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• Vaccine hesitant parents tend to see vaccine hesitant providers. • Provider vaccine hesitancy is associated with children's higher odds of non-timely vaccination. • Parental vaccine hesitancy is associated with children's higher odds of non-timely vaccination. • A higher the degree of parental and provider vaccine hesitancy is associated with increased odds of non-timely vaccination. Although medical providers are a trusted vaccination information source for parents, they do not universally support vaccination. Complementary medicine (CM) providers are particularly likely to hold vaccine hesitant (VH) views, and VH parents often consult with them. Little research compares VH of parents and providers, and if and how each is associated with uptake of recommended childhood vaccines. We defined non-timely receipt as recommended vaccines given > 1 month later than officially recommended, based on vaccination records. We administered versions of the Parent Attitudes about Childhood Vaccines (PACV) 5-item survey instrument to 1256 parents and their children's pediatricians (N = 112, 40 CM-oriented, 72 biomedical [not CM-oriented]) to identify moderately (PACV-score 5–6) and highly (PACV-score 7+) hesitant providers/parents. We obtained multivariable adjusted odds ratios to test relationships between parental VH and provider type/VH, and between non-timely receipt of selected childhood vaccines and parental VH and provider type/VH. No biomedical providers were VH, 9 CM providers were moderately VH, and 17 were highly VH. Parents seeing moderately and highly hesitant providers had adjusted odds ratio (AOR) for being VH = 6.6 (95% confidence interval (CI), 3.1–14.0) and AOR = 31.3 (95% CI 16.8–58.3), respectively. Across all vaccine uptake endpoints, children of moderately and highly hesitant parents had 1.9–3.8 and 7.1–12.3 higher odds of non-timely vaccination, and children seeing highly hesitant CM providers had 4.9–9.4 higher odds. Children seeing moderately hesitant CM providers had 3.3 higher odds of non-timely vaccination for the 1st dose of measles and 3.5 higher odds for 1st dose of polio/pertussis/tetanus. VH by both parents and providers each is associated with non-timely childhood vaccination. As VH parents are more likely to consult with VH providers, interventions aimed at increasing timely vaccination need to primarily target VH providers and their clients. [ABSTRACT FROM AUTHOR]

To examine predictors of state-level COVID-19 vaccination rates during the first nine months of 2021. Using publicly available data, we employ a robust, iteratively re-weighted least squares multivariable regression with state characteristics as the independent variables and vaccinations per capita as the outcome. We run this regression for each day between February 1 and September 21, the last day before vaccine booster rollout. We identify associations between vaccination rates and several state characteristics, including health expenditure, vaccine hesitancy, cost obstacles to care, Democratic voting, and elderly population share. We show that the determinants of vaccination rates have evolved: while supply-side factors were most clearly associated with early vaccination uptake, demand-side factors have become increasingly salient over time. We find that our results are generally robust to a range of alternative specifications. Both supply and demand-side factors relate to vaccination coverage and the determinants of success have changed over time. Investing in health capacity may improve early vaccine distribution and administration, while overcoming vaccine hesitancy and cost obstacles to care may be crucial for later immunisation campaign stages. [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 and COVID-19 pandemic threaten immunization coverage. • Educational videos intervention may lower vaccine hesitancy. • Videos can be used as health education tools in the community. As one of the essential programs that have been developed for decades, childhood immunizations are mandatory to protect children from vaccine-preventable diseases. Despite its availability and accessibility, immunization coverage has not reached the intended goals. Vaccine hesitancy and COVID-19 pandemic may threaten immunization coverage in children. This study aimed to evaluate the tailored educational videos to reduce vaccine hesitancy and analyze the changes in childhood routine immunization status. This was an interventional quasi-experimental study in three subdistricts of North Jakarta, Indonesia. Participants were allocated into educational videos exposures (intervention group, n = 116) or to the digital version of the maternal and child health handbook (control group, n = 104). We administered a pre- and post-intervention vaccine hesitancy survey using the Parent Attitudes about Childhood Vaccines (PACV) questionnaire with cut-off scores of 50. A total of 220 parents were recruited in this study from June 18, 2021, to December 10, 2021. The pre-intervention PACV survey showed that 19 (8.6%) parents were vaccine-hesitant from both groups: 12 (10.3%) and 7 (6.7%) of parents among intervention and control groups. After the interventions, there were 8 (6.9%) and 8 (7.7%) vaccine-hesitant parents in the intervention and control groups, respectively. We found a significant difference in the post-intervention PACV median score between the intervention and control groups (17 vs 23; p = 0.035). Around 25% of parents have not completed their children's immunization status: 22.4% and 28.8% in the intervention and control groups, respectively. There was a significant difference between the proportion of PACV hesitancy on the immunization status within intervention and control groups (p = 0.001). There was a reduction in vaccine hesitancy after interventions. Educational videos intervention distributed through WhatsApp group was associated with lower vaccine hesitancy and can be used as health education tools among Indonesian parents in the community. [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]

Experts debate whether COVID-19 vaccine mandates or financial incentives will reduce, rather than increase, interest in vaccination. Among 3,698 unvaccinated U.S. residents, we conducted a randomized, controlled survey-embedded experiment to estimate the absolute and relative psychological effects of vaccine policies specifying: mandates by employers or airlines, bars, and restaurants; lotteries for $1 million, $200,000, or $100,000; guaranteed cash for $1000, $200, or $100; and $1,000 as either a tax credit or penalty. Vaccine intention —the study outcome— predicts uptake and provides insight into the psychological mechanism that is most proximal to behavior (i.e., vaccination). Compared to controls, those who learned about the $1,000 cash reward policy were 17.1 (±5.3)% more likely to want vaccination. Employer mandates are more promising than other mandate policies (8.6 [+/- 7.4]% vs. 1.4 [+/- 6.0]%). The full results suggest that neither mandates nor financial incentives are likely to have counterproductive psychological effects. These policies are not mutually exclusive and, if implemented well, they may increase vaccine uptake. [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]

To measure the risk of influenza under-vaccination in children of vaccine-hesitant parents, referent to children of nonhesitant parents, in a sample of disadvantaged families in one influenza season. A prospective observational cohort study of English- and Spanish-speaking parents of 2-year-olds presenting at random for well, sick, or specialty visit care from August 1, 2019 to February 28, 2020. Parents answered demographic questions and the Parent Attitudes about Childhood Vaccines survey. We followed children until season's end, extracting vaccination data on April 30, 2020. We dichotomized vaccination status as unvaccinated or partially/fully vaccinated, analyzing data with multivariable Poisson regression; in secondary analyses, we conducted adjusted time-to-event analyses. Overall, 263 parents consented (response rate: 90%); our final sample included 255 dyads. Thirty-three (13%) parents were vaccine hesitant. In adjusted analyses, children of hesitant parents (n = 33) had a 195% increased risk (adjusted Risk Ratio 2.95; 95% confidence interval 1.91, 4.56) of being unvaccinated at season's end, referent to children of nonhesitant parents (n = 222). In time-to-event analyses, children of vaccine-hesitant parents were also more likely to be unvaccinated before influenza activity peaked (P =.02). Parental vaccine hesitancy tripled the risk of pediatric influenza nonvaccination in a sample of poor and minority families during the 2019 to 2020 influenza season. As parental vaccine hesitancy appears to exacerbate pediatric influenza vaccination disparities, future work should explore parental hesitancy with poor and minority stakeholders and tailor evidence-based interventions to benefit children from these communities who receive care at all practice sites. [ABSTRACT FROM AUTHOR]

To verify the reliability and validity of a vaccine hesitancy scale about knowledge, attitude, trust and vaccination environment (KATE-S) among the Chinese parents. A questionnaire survey was conducted by convenience sampling in China using the KATE-S to assess knowledge of vaccines, attitudes towards vaccines, trust in acquired information and vaccination environment and vaccination status of vaccine introduced in immunization program among children. A total of 199 valid questionnaires were collected from the parents. Among those, 83 (41.7%) parents accepted all vaccines without hesitancy, 111 (55.8%) parents accepted all but had hesitancy intention, and 5 (2.5%) had hesitancy behaviour of refusing or delaying vaccination. The overall test–retest reliability, split-half reliability and Cronbach's coefficient values were 0.924, 0.885 and 0.823, respectively. The scale-level content validity index (S-CVI) of universal agreement was 0.867, and the average S-CVI was 0.978. Exploratory factor analysis extracted seven common factors from the scale, and the cumulative contribution rate was 56.8%. The correlation coefficients between the items and their dimensions ranged from 0.405 to 0.760, with a calibration success rate of 100% for convergent and discriminant validity. After adjusting for the basic characteristics, the knowledge level of hesitancy intention group and hesitancy behavior group were both lower than accept all group (OR = 0.78, 95% CI: 0.65–0.94; OR = 0.26, 95 %CI: 0.07–0.94). The KATE-S has good reliability and validity in Chinese parents and would be considered to expand the sample size and survey areas to obtain more representative results. [ABSTRACT FROM AUTHOR]

Although pneumococcal vaccine is recommended for everyone 65 years of age and older, only 58% of Canadians in this age group have been vaccinated, well below the Public Health Agency of Canada's target of 80%. To improve uptake, a stepped-wedge cluster randomized trial testing the effectiveness of a community pharmacist intervention was developed. This prespecified sub-study aimed to uncover and quantify factors contributing to vaccine hesitancy by exploring the nature of patient-pharmacist conversations about pneumococcal vaccine. Beginning each month (April– August 2023), participating pharmacies were randomly selected to receive an education package designed to enhance pharmacists' knowledge, skills, and abilities in promoting pneumococcal vaccination. Pharmacists provided usual care (control stage) until they received the educational package and transitioned to the intervention stage. Weekly scorecards tracked patient-pharmacist conversations about pneumococcal vaccination. Chi-squared tests compared time taken for each conversation and patient-reported reason(s) for refusal between control and intervention stages. Thirteen pharmacies from across Alberta were included in the analysis, reporting 656 patient-pharmacist conversations (control stage n = 271, intervention stage n = 385). Time taken for pneumococcal vaccine conversations decreased after pharmacies received the education package (65% of conversations resulting in vaccination took <20 minutes in the control stage, compared to 88% in the intervention stage [ P = 0.004]). The most common patient-reported reason for refusal, needing more time to think about the vaccine , remained similar between stages (P = 0.23). However, during the intervention stage, fewer patients refused vaccination due to lack of time to receive it today (P = 0.016) and perceived lack of benefit (P = 0.035), but more patients refused vaccination due to cost barriers (P = 0.026). The education provided in this study changed the reasons for refusing vaccines, suggesting the nature of patient-pharmacist conversations became more efficient and informed. Similar interventions could be adopted across Canada and the United States to help combat vaccine hesitancy. [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]

Vaccine hesitancy can hinder the successful roll-out of vaccines. This paper examines COVID-19 vaccine hesitancy in the European Union, drawing from a large-scale cross-national survey covering all 27 EU Member States, carried out between February and March 2021 (n = 29,755). We study the determinants of vaccine hesitancy, focusing on the role of social media use. In multivariate regression models, we find statistically significant (p < 0.05) impacts on vaccine hesitancy of heavy use of social media and using social media as a main source of news. However, the effect of social media and the drivers of vaccine hesitancy vary depending on the reason for hesitancy. Most notably, hesitancy due to health concerns is mainly driven by physical health status and less by social media use, while views that COVID-19 risks are exaggerated (or that COVID-19 does not exist) are more common among men, people in good health, and those using social media as their main source of news. [ABSTRACT FROM AUTHOR]

• The developed model predicts vaccine acceptant individuals with 97% accuracy, and vaccine hesitant individuals with 72% accuracy. • Lack of trust in and knowledge about COVID-19 vaccines is the key predictor of vaccine hesitancy. • The belief that COVID-19 poses a significant risk to one's health, and the health of others in one's network is associated with vaccine acceptance. • Age is a strong predictor of vaccine choice, with older individuals exhibiting lower levels of vaccine hesitancy. Designing effective public health campaigns to combat COVID-19 vaccine hesitancy requires an understanding of i) who the vaccine hesitant population is, and ii) the determinants of said population's hesitancy. While researchers have identified a number of variables associated with COVID-19 vaccine hesitancy that could inform such campaigns, little is known about the cumulative or relative predictive power of these factors. In this article, we employ a machine learning model to analyze online survey data collected from 3353 respondents. The model incorporates an array of variables that have been shown to impact vaccine hesitancy, allowing us to i) test how well we can predict vaccine hesitancy, and ii) compare the relative predictive impact of each covariate. The model allows us to correctly classify individuals that are vaccine acceptant with 97% accuracy, and those that are vaccine hesitant with 72% accuracy. Trust in and knowledge about vaccines is, by far, the strongest predictor of vaccination choice. While our results demonstrate that public health campaigns designed to increase vaccination rates must find a way to increase public trust in COVID-19 vaccines, our results cannot speak to the malleability of such beliefs, nor how to enhance trust. [ABSTRACT FROM AUTHOR]

Female secondary school students are the primary recommended population for human papillomavirus (HPV) vaccines. However, vaccine hesitancy may affect uptake. In this study, we assessed the vaccine hesitancy levels among the guardians of female secondary school students in China. We developed a questionnaire and conducted cross-sectional surveys among guardians of secondary school girls aged 12–19 years in mainland China based on the Increasing Vaccination Model and the Precaution Adoption Process Model. We collected 3,225 valid samples. Among the participating guardians, 53.9% were vaccine hesitant, although only 0.9% had refused HPV vaccines. Some individual characteristics of guardians (e.g. sex, education/income level) were associated with understanding HPV vaccines. Better knowledge of HPV vaccines and communication with reliable sources of information were associated with vaccine nonhesitancy. Practical barriers such as vaccine shortage and busy schedules prevented nonhesitant guardians from vaccinating their children. A substantial proportion of the guardians surveyed were HPV vaccine hesitant. Promoting HPV knowledge and communication with reliable sources (e.g. clinical doctors) could help fight against vaccine hesitancy. [ABSTRACT FROM AUTHOR]

Vaccine hesitancy in parents and childhood vaccine refusal is increasing. A standard of care to address this problem has not been identified. To identify if the use of motivational interviewing by pediatric providers during routine well child visits, when compared to standard of care, would increase vaccine rates in children 0–12 months of age. Factors associated with vaccine hesitancy were also investigated. A quasi-experimental study was completed on a convenience sample of pediatric providers (N = 6) and caregivers of children 0–12 months of age (N = 66). Four providers were trained to use motivational interviewing. During the well child visit the Parent Attitudes About Childhood Vaccines survey was completed, and the motivational interviewing intervention was implemented. Clinic's data were compared with other clinic data of non-trained providers. Vaccine refusal/delays rate was 11.4% among caregivers. Vaccine refusal rate decreased after the intervention (9.00% pre-intervention and 6.40% post-intervention). An ordinal regression identified caregivers with higher vaccine hesitancy scores and more children were more likely to delay or refuse vaccines, while caregivers ≥30 years or with high income were less likely to delay/refuse vaccines. A difference in difference analysis identified that an additional 2.6% of children received vaccines when seen by trained providers compared to non-trained (β = −0.330, OR = 0.719, p = 0.470). Findings indicate a condensed motivational interviewing education session may be clinically significant in decreasing vaccine hesitancy among this population. A more robust study to confirm these findings is recommended prior to practice implementation. • A motivational interviewing education session may decrease vaccine hesitancy in parents of children 0-12 months of age. • Providers identified motivational interviewing as a feasible tool to use during a well child visit. • Regular screening for vaccine hesitancy can be helpful in identifying and addressing concerns of caregivers. • The COVID-19 pandemic negatively impacted the number of well child visits seen. [ABSTRACT FROM AUTHOR]

• Vaccination willingness is high, even for a sooner-than-expected vaccine. • Perceived inefficacy and vaccine risk are higher for a sooner-than-expected vaccine. • Vaccine conspiracy beliefs are the strongest predictor of vaccine hesitancy. • Media dependency is related to perceived vaccine efficacy and vaccination willingness. In the race to deploy vaccines to prevent COVID-19, there is a need to understand factors influencing vaccine hesitancy. Secondary risk theory is a useful framework to explain this, accounting for concerns about vaccine efficacy and safety. During the first week of July, 2020, participants (N = 216) evaluated one of three different hypothetical vaccine scenarios describing an FDA-approved vaccine becoming available "next week," "in one year," or "in two years." Dependent variables were perceived vaccine efficacy, self-efficacy, perceived vaccine risk, and vaccination willingness. Covariates included vaccine conspiracy beliefs, science pessimism, media dependency, and perceived COVID-19 risk. Data analysis employed multiple analysis of covariance (MANCOVA). Perceived vaccine efficacy was lowest for the next-week vaccine (η2 p =.045). Self-efficacy was higher for the two-year vaccine than the next-week vaccine (η2 p =.029). Perceived vaccine risk was higher for the next-week vaccine than for the one-year vaccine (η2 p =.032). Vaccination willingness did not differ among experimental treatments. In addition, vaccine conspiracy beliefs were negatively related to perceived vaccine efficacy (η2 p =.142), self-efficacy (η2 p =.031), and vaccination willingness (η2 p =.143) and positively related to perceived vaccine risk (η2 p =.216). The rapid development of the COVID-19 vaccine may have heightened public concerns over efficacy, availability, and safety. However, the current findings showed a general willingness to take even the most rapidly developed vaccine. Nonetheless, there remains a need to communicate publicly and transparently about vaccine efficacy and safety and work to reduce vaccine conspiracy beliefs. [ABSTRACT FROM AUTHOR]

• Acceptance of a COVID-19 vaccine in patients with immune-mediated diseases was high. • COVID-19 vaccine acceptance may be hampered by some comorbidities and treatments. • The short duration of trials was the main concern behind COVID-19 vaccine hesitancy. To identify potential predictors of COVID-19 vaccine hesitancy (C19-VH) in adults with immune-mediated inflammatory diseases (IMID). A total of 1000 IMID patients were enrolled in this web-based cross-sectional study. A standardised and self-administered survey was designed by members of the Brazilian Society of Rheumatology Steering Committee for Infectious and Endemic diseases and distributed to IMID patients spread across Brazil. Of the 908 (90.8%) respondents eligible for analysis, 744 (81.9%) were willing to get vaccinated against COVID-19. In our multivariable logistic regression model, concurrent malignancy, fibromyalgia, hydroxychloroquine use, and recent corticosteroid pulse therapy were independently associated with higher odds of C19-VH. The short duration of COVID-19 vaccine clinical trials was the main reason for C19-VH. We identified novel characteristics potentially associated with C19-VH among adults with IMID. Greater awareness on the safety and efficacy of COVID-19 vaccines is needed for both IMID patients and attending physicians. [ABSTRACT FROM AUTHOR]

The aim of this study was to explore the relationship between parental vaccine hesitancy and vaccine coverage for all recommended vaccines for children under five years residing in Statistical Areas Level 3 (SA3). SA3 groupings represent clustering groups of smaller areas, such as regional towns and cities or clusters of related suburbs, which share similar regional characteristics, administrative boundaries or labour markets, and generally have populations between 30,000 and 130,000 persons. We used parental vaccine hesitancy data from the VBAT (Vaccine Barrier Assessment Tool) study and vaccine coverage by postcode data from the Australian Immunisation Coverage Report 2020/21. Binary logistic regression analysis explored the association. There were complete data for 1110 participants. We found lower vaccine concerns in parents residing in medium coverage (adjusted odds ratio (aOR) 0.36, 95 % confidence interval (CI): 0.22 to 0.59) and high coverage (aOR 0.37, 95 % CI: 0.22 to 0.60) SA3 areas compared to low coverage geographical areas. Developing effective policies to vaccinate children under five in low coverage areas will help reduce vaccine inequity in Australia. Future strategies to improve vaccine coverage should consider ways to address both access and acceptance barriers. • Vaccine hesitancy in parents affects uptake of childhood vaccinations. • First Australian study exploring correlation between vaccine coverage and parental vaccine hesitancy. • Vaccine concerns doubled in low-coverage areas compared to medium/ high-coverage areas. • Vaccinating children under 5 in low-coverage areas can help reduce vaccine inequity. • Exploring behavioural and social drivers in low-coverage areas can help improve vaccine coverage. [ABSTRACT FROM AUTHOR]

Revaccination to restore immunity to vaccine-preventable diseases (VPDs) is essential risk mitigation in the prevention of infectious morbidity and mortality after hematopoietic cell transplantation (HCT). However, revaccination rates have been shown to be insufficient and to what extent vaccine hesitancy contributes to survivors not becoming fully revaccinated is unknown. We performed a cross-sectional, mixed methods survey-based study to explore how vaccine hesitancy influences revaccination among US adult HCT survivors who were 2 to 8 years after transplant. Participants were asked to complete the Vaccination Confidence Scale (VCS) and open-ended survey items regarding vaccine confidence. The survey response rate was 30 %; among 332 respondents, vaccine confidence was high in 69 %, medium in 20 %, and low in 11 %. On multivariable analysis, four factors associated with high vaccine confidence were: predominantly Democrat zip codes (per 2020 election results), ability to pay for revaccination out of pocket, receipt of pre-HCT adult vaccines, and receipt of COVID-19 vaccines. From 189 participants who also answered open-ended items, 14 themes associated with vaccine confidence were identified and collapsed into 4 categories based on the VCS: Benefits, Harms, Trust, and Other. Merged analysis showed congruence between VCS scores and open-ended survey responses and created a narrative about the relative importance of the constructs when approaching revaccination by vaccine confidence level. These findings significantly expand our knowledge of how vaccine hesitancy influences revaccination uptake among US adult HCT survivors. Population-specific interventions to approach vaccine-hesitant survivors should be developed and tested. [ABSTRACT FROM AUTHOR]

Background: Information about Cameroonians' views toward coronavirus disease 2019 (COVID-19) and amenability to receiving a vaccine is emerging. Learning more about Cameroonians' vaccine perspectives could guide prevention messaging and facilitate optimal communication modalities.Objectives: The primary objective of this study was to analyze the willingness to receive a COVID-19 vaccine among Cameroonians, pending availability. The secondary objectives were to assess perceptions of COVID-19's origin and to gauge views toward government-mandated vaccinations.Methods: An 11-item questionnaire queried Cameroonians in-person and online, from March through May 2021, about their demographics and whether they believed that COVID-19 was man-made, whether COVID-19 vaccinations should be governmentally mandated, and whether they would receive a COVID-19 vaccine, if available. A free-text option inviting rationales for COVID-19 vaccine hesitancy was included. In-person participation took place on the grounds of St. Louis University in Douala, Cameroon, and was restricted to participants lacking Internet access or electronic mobile devices. Online participation included use of an electronic link that contained questionnaire content located within Google Forms.Results: A total of 591 respondents participated by replying to at least 8 items on the questionnaire, 386 online and 205 in-person. Over 80% stated that they previously received a seasonal influenza vaccine. Roughly, 87% reported unwillingness to receive a COVID-19 vaccine, if available. Approximately 95% of respondents disagreed with governmental mandates on COVID-19 vaccinations. About 75% attributed COVID-19 to man-made as opposed to natural beginnings. Seven respondents' free-text comments cited lacking confidence in a COVID-19 vaccine, discriminatory COVID-19 vaccine distribution patterns in other parts of the world relative to Africa, and improper COVID-19 vaccine approval timeline.Conclusion: Raising awareness of COVID-19 misconceptions and barriers to vaccine acceptance is integral to accomplishing immunization goals. Cameroonians' pessimism in this study toward COVID-19 vaccination was multifaceted. Our findings signal a need for additional research that requests more qualitative insights, for example, interviews, focus groups, into vaccine aversion. [ABSTRACT FROM AUTHOR]

• Roughly 67% of the sample reported having received a COVID-19 vaccine. • Christian nationalism is negatively associated with COVID-19 vaccine confidence. • Christian nationalism is negatively related to the odds of COVID-19 vaccine uptake. Understanding COVID-19 vaccine hesitancy and uptake is vital for informing public health interventions. Prior U.S. research has found that religious conservatism is positively associated with anti-vaccine attitudes. One of the strongest predictors of anti-vaccine attitudes in the U.S. is Christian nationalism—a U.S. cultural ideology that wants civic life to be permeated by their particular form of nationalist Christianity. However, there are no studies examining the relationship between Christian nationalism and COVID-19 vaccine hesitancy and uptake. Using a new nationally representative sample of U.S. adults, we find that Christian nationalism is one of the strongest predictors of COVID-19 vaccine hesitancy and is negatively associated with having received or planning to receive a COVID-19 vaccine. Since Christian nationalists make up approximately 20 percent of the population, these findings could have important implications for achieving herd immunity. [ABSTRACT FROM AUTHOR]

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

The COVID-19 pandemic has affected the entire world, and the vaccine has emerged as a source of hope for return to normal life. Still, various countries have reported high vaccine hesitancy rates. It is important to know the vaccine hesitancy profile in Brazil to help design adequate communication strategies. A voluntary, anonymous online survey was conducted from January 22 to 29, 2021, including resident Brazilian adults to assess factors related to vaccine hesitancy. Sociodemographic and epidemiological data were analyzed. A bivariate analysis was conducted with the independent variables, with vaccine hesitancy as the outcome variable, and a multivariate logistic model was used to calculated adjusted odds ratios. The sample included 173,178 respondents, and vaccine hesitancy was found in 10.5%. The principal factors associated with vaccine hesitancy were the following: assigning importance to the vaccinés efficacy (AOR = 16.39), fear of adverse reactions (AOR = 11.23), and assigning importance to the vaccinés country of origin (AOR = 3.72). Other risk factors were the following: male gender (AOR = 1.62), having children (AOR = 1.29), 9 years of schooling or less (AOR = 1.31), living in the Central-West region (AOR = 1.19), age ≥ 40 years (AOR = 1.17), and monthly income < U$788.68 (AOR = 1.13). The two vaccines available in Brazil, Covishield and CoronaVac, showed similar confidence, 80.13% and 76.36%, respectively, despite the higher rejection of the latter vaccinés Chinese origin. This online survey confirms the low vaccine hesitancy rate among Brazilians and allowed the identification of a profile that can assist the elaboration of communication strategies to increase vaccine adherence. National Institute of Women, Children and Adolescents Health Fernandes Figueira, FIOCRUZ, Rio de Janeiro, Brazil. [ABSTRACT FROM AUTHOR]

• This study provides insight into drivers of vaccine hesitancy in the study setting. • Such drivers includes religion and internet-sourced misinformation. • Insightful and informative discussions further expatiated the identified drivers. • The study provides evidence of vaccine hesitancy in Cape Town. Vaccination coverage remains suboptimal in many parts of the world, especially in low-and middle-income countries (LMICs), including South Africa. Vaccine hesitancy, a recognized factor contributing to low vaccination uptake in many parts of the world, is suspect in the suboptimal vaccination coverage level in South Africa, particularly in the Western Cape Province. We aimed to investigate vaccine hesitancy and to describe point-of-care vaccinators' perceptions of the drivers of vaccine hesitancy in the Cape Metropolitan District, South Africa (Cape Metro). We conducted in-depth interviews with 19 point-of-care vaccinators in 16 purposively selected healthcare facilities in the Cape Metro between September and November 2019. Participants were sampled purposively as 'rich cases' who had been delivering vaccination services for at least five years post-qualification. We organized the data thematically in ATLAS.ti and report findings thematically by the types of reasons participants reported for vaccine hesitancy amongst clients. Of the 19 interviewees, 11 (59%) reported having encountered vaccine-hesitant clients at some point in their careers. Reasons reported for vaccine hesitancy by clients included: (a) religion, (b) internet misinformation, (c) concern over causing the child pain, (d) natural immunity development, and (e) concern about possible adverse effect following immunization. Vaccine hesitancy in the Cape Metro cuts across all socio-economic classes. Also, some communities perceived to be vaccine-hesitant were mentioned by the participants in this study. Attitude towards vaccination are generally positive in the Cape Metro. However, vaccine hesitancy is present. The issues of vaccine hesitancy at the reported levels can still be mitigated by continuous health education in the clinics and communities, as well as stakeholder engagement as suggested by the point-of-care vaccinators in the Cape Metro. [ABSTRACT FROM AUTHOR]

This article applies a qualitative approach to the 2017 dengue vaccine controversy involving Sanofi Pasteur's Dengvaxia to understand vaccine hesitancy and related anxieties in contemporary Philippines. Through a multisited project that investigated the health aspirations and lived experiences of low- and middle-income Filipinos across urban and rural Philippines, this article distills the perspectives of both ordinary community members and health workers in local and national capacities regarding the controversy—and how it altered their perceptions toward vaccines, health care, and government. Our study reveals widespread mistrust and fear in the communities toward both the state and health institutions following the controversy, with frontline health workers bearing the brunt of the communities' apprehensions, and the media partly responsible in fomenting these fears. Given the repetitive nature of health and vaccine controversies, this article suggests the importance of responsible journalism, well-calibrated crisis communications, and a people-centered health paradigm that involves exploring local contexts of vaccine hesitancy and mining people's lived experiences in tackling present and future health crises—especially now in the advent of COVID-19 vaccinations. [ABSTRACT FROM AUTHOR]

• The present study is the first to examine hesitancy toward accepting a malaria vaccine by caregivers within the community. • Close to one-third of the caregivers in this survey were hesitant to accept a malaria vaccine for their under-five children. • Receiving information about the malaria vaccine initially from healthcare workers was associated with lower odds of hesitancy. • Having a high monthly income (> NGN100, 000), and having a family size >10 was associated with higher odds of hesitancy. • Major reasons for hesitancy included fear of vaccine adverse effects and availability of other malaria preventive measures. Malaria contributes to an enormous global burden of disease and mortality, especially in children. Approximately one in every four global cases and deaths from malaria occurs in Nigeria. This study aims to evaluate the prevalence and correlates of community hesitancy to the malaria vaccine, including the reasons for the hesitancy, following the approval of the RTS,S malaria vaccine by the World Health Organization (WHO). This was a nationwide cross-sectional online survey of Nigerian adults conducted from 20th October to 30th November 2021. Participants who replied 'no' or 'maybe' to a question assessing their willingness to accept the RTS,S malaria vaccine were considered "hesitant". We fit a multivariate logistic regression model to report the adjusted odds ratio (aOR) and 95 % confidence interval (CI) for the factors associated with vaccine hesitancy. Among 3377 total respondents (1961 [57.86 %] males; mean age [SD]: 30[9.1]), 1010 (29.91 %) were hesitant. Receiving information about the RTS,S malaria vaccine initially from healthcare workers (vs. the internet) (aOR:0.55; 95 % CI:0.35–0.87) was significantly associated with lower odds of hesitancy. Conversely, earning a high income of over NGN100, 000 (vs. < NGN 30,000) per month (aOR: 2.10, 95 % CI: 1.36–3.24), belonging to other religious groups (vs. Islam) (aOR:3.25, 95 % CI:1.18–8.98), and having a family size of more than ten (vs. < 5) (aOR:1.84; 95 % CI:1.08–3.13) were significantly associated with a higher odds of hesitancy. The main reasons for vaccine hesitancy included fear of vaccine adverse effects (34.95 %), availability of other malaria preventive measures (33.96 %) and not seeing the positive effect of the vaccine in others first (32.97 %). The findings of this survey provide a valuable blueprint for the development of targeted interventions to facilitate caregiver acceptance of the RTS,S vaccine. [ABSTRACT FROM AUTHOR]

There is widespread hesitancy towards COVID-19 vaccines in the United States, United Kingdom, and Australia. To identify predictors of willingness to vaccinate against COVID-19 in five cities with varying COVID-19 incidence in the US, UK, and Australia. Online, cross-sectional survey of adults from Dynata's research panel in July-September 2020. Adults aged 18 and over in Sydney, Melbourne, London, New York City, or Phoenix. Willingness to receive a COVID-19 vaccine; reason for vaccine intention. To identify predictors of intention to receive a COVID-19 vaccine, we used Poisson regression with robust error estimation to produce prevalence ratios. The proportion willing to receive a COVID-19 vaccine was 70% in London, 71% NYC, 72% in Sydney, 76% in Phoenix, and 78% in Melbourne. Age was the only sociodemographic characteristic that predicted willingness to receive a COVID-19 vaccine in all five cities. In Sydney and Melbourne, participants with high confidence in their current government had greater willingness to receive the vaccine (PR = 1.24; 95% CI = 1.07–1.44 and PR = 1.38; 95% CI = 1.74–1.62), while participants with high confidence in their current government in NYC and Phoenix were less likely to be willing to receive the vaccine (PR = 0.78; 95% CI = 0.72–0.85 and PR = 0.85; 95% CI = 0.76–0.96). Consumer panels can be subject to bias and may not be representative of the general population. Success for COVID-19 vaccination programs requires high levels of vaccine acceptance. Our data suggests more than 25% of adults may not be willing to receive a COVID-19 vaccine, but many of them were not explicitly anti-vaccination and thus may become more willing to vaccinate over time. Among the three countries surveyed, there appears to be cultural differences, political influences, and differing experiences with COVID-19 that may affect willingness to receive a COVID-19 vaccine. [ABSTRACT FROM AUTHOR]

Vaccine hesitancy is a growing complex and multifaceted phenomenon. It encompasses a wide spectrum of context-dependent attitudes and beliefs. Multiple factors influence parental decision-making including knowledge, sources of information, risk perception, trust, and individual experiences among others. This review focuses on describing the most common reasons that contribute to vaccine hesitancy among parents. Social media and the Internet have been described as major elements that can negatively influence parental decision-making regarding vaccines. The next focus is describing effective interventions that clinical providers can apply. Nonconfrontational and open discussions along with trusting and strong relationships between parents and providers seem to create a solid foundation toward vaccine acceptance. In addition, motivational interviewing is a helpful tool that has proven to be effective during these discussions. Ultimately, an individualized approach tailored to a specific community will likely be most effective in addressing vaccine hesitancy. [ABSTRACT FROM AUTHOR]

Vaccine hesitancy is an urgent public health threat. While tools have been developed to monitor vaccine hesitancy among parents and the general adult population, no such tool exists for adolescents. We modified an existing adult Vaccine Hesitancy Scale to create a teen COVID-19 Vaccine Hesitancy Scale (tVHS-COVID) for adolescents and their parents. To validate our scale, we conducted a nationally representative survey of 764 parent-teen dyads. We performed exploratory factor analysis (EFA) to determine the factor structure followed by confirmatory factor analysis (CFA) to test the factor structure validity using two random subsets. We evaluated internal consistency by Cronbach alpha values and construct validity by comparing tVHS-COVID scores to intention to receive future COVID-19 doses. EFA suggested a three-factor structure with 13-items. CFA indicated good fit for adolescents (CFI = 1.00; RMSEA = 0.023; SRMR = 0.062; NNFI-TLI = 0.998) and for parents (CFI = 1.00, RMSEA = 0.031; SRMR = 0.028; NNFI-TLI = 1.00). Internal consistency exceeded 0.79 for adolescents and 0.78 for parents. As tVHS-COVID scores increased, the percent of adolescent and parent respondents who reported they were willing to receive a COVID-19 vaccine decreased. The tVHS-COVID offers a unique tool that can be used to monitor COVID-19 vaccine hesitancy among adolescents and their parents. As adolescents take on more proactive roles in medical decision-making, monitoring vaccine hesitancy among this population becomes increasingly important. [ABSTRACT FROM AUTHOR]

In 2018, Europe experienced a surge in measles cases, revealing the consequences of suboptimal immunization coverage. This trend was exacerbated by long-standing vaccine hesitancy. Parental attitudes toward childhood vaccines have increasingly shifted, influenced by ethical, religious, and safety concerns. Vaccines hesitancy has substantially increased after the Covid-19 pandemic. Using PubMed, we reviewed cross-sectional studies, published during years 2023–2024, related to parents' vaccine hesitancy, with the aim to provide an overview of its prevalence, underlying reasons and consequences for public health. Data summarised highlight various factors contributing to vaccine hesitancy. These include socio-demographic factors, the impact of the Covid-19 pandemic, and widespread misinformation, particularly through social media. Several cross-sectional studies show that vaccine hesitancy is often linked to lower education levels, misinformation, and decreased trust in healthcare systems. The pandemic exacerbated this issue. This article underscores the need for targeted communication strategies to address vaccine hesitancy, focusing on specific populations, such as those in low-income settings or with limited access to healthcare information. It emphasizes the importance of countering misinformation to improve vaccination rates and public health outcomes. [ABSTRACT FROM AUTHOR]

On April 13, 2021, U.S. authorities announced an investigation into potential adverse events associated with the Johnson & Johnson (Janssen, J&J) COVID-19 vaccine and recommended "a pause in the use of this vaccine out of an abundance of caution." We examined whether public attitudes toward COVID-19 vaccination shifted after this recommended suspension using an interrupted time series with data from the Census Bureau's Household Pulse Survey, which was fielded bi-weekly between January 6 and April 26, 2021. We found no significant changes in trends of the proportion of the U.S. adult population hesitant about getting a COVID-19 vaccine, but a significant increase in concerns about safety and efficacy of COVID-19 vaccines among the already hesitant population. [ABSTRACT FROM AUTHOR]

Parental vaccine hesitancy (VH) is a major barrier to childhood vaccination. We aimed to identify the determinants of parental VH towards routine childhood immunization in 12 Sub-Saharan African countries. A cross-sectional study was conducted from November 1 to December 15, 2022. Parents of children aged 19 months to 6 years and residing in the Sub-Saharan Africa were included. An anonymous online survey and face-to-face interviews were conducted. The Parent Attitude about Childhood Vaccine Scale was used to identify vaccine-hesitant parents. Multivariate regression and mediating analysis were performed. Across the 5032 participants, 21.2% were hesitant towards routine childhood immunization. Urban residents (adjusted odds ratio [AOR] = 1.32, 95% confidence interval [CI]: 1.10–1.58), non-first-born children (AOR = 1.54, 95% CI: 1.19–1.98), and chronically ill children (AOR = 2.00, 95% CI: 1.69–2.37) increased the likelihood of parental VH. Mothers with higher education, attending at least one antenatal care (ANC) visit (AOR = 0.25, 95% CI: 0.19–0.32), and had a healthcare facility–based delivery (AOR = 0.55, 95% CI: 0.44–0.70) decreased the odds of parental VH. Parental VH mediated the effect of ANC and mothers' age on vaccination uptake. ANC increased the odds of vaccination uptake (odds ratio [OR] = 12.49, 95% CI: 9.68–16.13). Parental VH mediated the association between ANC and vaccination uptake, decreasing the likelihood of vaccination uptake (OR = 0.12, 95% CI: 0.10–0.14). Each additional year of the mother's age decreased the odds of vaccination uptake (OR = 0.95, 95% CI: 0.95–0.96). The indirect effect of mother's age on vaccination through parental VH decreased the odds of vaccination uptake (OR = 0.45, 95% CI: 0.44–0.45). Parental VH continued to be a mediator of the combined effect of mother's age and ANC on vaccination uptake, decreasing the likelihood of vaccination uptake (OR = 0.0017, 95% CI: 0.00166–0.00168). Context-specific interventions are needed to address parental VH and improve vaccine acceptance and coverage. [ABSTRACT FROM AUTHOR]

A health care provider's vaccination recommendation is one of the most important factors influencing parents' decisions about whether to vaccinate their children. Unfortunately, vaccine hesitancy is associated with mistrust of health care providers and the medical system. We conducted a survey of 2440 adults through the RAND American Life Panel in 2019. Respondents were asked to rate their trust in pediatricians, OB/GYNs, doulas, midwives, lactation consultants, friends and family for information about childhood vaccines. Respondents were also asked about willingness to vaccinate a hypothetical child as a measure of vaccine hesitancy. We used principal component analysis to characterize variance in responses on trust items and logistic regression to model the relationship between trust and vaccine hesitancy. Vaccine hesitancy was associated with: (1) lower overall trust; (2) reduced trust in OB/GYNs and pediatricians and greater trust in doulas, midwives, and lactation consultants; and (3) greater trust in friends and family. [ABSTRACT FROM AUTHOR]