is needed to identify risk factors associated with decreased vaccine confidence and investigate what intervention can increase VI and vaccine confidence for COVID-19 vaccines. TRIAL REGISTRATION NUMBER: UMIN000045747.

The Impact of Priority Settings at the Start of COVID-19 Mass Vaccination on Subsequent Vaccine Uptake in Japan: One-Year Prospective Cohort Study.

BACKGROUND: Distributing COVID-19 vaccines to the public was an important task for the governments of each country. Because of various limitations, priority settings for vaccination were determined at the time of mass vaccination. However, trends between vaccine intention and uptake, as well as reasons for getting vaccinated or not getting vaccinated, among these groups were understudied, undermining verification of the legitimacy of priority selection. OBJECTIVE: This study aims to illustrate a trend from prior COVID-19 vaccine intention, when the vaccine was not available, to the actual uptake within 1 year when all residents had access to the vaccine, to illustrate a change of reason for getting vaccinated or not getting vaccinated and to examine whether priority settings predicted subsequent vaccination uptake. METHODS: Prospective cohort, web-based, self-administered surveys were conducted in Japan at 3 time points: February 2021, September to October 2021, and February 2022. In total, 13,555 participants (age: mean 53.1, SD 15.9 years) provided valid responses, with a 52.1% follow-up rate. On the basis of the information obtained in February 2021, we identified 3 types of priority groups: health care workers (n=831), people aged ≥65 years (n=4048), and those aged 18 to 64 years with underlying medical conditions (n=1659). The remaining patients were treated as nonpriority (n=7017). Modified Poisson regression analysis with a robust error estimated the risk ratio for COVID-19 vaccine uptake after adjusting for socioeconomic background, health-seeking behavior, attitude toward vaccines, and COVID-19 infection history. RESULTS: In February 2021, a total of 5182 out of 13,555 (38.23%) respondents expressed their intention to get vaccinated. In February 2022, a total of 1570 out of 13,555 (11.6%) respondents completed the third dose and 10,589 (78.1%) respondents completed the second dose. Prior vaccine intention and subsequent vaccine coverage rates were higher in the priority groups. Protection of themselves and their families from potential infection was the most frequent reason for getting vaccinated, whereas concern about side effects was the most frequent reason for hesitation across the groups. Risk ratios for received, reserved, or intended for vaccination in February 2022 were 1.05 (95% CI 1.03-1.07) for the health care worker group, 1.02 (95% CI 1.005-1.03) for the older adult group, and 1.01 (95% CI 0.999-1.03) for the preexisting conditions group compared with the nonpriority group. Prior vaccine intention and confidence in vaccines were strong predictors of vaccine uptake. CONCLUSIONS: The priority settings at the start of the COVID-19 vaccination program had a significant impact on vaccine coverage after 1 year. The priority group for vaccination achieved higher vaccination coverage in February 2022. There was room for improvement among the nonpriority group. The findings of this study are essential for policy makers in Japan and other countries to develop effective vaccination strategies for future pandemics.

Sexual orientation was associated with intention to be vaccinated with a smallpox vaccine against mpox: A cross-sectional preliminary survey in Japan.

This survey aimed to assess the prevalence of intention to receive smallpox vaccine against mpox and its relationship with sexual orientation in Japan. A cross-sectional online survey was conducted in September-October 2022, with 12,900 assigned males and 13,413 assigned females participating. Modified Poisson regression analyses were performed to determine the relationship between vaccine willingness and sexual orientation, adjusting for socioeconomics, trust in government, COVID-19 vaccination status, and frequency of brothel visits. Vaccine willingness was higher in homosexual respondents than heterosexual counterparts, with proportions of 23.1 % among assigned males and 13.4 % among assigned females. Homosexual orientation was significantly associated with vaccine willingness, with prevalence ratios of 1.37 (95 % CI: 1.23-1.54) among assigned males and 1.34 (95 % CI: 1.13-1.59) among assigned females. These findings highlight the need for targeted vaccine promotion campaigns and ongoing monitoring of attitudes towards mpox and vaccine compliance in high-risk groups.

Barriers, refusal and a hypothetical monetary incentive for Covid-19 vaccination in Mexican adults

Objective. To estimate vaccine uptake and assess sociodemographic conditions associated with vaccination barriers and refusal and to explore the effect of a monetary incentive to overcome them. Materials and methods. We used data from adults from the 2021 National Continuous Health and Nutrition Survey conducted during August-October 2021. We evaluated if an hypothetical monetary incentive between 50-650 MXN (~2.5-31 USD) would overcome barriers or refusal. Results. 73.9% were vaccinated with at least one dose, 7.5% refused, 4.8% reported barriers and 13.8% were ineligible at the time of the survey. Refusal and barriers were more frequent in men, older age, lower education and socioeconomic status, unemployed and informal workers. In people with barriers and refusal, the hypothetical incentive increased the acceptance in 57.6% (95%CI 50.7,64.4%) and 17.4% (95%CI 13.2,21.7%) in people with barriers and refusal, respectively. Conclusion. Understanding the reasons for barriers and refusal is crucial for future Covid-19 vaccination campaigns or epidemics. A monetary incentive might increase vaccination uptake, although, cost-effectiveness analyses are needed. © 2023,Salud Publica de Mexico. All Rights Reserved.

Reasons for hesitancy to take COVID-19 vaccinea survey amongst healthcare workers

Background: Concern about vaccine hesitancy is growing worldwide. Vaccine hesitancy can have effects for both the individual and the community, especially in the context of severe acute respiratory syndrome coronavirus 2 disease (COVID-19) pandemic. Methods: A 16-item questionnaire was administered to 385 healthcare workers to find out the reasons for COVID-19 vaccine hesitancy. Results: Their mean age was 36.6 +or- 9.6 years. 'Fear of getting side effects' (61.8%) was the most common reason for vaccine hesitancy, followed by reasons such as 'to wait and observe for some more time' (60.3%), 'doubts on safety and efficacy of vaccine' (49.4%), 'The intensity of COVID-19 has come down' (36.6%), 'self-perception of having good immunity' (33.8%), 'need to apply for leave' (30.3%) and 'Fear of death' (29.0%). 'To wait and observe for some more time' was the major reason for hesitancy amongst men. Security guards were more hesitant to take the vaccine, because of side effects, whereas doctors and sanitary workers wanted to wait and observe for some more time. Conclusions: Factors identified in the present study need to be addressed for overcoming vaccine hesitancy.

How to reduce vaccination hesitancy? The relevance of evidence and its communicator.

Even though the immediate urgency of the COVID-19 pandemic seems to have passed, many countries did not reach the vaccination rates they initially aimed for. The stagnation in vaccine uptake during the height of the pandemic presented policy makers with a challenge that remains unresolved and is paramount for future pandemics and other crises: How to convince the (often not insubstantial) unvaccinated proportion of the population of the benefits of a vaccination? Designing more successful communication strategies, both in retrospect and looking ahead, requires a differentiated understanding of the concerns of those that remain unvaccinated. Guided by the elaboration likelihood model, this paper has two objectives: First, it explores by means of a latent class analysis how unvaccinated individuals might be characterized by their attitudes towards COVID-19 vaccination. Second, we investigate to what extent (i) varying types of evidence (none/anecdotal/statistical) can be employed by (ii) different types of communicators (scientists/politicians) to improve vaccination intentions across these subgroups. To address these questions, we conducted an original online survey experiment among 2145 unvaccinated respondents from Germany where a substantial population share remains unvaccinated. The results suggest three different subgroups, which differ regarding their openness towards a COVID-19 vaccination: Vaccination opponents (N = 1184), sceptics (N = 572) and those in principle receptive (N = 389) to be vaccinated. On average, neither the provision of statistical nor anecdotal evidence increased the persuasiveness of information regarding the efficacy of a COVID-19 vaccine. However, scientists were, on average, more persuasive than politicians (relatively increase vaccination intentions by 0.184 standard deviations). With respect to heterogeneous treatment effects among the three subgroups, vaccination opponents seem largely unreachable, while sceptics value information by scientists, particularly if supported by anecdotal evidence (relatively increases intentions by 0.45 standard deviations). Receptives seem much more responsive to statistical evidence from politicians (relatively increases intentions by 0.38 standard deviations).

[Factors Influencing the COVID-19 Vaccination Intentions in Parents for Their Children Aged 5~11: Korea, April 2022].

PURPOSE: This study aimed to investigate COVID-19 vaccination intentions in Korean parents for their children aged 5 to 11 years and the factors influencing them. METHODS: A cross-sectional online survey of 363 parents of children aged 5 to 11 years was conducted in Korea in April 2022. Data were analyzed using independent t-test, χ²-test, Fisher's exact test, and hierarchical logistic regression analysis using SPSS/WIN 26.0 and MedCalc software version 20.113. RESULTS: Of 363 Korean parents with children aged 5 to 11, 42.4% intended to vaccinate their children. Significant factors influencing vaccination intention were the second or third birth order of children (OR = 3.45, 95% CI = 1.45~8.21), vaccine hesitancy-confidence (OR = 2.00, 95% CI = 1.51~2.65), vaccine hesitancy-collective responsibility (OR = 1.57, 95% CI: 1.10~2.25), and COVID-19 anxiety-avoidance (OR = 1.55, 95% CI = 1.13~2.11). CONCLUSION: Findings suggest that COVID-19 vaccine campaigns based on reliable information and evidence from health authorities are needed to increase COVID-19 vaccination. Well-designed health communications for the target population may help to increase parental vaccine acceptance.

Evidence and rationale for vaccinating children and adolescents against SARS-CoV-2: a comprehensive narrative review

Vaccines remain the most rigorous and cost-effective weapon of the public health care system against infectious diseases. The development of safe and effective vaccines against Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) emerged as an imperative response to the unprecedented morbidity and mortality of the Coronavirus Disease 2019 (COVID-19) pandemic and the subsequent immense pressure on health care systems, families and global society. Despite the typically mild disease course of SARS-CoV-2 in minors, the associated rare but potentially life-threatening complications, as well as the emergence of new highly transmissible variants, led promptly to the extension of COVID-19 vaccine clinical trials in children and adolescents. To date, various COVID-19 vaccine candidates have been successfully trialed in pediatric populations, followed by their incorporation into corresponding vaccination campaigns in both high- and low-income countries. However, the universal COVID-19 vaccination of children and adolescents remains a matter of debate, along with skepticism about their overall safety and benefits in this age group. In this narrative review, we attempt to summarize the multi-faceted burden of COVID-19 on minors, highlighting the favourable safety/effectiveness profile of COVID-19 vaccines in this age group, elucidating the raised concerns and presenting the current implemented vaccination strategies. [ FROM AUTHOR] Copyright of Signa Vitae is the property of Pharmamed Mado Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

When reality bites: Local deaths and vaccine take-up

In this study, we investigate whether COVID-19 deaths that occurred before vaccination rollouts impact subsequent vaccination take-up. We use data on local vaccination rates and COVID-19-related deaths from England measured at high geographic granularity. We find that vaccination take-up as of November 2021 is positively associated with pre-vaccine COVID-19-related deaths, controlling for demographic, economic, and health-related characteristics of the localities, while including geographic fixed effects. In addition, the share of ethnic minorities in a locality is negatively associated with vaccination rates, and localities with a larger share of ethnic minorities increase their vaccination rates if they are exposed to more COVID-related-deaths. Further evidence on vaccination intention at the individual level from a representative sample corroborates these patterns. Overall, our evidence suggests that social proximity to victims of the disease triggers a desire to take protective measures against it.

COVID-19 Vaccination Perceptions in Patients With Rheumatic Disease: A Cross-Sectional Online Survey.

OBJECTIVE: To identify the factors that affect coronavirus disease 2019 (COVID-19) vaccine decision making among individuals diagnosed with a rheumatologic condition, given that previous international studies have demonstrated that a significant proportion of patients with rheumatic disease (RD) are vaccine hesitant. METHODS: This cross-sectional study involved an online survey with adult patients with RD from the Kaye Edmonton Clinic Rheumatology Clinic between June and August 2021. Quantitative results were descriptively analyzed, whereas qualitative thematic analysis was conducted for open-ended responses. RESULTS: The survey had a response rate of 70.9% (N = 231). Regarding COVID-19 vaccines, patients with RD were most concerned about the possible effect of vaccination on their rheumatic condition (45.2%) and about vaccine effectiveness (45.1%). Most patients had discussed COVID-19 vaccination (75.9%) and its risks and benefits (66.1%) with their medical team, and 83.6% of respondents were confident in the information provided. Patients' perceptions of the government's role in handling the COVID-19 pandemic varied: 33% reported that they found government-instituted public health measures effective. Surprisingly, 9.7% of patients with RD still reported concerns that they could develop COVID-19 from an approved COVID-19 vaccine. CONCLUSION: This study describes factors implicated in COVID-19 vaccine decision making among patients with RD. Three important themes included possible adverse effects of the vaccine on RD control, reduced vaccine efficacy because of RD/treatment, and risk of contracting SARS-CoV-2 from the COVID-19 vaccine. Knowledge from this study can assist healthcare providers in looking after patients with RD to initiate discussions with patients to share evidence-based vaccine information and assist with informed decision making.

Vaccine hesitancy in patients with COVID-19 who have back pain.

OBJECTIVES: Musculoskeletal pain is among the most common symptoms in patients diagnosed with coronavirus disease 2019 (COVID-19), and it has placed a significant burden on health worldwide during the pandemic. This study explored vaccine hesitancy and associated factors in patients with positive COVID-19 polymerase chain reaction test results who were hospitalized and had back pain. METHODS: A cross-sectional study was conducted among 170 hospitalized COVID-19 patients over 18 years of age. Data were analyzed using descriptive statistics with IBM SPSS ver. 25.0. RESULTS: COVID-19 patients who were married considered COVID-19 vaccinations riskier than unmarried COVID-19 patients. Patients who had not been vaccinated expressed higher levels of distrust towards COVID-19 vaccines than patients who had been vaccinated. Participants had relatively little hesitation toward the Sinovac vaccine. High vaccine confidence was found in all participants regardless of vaccination status. Those who had not received the COVID-19 vaccine reported higher risk perceptions than those who had received at least 1 dose of any COVID-19 vaccine. CONCLUSION: Measurements of the hesitancy of vaccinated and non-vaccinated patients or members of society towards vaccines can be an important parameter for health authorities to find solutions.

Study of optimal vaccination strategies for early COVID-19 pandemic using an age-structured mathematical model: A case study of the USA.

In this paper we study different vaccination strategies that could have been implemented for the early COVID-19 pandemic. We use a demographic epidemiological mathematical model based on differential equations in order to investigate the efficacy of a variety of vaccination strategies under limited vaccine supply. We use the number of deaths as the metric to measure the efficacy of each of these strategies. Finding the optimal strategy for the vaccination programs is a complex problem due to the large number of variables that affect the outcomes. The constructed mathematical model takes into account demographic risk factors such as age, comorbidity status and social contacts of the population. We perform simulations to assess the performance of more than three million vaccination strategies which vary depending on the vaccine priority of each group. This study focuses on the scenario corresponding to the early vaccination period in the USA, but can be extended to other countries. The results of this study show the importance of designing an optimal vaccination strategy in order to save human lives. The problem is extremely complex due to the large amount of factors, high dimensionality and nonlinearities. We found that for low/moderate transmission rates the optimal strategy prioritizes high transmission groups, but for high transmission rates, the optimal strategy focuses on groups with high CFRs. The results provide valuable information for the design of optimal vaccination programs. Moreover, the results help to design scientific vaccination guidelines for future pandemics.

A lesson from MMR: is choice of vaccine the missing link in promoting vaccine confidence through informed consent?

A recent study suggests that vaccine hesitancy amongst key demographics – including females, younger individuals, and certain ethnic groups – could undermine the pursuit of herd immunity against COVID-19 in the United Kingdom. At the same time, the UK Joint Committee on Vaccination and Immunization (JVCI) indicated that it will not facilitate the choice between available COVID-19 vaccines. This paper reflects upon lessons from the introduction of the UK's combined Measles, Mumps and Rubella (MMR) vaccine strategy of the 1980s when Member of Parliament Miss Julie Kirkbride argued that had parents been allowed to choose between vaccine variants, then the crisis of low herd immunity – and subsequent outbreaks – could have been avoided. This paper explores this argument, as applied to the COVID-19 vaccination strategy, by considering how three key elements of informed consent – disclosure of risk, benefit, and reasonable alternatives – may be employed to tackle vaccine hesitancy and build vaccine confidence.