A study of COVID-19 vaccination in the US and Asia: The role of media, personal experiences, and risk perceptions.

The COVID-19 pandemic presents an opportunity to assess the relationship between personal experiences and vaccine decision-making. The aim of this study was to examine the associations between experiences with COVID-19 and COVID-19 vaccination status. We administered 28 repeated cross-sectional, online surveys between June 2020 and June 2021 in the US and Asia. The main exposure was media showing COVID-19 cases, and we distinguished those with no such experience, those seeing a not severe case of disease, and those seeing a severe case of disease. Logistic regression models estimated the association between experience and acceptance of a hypothetical COVID-19 vaccine (pre-rollout) or actual vaccination (post-rollout). We explored perceived susceptibility as a potential mediator. Intent to vaccinate was lowest in the US and Taiwan, and highest in India, Indonesia, and China. Across all countries, seeing a severe case of COVID-19 in the media was associated with 1.72 times higher odds of vaccination intent in 2020 (95% CI: 1.46, 2.02) and 2.13 times higher odds of vaccination in 2021 (95% CI: 1.70, 2.67), compared to those not seeing a case or a less severe case. Perceived susceptibility was estimated to mediate 25% of the relationship with hypothetical vaccination (95% CI: 18%, 31%, P<0.0001), and 16% of the relationship with actual vaccination 16% (95% CI: 12%, 19%, P<0.0001). Seriousness of experiences could relate to intention to vaccinate against COVID-19. Media exposures are a modifiable experience, and this study highlights how this experience can relate to risk perceptions and eventual vaccination, across a variety of countries where the course of the pandemic differed.

Modification of a vaccine hesitancy scale for use in adult vaccinations in the United States and China.

Most research on vaccine hesitancy has focused on parental attitudes toward childhood vaccination, but it will be important to understand dimensions of vaccine hesitancy in the adult population as more adult vaccines are introduced in the future. We modified the Vaccine Hesitancy Scale to target adult vaccines and provide measures of its reliability and validity relative to influenza vaccine uptake and COVID-19 vaccination acceptance in cross-sectional internet surveys in the United States and in China. We assessed the impact of vaccine hesitancy on influenza and COVID-19 vaccination using multivariable regression modeling, which informed concurrent validity of the adult Vaccine Hesitancy Scale (aVHS). Among 1103 participants in the March 2020 China survey, 5.4% would not accept a COVID-19 vaccine, whereas this figure was 18.8% for the March 2020 US survey and 27.3% for the June 2020 US survey. The aVHS exhibits good internal consistency in all three surveys. Models adjusted for age, gender and income level show that prevalence of COVID-19 vaccine acceptance was a fraction as high in those who scored higher on the VHS than those who scored lower on all three surveys. Prevalence of past and future flu vaccine acceptance was a fraction as high in those with higher aVHS scores than those with lower scores. Prevalence of COVID-19 vaccine acceptance is lower in those with higher vaccine hesitancy scores, which supports the scale's concurrent validity. The aVHS exhibits good internal consistency, making it a valid and reliable tool for measuring vaccination uptake.

Disruption of childhood vaccination during the COVID-19 pandemic in Indonesia.

The aim of this study was to assess the magnitude of childhood vaccination disruption and to determine the predictors of delaying childhood vaccinations during the coronavirus disease 2019 (COVID-19) pandemic among Indonesian parents. We conducted a nationwide, online, cross-sectional study. A set of questionnaires assessed the disruption of childhood vaccinations and possible explanatory variables, including demographic characteristics, current underlying disease, exposure to and confidence in COVID-19 information, perceived risk, attitude and practice on vaccination, and COVID-19 prevention practice. A multivariable linear regression was used to characterize the relationship between explanatory variables and delayed childhood vaccination. We included 1137 respondents for analysis, of which 52.6% were males and 58.4% participants aged between 31 and 50-years old. Disruption of childhood vaccination service in local health facilities was reported in 42.2% (480/1137) of respondents and 13.3% (193/1137) of respondents explained that their children could not be vaccinated because a healthcare facility temporary stopped the vaccination service. Of all respondents, 312 (27.4%) delayed vaccinating their children for a compulsory vaccination shot. Factors associated with higher odds of delaying compulsory vaccinations for children were employment and chronic disease status, flu vaccination status in the past year, and prior COVID-19 infection. In conclusion, there was a significant disruption of childhood vaccination practices in Indonesia during the COVID-19 pandemic. This is not only due to healthcare closures but also due to parents' practice - delaying the compulsory childhood vaccination for their children. We urge the government to strengthen strategies to ensure childhood vaccination services are available to all children in the country during a pandemic.

Social distancing in response to the novel coronavirus (COVID-19) in the United States.

In order to reduce the spread of SARS-CoV-2, much of the US was placed under social distancing guidelines during March 2020. We characterized risk perceptions and adherence to social distancing recommendations in March 2020 among US adults aged 18+ in an online survey with age and gender quotas to match the general US population (N = 713). We used multivariable logistic and linear regression to estimate associations between age (by generational cohort) and these outcomes. The median perceived risk of infection with COVID-19 within the next month was 32%, and 65% of individuals were practicing more social distancing than before the outbreak. Baby Boomers had lower perceived risk than Millennials (-10.6%, 95% CI: -16.2%, -5.0%), yet were more frequently social distancing (OR = 1.64; 95% CI: 1.05, 2.56). Public health outreach should focus on raising compliance with social distancing recommendations, especially among high risk groups. Efforts to address risk perceptions alone may be inadequate.