Positive attitudes towards COVID-19 vaccines: A cross-country analysis.

COVID-19 severely impacted world health and, as a consequence of the measures implemented to stop the spread of the virus, also irreversibly damaged the world economy. Research shows that receiving the COVID-19 vaccine is the most successful measure to combat the virus and could also address its indirect consequences. However, vaccine hesitancy is growing worldwide and the WHO names this hesitancy as one of the top ten threats to global health. This study investigates the trend in positive attitudes towards vaccines across ten countries since a positive attitude is important. Furthermore, we investigate those variables related to having a positive attitude, as these factors could potentially increase the uptake of vaccines. We derive our text corpus from vaccine-related tweets, harvested in real-time from Twitter. Using Natural Language Processing (NLP), we derive the sentiment and emotions contained in the tweets to construct daily time-series data. We analyse a panel dataset spanning both the Northern and Southern hemispheres from 1 February 2021 to 31 July 2021. To determine the relationship between several variables and the positive sentiment (attitude) towards vaccines, we run various models, including POLS, Panel Fixed Effects and Instrumental Variables estimations. Our results show that more information about vaccines' safety and the expected side effects are needed to increase positive attitudes towards vaccines. Additionally, government procurement and the vaccine rollout should improve. Accessibility to the vaccine should be a priority, and a collective effort should be made to increase positive messaging about the vaccine, especially on social media. The results of this study contribute to the understanding of the emotional challenges associated with vaccine uptake and inform policymakers, health workers, and stakeholders who communicate to the public during infectious disease outbreaks. Additionally, the global fight against COVID-19 might be lost if the attitude towards vaccines is not improved.

Factors influencing COVID-19 vaccine uptake among adults in Nigeria.

BACKGROUND: Emerging variants of Coronavirus disease 2019 (COVID-19) has claimed over 3000 lives in Nigeria and vaccination remains a means of reducing the death toll. Despite ongoing efforts by the government to ensure COVID-19 vaccination of most residents to attain herd immunity, myths and beliefs have adversely shaped the perception of most Nigerians, challenging the uptake of COVID-19 vaccine. This study aimed to assess the factors influencing the awareness, perception, and willingness to receive COVID-19 vaccine among Nigerian adults. METHODS: A cross-sectional online nationwide study was conducted from April to June 2021 among Nigerian adult population using the snowballing method. Descriptive analysis was used to summarise the data. Univariate and multivariate analysis was used to identify the predictors of COVID-19 uptake among the respondents. A p value <0.05 was considered significant. RESULTS: A total of 1058 completed forms were analysed and 63.9% were females. The mean age was 40.8 years±12.2 years. Most of the respondents (740; 69.5%) had satisfactory awareness of the vaccination exercise. The media was the main source of information. Health workers reported higher level of awareness (aOR = 1.822, 95% CI: 1.388-2.524, p<0.001). Respondents that are Christians and Muslims had better awareness compared to the unaffiliated (aOR = 6.398, 95% CI: 1.918-21.338, P = 0.003) and (aOR = 7.595, 95% CI: 2.280-25.301, p<0.001) respectively. There is average score for perception statements (566; 53.2%) towards COVID-19 vaccination. Close to half of the respondents (44.2%) found the short period of COVID-19 production worrisome. Majority of the respondents were willing to get the vaccine (856; 80.9%). Those without a prior diagnosis of COVID-19 had a lower willingness to get vaccinated (aOR = 0.210 (95% CI: 0.082-0.536) P = 0.001). CONCLUSION: The study revealed a high level of awareness, willingness to receive the vaccine and moderate perception towards the vaccination activities. Influencing factors that significantly affects awareness were religion, occupation, education and prior diagnosis of COVID-19; for perception and willingness-occupation, and prior diagnosis of the COVID-19 were influencing factors.

People's perceptions of, willingness-to-take preventive remedies and their willingness-to-vaccinate during times of heightened health threats.

Pandemics, such as the current SARS-CoV-2 pandemic, represents a health threat to humans worldwide. During times of heightened health risks, the public's perceptions, and acceptance of evidence-based preventive measures, such as vaccines, is of high relevance. Moreover, people might seek other preventive remedies to protect themselves from getting infected (e.g., herbal remedies, nutritional supplements). A recent study on consumers' preference for naturalness showed that people put more weight on perceived naturalness of a preventive remedy compared to a curative one. This result was attributed to the increased focus on perceived effectiveness as opposed to perceived risk. This raises the question whether the current pandemic would shift people's perceptions from prevention to curing and thus, exhibit a preference for synthetic remedies because they are seen as more effective. The present online experiment (conducted in April 2021) investigated people's perceptions of vaccines and remedies within the context of the current SARS-CoV-2 pandemic. A 2x2 between-subject design with type of remedy (natural vs. synthetic) and salience of SARS-CoV-2 pandemic (high vs. low) was conducted in Switzerland in spring 2021 (N = 452). The data did not provide evidence of a curative mindset for preventive remedies, as the participants exhibited a clear preference for the natural remedy compared to the synthetic remedy. Our study stresses the importance of understanding people's mindsets on how to protect themselves from infection with a virus during an ongoing pandemic to tackle misinformation and vaccine hesitancy.

Vaccination-related attitudes and behavior across birth cohorts: Evidence from Germany.

We use German KiGGS data to add to existing knowledge about trends in vaccination-related attitudes and behavior. Looking at vaccinations against measles, we assess whether a low confidence in vaccination and vaccination complacency is particularly prevalent among parents whose children were born somewhat recently, as compared to parents whose children belong to earlier birth cohorts. We further analyze how these attitudes relate to vaccination rates in the corresponding birth cohorts, and which sociodemographic subgroups are more likely to have vaccination-hesitant attitudes and to act upon them. Results show that the share of parents who report "deliberate" reasons against vaccination has decreased across birth cohorts; at the same time, the children of these parents have become less likely to be vaccinated. This suggests that vaccination-hesitant parents became more willing to act upon their beliefs towards the turn of the millennium. Regarding efforts to convince parents and the public about the benefits of vaccination, the number of parents who think that vaccinations have serious side effects, or that it is better for a child to live through a disease, may have become smaller-but these parents are more determined to follow their convictions. Interestingly, the trend we describe started before the Internet became a widespread source of health-related information.

The social specificities of hostility toward vaccination against Covid-19 in France.

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.

Decline in Uptake of Childhood Vaccinations in a Tertiary Hospital in Northern Ghana during the COVID-19 Pandemic.

At the beginning of the COVID-19 pandemic, early modelling studies estimated a reduction in childhood vaccinations in low- and middle-income countries. Regular provision of both curative and preventive services such as antenatal care and childhood immunizations has been negatively affected since the onset of the pandemic. Our study was aimed at examining the impact that the pandemic had on childhood vaccination services at the Tamale Teaching Hospital (TTH). A mixed methods study design was employed for the study, which was conducted at the Child Welfare Clinic (CWC) of the TTH. With quantitative approach, we retrospectively looked at the uptake of the various vaccines during the pandemic era, defined as the period between 1st March 2020 and 28th February, 2021, and the prepandemic era defined as the period 1st March 2019 to 29th February, 2020. The qualitative approach was used to understand the perspective of five healthcare providers at the CWC and the four caregivers of children who have missed a vaccine or delayed in coming, on the factors accounting for any observed change. Data analysis was done using Microsoft Excel 2016 and thematic content analysis. Quantitative data were presented in frequencies, percentages, and line graphs. With the exception of the Measles Rubella (MR) 2 vaccine, we observed a decline ranging from 47% (2298) to 10.5% (116), with the greatest decline seen in the BCG and the least decline seen in the MR1 vaccine. The month of May 2020 saw the greatest decline, that is, 70.6% (813). A decline of 38.3% (4473) was noted when comparison was made between the designated prepandemic and pandemic eras, for all the vaccines in our study. Fear of COVID-19 infection and misinformation were commonly given as reasons for the decline. Catch-up immunization schedule should be instituted to curtail possible future outbreaks of vaccine-preventable diseases.

Time trends, factors associated with, and reasons for COVID-19 vaccine hesitancy: A massive online survey of US adults from January-May 2021.

IMPORTANCE: COVID-19 vaccine hesitancy has become a leading barrier to increasing the US vaccination rate. OBJECTIVE: To evaluate time trends in COVID-19 vaccine intent during the US vaccine rollout, and identify key factors related to and self-reported reasons for COVID-19 vaccine hesitancy in May 2021. DESIGN, PARTICIPANTS AND SETTING: A COVID-19 survey was offered to US adult Facebook users in several languages yielding 5,088,772 qualifying responses from January 6 to May 31, 2021. Data was aggregated by month. Survey weights matched the sample to the age, gender, and state profile of the US population. EXPOSURE: Demographics, geographic factors, political/COVID-19 environment, health status, beliefs, and behaviors. MAIN OUTCOME MEASURES: "If a vaccine to prevent COVID-19 were offered to you today, would you choose to get vaccinated." Hesitant was defined as responding probably or definitely would not choose to get vaccinated (versus probably or definitely would, or already vaccinated). RESULTS: COVID-19 vaccine hesitancy decreased by one-third from 25.4% (95%CI, 25.3, 25.5) in January to 16.6% (95% CI, 16.4, 16.7) in May, with relatively large decreases among participants with Black, Pacific Islander or Hispanic race/ethnicity and ≤high school education. Independent risk factors for vaccine hesitancy in May (N = 525,644) included younger age, non-Asian race, < 4 year college degree, living in a more rural county, living in a county with higher Trump vote share in the 2020 election, lack of worry about COVID-19, working outside the home, never intentionally avoiding contact with others, and no past-year flu vaccine. Differences in hesitancy by race/ethnicity varied by age (e.g., Black adults more hesitant than White adults <35 years old, but less hesitant among adults ≥45 years old). Differences in hesitancy by age varied by race/ethnicity. Almost half of vaccine hesitant respondents reported fear of side effects (49.2% [95%CI, 48.7, 49.7]) and not trusting the COVID-19 vaccine (48.4% [95%CI, 48.0, 48.9]); over one-third reported not trusting the government, not needing the vaccine, and waiting to see if safe. Reasons differed by degree of vaccine intent and by race/ethnicity. CONCLUSION: COVID-19 vaccine hesitancy varied by demographics, geography, beliefs, and behaviors, indicating a need for a range of messaging and policy options to target high-hesitancy groups.

Changes in attitudes to vaccination as a result of the COVID-19 pandemic: A longitudinal study of older adults in the UK.

BACKGROUND: The rapid development of COVID-19 vaccines has brought an unprecedented focus on public attitudes to vaccines, with intention to accept a COVID-19 vaccine fluctuating during the pandemic. However, it is unclear how the pandemic may influence attitudes and behaviour in relation to vaccines in general. The aim of the current study is to examine older adults' changes in vaccination attitudes and behaviour over the first year of the pandemic. METHODS: In February-March 2020 (before the first COVID-19 national lockdown in the UK), 372 older adults (aged 65+) provided sociodemographic information, self-reported influenza vaccine uptake, and completed two measures of vaccination attitudes: the 5C scale and the Vaccination Attitudes Examination Scale. One-year later, following rollout of COVID-19 vaccines to older adults, participants provided information on their COVID-19 and influenza vaccine uptake in the previous 12 months, and completed the 5C and VAX scales again. Paired samples t-tests were used to examine changes in vaccination attitudes over time. RESULTS: Almost all participants (98.7%) had received at least one dose of a COVID-19 vaccine, and a significant increase in influenza uptake was identified (83.6% in 2020 to 91.6% in 2021). Complacency, mistrust of vaccine benefit, concerns about commercial profiteering, and constraints to vaccination had significantly decreased between Time 1 and Time 2, and collective responsibility had significant increased. However, calculation and worries about unforeseen future effects had increased, indicating that participants now perceived higher risks related to vaccination and were taking a more deliberative information-seeking approach. CONCLUSION: The results show significant changes in vaccination attitudes across the pandemic. These changes suggest that while older adults became less complacent about the importance of vaccines, concerns about potential risks associated with vaccination increased. It will be important for public health communication to address these concerns for all vaccines offered to this group.

Undergraduate nursing students' COVID-19 vaccine intentions: A national survey.

INTRODUCTION: In December 2020, the first two COVID-19 vaccines were approved in the United States (U.S.) and recommended for distribution to front-line personnel, including nurses. Nursing students are being prepared to fill critical gaps in the health care workforce and have played important supportive roles during the current pandemic. Research has focused on vaccine intentions of current health care providers and less is known about students' intentions to vaccinate for COVID-19. METHODS: A national sample of undergraduate nursing students were recruited across five nursing schools in five U.S. regions in December 2020. The survey measured perceived risk/threat of COVID-19, COVID-19 vaccine attitudes, perceived safety and efficacy of COVID-19 vaccines, sources for vaccine information and level of intention to become vaccinated [primary, secondary (i.e., delayed), or no intention to vaccinate]. RESULTS: The final sample consisted of 772 students. The majority (83.6%) had intentions to be vaccinated, however of those 31.1% indicated secondary intention, a delay in intention or increased hesitancy). The strongest predictors of primary intention were positive attitudes (OR = 6.86; CI = 4.39-10.72), having lower safety concerns (OR = 0.26; CI = 0.18-0.36), and consulting social media as a source of information (OR = 1.56; CI = 1.23-1.97). Asian (OR = 0.47; CI = 0.23-0.97) and Black (OR 0.26; CI = 0.08-0.80) students were more likely to indicate secondary intention as compared to primary intention. Students in the Midwest were most likely to indicate no intention as compared to secondary intention (OR = 4.6; CI = 1.32-16.11). CONCLUSIONS: As the first two COVID-19 vaccines were approved/recommended in the U.S. nursing students had overall high intentions to vaccinate. Findings can guide development of educational interventions that reduce concerns of vaccine safety that are delivered in a way that is supportive and affirming to minoritized populations while being respectful of geo-political differences.

Exploring Challenges to COVID-19 Vaccination in the Darfur Region of Sudan.

The current COVID-19 pandemic has affected the ability of health systems to provide essential services globally. The Darfur region, located in the western part of Sudan, has been largely devastated by the war that began in 2003 and has been drawing considerable attention from the international community. The war, which erupted as a result of environmental, political, and economic factors, has led to tragic outcomes. Collapsing health-care infrastructures, health workforce shortages, lack of storage facilities for medicines and medical products, and inadequate access to health services are some of the effects of the war. After Sudan received the AstraZeneca COVID-19 vaccine through the COVID-19 Vaccines Global Access facility, significant challenges have been implicated in the delivery, storage, and use of the vaccine in the Darfur region. Lack of vaccine storage and transportation facilities, vaccination hesitancy, inequity in the distribution to health facilities, and shortage of health-care professionals resulting from insecurity and instability have added an extra layer of burden on local authorities and their ability to manage COVID-19 vaccinations in the region adequately. Addressing the impact of COVID-19 requires an effectively managed vaccination program. In the face of current challenges in Darfur, ensuring a fully vaccinated population might remain far-fetched and improbable if meaningful efforts are not put in place by all stakeholders and actors to address some of the challenges identified.