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• HCPs play an important role in informing pregnant women about maternal vaccinations. • Strategies to increase MPV uptake should not only focus on providing information. • Decrease experienced barriers in pregnant women that are intended to accept the MPV. In December 2019, the maternal pertussis vaccination (MPV) became part of the Dutch National Immunization Program. This study aims to study MPV behavior and associated psychosocial, attitudinal and organizational factors of pertussis vaccination behavior during pregnancy in the Netherlands. We conducted a cross-sectional survey among pregnant women and recent mothers, up to six months post-partum. The primary outcome measure of this study was MPV behavior. Associations between psychosocial, attitudinal and organizational factors and MPV behavior were assessed using univariate and multivariate binary logistic regression analysis. In total 1348 participants filled out the questionnaire, including 1282 (95.1%) MPV acceptors and 66 (4.9%) MPV refusers. The most important factors associated with MPV behavior were: attitude (aOR: 10.19; 95%CI: 4.30–24.16), outcome expectations (aOR: 8.94; 95%CI: 3.60–22.21), omission bias (aOR: 0.11; 95%CI: 0.02–0.59) and physical accessibility (aOR: 7.44; 95%CI: 3.37–16.46). Pregnant women make their decision about the MPV primarily based on attitudinal and psychosocial factors, such as outcome expectations and attitude. A combination and variation of different messages, about the advantages (effectiveness) and disadvantages (side effects) of maternal vaccination, can be used in reaching pregnant women with a positive and negative attitude about the MPV. In addition, strategies to increase MPV uptake should not only focus on providing information, but also decrease experienced practical barriers, such as poor physical accessibility, in people that are intended to receive the MPV but are not getting vaccinated. [ABSTRACT FROM AUTHOR]

• Preference by groups for COVID-19 vaccine by public is yet to be researched in Bangladesh. • Primary data were collected via an online survey (n = 2291) during countrywide lockdown (December 2020–January 2021). • Strong public preference of early vaccination was towards the frontline workers, severely sick and the elderly. • Preference rankings varied across sociodemographic factors including differences between urban and rural residents. • Effective communication on vaccine delivery are needed for any future health crisis for effective national immunization. One of the most challenging aspects of the COVID-19 pandemic is the inability to ensure equitable distribution of vaccines to fight the pandemic. Many governments around the globe had to prioritize and perform a triage in distributing the vaccines due to the limited supply as well as a lack of financial strength to acquire a sufficient number of vaccines in time. The present study assessed the public opinion in Bangladesh regarding vaccination prioritization strategy and its associated aspects. Due to the infectious nature of the viral transmission, the study used an online survey and collected a sample of 2291 respondents, distributed proportionally across sex, and income groups. Descriptive statistics and multinomial logistic regression modelling were utilized to conduct the analyses. The results emphasized unanimous preference of prioritized vaccination leaning towards the frontline workers, the severely sick and the elderly. However, the segregation across ethnicity was noted with no major preference among sexes or religion. The results reinforce the Bangladesh government's undertaken strategy of prioritization. However, the preference rankings varied across sociodemographic factors including self-assessed COVID-19 knowledge and income tiers, among others. The findings underline the necessity of improved risk communication strategies to ensure public confidence and conformity to vaccination efforts and their effective deployment across the country. [ABSTRACT FROM AUTHOR]

Coronavirus disease 2019 (COVID-19) has brought great uncertainty to our society and it may have disrupted people's ontological security. Consequently, this hospital-based study concerns the impact of ontological insecurity on vaccination behavior against COVID-19. This cross-sectional study was conducted among hospital inpatients. A questionnaire survey addressing inpatient ontological insecurity and vaccination behavior against COVID-19 was administered in Taizhou, China. A total of 1223 questionnaires were collected; specifically, 1185 of them were credible, for a validity rate of 96.9%. The score of ontological insecurity was 13.27 ± 7.84, which was higher in participants who did not recommend vaccination for others than those who did (12.95 ± 8.25 vs 14.00 ± 6.78, P = 0.022). There was no difference between the vaccinated and unvaccinated groups (13.22 ± 7.96 vs 13.35 ± 7.67, P = 0.779). Lower ontological insecurity (odds ratio [OR] = 1.40, 95% confidence interval [CI]: 1.08–1.81) and being inoculated with COVID-19 vaccines (OR = 2.17, 95% CI: 1.67–2.82) were significantly associated with recommendation of COVID-19 vaccines to others after adjusting for sex, age, education, and occupation. Associations between low ontological insecurity and recommendations for COVID-19 vaccines were observed in men, adults aged 18–59 years, non-farmers, and vaccine recipients. This study suggests that the ontological insecurity of participants affects their behavior of recommending the COVID-19 vaccination to others rather than getting vaccinated themselves. This promotion of vaccination can be considered from the perspective of improving ontological security in China. [ABSTRACT FROM AUTHOR]

Understanding human responses to epidemic outbreaks—particularly to control measures such as vaccination—is essential for accurately modeling the complex interplay between epidemics and human behavior. Through the framework of evolutionary vaccination games, we explore how individuals' opinions influence vaccine uptake attitudes under imperfect vaccination and, in turn, how this affects to the spread of an epidemic. In our model, individuals update their vaccination strategies by comparing their payoff with one of their neighbors. Individuals payoffs have two contributions regulated by the conformity parameter α. When α → 0 , the payoff is based on a classical assessment of relative vaccine-to-disease costs C r , whereas as α → 1 , individuals have their payoffs influenced by the assortativeness of peers' opinions on the vaccine. The epidemic stage is described by the susceptible-infected-recovery (SIR) model. Extensive simulations have shown that on homogeneous systems, a small region in the parameter space (α , C r) emerges where the vaccination dilemma can be totally overcome. However, it is also found that social influence tends to promote vaccine hesitancy except for small C r. Abrupt phase transitions are observed leading the system from high vaccination coverage to full vaccine hesitancy. On heterogeneous networks, the vaccination dilemma has not only been overcome to some extent, but has also demonstrated bi-stability in specific regions. Our results demonstrate the significant impact of social influence on vaccination. • The interrelationships between opinion dynamics and voluntary vaccination campaigns are considered. • Our findings indicate that the conformity parameter demonstrates optimal values in the homogenized network. • The findings demonstrate a dual stabilization phenomenon within heterogeneous networks. [ABSTRACT FROM AUTHOR]

This study draws upon the stimulus-organism-response (S–O-R) framework in examining the influence of stimulus factors (i.e., passive exposure to and active information seeking for COVID-19 vaccine information on social media) on users' internal psychological mechanisms (i.e., perceived information overload and psychological reactance) and vaccination behavior. We collected two-wave online panel data (W 1 N = 411, W 2 N = 264) in Hong Kong and tested our hypothesized model using structural equation modeling. The results showed that passive information exposure and active information seeking on social media were positively associated with both vaccination initiation (i.e., receiving the first dose) and full vaccination (i.e., completing the recommended 3-dose schedule at W2). We identified different mediation pathways from passive information exposure and active information seeking to vaccine skepticism through perceived information overload and psychological reactance. Specifically, a double-edged sword effect was found for active information seeking. Active information seeking was associated with lower vaccine skepticism both directly and indirectly through lower psychological reactance. On the other hand, active information seeking was associated with higher perceived information overload, which in turn was associated with higher psychological reactance and subsequently higher vaccine skepticism. Passive information exposure indirectly affected psychological state and vaccine skepticism through higher active information seeking. These findings contribute to the literature on the impact of social media use on vaccination behavior in the context of public health emergencies and offer practical implications for governments and social media platforms in risk communication and vaccination promotion. • Passive information exposure and active information seeking on social media were positively associated with COVID-19 vaccination behaviors. • Active information seeking was associated with lower psychological reactance but higher perceived information overload. • Active information seeking had a dual effect on vaccine skepticism mediated via perceived information overload and psychological reactance. • The effect of passive information exposure on psychological states and vaccine skepticism was fully mediated by active information seeking. • Lower vaccine skepticism led to the initiation and completion of COVID-19 vaccination. [ABSTRACT FROM AUTHOR]

Chinese elders are under high threats of seasonal influenza, while showing low influenza vaccination coverage comparing with other countries. The study explored the impacts of free vaccination policy and associated factors on influenza vaccination behavior of the elderly in Zhejiang Province, China, offering a guidance of interventions for protecting elders from seasonal influenza. 1210 elders ≥60 years were conveniently recruited between July and September of 2019. 607 of them were sampled from 6 counties with free vaccination policy, while the other 603 elderly people were sampled from another 6 comparable counties without the policy. A self-reported questionnaire, involving socio-democratic information, physical status and behavior, influenza knowledge, vaccination awareness, relatives of healthcare workers, and vaccination behavior, was completed by elders under supports of research assistants. Chi-square tests and logistic regression analyses were performed to explore the impacts of research factors. A total of 464 (38.3%, 95%CI: 36.9–39.7%) elders claimed that they got vaccinated, and the vaccination coverages of elders in the counties with and without free vaccination policy were 68.4% (95%CI: 64.7–72.1%) and 8.1% (95%CI: 5.9–10.3%), respectively. Protective and risk factors of vaccination behavior were identified, including free vaccination policy (OR step = 27.29, 95%CI: 18.69–39.82), positive vaccination awareness (OR step = 7.93, 95%CI: 5.50–11.43), catching cold frequently (OR step = 2.00, 95%CI: 1.32–3.05), and having relatives of healthcare workers (OR step = 0.56, 95%CI: 0.34–0.93). Age, education level, monthly income, family structure, physical status, and influenza knowledge were significantly associated with vaccination behavior. Having relatives of healthcare workers may indirectly affect vaccination behavior through vaccination awareness. Free vaccination policy plays the most fundamental role of improving vaccination coverage among studied factors. To protect elders from seasonal influenza, effective measurements, such as issuing free vaccination policy, enriching influenza knowledge, and guiding positive vaccination awareness for both elders and healthcare professionals are recommended to be included into influenza immunization strategies. [ABSTRACT FROM AUTHOR]

Background Influenza is a major cause of morbidity and mortality worldwide. Annual vaccination is effective in its prevention and is recommended especially in susceptible populations such as the elderly over 65 years, children younger than 5, pregnant women, and people with chronic diseases. Overall, South Korea has a high vaccination rate owing to its National Immunization Program, although the method and extent of its coverage varies among the target subgroups. The aim of this study is to assess the trend of influenza vaccination coverage between 2005 and 2014 in South Korea to address the influence of sociodemographic and disease factors on vaccination behavior. Also, we aim to compare the vaccination coverage of target subgroups and evaluate the effect of relevant policies to provide suggestions for their improvement. Methods A total of 61,036 respondents from the Korea National Health and Nutrition Examination Surveys III to VI were included. Results The total influenza vaccination coverage increased from 38.0% in 2005 to 44.1% in 2014. Vaccination coverage was higher among the elderly aged ≥65 years (range, 70.0–79.8%; p-for-trend <0.001) and children under 5 (range, 64.6–78.9%; p-for-trend < 0.001) than among pregnant women (range, 9.4–37.8%; p-for-trend = 0.122) and people with chronic diseases (range, 29.6–42.6%; p-for-trend = 0.068) from 2005 to 2014. High vaccination coverage was associated with female gender, rural residence, low education level, high income, and increasing number of chronic diseases. But the effect of high income on high vaccination coverage was absent in the elderly aged ≥65 years and children under 5. Conclusion Influenza vaccination rates have steadily increased from 2005 to 2014 in South Korea. Disparities between target groups correspond to their financial coverage under the National Immunization Program, and financial aids remove the influence of high income on higher vaccination rates. Future vaccination policies should focus on pregnant women and people with chronic diseases. [ABSTRACT FROM AUTHOR]

The first purpose of this research was to explore the relationship between goal-directed motivation and vaccination behavior. The second purpose was to find ways to motivate people to get vaccinated against COVID-19 and infectious diseases in general. According to regulatory focus theory, goal-directed behavior is regulated by two motivational systems – prevention and promotion. Prevention-focused behavior is motivated by needs for security and safety, and it is associated with a strategic preference for vigilant means of goal-pursuit. Promotion-focused behavior is motivated by needs for self-development and growth, and it is associated with a strategic preference for eagerness means. Based on regulatory focus theory, this research examined the proposal that motivation in goal-pursuit and self-regulatory processes would play a central role in shaping vaccination intention and behavior. Two studies tested the relationship between participants' self-reported intention to get vaccinated and regulatory focus. In Study 1, regulatory focus was measured as a chronic variable. In Study 2, regulatory focus was experimentally induced. Study 1 showed that chronic prevention focus moderated the relationship between vaccine safety concerns and vaccination intention. The higher the concerns about vaccine safety, the lower was the probability of expressing an intention to get vaccinated, and the stronger the prevention focus the stronger was the effect. Moreover, vaccine safety concerns mediated the relationship between chronic promotion focus and vaccination intention. The stronger the promotion focus, the lower was the concern over vaccine safety, and thus the higher was the probability of expressing an intention to get vaccinated. In Study 2, a situationally induced regulatory focus moderated the relationship between vaccination intention and vaccine safety concerns. As concerns about vaccine safety decreased, the intention to get vaccinated increased, and the effect was stronger for prevention compared with promotion focus. Implications for public health and health communication are discussed. • Prevention focus moderated the link of vaccine safety concerns to vaccine acceptance. • Vaccine safety concerns mediated the link of promotion focus to vaccine acceptance. • Induced regulatory focus moderated the link vaccine acceptance-vaccine safety concern. [ABSTRACT FROM AUTHOR]