Search

• Vaccine Pass policy was associated with reduced COVID-19 vaccine hesitancy and associated with increased vaccine uptake. • Various significant psychosocial factors were identified to influence COVID-19 vaccine uptake. • Vaccine uptake in older adults was increased by a greater extent after introduction of the Vaccine Pass policy. Recognising the importance of attaining high vaccine coverage to mitigate the COVID-19 impact, a Vaccine Pass scheme was implemented during and after the first large Omicron wave with high mortality in older ages in Hong Kong in early 2022 requiring three doses by June 2022. We did not identify any studies evaluating the policy impact of vaccination mandates with vaccine uptake over whole policy period of time in a Chinese population. We aim to evaluate the impact of the Vaccine Pass policy on COVID-19 vaccine uptake in adults in a Chinese population in Hong Kong. We analysed patterns in vaccine uptake and hesitancy using local data from population vaccine registry and 32 cross-sectional telephone surveys conducted from October 2021 to December 2022. The association of Vaccine Pass phases with vaccine uptake was examined using logistic regression analyses, taking into account covariates including self-risk perception, perceived self-efficacy in preventing COVID-19 and trust in government in pandemic control as well as physical distancing measures and demographics. The uptake of primary series and third doses was positively significantly associated with the successive stages of Vaccine Pass implementation (adjusted odds ratios ranged from 2.41 to 7.81). Other statistically significant drivers of uptake included age group, chronic condition, higher perceived personal susceptibility to COVID-19, higher trust in government, and higher educational attainment. Vaccine uptake in older adults was observed to have increased by a greater extent after the policy annoucement and implementation, under the contextual changes during and after a large Omicron wave with high mortality in Hong Kong in early 2022. Since the policy withdrawal the uptake of further booster doses has been very low in all ages. We suggest that improving voluntary booster uptake in older adults should be prioritized. [ABSTRACT FROM AUTHOR]

• The perception that COVID-19 vaccine is safe is positively affected by age group and negatively by religion; • The older the person, the greater the probability of considering the vaccine safe and, consequently, of getting vaccinated; • The religion variable showed great importance in the causal model. • The religion variable has a simultaneous causal effect on political preferences and the perception of vaccine safety; • The probability of a person accepting the vaccination against COVID-19 is reduced given the fact that they believe fake news related to the vaccine. This article presents a causal inference analysis of vaccine hesitancy for Coronavirus disease 2019 (COVID-19) vaccines based on socio-demographic data obtained via questionnaires applied to a sample of the Brazilian population. This data includes the respondents' political preferences, age group, education, salary range, country region, sex, believing fake news, vaccine confidence, and intention to get the COVID-19 vaccine. The research created a causal graph using these variables, seeking to answer questions about the probability of people getting vaccinated. The results of this research corroborate findings observed in the literature, also presenting unique findings: (i) The perception that the vaccine is safe is positively affected by age group and negatively by religion; (ii) The older the person, the greater the probability of considering the vaccine safe and, consequently, of getting vaccinated; (iii) The religion variable showed great importance in the model since it has a simultaneous causal effect on political preferences and the perception of vaccine safety; (iv) The data reveal that the probability of a person accepting the vaccination against COVID-19 is reduced given the fact that they believe fake news related to the vaccine. The methodology applied in this research can be replicated for populations from other countries so that it is possible to generate customized models. General causal models can be helpful for agencies dealing with vaccine hesitancy to decide which variables should be addressed to reduce this phenomenon. [ABSTRACT FROM AUTHOR]

• Partisanship and race/ethnicity influence parents'/guardians'vaccine hesitancy. • Children living in Republican states are less likely to receive a COVID-19 vaccine. • Children of White parents/guardians are less likely to receive a COVID-19 vaccine. We undertook an observational study to assess the impact of state-level partisanship and parents'/guardians' race/ethnicity on their degree of COVID-19 vaccine hesitancy. We observed a pooled cross-section of 59,280 U.S. adults residing with children in the same household between June 29 and November 14, 2022. Using household-weighted logistic regression models, we evaluated the association between partisanship, race/ethnicity, and vaccine hesitancy, while controlling for other social determinants of COVID-19 vaccine hesitancy. We found that children were less likely to receive a COVID-19 vaccine if they resided in Republican as compared to Democratic states, with the difference in probability greatest among those households where parents/guardians identified as White. We also found that children were less likely to receive a COVID-19 vaccine if their parents/guardians identified as White as compared to any other race/ethnicity, with the differences in probability greatest among households in Republican states. [ABSTRACT FROM AUTHOR]

• This study examines the association with food insecurity and vaccine hesitancy among U.S. adults. • In our study, one in four adults with food insecurity were vaccine hesitant. • Education mediated the relationship between food insufficiency and vaccine hesitancy. Some documented barriers of vaccination behaviors include social determinants of health (SDoH). While there have been many devastations from COVID-19, food security has fluctuated during the pandemic. The purpose of this study is to examine the association with food insecurity and vaccine hesitancy among adults in the U.S. In response to the COVID-19 pandemic, Federal agencies created the online Household Pulse Survey (HPS) to track social outcomes of the pandemic in the U.S. We performed cross-sectional analysis with data from the HPS collected between March 30, 2022, and April 11, 2022 (Week 44) on adults (N = 6449, weighted N = 37,687,910). Vaccine hesitancy was divided into two groups: 1) probably, not sure, probably not, and definitely not receiving the vaccine, and 2) received the vaccine and definitely will get the vaccine. Food sufficiency was a binary variable (Yes/no) based on the question that best described the food eaten in the household the last 7 days. Chi-square tests and multivariable logistic regressions were conducted using replicate weights with SAS. Logistic regressions adjusted for sex, age, race and ethnicity, income, education, COVID-19 infection, health insurance, food insecurity, children <17 years, remote work, health worker status, functional status, and mental health. During HPS Week 44, 11.2 % of represented Americans experienced food insecurity and 13.8 % were vaccine hesitant. The unadjusted odds ratio was 2.41 (95 % CI = 1.30, 4.50), suggesting adults with food insecurity were more likely to be vaccine hesitant than those with food security. After adjusting for age, sex, race and ethnicity, marital status, and COVID-19 history, the statistical significance remained (AOR = 2.14, 95 % CI = 1.15, 3.99). However, after adjusting for education, we no longer observed a significant association (AOR = 1.70, 95 % CI = 0.89, 3.34), and it remained insignificant in the fully adjusted model (AOR = 1.62, 95 % CI = 0.78, 3.34). Overall, adults with food insecurity were 2.41 times as likely as those with food security to also have vaccine hesitancy. Education mediated the relationship between food insufficiency and vaccine hesitancy. Programs to improve vaccination rates need to also focus on food sufficiency. [ABSTRACT FROM AUTHOR]

Existing research, including work specific to COVID-19, suggests that endorsement by medical practitioners increases vaccine uptake. Yet, vaccine hesitancy persists despite health professionals continuing to widely endorse multiple vaccines to combat COVID-19 since late 2020. Could endorsement by other trusted leaders reduce vaccine hesitancy? Although some studies suggest that trust in religious leaders can influence individuals' health attitudes and behaviors, the evidence is mixed. Our study explores the potential added value of messaging by religious leaders across religious traditions – specifically, it asks whether their endorsement of the COVID-19 vaccine might increase vaccine uptake in an environment where health professionals are already endorsing vaccines. To investigate this question, we conducted an online survey experiment with 6,000 respondents across five countries with different dominant religions (Buddhism, Christianity, and Islam). Respondents were randomly assigned to either a control group that only included endorsement by medical practitioners or a treatment group that added either endorsement by religious leaders or, for comparative purposes, endorsement by political leaders. We found that endorsement by religious leaders reduced vaccine hesitancy only in one country. These findings corroborate existing research that medical practitioners are the best line of defense to combat vaccine hesitancy. They also suggest the limitations of endorsement by non-experts. [ABSTRACT FROM AUTHOR]

Many children are still not vaccinated against COVID-19, often attributed to rising pediatric vaccine hesitancy. To address this complex public health issue, interventions that uncover parental thinking at point of care are needed to help facilitate discussions in the exam room. The cognitive science framework of Rule Developing Experimentation helps distinguish how people think about day-to-day topics by presenting respondents with a systematic combination of messages that determines the ideas primarily driving their decisions. We hypothesized that Rule Developing Experimentation can empirically assess and identify parental mind-sets in deciding to vaccinate their children to prevent COVID-19. Artificial intelligence was also incorporated to more efficiently help formulate messages. Through an iterative process, surveying a total of 600 participants, three mind-sets emerged regarding the types of messages which parents believe would convince them to vaccinate their children to prevent COVID-19. These three mind-sets are summarized by the following phrases – "Covid is Serious," "Science Says Vaccine Works," and "Vaccine Returns Kids to Normalcy". Using these mind-sets, a simple six-question instrument (i.e., Personal Viewpoint Identifier) was then created to quickly discern at point of care a parent's mind-set surrounding pediatric COVID-19 vaccination. By quickly identifying a parent's mindset at point of care, providers can then utilize the results of the assessment to deliver individualized messaging to parents about the benefits of COVID-19 vaccination. A future study is planned to evaluate the impact of incorporating the Personal Viewpoint Identifier into routine pediatric care settings on COVID-19 vaccination rates. [ABSTRACT FROM AUTHOR]

The aim of this study was to explore the sociodemographic and individual-level factors associated with vaccine hesitancy in general, including political affiliation and beliefs in vaccine conspiracy theories, in a diverse group of Canadian adults within the context of the COVID-19 pandemic. 641 responses were included in the analysis, with those self-identifying as Indigenous, Black Canadian, and low-income (household income <$40,000) being sampled to yield data from historically marginalized populations. Demographic variables and responses to questions on vaccine hesitancy, and beliefs in vaccine conspiracy theories were used to explore explanatory variables of vaccine hesitancy. General linear regression models were fit using the method of least squares via PROC GLM and used to examine sociodemographic and individual explanatory variables of vaccine hesitancy. Age, ethnicity, political affiliation, and beliefs in vaccine conspiracies were associated with vaccine hesitancy. Findings are discussed in relation to the critical role of distrust and misinformation in hesitancy. Our data provide insight into how Canadian provincial governments may promote uptake of vaccines in ways that target diverse groups that may differ from those developed in a pre-pandemic context. [ABSTRACT FROM AUTHOR]

In this ecological study, we aim to establish the role vaccines play in bringing the pandemic under control, as well as the impact of pathogen variants, vaccine hesitancy, and medical resource availability during the process by utilizing publicly available data. The study spans a three-year data collection period for daily hospital admissions due to COVID-19 and the daily reported cases of COVID-19 across all 50 states in the USA. In doing so, we aim to demonstrate the difference in severity of the SARS-CoV-2 pathogen among vaccinated and unvaccinated populations in the USA. The study assesses the correlation of COVID-19 vaccines (e.g., Pfizer, Moderna, and Janssen) and disease outcomes (transmissibility, severity, and deaths) caused by different strains of SARS-CoV-2 and establishes a negative correlation between COVID-19 vaccine and disease outcomes. By considering potential confounders in vaccine hesitancy, medical resource availability and vaccine dosage, we demonstrate the aforementioned to be insubstantial in predicting disease outcomes while the latter displays a contrasting significance in terms of disease outcomes. Between all the major variants of concern, the Delta and Omicron variants in particular have been associated with higher virulence and transmissibility factors respectively. Hence, the CDC continues to encourage the US population to get vaccinated since vaccines are one of the most effective ways to protect the community from potential outbreaks and prevent severe disease manifestations. [ABSTRACT FROM AUTHOR]

While Canada has had relatively high vaccination rates against COVID-19, specifically during earlier waves of the pandemic, vaccine hesitancy has continued to serve as a significant barrier to adequate protection against the virus and, more recently, booster vaccine uptake. This paper explores the processes underlying Canadians' perceptions of COVID-19 vaccines and their decisions to take or refuse them, as well as how public policy and health messaging about vaccination has influenced vaccination attitudes and behaviors. Our focus group interviews with 18 vaccinated and unvaccinated adult Canadians conducted during October 2021 reveal that, in some respects, COVID-19 vaccine hesitancy conforms to prior knowledge about some of the factors that affect vaccine attitudes (e.g., the influence of known medical providers) but deviates from current theoretical frameworks regarding general vaccine hesitancy. Specifically, these frameworks emphasize a lack of scientific knowledge and literacy ("knowledge deficit" accounts) or individuals' inability to incorporate rational risk perceptions into initial emotional responses to vaccines ("emotionality/irrationality" accounts). In contrast to the knowledge deficit account, we find that expressions of COVID-19 vaccine hesitancy were most frequently associated with an information surplus or inability to prioritize information from multiple and often contradictory sources. Furthermore, top-down pro-vaccination messaging often triggered significant pushback against what participants perceived as moral shaming of the unvaccinated. Our findings demonstrate the necessity for a new framework to understand and address vaccine hesitancy. A better theoretical account of vaccine hesitancy has important implications for future vaccination efforts, specifically within the context of new variants and low booster vaccination rates in Canada. [ABSTRACT FROM AUTHOR]

Children under five years old have a high rate of SARS-CoV-2 (COVID-19) infection, yet rates of vaccination are relatively low. Our qualitative study investigated reasons why caregivers of children ages six months to four years old may be hesitant to vaccinate their children against COVID-19. Qualitative study. We enrolled a convenience sample of caregivers of patients aged six months to four years who presented for care at a pediatric Emergency Department in southern California. We conducted face-to-face semi-structured interviews with caregivers to probe for themes regarding any hesitations they may have regarding vaccinating their children against COVID-19. Interviews were recorded, transcribed, translated if necessary, and coded. When thematic saturation was achieved, we applied grounded theory methodology to assess for themes and adapted the World Health Organization Strategic Advisory Group of Experts model of vaccine hesitancy determinants matrix to provide a framework for the identified themes. We conducted 20 interviews, two in Spanish, and achieved thematic saturation at 17 interviews. We categorized themes surrounding vaccine hesitancies into external, patient-centric, and vaccine-centric factors. External factors included sources of information and family/community influence. Patient-centric factors included the perceived risk versus benefit ratio, caregiver beliefs, and caregiver knowledge and awareness. Vaccine-centric factors included vaccine safety, vaccine efficacy, vaccine information, and barriers to vaccination. Using qualitative methodology, we gained important insights into caregiver thoughts regarding the COVID-19 vaccine in children under five years old. We identified themes not previously published in the literature that may be specific to the COVID-19 vaccine in the young pediatric population. [ABSTRACT FROM AUTHOR]

Vaccines reduce the risk of contracting and developing complications from coronavirus disease 2019 (COVID-19). Pregnant people are at increased risk of disease-related complications but have a higher prevalence of vaccine hesitancy (VH) than their nonpregnant counterparts. This study aimed to describe risk factors and COVID-19- and vaccine-related perspectives that lead to VH among pregnant people in Mexico to target strategies to increase vaccine acceptance in this population. A cross-sectional survey-based study to evaluate risk factors and COVID-19- and vaccine-related perspectives associated with VH among pregnant people was conducted. Respondents were pregnant people of all ages attending a regular follow-up visit or admitted to labor and delivery in a third-level maternity hospital in Mexico. VH was defined as not having received a COVID-19 vaccine and either declining or being undecided to accept a vaccine during their pregnancy. We used bivariate and multivariable logistic regression models to estimate assess the relationship among demographic factors, COVID-19- and vaccine-related perspectives, and VH. A total of 1475 respondents completed the questionnaire; 216 (18%) were under the age of 18 years, and 860 (58%) had received at least one dose of a COVID-19 vaccine. In this sample, 264 (18%) were classified as vaccine hesitant. Key factors associated with VH were adolescence, having family as a primary source of information, first pregnancy, and history of vaccines in previous pregnancies. COVID-19 perspectives were also strongly associated with VH. Among pregnant people in Mexico, VH is associated with demographic factors, vaccination history, sources of information, and perceived risks to the fetus. This information is relevant to policy makers and health care professionals to identify those more likely to be hesitant and to inform strategies to increase vaccine uptake among pregnant people. [ABSTRACT FROM AUTHOR]

• COVID-19 vaccine hesitancy was heterogeneous both in terms of time and magnitude. • Following COVID-19 news, trust levels, risk preferences, and vaccine confidence predicted intention reversals. • Lowering the cost of following the news for the population may raise vaccine uptake. This paper investigates the prevalence and determinants of three main states of people's willingness to be vaccinated (WTBV) against COVID-19 – willing, unwilling and hesitant – and the occurrence and predictors of shifts between these states over time. Understanding the dynamics of vaccine intentions is crucial for developing targeted campaigns to increase uptake and emergency response preparedness. A panel survey consisting of 9 quarterly waves of data collected between April 2020 and January 2022. Baseline data included 24 952 adults from Germany, UK, Denmark, the Netherlands, France, Portugal, and Italy recruited from online panels to construct census-matched nationally representative samples. Self-reported COVID-19 vaccine intention was the main outcome. Multinomial logit random effects models were used to analyze the relationships of interest. All results reported as relative risk ratios (RRR). Hesitancy to get vaccinated was the most unstable vaccine intention, with on average 42% of ever hesitant respondents remaining in this state through future waves, followed by the 'unwilling' (53%) and 'willing (82%). Following COVID-19 news, trust in information from the government, GPs and the WHO, risk preferences, risk perceptions, and confidence in vaccines (or lack thereof) predicted vaccination intention reversals. Risk preferences acted both as an impediment and as a facilitator for the vaccine uptake depending on the initial vaccine intention. This study revealed the dynamic nature of COVID-19 vaccine intentions and its predictors in 7 European countries. The findings provide insights to policymakers for designing more effective communication strategies, particularly targeted at hesitant and unwilling to vaccinate population groups, to increase vaccine uptake for future public health emergencies. [ABSTRACT FROM AUTHOR]

The aims of this study were to examine vaccine hesitancy for COVID-19 vaccinations, comparing immigrant and non-immigrant older adults (aged ≥60 years), after accounting for group-level and individual-level characteristics, and the interaction between immigrant and socio-economic status. This study used a retrospective cohort design. Analyses were conducted using R version 4.3.2. Logistic regression models had the dependent variables of obtained any COVID-19 vaccinations vs not and obtained all four required COVID-19 vaccinations vs not. The linear regression model's dependent variable was the interval in days between the COVID-19 vaccination availability and the date of obtaining the first COVID-19 vaccination. In the cohort of older adults (n = 35,109), immigrants were less likely than non-immigrants to obtain a single COVID-19 vaccination (P < 0.001) or the full series of required COVID-19 vaccinations (P < 0.001); however, immigrants vs non-immigrants delayed only in obtaining the first vaccination (P < 0.001) but not the remaining required COVID-19 vaccinations. In the linear regression model, a longer interval before obtaining the first COVID-19 vaccination was associated with immigrant status (P < 0.001), lower socio-economic status (SES; P < 0.001), and the interaction between immigrant status and low SES (P < 0.001), while a shorter interval was associated with preventive behaviours of obtaining seasonal influenza (P < 0.001) or pneumococcal (P < 0.001) vaccinations previously. Immigrant status in general, and especially when combined with low SES, is a major risk factor for vaccination hesitancy. Reorienting immigrants to embrace preventive healthcare behaviours is key. Culturally appropriate communication campaigns may improve the dissemination of effective vaccination-related information to immigrant communities. [ABSTRACT FROM AUTHOR]

• Many participants from GRT communities felt coerced into COVID-19 vaccinations. • Healthcare staff inadequately addressed or even dismissed vaccine concerns. • Vaccination decisions were affected by prior discrimination and barriers to care. • The standard 'vaccine hesitancy' model is of limited use in this situation. • Health services for GRT communities need to improve their overall trustworthiness. Many people refuse vaccination and it is important to understand why. Here we explore the experiences of individuals from Gypsy, Roma, and Traveller groups in England to understand how and why they decided to take up or to avoid COVID-19 vaccinations. We used a participatory, qualitative design, including wide consultations, in-depth interviews with 45 individuals from Gypsy, Roma, and Traveller, communities (32 female, 13 male), dialogue sessions, and observations, in five locations across England between October 2021 and February 2022. Vaccination decisions overall were affected by distrust of health services and government, which stemmed from prior discrimination and barriers to healthcare which persisted or worsened during the pandemic. We found the situation was not adequately characterised by the standard concept of "vaccine hesitancy". Most participants had received at least one COVID-19 vaccine dose, usually motivated by concerns for their own and others' health. However, many participants felt coerced into vaccination by medical professionals, employers, and government messaging. Some worried about vaccine safety, for example possible impacts on fertility. Their concerns were inadequately addressed or even dismissed by healthcare staff. A standard "vaccine hesitancy" model is of limited use in understanding vaccine uptake in these populations, where authorities and health services have been experienced as untrustworthy in the past (with little improvement during the pandemic). Providing more information may improve vaccine uptake somewhat; however, improved trustworthiness of health services for GRT communities is essential to increase vaccine coverage. This paper reports on independent research commissioned and funded by the National Institute for Health Research (NIHR) Policy Research Programme. The views expressed in this publication are those of the authors and not necessarily those of the NHS, the NIHR, the Department of Health and Social Care or its arm's length bodies, and other Government Departments. [ABSTRACT FROM AUTHOR]

In the wake of mass COVID-19 vaccination campaigns in 2021, significant differences in vaccine skepticism emerged across Europe, with Eastern European countries in particular facing very high levels of vaccine hesitancy and refusal. This study investigates the determinants of COVID-19 vaccine hesitancy and refusal, with a focus on these differences across Eastern, Southern and Western Europe. The statistical analyses are based on individual-level survey data comprising quota-based representative samples from 27 European countries from May 2021. The study finds that demographic variables have complex associations with vaccine hesitancy and refusal. The relationships with age and education are non-linear. Trust in different sources of health-related information has significant associations as well, with people who trust the Internet, social networks and 'people around' in particular being much more likely to express vaccine skepticism. Beliefs in the safety and effectiveness of vaccines have large predictive power. Importantly, this study shows that the associations of demographic, belief-related and other individual-level factors with vaccine hesitancy and refusal are context-specific. Yet, explanations of the differences in vaccine hesitancy across Eastern, Southern and Eastern Europe need to focus on why levels of trust and vaccine-relevant beliefs differ across regions, because the effects of these variables appear to be similar. It is the much higher prevalence of factors such as distrust of national governments and medical processionals as sources of relevant medical information in Eastern Europe that are relevant for explaining the higher levels of vaccine skepticism observed in that region. [ABSTRACT FROM AUTHOR]

OBJECTIVE: We surveyed a diverse group of US participants to understand parental coronavirus disease 2019 (COVID-19) vaccine hesitancy. METHODS: We administered a telephone and online survey from May 7 to June 7, 2021 using stratified sampling to ensure robust sample sizes of racial and ethnic minorities. Of the 20,280 contacted, 12,288 respondents completed the survey (response rate 61%). We used chi-square tests and adjusted risk ratios to compare results by racial/ethnic group. RESULTS: Overall, 23% of parents stated that they plan to (or have) vaccinated their children; 30% said that they would not vaccinate their children, and 25% were unsure. Latino/a, Native American, and Asian American-Pacific Islander (AAPI) parents were generally more likely to vaccinate their children than Black or White parents. After adjusting for demographic factors, AAPI parents were significantly more likely to vaccinate their children than were others. Of parents who said that they would not vaccinate their child, 55% stated it was due to insufficient research. However, over half of parents stated that they would follow their child's health care provider's recommendations. After adjusting for demographic factors, trust in their primary care doctor was significantly lower among AAPI, Black, and Native American parents than White parents. CONCLUSIONS: Parental vaccine hesitancy was similar overall, but drivers of hesitancy varied by racial/ethnic groups. While the perception that vaccines had been "insufficiently researched" was a major concern among all groups, we found that parents are gen-erally inclined to follow health providers' recommendations. Health professionals can play an important role in COVID-19 vaccine education and should provide access to vaccines. [ABSTRACT FROM AUTHOR]

The highest death toll during the COVID-19 pandemic in Thailand was among unvaccinated older adults. Deaths among older adults in Narathiwat Province were related to a lower COVID-19 vaccination rate. This study explored the factors influencing COVID-19 vaccination hesitancy in a Muslim community with low vaccination rates. A case-control study was conducted with participants assigned to the unvaccinated "case" group and the vaccinated "control" group. The sample was Thai older adults who practiced Islam and lived in Narathiwat Province. Purposive sampling was conducted by selecting a case house and finding the control around the case house in a 1:2 ratio. This study included 141 participants with a median age of 67 years (interquartile range [IQR], 8). More than 80% of both groups were retired and lived with their extended relatives. More participants in the vaccinated group believed that vaccines could prevent death from COVID-19 than in the unvaccinated group. In the multivariable analysis, factors related to the low perceived importance of the COVID-19 vaccination (odds ratio [OR] = 2.63) and a lack of vaccine recommendation from religious leaders (OR = 4.67) significantly influenced COVID-19 vaccination refusal. The COVID-19 guidance from religious leaders and the perceived importance of COVID-19 vaccination influence vaccination uptake among Muslim older adults in Thailand. [ABSTRACT FROM AUTHOR]

• COVID-19 non-vaccination in parents correlates with more negative views on childhood vaccines over time. • There is spillover between beliefs about the COVID-19 vaccine and routine childhood vaccines. • More negative beliefs about childhood vaccines over time clustered in places with low COVID-19 vaccination rates. • Parental experiences with COVID-19 vaccination and disease are predictive of beliefs about childhood vaccines. It is unclear how hesitancy towards pediatric vaccines has changed quantitatively since the onset of the COVID-19 pandemic, and if changes are more readily apparent in clusters of low COVID-19 vaccination. In this study, we assess how clusters of low COVID-19 vaccination correlate with changing parental beliefs about childhood vaccines. A cross-sectional, opt-in, internet-based survey of parents resident in the U.S. was conducted during August-September 2022. Our survey measured changes in beliefs about childhood vaccine safety, importance, and effectiveness since the start of COVID-19. We also measured parents' perceived vaccination rates in the community, assessing its relationship with changing vaccination perceptions using Rao-Scott chi-square tests, and multinomial logistic regression models. Among 310 parents of children 0–17 years old, 11 % (95 % CI: 7 %, 15 %) believed that childhood vaccines are less safe, 12 % (95 % CI: 8 %, 17 %) less important, and 13 % (95 % CI: 9 %, 18 %) less effective since the start of the COVID-19 pandemic. About 9 % (95 % CI: 5 %, 12 %) stated COVID-19 vaccination coverage was low in their community. Among those who stated COVID-19 vaccination coverage was low, 38 % reported believing childhood vaccines were less effective (vs 12 % of those who stated vaccination coverage was high). This corresponds to 4.34 times greater odds of believing childhood vaccines were less effective since the start of the pandemic (95 % CI: 1.38, 13.73) in those who believe COVID-19 vaccination coverage to be low in their community vs high. Our study demonstrates that parental perceptions about childhood vaccines have been affected by the COVID-19 pandemic through geographic and social clustering of non-vaccination. Beliefs about the COVID-19 vaccine have spillover with beliefs about childhood vaccines, and more negative beliefs may be clustering in areas with low vaccination coverage, which could predispose the area to outbreaks of vaccine-preventable disease. [ABSTRACT FROM AUTHOR]

COVID-19 is a deadly worldwide pandemic and has led to rapid vaccine development. Vaccinating children is a key step to ending the pandemic. This project used a pretest-posttest design to determine if a 1-hr webinar improved parental COVID-19 vaccine hesitancy. The webinar was streamed live and later posted to YouTube. Parental vaccine hesitancy was measured by an adapted version of the Parental Attitudes about Childhood Vaccine survey for COVID-19 vaccines. Parental Attitudes about Childhood Vaccine data were collected during the live session and from YouTube for 4 weeks after the original webinar air date. After calculating a Wilcoxon signed rank test to measure the change of vaccine hesitancy before (median, 40.00) and after (median, 28.50) the webinar, there was a statistically significant difference (z = 0.003, p =.05). The webinar demonstrated improved vaccine hesitancy and provided scientifically based vaccine information to parents. [ABSTRACT FROM AUTHOR]

• General population distinguishes between trust in their own doctor and medical research. • People's race and ethnicity good predictor of medical mistrust archetype. • Medical mistrust a stronger predictor than political affiliation for COVID-19 vaccine hesitancy. Using a nationally representative household sample, we sought to better understand types of medical mistrust as a driver of COVID-19 vaccine hesitancy. We used survey responses to conduct a latent class analysis to classify respondents into categories and explained this classification as a function of sociodemographic and attitudinal variables using multinomial logistic regression models. We then estimated the probability of respondents agreeing to receive a COVID-19 vaccine conditional on their medical mistrust category. We extracted a five-class solution to represent trust. The high trust group (53.0 %) is characterized by people who trust both their doctors and medical research. The trust in own doctor group (19.0 %) trust their own doctors but is ambiguous when it comes to trusting medical research. The high distrust group (6.3 %) neither trust their own doctor nor medical research. The undecided group (15.2 %) is characterized by people who agree on some dimensions and disagree on others. The no opinion group (6.2 %) did not agree nor disagree with any of the dimensions. Relative to the high trust group, those who trust their own doctors are almost 20 percentage points less likely to plan to get vaccinated (average marginal effect (AME) = 0.21, p <.001), and those who have high distrust are 24 percentage points less likely (AME = -0.24, p <.001) to report planning to get the vaccine. Results indicate that beyond sociodemographic characteristics and political attitudes, people's trust archetypes on parts of the medical field significantly predict their probability of wanting to get vaccinated. Our findings suggest that efforts to combat vaccine hesitancy should focus on building capacity of trusted providers to speak with their patients and parents of their patients, to recommend COVID-19 vaccination and build a trusting relationship; and increase trust and confidence in medical research. [ABSTRACT FROM AUTHOR]

Vaccine hesitancy is a serious threat to global health; however, significant COVID-19 vaccine hesitancy exists throughout the United States. The 5C model, which postulates five person–level determinants for vaccine hesitancy – confidence, complacency, constraints, risk calculation, and collective responsibility – provides one theoretical way of understanding COVID-19 vaccine hesitancy. The present study examined the effects of these 5C drivers of vaccine behavior on early vaccine adoption and vaccine intentions above and beyond theoretically salient demographic characteristics and compared these associations across a National sample (n = 1634) and a statewide sample from South Carolina (n = 784) – a state with documented low levels of COVID-19 vaccination uptake. This study used quantitative and qualitative data collected in October 2020 to January 2021 from the MFour-Mobile Research Panel, a large, representative non-probability sample of adult smartphone users. Overall, the South Carolina sample reported lower COVID-19 vaccine intentions and higher levels of 5C barriers to vaccine uptake compared to the National sample. Findings further indicated that both demographic characteristics (race) and certain drivers of vaccine behavior (confidence and collective responsibility) are associated with vaccine trust and intentions across samples above and beyond other variables. Qualitative data indicated that COVID-19 vaccine hesitancy was driven by fears about the quick vaccine development, limited research, and potential side effects. Although there are some limitations to the cross-sectional survey data, the present study offers valuable insight into factors associated with early COVID-19 vaccine hesitancy across the United States. [ABSTRACT FROM AUTHOR]

• COVID-19 vaccine uptake rates are lower in care home staff than residents. • Three main causes of reduced uptake have been identified: vaccine hesitancy, logistical issues, and medical concerns. • The main reasons for vaccine hesitancy were concerns about limited research into vaccine safety, and concerns about long-term impact on pregnancy and fertility. • Addressing care home staff vaccination concerns should be given priority in these settings. Uptake of COVID-19 vaccine first doses in UK care homes has been higher among residents compared to staff. We aimed to identify causes of lower COVID-19 vaccine uptake amongst care home staff within Liverpool. An anonymised online survey was distributed to all care home managers, between the 21st and the 29th January 2021. 53 % of 87 care homes responded. The overall COVID-19 vaccination rate was 52.6 % (n = 1119). Reasons, identified by care home managers for staff being unvaccinated included: concerns about lack of vaccine research (37.0 %), staff being off-site during vaccination sessions (36.5 %), pregnancy and fertility concerns (5.6 %), and allergic reactions concerns (3.2 %). Care home managers wanted to tackle vaccine hesitancy through conversations with health professionals, and provision of evidence dispelling vaccine misinformation. Vaccine hesitancy and logistical issues were the main causes for reduced vaccine uptake among care home staff. The former could be addressed by targeted training, and public health communication campaigns to build confidence and acceptance of COVID-19 vaccines. [ABSTRACT FROM AUTHOR]

Recent evidence suggests that COVID-19 vaccine hesitancy is not static. In order to develop effective vaccine uptake interventions, we need to understand the extent to which vaccine hesitancy fluctuates and identify factors associated with both between- and within-person differences in vaccine hesitancy. The goals of the current study were to assess the extent to which COVID-19 vaccine hesitancy varied at an individual level across time and to determine whether disgust sensitivity and germ aversion were associated with between- and within-person differences in COVID-19 vaccine hesitancy. A national sample of U.S. adults (N = 1025; 516 woman; M age = 46.34 years, SD age = 16.56, range: 18 to 85 years; 72.6 % White) completed six weekly online surveys (March 20 – May 3, 2020). Between-person mean COVID-19 vaccine hesitancy rates were relatively stable across the six-week period (range: 38–42 %). However, there was considerable within-person variability in COVID-19 vaccine hesitancy. Approximately, 40 % of the sample changed their vaccine hesitancy at least once during the six weeks. There was a significant between-person effect for disgust sensitivity, such that greater disgust sensitivity was associated with a lower likelihood of COVID-19 vaccine hesitance. There was also a significant within-person effect for germ aversion. Participants who experienced greater germ aversion for a given week relative to their own six week average were less likely to be COVID-19 vaccine hesitant that week relative to their own six-week average. This study provides important information on rapidly changing individual variability in COVID-19 vaccine hesitancy on a weekly basis, which should be taken into consideration with any efforts to decrease vaccine hesitancy and increase vaccine uptake. Further, these findings identify-two psychological factors (disgust sensitivity and germ aversion) with malleable components that could be leveraged in developing vaccine uptake interventions. [ABSTRACT FROM AUTHOR]

Strategies to increase COVID-19 vaccine coverage require an understanding of the extent and drivers of vaccine hesitancy and trust in government related to COVID-19 vaccine programs, especially in low-resource communities. We conducted a cross-sectional household survey post-COVID-19 vaccine introduction among adults (n = 362) in four municipalities in Sarlahi District, Nepal from August to December 2022. The survey included modules on participant demographics and socioeconomic factors and vaccine hesitancy, information seeking, and trust in authorities related to COVID-19 vaccination. Of the study participants, 38.4 % expressed hesitancy related to COVID-19 vaccination. The adjusted odds of being "vaccine hesitant" were significantly lower among the older adults (51+ years) relative to younger (<30 years) (aOR: 0.49, CI: 0.24–0.97) and among males relative to females (aOR: 0.51, CI: 0.26, 0.95). The study population highly trusted the government's handling of the COVID-19 pandemic. While for most, self-reported access to vaccination opportunities was high (88.4 %), 70.4 % of participants did not know if vaccines were in stock at their local vaccination facility. Commonly reported statements of misinformation include the vaccine being developed in a rush or too fast (21.5 %), COVID-19 infection can be effectively treated with ayurvedic medicine(16.3 %) and obtaining immunity from natural infection is better than through vaccination (19.9 %). The primary sources of information on COVID-19 programs were family and friends (98.6 %), healthcare professionals (67.7 %), Female Community Health Volunteers (FCHVs) (61.9 %), television (56.4 %), and radio (43.1 %). Although many respondents expressed concerns about COVID-19 effectiveness and safety, a high proportion trusted COVID-19 information provided by healthcare workers and approved of the government's response to the pandemic. This study highlights an opportunity to design new evidence-based communication strategies to improve vaccine confidence delivered through frontline government healthcare workers. Approaches could be targeted to certain communities in the region shown to have higher vaccine hesitancy, including younger people and women. [ABSTRACT FROM AUTHOR]

• The COVID-19 vaccine hesitancy scale (C19-VHS) has sound psychometric properties and is predictive of actual uptake of COVID-19 vaccination. • Higher hesitancy was observed among younger aged participants and female gender. • Older age, female gender, and getting the flu vaccine in the past year were predictive of COVID-19 vaccine uptake. The public's willingness to get vaccinated continues to be a source of concern. In this study we assessed the psychometric properties of the COVID-19 vaccine hesitancy scale (C19-VHS) as well as the association between the scale and self-reported past COVID-19 vaccination, approximately two weeks after the national vaccine distribution plan was launched in Israel. Participants were recruited via an online survey distributed through social media platforms and mailing lists. A total of 650 individuals completed the C19-VHS, the general vaccine hesitancy scale, and the fear of COVID-19 scale, and reported on demographic and pandemic-related characteristics. Principal component and Cronbach's alpha analyses were performed to assess the factor structure and reliability of the scale. Logistic regressions were employed to assess the scale's convergent and discriminative validity. Two factors pertaining to "lack of confidence" (Factor 1) and "risk perception" (Factor 2) emerged. Cronbach's alpha indicated good reliability of Factor 1 (0.93), with lower reliability of Factor 2 (0.72). Younger age was associated with higher risk perception, with women showing less confidence and perceiving greater risks. Lower hesitancy significantly predicted actual COVID-19 vaccine uptake after adjusting for demographic and pandemic-related factors (OR = 1.16, 95%CI 1.11–1.21, p <.001). Older age, being a woman, and receiving the flu vaccine in the past year were also predictive of COVID-19 vaccine uptake. The C19-VHS measure shows robust psychometric properties and is associated with actual vaccine uptake. Future studies assessing COVID-19 vaccination attitudes may utilize this scale to assess current COVID-19 vaccine hesitancy in different contexts and cultures. [ABSTRACT FROM AUTHOR]

Vaccine hesitancy disproportionally impacts racial/ethnic minority populations. Regarded as trusted, accessible, and knowledgeable, pharmacists are strategically positioned to address this threat using effective communication strategies such as motivational interviewing (MI). Little data exists on programs that prepare student-pharmacists to use MI to combat vaccine hesitancy in underrepresented populations. Student pharmacists elected to participate in co-curricular training on addressing COVID-19 vaccine hesitancy in racial/ethnic minority populations. The training included a web-based module on using MI to address COVID-19 vaccine hesitancy and a live group objective structured clinical examination (OSCE) with standardized patient encounters that included prevalent COVID-19 vaccine concerns. Faculty assessed the group's ability to employ core elements of MI to correct vaccine misinformation. After the OSCE, students received feedback from the standardized actors and evaluators. Change in student confidence was assessed. After the training, students volunteered at eight different community events to utilize MI to address vaccine hesitancy in underrepresented patient populations. A total of 17 students completed the training. Four out of the six groups received a passing score on the OSCE. Students performed satisfactory in the major domains of MI but struggled to answer knowledge-based questions regarding COVID-19 vaccines. As a result of the training, a significant increase in student confidence was seen. All participating students rated the training as either "excellent" or "good." A novel, co-curricular educational initiative was an effective tool to prepare student-pharmacists to utilize MI to combat vaccine hesitancy in underrepresented racial/ethnic minority populations. [ABSTRACT FROM AUTHOR]

The aim of this study was to explore key informants' views on and experiences with Covid-19 vaccine hesitancy in a Dublin community with a high concentration of economic and social disadvantage and to identify feasible, community-centred solutions for improving vaccination acceptance and uptake. Qualitative, semi-structured interviews were carried out at a local community-centre and a central hair salon. Twelve key informants from the target community were selected based on their professional experience with vulnerable population groups: the unemployed, adults in recovery from addiction, the elderly, and Irish Travellers. Inductive thematic framework analysis was conducted to identify emergent themes and sub-themes. Drivers of vaccine hesitancy identified by key informants largely fell under the WHO '3Cs' model of hesitancy: lack of confidence in the vaccine and its providers, complacency towards the health risks of Covid-19, and inconvenient access conditions. Covid-19 Communications emerged as a fourth 'C' whereby unclear and negative messages, confusing public health measures, and unmet expectations of the vaccine's effectiveness exacerbated anti-authority sentiments and vaccine scepticism during the pandemic. Community-specific solutions involve the provision of accurate and accessible information, collaborating with community-based organizations to build trust in the vaccine through relationship building and ongoing dialogue, and ensuring acceptable access conditions. The proposed Confidence, Complacency, Convenience, Covid-19 Communications ('4Cs') model provides a tool for considering vaccine hesitancy in disadvantaged urban communities reacting to the rapid development and distribution of a novel vaccine. The model and in-depth key informants' perspectives can be used to compliment equitable vaccination efforts currently underway by public health agencies and non-governmental organizations. [ABSTRACT FROM AUTHOR]

Monitoring COVID-19 vaccine hesitancy helps design and implement strategies to increase vaccine uptake. Utilizing the large scale cross-sectional Household Pulse Survey data collected between July 21 and October 11 in 2021, this study aims to construct measures of COVID-19 vaccine hesitancy and identify demographic disparities among U.S. adults (18y+). Factor analysis identified three factors of vaccine hesitancy: safety concerns (prevalence: 70.1 %). trust issues (53.5 %), and not seen as necessary (33.8 %). Among those who did not show willingness to receive COVID-19 vaccine, females were more likely to have safety concerns (73.7 %) compared to males (66.7 %), but less likely to have trust issues (female: 49.7 %; male: 57.1 %) or not seen as necessary (female: 23.8 %; male 43.4 %). Higher education was associated with higher prevalence of not seen as necessary. Younger adults and Whites had higher prevalence of having trust issues and not seen as necessary compared to their counter parts. [ABSTRACT FROM AUTHOR]

• Ways of coping with the threat of COVID-19 predicted subsequent vaccine hesitancy. • Avoidance coping was associated with subsequent vaccine hesitancy. • Low perception of COVID-19 threat was associated with subsequent vaccine hesitancy. • Approach coping reduced vaccine hesitancy among those perceiving low COVID-19 threat. • Coping responses may serve as targets for intervention to reduce vaccine hesitancy. The COVID-19 pandemic has brought to light the importance of identifying factors associated with vaccine hesitancy. Disease threat and coping responses are central to health behavior engagement and present potential alterable targets for intervention. To examine the roles of perceived threat of COVID-19 and coping in vaccine hesitancy, we examined how coping strategies involving approach and avoidance interact with perceived threat of COVID-19 to predict vaccine hesitancy. We used data from 1570 North American participants who reported their vaccine hesitancy as part of a longitudinal study assessing psychosocial responses to the pandemic. We used logistic regression models and mean scores of perceived threat of COVID-19, approach coping, and avoidance coping from prior timepoints to predict vaccine hesitancy in December 2020, when COVID-19 vaccines were first being approved for use in North America. Low perceived threat of COVID-19 was associated with greater likelihood of being vaccine hesitant. However, approach coping moderated this association, such that people who engaged in more approach coping were less likely to be vaccine hesitant even when they did not feel personally threatened by COVID-19. In contrast, avoidance coping was associated with greater likelihood of vaccine hesitancy regardless of perceived threat of COVID-19. Our results illustrate the contributions of approach and avoidance coping to vaccine hesitancy and in doing so, provide preliminary evidence for coping behavior to serve as a target for intervention to reduce vaccine hesitancy. [ABSTRACT FROM AUTHOR]

• Asking people to choose a vaccine versus contemplate whether to vaccinate reduces vaccine hesitancy. • The effect is particularly evident amongst those who are more vaccine hesitant, such as Pro-Trump Republicans. • Asking patients which vaccine they would like could protect upwards of 5 million Americans from Coronavirus. To investigate if a behavioral nudge comprising a vaccination opportunity that employs a comparative probe first (i.e., which vaccine to take) versus the more commonly-used deliberative probe (i.e., willingness to take a vaccine), reduces vaccine hesitancy, while controlling for political partisanship. In a randomized study, conducted on Amazon Mechanical Turk and Prolific, we varied the manner in which the vaccination offer is posed. In one group, participants were asked to compare which vaccine they would like to take (i.e., the comparative probe), while, in another group, participants were asked to deliberate whether they would like to take the vaccine (i.e., the deliberative probe). Participants' political preferences were also measured. The primary outcome variable was vaccine hesitancy. A LOGIT regression (N = 1736), was conducted to test the research questions. Overall, the comparative probe yielded a 6% reduction in vaccine hesitancy relative to the typical deliberative probe. Additionally, while vaccine hesitancy varies due to individual political views, the comparative probe is effective at reducing vaccine hesitancy even among the most vaccine hesitant population (i.e., Pro-Trump Republicans) by almost 10% on average. Subtly changing the manner in which the vaccination offer is framed, by asking people to compare which vaccine to take, and not deliberate about whether they would like to take a vaccine, can reduce vaccine hesitancy, without being psychologically taxing or curtailing individuals' freedom to choose. The nudge is especially effective among highly vaccine hesitant populations such as Pro-Trump Republicans. Our results suggest a costless communication protocol in face-to-face interactions on doorsteps, in clinics, in Pro-Trump regions and in the mass media, that might protect 5 million Americans from COVID-19. [ABSTRACT FROM AUTHOR]

• As of August 2021, 51% of pregnant women in Japan were vaccine hesitant. • 32% of mothers of young children in Japan were vaccine hesitant. • Functional and interactive/critical vaccine literacy skills had different effects. • Vaccine hesitancy correlated with low interactive/critical skills in both groups. • Vaccine hesitancy correlated with low functional skills among the mothers only. Delays in the spread of vaccination have been recognized as an urgent public health issue in the context of the COVID-19 pandemic. Vaccine literacy (VL) is a critical determinant of vaccine uptake; however, little is known about VL among pregnant women and mothers of young children. We analyzed data from a nationwide, cross-sectional internet survey in Japan on VL and vaccine hesitancy, conducted with 1,639 pregnant women and 5,688 mothers of young children who had given birth after July 2019, between July 24 and August 30, 2021. Vaccine hesitancy was observed in 51.1 % of pregnant women and 31.9 % of mothers of young children. The risk of vaccine hesitancy was significantly higher among pregnant women with lower interactive/critical skills (risk ratio [RR] 2.10, 95 % confidence interval [CI] 1.59, 2.78, p < 0.001), although functional skills did not significantly correlate with vaccine hesitancy. For mothers of young children, we found a significantly higher risk of vaccine hesitancy among those with low VL functional skills (RR 1.38, 95 % CI 1.19, 1.61), p < 0.001) and low interactive/critical skills (RR 1.29, 95 % CI 1.10, 1.50, p = 0.001). Our findings suggest that aiding individuals to correctly evaluate vaccine-related information is critical for improving vaccine acceptance rates among both pregnant women and mothers of young children. Meanwhile, improving the comprehensibility of communication toolkits may be important for women with children but have a limited effect among pregnant women. [ABSTRACT FROM AUTHOR]

Uptake of COVID-19 vaccination remains suboptimal in the United States and other settings. Though early reports indicated that a strong majority of people were interested in receiving the COVID-19 vaccine, the association between vaccine intention and uptake is not yet fully understood. Our objective was to describe predictors of vaccine uptake, and estimate the sensitivity, specificity, and predictive values of self-reported COVID-19 vaccine status compared to a comprehensive statewide COVID-19 vaccine registry. A cohort of California residents that received a molecular test for SARS-CoV-2 infection during 24 February-5 December 2021 were enrolled in a telephone-administered survey. Survey participants were matched with records in a statewide immunization registry. Cox proportional hazards model were used to compare time to vaccination among those unvaccinated at survey enrollment by self-reported COVID-19 vaccination intention. Among 864 participants who were unvaccinated at the time of interview, 272 (31%) had documentation of receipt of COVID-19 vaccination at a later date; including 194/423 (45.9%) who had initially reported being willing to receive vaccination, 41/185 (22.2%) who reported being unsure about vaccination, and 37/278 (13.3%) who reported unwillingness to receive vaccination. Adjusted hazard ratios (aHRs) for registry-confirmed COVID-19 vaccination were 0.49 (95% confidence interval: 0.32–0.76) and 0.21 (0.12–0.36) for participants expressing uncertainty and unwillingness to receive vaccination, respectively, as compared with participants who reported being willing to receive vaccination. Time to vaccination was shorter among participants from higher-income households (aHR = 3.30 [2.02–5.39]) and who reported co-morbidities or immunocompromising conditions (aHR = 1.54 [1.01–2.36]). Sensitivity of self-reported COVID-19 vaccination status was 82% (80–85%) overall, and 98% (97–99%) among those referencing vaccination records; specificity was 87% (86–89%). Willingness to receive COVID-19 vaccination was an imperfect predictor of real-world vaccine uptake. Improved messaging about COVID-19 vaccination regardless of previous SARS-CoV-2 infection status may help improve uptake. [ABSTRACT FROM AUTHOR]

• Studies suggest that people with stronger religious beliefs are more vaccine hesitant. • Research on religiosity (prayer frequency) and vaccine hesitancy across Europe is limited. • People aged 50 + in 27 European countries were more vaccine-hesitant when praying frequently. • Future studies should examine differences in religious belonging and its relation to vaccine hesitancy. Differences in levels of vaccine uptake have emerged across Europe, and this may partly be explained by religious beliefs. Our aim is to study the association between religiosity, measured by prayer frequency, and vaccine hesitancy, and to examine how this association varies across European countries and regions. This study was based on 42,583 adults aged 50 years and above from 27 European countries in the Survey of Health, Ageing and Retirement in Europe (SHARE), waves 1–8, and the 2nd SHARE COVID-19 Survey. Logistic regression models were used to investigate the associations. Participants were more likely to be vaccine-hesitant when praying 'weekly or less' (odds ratio (OR) 1.32 95 % confidence interval (CI) 1.23–1.42) or daily (OR 1.78 95 % CI 1.65–1.92). Praying 'weekly or less' was associated with increased vaccine hesitancy in Southern Europe (OR 1.48 95 % CI 1.17–1.87) and Central and Eastern (OR 1.35 95 % CI 1.24–1.47) Europe, while daily praying was associated with vaccine hesitancy in Western (OR 1.77 95 % CI 1.51–2.08), Southern (OR 1.30 95 % CI 1.03–1.64), Central and Eastern (OR 1.89 95 % CI 1.73–2.06) and Northern (OR 2.75 95 % CI 1.54–4.89) Europe. These findings provide support for an association between daily prayer frequency and COVID-19 vaccine hesitancy, with a consistent pattern across European regions. [ABSTRACT FROM AUTHOR]

Vaccine hesitancy has been identified as a major obstacle preventing comprehensive coverage against the COVID-19 pandemic. However, few studies have analyzed the association between ex-ante vaccine hesitancy and ex-post vaccination coverage. This study leveraged one-year county-level data across the contiguous United States to examine whether the prospective vaccine hesitancy eventually translates into differential vaccination rates, and whether vaccine hesitancy can explain socioeconomic, racial, and partisan disparities in vaccine uptake. A set of structural equation modeling was fitted with vaccine hesitancy and vaccination rate as endogenous variables, controlling for various potential confounders. The results demonstrated a significant negative link between vaccine hesitancy and vaccination rate, with the difference between the two continuously widening over time. Counties with higher socioeconomic statuses, more Asian and Hispanic populations, more elderly residents, greater health insurance coverage, and more Democrats presented lower vaccine hesitancy and higher vaccination rates. However, underlying determinants of vaccination coverage and vaccine hesitancy were divergent regarding their different associations with exogenous variables. Mediation analysis further demonstrated that indirect effects from exogenous variables to vaccination coverage via vaccine hesitancy only partially explained corresponding total effects, challenging the popular narrative that portrays vaccine hesitancy as a root cause of disparities in vaccination. Our study highlights the need of well-funded, targeted, and ongoing initiatives to reduce persisting vaccination inequities. [ABSTRACT FROM AUTHOR]

The study was conducted to examine the effects of parents' vaccine hesitancy and COVID-19 vaccine literacy on their attitudes toward vaccinating their children during the COVID-19 pandemic. The study was descriptive, cross-sectional, and comparative. The data were collected from 199 parents with children aged 0–18 using a Google Form on social media. In the study, the Parent Introductory Information Form, the Vaccine Hesitancy Scale in Pandemics, and the COVID-19 Vaccine Literacy Scale were used. In the analysis of the data, numbers, percentages, and means were calculated, and the significance test of the difference between the two means and the logistic regression analysis were used. Parents' vaccination hesitancy scale sub-dimensions and COVID-19 vaccine literacy scale sub-dimensions together explain 25.4% of their attitudes toward having their children vaccinated against COVID-19. When the variables were examined individually, it was determined that the sub-dimensions of the Vaccine Hesitancy Scale in Pandemics alone significantly affected their attitudes during the pandemic period (p < 0.001). Parents are hesitant about getting their children vaccinated against COVID-19. Improving vaccine literacy can increase vaccination rates in special groups to overcome vaccine hesitancy. • Vaccine confidence positively influenced parental attitudes toward vaccinating their children during the COVID-19 pandemic. • Finding the vaccine risky negatively affects the attitudes of parents toward getting their children vaccinated against COVID–19. • The attitudes of parents towards the COVID-19 vaccine predict getting their children vaccinated against COVID-19. • The parents' health literacy levels predict the attitudes of parents toward getting their children vaccinated against COVID-19. [ABSTRACT FROM AUTHOR]

Vaccine hesitancy (VH) is a major health threat to the efforts to tackle COVID-19 morbidity and mortality. This study's objectives were to assess COVID-19 VH before and after vaccines' availability and to analyze the associations between COVID-19 VH and participants' characteristics. A national cross-sectional telephone interview survey among Israeli adults aged 21 and older was conducted from September 2020 through May 2021. Attitudes towards COVID-19 vaccines were assessed pre/post vaccines' availability. Multivariate logistic regression analyses were used to identify associations between demographic and health-related characteristics and COVID-19 VH. Most study participants (72.0 % of 2,998) were willing to be vaccinated against COVID-19 across the survey period. The COVID-19 VH declined significantly from 45.6 % pre-vaccine availability to 16.3 % post-vaccine availability (P < 0.001). The multivariable analysis demonstrated that post-vaccine availability, COVID-19 VH was associated with younger age, Arab ethnicity, higher level of religiosity, lower education, past diagnosis of COVID-19, and influenza VH. The main reasons for VH after the vaccine availability included insufficient data on the vaccine (37.4 %) and fear of the vaccine's side effects (33.8 %). Despite the significant decrease in COVID-19 VH following vaccine availability, 16.3% of the population still refuses to get vaccinated. As Israel may face additional waves of the COVID-19 pandemic and booster vaccinations, multimedia vaccine promotions targeting the above-mentioned hesitant populations and their reasons for VH are urgently needed. [ABSTRACT FROM AUTHOR]

Vaccine hesitancy affects immunization programs worldwide and can impact vaccine coverage and fight against Coronavirus disease 2019 (COVID-19) too. Primary objectives: To find out the magnitude of COVID-19 vaccine hesitancy among the Health Care Worker Parents (HCWPs), the reasons for vaccine hesitancy, and their perceptions regarding COVID-19 vaccination of their children. Secondary objective: To analyze the clinic-socio-demographic correlates of COVID-19 vaccine hesitancy among HCWPs. This was a cross sectional descriptive study. Health care workers who are parents were invited to participate in the study. Details about COVID vaccination status, COVID-19 illness of HCWPS and family members and its outcomes , reasons for not getting vaccinated, willingness to vaccinate their children, reasons for not willing to vaccinate their children, their responses to vaccine hesitancy survey (VHS) questionnaire and Modified Oxford COVID-19 vaccine hesitancy scale (MOVHS) were collected and analyzed using descriptive statistics. A total of 269 HCWPs participated in the study. Of the HCWPs, 97% had completed their COVID-19 vaccination schedule. Majority stated that they would vaccinate their children when it is available. Although majority of the responses were positive or towards agreement, there were some striking variations in the responses among some sections of HCWPs. Positive responses to the questionnaire were associated with higher self-vaccination and a decision to vaccinate their children. Vaccine hesitancy was less common among HCWPs in our study. A section of the HCWPs might be disproportionately more hesitant than others. Majority were in favor of vaccinating their children. [ABSTRACT FROM AUTHOR]

COVID-19 vaccine hesitancy has been particularly high among immigrant populations, whose experience is shaped by a history of racism and discriminations, and distrust of the healthcare system. In this study we draw from the Theory of Planned Behavior to examine COVID-19 vaccine hesitancy among immigrants in Chicago. A mixed-methods approach comprising of both focus groups and a health survey was conducted from February to August 2022. Five focus groups were held (N = 35) among Black, Asian and Arab/Palestine participants to understand attitudes and beliefs around the COVID-19 vaccine. Focus groups were analyzed using a modified template approach to text analysis. Based on these findings and themes, we developed a survey that was conducted among 413 immigrants from the mentioned communities. We used hierarchical ordinal regression analyses to examine the relationship between COVID-19 vaccine hesitancy and vaccination status. Qualitative analysis suggest that the major factors influencing COVID-19 vaccine hesitancy included fear of adverse reactions, misinformation around COVID-19 and the vaccine, negative social norms around vaccination, and external pressure to get vaccinated. From our quantitative analysis we found that 24% of participants were unvaccinated, 5% were partially vaccinated, 32.3% were vaccinated but not boosted, and 39% were vaccinated and boosted for COVID-19. Hierarchical regression models suggest that immigrants who hold negative attitudes and social norms around the COVID-19 vaccine are less likely to vaccinate. Understanding vaccine hesitancy among immigrants allows for the creation of culturally and linguistically tailored education that can be utilized to increase vaccine confidence and uptake. [ABSTRACT FROM AUTHOR]

The public's hesitant attitude is a major subjective barrier in promoting vaccination against COVID-19 to build herd immunity. The current study aimed to address how individual factors such as health literacy and perceived stress affect people's vaccine hesitancy of COVID-19 vaccine, and to provide insights for tailoring vaccine-promotion strategies. With structured questionnaires, an online survey was conducted to address the relationship between the health literacy, perceived stress, and COVID-19 vaccine hesitancy among community population in mainland, China. Moderated analysis was conducted to test the effect of health literacy on vaccine hesitancy among people with different levels of perceived stress. 560 responses were collected in total. 39.8% of the participants reported vaccine hesitancy, and this rate was higher among younger people and female. Moreover, people with higher level of health literacy showed reduced vaccine hesitancy, while this effect was only significant among those with low or moderate level of stress. For people with high level of stress, no significant effect of health literacy was found. The findings suggest that increasing people's health literacy could lead to reduced vaccine hesitancy in community sample. However, this effect disappeared when the stress level was high, suggesting other promotion services may need to be developed to increase the acceptance of COVID-19 vaccine. In conclusion, vaccine promotion strategies should be tailored for different populations, with taking account of individual's health literacy and perceived stress. [ABSTRACT FROM AUTHOR]

This study introduces a SIR (Susceptible-Infectious-Recovered) model using fractional derivatives to assess the population's hesitancy to the COVID-19 vaccination campaign in Portugal. Leveraging the framework developed by Angstmann [1] , our approach incorporates fractional derivatives to best describe the nuanced dynamics of the vaccination process. We begin by examining the qualitative properties of the proposed model. To substantiate the inclusion of fractional derivatives, empirical data along with statistical criteria are applied. Numerical simulations are performed to compare both integer and fractional order models. An epidemiological interpretation for the fractional order of the model is provided, in the context of a vaccination campaign. • Fractional order models are suited to describe epidemics in the presence of population hesitancy towards a vaccine. • The fractional order measures the degree to which the time elapsed without vaccination influences future vaccine uptake. • Fractional order was estimated to be 0.7398 for COVID-19 vaccination in Portugal during 2021. [ABSTRACT FROM AUTHOR]

• Trust is positively associated with whether people are hesitant towards getting COVID-19 vaccine. • Trust in doctors and institutions were both important for White and Black Americans. • Trust in non-discrimination by medical providers was important for Black Americans. • Trust in social media was important for White Americans. Mass vaccination has been identified as the easiest way to combat the deadly spread of the coronavirus (COVID-19) disease, yet many Americans are still hesitant to be vaccinated. To understand motivations behind why someone is vaccine hesitant, we conceptualized a theoretical model in which demographic variables are positively associated with four types of trust (i.e., trust in institutions, physicians, non-discrimination, and social media). These trust variables, in turn, are positively associated with the outcome variable of vaccine acceptance. A multi-group structural equation modeling analysis of survey data from 1008 U.S. adults suggested that trust in institutions and physicians were important for both White and Black Americans in whether they were vaccine accepting or hesitant, while trust in non-discrimination was important for Black Americans and trust in social media was important for White Americans. Implications of the findings and how they can inform future vaccine campaigns are discussed. [ABSTRACT FROM AUTHOR]

A number of minority ethnic groups (MEGs) exhibited persistent reluctance to receive the COVID-19 vaccine. This paper attempts to empirically identify and validate some of the contentious behavioral determinants for vaccine hesitancy (VH) that remain unexplained including the role of risk perceptions, trust in government institutions, and prior experiences of racism and trauma. We draw on unique longitudinal data from a minority-boosted sample that was collected in the United Kingdon (UK). We document robust evidence of MEG disparities in VH, which declined between November 2020 and March 2021. While VH is associated to both historical and current distrust in government, risk beliefs, exposure to racism, and an individuals socio-economic background, these factors do not fully explain MEG disparities. Furthermore, similar patterns of inequality are observed when we examine MEG disparities in healthcare use, suggesting that disparities in VH reflect broader unobservable structural barriers to healthcare access. • COVID-19 vaccine hesitancy is higher among some minority ethnic groups (MEGs). • Factors like trust in government, inaccurate risk perceptions, and experiences of racism are examined. • Data was collected in the UK from a minority-boosted sample between November 2020 and March 2021. • Distrust, risk beliefs, racism, and socio-economic factors do not fully explain the disparities among MEGs. • Similar healthcare inequalities suggest that structural barriers limit access to healthcare for these groups. [ABSTRACT FROM AUTHOR]

Previous research has shown that young adults are more hesitant/resistant to COVID-19 vaccine uptake than older age groups, although the factors underlying this tendency are still under debate. The current study aimed to identify the sociodemographic and psychological correlates of vaccine hesitancy and resistance among young adults (18–40 years) during the nationwide COVID-19 vaccination campaign in Italy, the first country after China being hit by the pandemic and which suffered a large number of fatalities. This is a cross-sectional, web-based study conducted in Italy using an ISO-certified international survey company (respondi.com). Data were collected on 1200 participants in June 2021. Vaccine hesitancy/resistance was found for 25% of the sample. In multinomial logistic regression (N = 1159), being aged 30–40 years, residing in northern Italy, having lower educational and income level, being unemployed, and not knowing any friends/relatives diagnosed with COVID-19 were associated with higher odds of hesitancy or resistance. In multivariate analysis of variance (N = 1177), both vaccine hesitant and resistant young adults perceived significantly less social support from friends and family than vaccine accepting ones. Resistant individuals reported significantly higher levels of conspiracy theories and negative attitudes toward vaccines than their accepting and hesitant counterparts. Moreover, resistant individuals reported significantly lower levels of attachment to country and perceptions of a just government compared to accepting ones, with hesitant young adults scoring in between. Our findings support the idea that young adults with a hesitant (vs. resistant) attitude show a more nuanced and less extreme psychological profile. Public health messaging should capitalize on social media to provide accessible, transparent, and age-appropriate information concerning COVID-19 vaccine safety. Moreover, policy efforts improving the availability of social support systems are warranted to strengthen connectedness and foster trust in institutions amongst this particular segment of the population. [ABSTRACT FROM AUTHOR]

• College students (N = 989) from 4 universities completed a survey in spring 2021. • Three in ten participants (29%) were hesitant to receive the COVID-19 vaccine. • Explicit reasons for hesitancy were varied, including safety concerns and distrust. • Perceived descriptive and injunctive norms were related to vaccine hesitancy. • Correcting misperceived norms may increase young adults' vaccine uptake. Among US adults, the highest rates of hesitancy to receive the COVID-19 vaccine are among young adults aged 18 to 25. Vaccine hesitancy is particularly concerning among young adults in college, where social interactions on densely populated campuses can lead to substantial community spread. Given that many colleges have opted not to mandate vaccines, identification of modifiable predictors of vaccine hesitancy – such as perceived social norms – is key to informing interventions to promote vaccine uptake. To address this need, we examined predictors of and explicit reasons for vaccine hesitancy among 989 students aged 18 to 25 recruited from four geographically diverse US universities in the spring of 2021. At the time of the survey, 57.3% had been vaccinated, 13.7% intended to be vaccinated as soon as possible, and 29.0% were vaccine hesitant. Common reasons for hesitancy were wanting to see how it affected others first (75.2%), not believing it was necessary (30.0%), and other reasons (17.4%), which were examined via content analysis and revealed prominent safety concerns. Despite these varied explicit reasons, logistic regressions revealed that, when controlling for demographics and pandemic-related experiences, perceived descriptive and injunctive social norms for vaccine uptake were each significant predictors of vaccine hesitancy (ORs = 0.35 and 0.78, respectively). When both norms were entered into the same model, only perceived descriptive norms uniquely predicted vaccine hesitancy (OR = 0.37; 95% CI: 0.29 – 0.46). Findings suggest perceived social norms are strongly associated with vaccine-related behavior among young adult college students. Correcting normative misperceptions may be a promising approach to increase vaccine uptake and slow the spread of COVID-19 among young adults. [ABSTRACT FROM AUTHOR]

Due to complex social, political and economic causes, Venezuela has encountered difficulties managing the Covid-19 pandemic. Although a vaccination program has started, it is still comparatively slow and largely inefficient. One particular challenge has been vaccine hesitancy. Venezuelan policymakers have traditionally not rendered much attention to ethnic disparities. In this study, we assess whether vaccine hesitancy varies across ethnic groups, in a sample of 273 Venezuelan university students. Results come out showing that marginalized ethnic groups in Venezuela are more prone to vaccine hesitancy, and also have greater levels of acceptance regarding conspiracy theories. Coefficients of correlation of ethnic discrimination with vaccine hesitancy and conspiracy beliefs are moderate. Coefficients of correlation of paranoid ideation with vaccine hesitancy and conspiracy beliefs are weak. This suggests that in order to successfully complete the vaccination program, policymakers in Venezuela must begin to approach racial disparities. [ABSTRACT FROM AUTHOR]

Scientists and medical experts are among the professionals trusted the most. Are they also the most suitable figures to convince the general public to get vaccinated? In a pre-registered experiment, we tested whether expert endorsement increases the effectiveness of debunking messages about COVID-19 vaccines. We monitored a sample of 2,277 people in Italy through a longitudinal study along the salient phases of the vaccination campaign. Participants received a series of messages endorsed by either medical researchers (experimental group) or by generic others (control). In order to minimise demand effects, we collected participants' responses always at ten days from the last debunking message. Whereas we did not find an increase in vaccination behaviour, we found that participants in the experimental group displayed higher intention to vaccinate, as well as more positive beliefs about the protectiveness of vaccines. The more debunking messages the participants received, the greater the increase in vaccination intention in the experimental group compared to control. This suggests that multiple exposure is critical for the effectiveness of expert-endorsed debunking messages. In addition, these effects are significant regardless of participants' trust toward science. Our results suggest that scientist and medical experts are not simply a generally trustworthy category but also a well suited messenger in contrasting disinformation during vaccination campaigns. [ABSTRACT FROM AUTHOR]

Understanding correlates of COVID-19 vaccine intentions is critical for increasing vaccine uptake. Given associations of trauma exposure and posttraumatic stress disorder (PTSD) with alterations in threat sensitivity and health behaviors, we hypothesized they could influence COVID-19 vaccine acceptance and hesitancy and be important variables to consider in the design of vaccination campaigns. Data came from a longitudinal online study of 544 US adults with high levels of pre-pandemic trauma and PTSD, assessed in August/September 2020 and March/April 2021. Individuals reported socio-demographic factors, pandemic factors, lifetime trauma history and PTSD symptoms, and COVID-19 vaccinations or intentions. We estimated bivariate associations between socio-demographics, pandemic factors, and trauma and PTSD symptoms at baseline and follow-up with COVID-19 vaccine acceptance versus hesitancy (i.e., vaccinated against COVID-19 or willing to get vaccinated versus unsure or unwilling to get vaccinated) six months later. Multiple socio-demographics (e.g., race/ethnicity, income, education, political preference) and pandemic factors (e.g., perceived likelihood of infection, household COVID-19 infection) were associated with COVID-19 vaccine hesitancy (27.2% were hesitant). However, trauma history, PTSD symptoms, and other mental health factors were not associated with COVID-19 vaccine acceptance versus hesitancy. Socio-demographic and pandemic-related factors appear more important than trauma or mental health for understanding COVID-19 vaccine intentions. [ABSTRACT FROM AUTHOR]

• Nationally representative sample of parents in Ireland surveyed in March/April 2021. • 52.1% had, or were intending to have their child vaccinated against COVID-19. • 30.1% were hesitant about vaccinating their child and 17.8% were resistant. • Safety was the most prominent concern for hesitant and resistant parents. • Vaccine-resistant parents trusted less in scientist. As COVID-19 vaccination for children becomes commonplace in Ireland, it is important to understand parent's willingness to vaccinate their children and factors associated with hesitancy and resistance. Amongst a nationally representative sample of parents from Ireland, surveyed in March/April 2021, 52.1% had, or were intending to have their child vaccinated; 30.1% reported they might vaccine their child; and 17.8% reported they would not vaccinate their child. Compared to vaccine-accepting parents, hesitant parents were more likely to be younger, less educated, poorer, to not know somebody who was sick from COVID-19, to believe the COVID-19 vaccines were unsafe, and to hold negative beliefs about scientists and healthcare professionals. Vaccine-resistant parents were more likely to be younger, living alone, to distrust scientists, and to believe the COVID-19 vaccines were unsafe. Public health messaging should target younger, lower income parents with clear information about the safety of COVID-19 vaccines for children. [ABSTRACT FROM AUTHOR]

• Russia demonstrates low vaccination intentions compared to most European countries and some emerging economies. • The paper uses a nationally representative dataset for Russia (RLMS HSE-2020) to analyze the scope of COVID-19 vaccination hesitancy and resistance prior to the start of the vaccination campaign. • 43% of the Russian adult population were resistant towards vaccination, while 13% were hesitant. • Vaccination attitudes depend on age, family composition, education, type of settlement, employment, self-rated health, previous COVID-19 experience, and self-perceived risk of being infected. • Personality traits, risk attitudes, and trust, reflect the deep-rooted causes of vaccination attitudes and strongly predict vaccination intentions. Vaccination is the main tool available to handle the COVID-19 pandemic globally. Though no vaccine is proven to be 100% effective, vaccination secures against getting seriously ill and dying from the disease. Russia announced the development of its first domestic vaccine back in August 2020 and launched the nationwide immunization campaign at the beginning of 2021. Despite these achievements, as of mid-October 2021, only 36% of the population got at least one shot of the vaccine. Massive vaccination hesitancy and refusal pose a great threat to public health and postpone social and economic recovery. Using nationally representative data from the general adult population of Russia, this study explores the scope of vaccination hesitancy and refusal as well as the determinants of vaccination attitudes. The results suggest that only 45% of the Russian population demonstrated positive attitudes towards the COVID-19 vaccination prior to the launch of a nationwide vaccination program. We analyze a wide array of demographic, socio-economic, and health-related factors in relation to vaccination intentions and explore the deep-rooted causes of vaccination reluctance by looking at personality traits, religiosity, and trust. The obtained results are vital for designing policy measures to promote vaccination. [ABSTRACT FROM AUTHOR]