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Hesitancy toward COVID-19 vaccines was not particularly high in Romania at the beginning of the vaccination campaign. Nevertheless, the country became one of the laggards in the European Union in terms of vaccination rates. We provide an empirical explanation for this phenomenon based on a representative survey conducted in November–December 2021. We test the influence of various factors on vaccine hesitancy, such as personal experiences with the disease, trust in relevant institutions, general worldviews, and contact with certain institutions, such as the Romanian Orthodox Church, and general practitioners. Furthermore, we find that three COVID-specific cognitive factors played a crucial role, namely the evaluation of anti-COVID state measures, belief in COVID-related conspiracy theories, and, especially, fears of negative effects of COVID-19 vaccines. The high explanatory power of these three factors also shows that low vaccination rates were not inevitable consequences of some "inherent" attitudinal characteristics widespread in Romanian society; on the contrary, vaccine hesitancy has developed as an unfortunate side effect of weak crisis management, as the government and relevant state institutions failed to properly utilize key organizational resources, such as the national network of general practitioners, and they proved unable to dissipate fears and countervail the spread of conspiracy theories, while emergency measures did not resonate enough among the Romanian public. [ABSTRACT FROM AUTHOR]

This study identified the significant COVID-19 vaccine hesitancy and intention to uptake motives and sociodemographic predictors among vaccinated Malaysian adults. A cross-sectional study using a self-administered online questionnaire adapted from the COVID-19 Vaccine Hesitancy Scale and extended based on previous studies was used to solicit data from 698 Malaysians. A theoretical framework comprising Trust, Vaccine Concerns, Unreliable Entities, Uptake Influencers, Brand Influencers, and Brand_Side-effect was used as a guide to assess intention to receive COVID-19 vaccines in the future. Hierarchical linear regressions revealed Trust, Vaccine Concerns, Brand_Side-effect and Uptake Influencers to significantly predict intention to receive vaccines in the future when controlled for sociodemographic correlates. Ethnicity and technology literacy were found to have significant impacts on future vaccine uptake. Age significantly correlated with intention to be vaccinated as well. Underlying motives and sociodemographic correlates were identified for COVID-19 vaccine hesitancy and uptake. Plain Language Summary: COVID-19 Vaccine hesitancy and uptake This study investigated COVID-19 vaccine hesitancy and intention to uptake among 698 vaccinated Malaysian adults, using a self-administered online questionnaire based on the COVID-19 Vaccine Hesitancy Scale and a theoretical framework encompassing Trust, Vaccine Concerns, Unreliable Entities, Uptake Influencers, Brand Influencers, and Brand_Side-effect. The analysis, conducted through hierarchical linear regressions, revealed significant predictors for future vaccine intention, including Trust, Vaccine Concerns, brand side effects, and Uptake Influencers, after controlling for sociodemographic factors. Ethnicity, technology literacy, and age were identified as significant influencers on future vaccine uptake. This study provides insights into the underlying motives and sociodemographic correlates of COVID-19 vaccine hesitancy and uptake among Malaysians. [ABSTRACT FROM AUTHOR]

Popular press and academic articles alike suggest that political orientation is a primary determinant of vaccination willingness, vaccination, and vaccine word-of-mouth (i.e., sharing of information regarding vaccines). In the current article, we test the validity of these suggestions, and we also assess the differential roles of political ideology (e.g., liberal-conservative) and party affiliation (e.g., Democrat-Republican) as well as the mediating effect of vaccine hesitancy's dimensions. To do so, we perform a four-wave survey study with 223 participants that completed all waves. Our results support that political orientation indeed relates to our outcomes of interest. Our results also show that political ideology has a more pronounced effect than party affiliation, and the vaccine hesitancy dimensions of Health Risks and Healthy mediate many of these relations. From these results, we suggest many directions for future research and practice, including the integration of political discourse theories in studies on political orientations and vaccination. [ABSTRACT FROM AUTHOR]

The vaccination drive for the COVID-19 pandemic was initiated globally more than a year ago, with booster shots being the new addition currently. There are some setbacks regarding the acceptance of the vaccine that the government needs to tackle to achieve a fully vaccinated ecosystem. Vaccine hesitancy is not a new concept and has been witnessed by people for decades. In simple terms, vaccine hesitancy refers to a situation where people are reluctant to get vaccinated despite its availability. This is due to technological retrogression, superstitions, doubt towards the government and misinformation. This paper is a systematic literature review to analyse the behavioural economics theories shown by people towards vaccines in the SARS-CoV-2 pandemic. We aim to connect psychological and economic factors that lead to this hesitancy through behavioural economics. Availability bias, omission bias, confirmation bias, incentives, anticipated regret, illusory correlation, recency effect, tailoring and framing are the biases that influence decision-making under the behavioural economics framework. This paper is an attempt to analyse these principles and explain potential barriers to vaccine acceptance and intervention strategies for medical professionals and the state. JEL Classifications : D03, D70, I18 [ABSTRACT FROM AUTHOR]

Coronavirus disease 2019 exacerbated health inequities in Bronx Communities. This study explored vaccine hesitancy among a random sample of faculty and students from Hebert Lehman College. Findings suggest faculty are largely vaccinated (87%), while 59% of students are unvaccinated. Significant gaps in information were found related to safety and complications. This suggests universities need to adopt an educational model with a multipronged social support strategy to gain students' trust and a greater sense of belonging. [ABSTRACT FROM AUTHOR]

The prevalence of vaccine hesitancy underscores the fact that the general public does not uniformly embrace scientific recommendations. Vaccine hesitancy represents a spectrum, encompassing both those who accept all vaccines and those who outright reject them. This paper aims to explore the relationship between science literacy, contextual factors, and vaccine hesitancy while accounting for specific mediation mechanisms. The authors applied a theoretical framework derived from the deficit model and the contextual model of public understanding of science. Hypotheses regarding the relationship between scientific literacy, religiosity, political identification, and vaccine hesitancy were tested. The authors also tested several hypotheses based on the assumption that the perception of scientific credibility and institutional trust are significant mediators of the above-mentioned relationships. The data from an online survey with a nationally representative quota sample of the Croatian population (with an average age of 42.6 years.) were used (N = 1,500), while the data were analyzed using structural equation modeling. The results indicated that the perception of scientific credibility plays a significant role as a mechanism that translates the impacts of literacy, religiosity, and political identification. Institutional trust proved to be a significant mediator but in a way opposite to the hypotheses, which points to the need to contextualize the aforementioned relationships. The authors also determined that younger age, right-wing political orientation, higher religiosity, and lower scientific literacy were the determinants of hesitancy in both vaccine types (COVID-19 and vaccines in general), thus indicating that they might be connected to deeply rooted value dispositions. Plain Language Summary: Vaccine hesitancy and trust in science The paper deals with the issue of vaccine hesitancy and tries to determine the characteristics of people with a more skeptical attitude towards vaccination. The results of online research conducted among the general Croatian population showed that younger people, more religious people, and people with a right-wing political orientation have a more negative attitude towards vaccination and that this can mostly be explained by their lower trust in science and scientists. [ABSTRACT FROM AUTHOR]

U.S. print news coverage of Covid vaccine hesitancy represents a departure from previous depictions of vaccine skepticism as a problem of wrong belief. This article reports on a mixed methods study of 334 New York Times texts about Covid nonvaccination and vaccine hesitancy published between December 2020–December 2021. Texts were analyzed for common themes and compared with prior media depictions of vaccine skepticism. Findings show that texts published during phased Covid vaccine distribution framed nonvaccination as a response to structural inequities, while later texts returned to blaming individuals for their hesitancy. These findings attest to the durability of individualistic framings of health while also illustrating possibilities of alternative frames. [ABSTRACT FROM AUTHOR]

Aims: The novelty of the COVID-19 pandemic and fast-developed vaccines may increase concerns about the safety and effectiveness of the COVID-19 vaccine and thereby influence vaccine hesitancy. The aims of this study were to examine (a) the main reasons for COVID-19 vaccine hesitancy and (b) factors associated with COVID-19 vaccine hesitancy. Methods: A nationwide survey was conducted in the autumn of 2021 when most Danes had received at least one dose of a COVID-19 vaccine. The sample (N =13,570) was based on a random selection of individuals (⩾15 years), and data were collected via self-administered mailed questionnaires (digital and physical). The participants were asked whether they had been vaccinated against COVID-19, and if they had not, they were asked about their reasons for vaccine hesitancy. Logistic regression models were used to determine factors associated with vaccine hesitancy. Results: In all, 5,384 (39.7%) individuals completed the questionnaire. The main reasons for vaccine hesitancy were worries about adverse effects (57.6%) and the belief that natural immunity is better than vaccination (43.8%). Factors associated with vaccine hesitancy included female sex, younger age, being divorced, a country of origin other than Denmark, lower educational level, being unemployed, previously infected with COVID-19 and being worried to a greater extent about oneself and others getting infected. Mental health indicators were not associated with vaccine hesitancy. Conclusions: COVID-19 vaccine hesitancy is likely to pose a challenge for population immunity. To reduce vaccine hesitancy and increase vaccination uptake, future vaccination programmes should focus on specific socio-demographic subgroups identified in this study. [ABSTRACT FROM AUTHOR]

The article investigates COVID-19 vaccine hesitancy among caregivers of developmentally disabled youth using a forced-choice evaluation to identify the primary reasons influencing their decisions. The study, involving 87 caregivers, reveals that concerns about the newness of the vaccine and potential side effects are the predominant factors contributing to hesitancy, emphasizing the need for tailored strategies in addressing vaccine concerns within this vulnerable population.

As the COVID-19 pandemic recedes, SARS-CoV-2 vaccination is crucial for reducing transmission and severity, but vaccine hesitancy remains a challenge. The study explored community actions and initiatives addressing vaccine hesitancy among Somali immigrant communities in cities in the Upper Midwest, USA, and Western Norway, focusing on trust factors and comparing members of the Somali diaspora in two distinct social and cultural contexts. Qualitative collective case studies were conducted, involving 14 semi-structured interviews with key informants from the Upper Midwest and Western Norway knowledgeable about initiatives designed to address SARS-CoV-2 vaccine hesitancy. Data were coded in NVivo 12 and analyzed thematically, guided by the Bergen Model of Collaborative Functioning and the Socioecological Model to identify basic and organizational themes. The findings illustrate critical sociopolitical influences on vaccine hesitancy, like racial tensions following George Floyd’s murder in Minneapolis and mistrust toward the government in Norway. Effective strategies in the Upper Midwest included maintaining long-term community relationships and culturally tailored outreach and communication to reduce hesitancy. Conversely, Western Norway’s less community-centric approach, focusing on translation services without deeper engagement, faced challenges in trust-building. The study highlights the essential role of culturally affirming and community-centric approaches in addressing health challenges in immigrant communities. Trust, fostered through community involvement and understanding sociopolitical contexts, is pivotal in addressing vaccine hesitancy. This research offers insights into designing and implementing effective health promotion strategies tailored to immigrant populations’ unique needs. It emphasizes the necessity of integrating socioecological perspectives and community-specific interventions in health promotion practice and policy. [ABSTRACT FROM AUTHOR]

Objectives: Vaccine hesitancy among essential workers remains a significant public health challenge. We examined psychological constructs of perceived susceptibility, threat, and self-efficacy and their associations with COVID-19 vaccine hesitancy among a racially and ethnically diverse essential workforce population. Methods: We performed a cross-sectional survey of essential workers from September-December 2020 at a large Los Angeles safety-net medical center as part of a program offering free COVID-19 serology testing. Program participants completed a standardized survey at the time of phlebotomy. Hierarchical logistic regression was utilized to determine factors independently associated with vaccine hesitancy. Results: Among 1327 persons who had serology testing, 1235 (93%) completed the survey. Of these, 958 (78%) were healthcare workers. Based on expressed intent, 22% were vaccine-hesitant 78% were vaccine acceptors. In our multivariate model, vaccine hesitancy was associated with female gender [aOR = 2.09; 95% CI (1.44-3.05)], African American race [aOR = 4.32; (2.16-8.62)], LatinX ethnicity [aOR = 2.47; 95% CI (1.51-4.05)] and history of not/sometimes receiving influenza vaccination [aOR = 4.39; 95% CI (2.98-6.48)]. Compared to nurses, vaccine hesitancy was lower among physicians [aOR = 0.09; 95% CI (0.04-0.23)], non-nursing/non-physician healthcare workers [aOR = 0.55; 95% CI (0.33-0.92)], and non-healthcare care workers [aOR = 0.53; 95% CI (0.36-0.78)]. Conclusions: Among a racially/ethnically diverse group of safety net medical center essential workers, COVID-19 vaccine hesitancy was associated with racial/ethnic minority groups, employment type, and prior influenza vaccination hesitancy. Interestingly, we found no association with the Health Belief Model construct measures of perceived susceptibility, threat, and self-efficacy. Psychological constructs not assessed may be drivers of vaccine hesitancy in our population. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to qualitatively explore perceptions related to COVID-19 vaccination intention among African American and Latinx participants and suggest intervention strategies. Approach: Ninety minute virtual focus groups (N = 8), segmented by county, race and ethnicity were conducted with stakeholders from 3 vulnerable Alabama counties. Participants: Participants (N = 67) were primarily African American and Latinx, at least 19 years, and residents or stakeholders in Jefferson, Mobile, and Dallas counties. Setting: Focus groups took place virtually over Zoom. Methods: The semi-structured guide explored perceptions of COVID-19, with an emphasis on barriers and facilitators to vaccine uptake. Focus groups lasted approximately 90 minutes and were audio recorded, transcribed, and analyzed by a team of 3 investigators, according to the guidelines of Thematic Analysis using NVivo 12. To provide guidance in the development of interventions to decrease vaccine hesitancy, we examined how themes fit with the constructs of the Health Belief Model. Results: We found that primary themes driving COVID-19 vaccine hesitancy, ordered from most to least discussed, are mistrust, fear, and lack of information. Additionally, interventions to decrease vaccine hesitancy should be multi-modal, community engaged, and provide consistent, comprehensive messages delivered by trusted sources. [ABSTRACT FROM AUTHOR]

Building on the construal-level theory and the multi-dimensional model of behavioral barriers, this study examined whether psychological distance and construal level explain the association between behavioral intention and behavioral barriers that may lead to parental vaccine hesitancy. Results of multilevel structural equation models show that low vaccination intention, far distance perception, and abstract construal of vaccines led to more global concerns, such as vaccine safety and relevance. Such effects emerged when people considered specific vaccines, such as coronavirus disease 2019 (COVID-19), human papillomavirus (HPV), and monkeypox vaccines, and when they considered multiple vaccines in general. [ABSTRACT FROM AUTHOR]

Background: Vaccine willingness among people living with multiple sclerosis (PwMS) requires assessment following the approval of the first COVID-19 vaccines, since there remains uncertainty on multiple aspects of COVID-19 vaccination in immunosuppressed patients. Objective: To understand COVID-19 and influenza vaccine willingness and its associations among PwMS, following the approval of the first two mRNA COVID-19 vaccines. Methods: A survey was distributed to PwMS via an online platform from December 2020 to February 2021. Logistic regression models were constructed to determine the relationship between (1) COVID-19 and (2) influenza vaccination willingness with demographic and clinical characteristics. Results: Of 701 responding PwMS, 76.6% were COVID-19 vaccine willing. COVID-19 vaccine willingness was significantly associated with influenza vaccine willingness (p < 0.001). In multivariable models, older age increased the odds of COVID-19 and influenza vaccine willingness (odds ratios (ORs) > 1) and other race decreased the odds of COVID-19 and influenza vaccine willingness (ORs < 1); higher functional disability decreased the odds of COVID-19 vaccine willingness (OR = 0.88, 95% confidence interval = 0.80–0.96). Prevalent vaccine-related concerns include safety (n = 244) and efficacy (n = 122). Conclusion: Our findings identify demographic and clinical factors as well as concerns influencing vaccine hesitancy in PwMS. These results may inform effective public health interventions to improve vaccine acceptability in this at-risk group. [ABSTRACT FROM AUTHOR]

From the societal approach of the Theory of Social Representations, this study aimed to investigate the social representations of coronavirus/COVID-19 among the Italian population. By means of an online questionnaire, 599 individuals participated in the research, with a mean age of 38.09 years (SD = 14.44), 62.1% being women. The instrument was composed of sociodemographic questions, free association technique for the inductive term "coronavirus/COVID-19" and scales on conspiracy beliefs, vaccine hesitancy, and psychological dimension. The results allowed us to identify four social representations: "Citizens driven by Social Representations anchored to factual Covid-19 pandemic data," with lower vaccine hesitancy and conspiracy beliefs, and greater faith in science; "Citizens with low confidence in anti-pandemic preventive measures by government," with lower agreement with restriction measures; "Emotional people," with higher agreement with restriction measures and expression of psychological distress; and "Minority group of Citizens driven by denial of Covid-19," with higher vaccine hesitancy and conspiracy beliefs. We discuss the different social representations identified from the psychological and psychosocial anchoring processes in the context of the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

COVID-19 conspiracy beliefs have a powerful detrimental influence on COVID-19 vaccine perceptions and behaviors. We investigate an expanded range of outcomes for COVID-19 conspiracy beliefs, and we test which vaccine hesitancy dimensions mediate these relations. Our results show that COVID-19 conspiracy beliefs relate to COVID-19 vaccination willingness and receipt, flu vaccination willingness and receipt, as well as vaccine word-of-mouth. Many of these relations are mediated by vaccine hesitancy dimensions that represent perceptions that vaccines pose health risks as well as perceptions that vaccines are not needed because the respondent is healthy. Our discussion identifies directions for future research. [ABSTRACT FROM AUTHOR]

Background: The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) vaccine is thought to be the most effective preventive method of controlling the coronavirus disease 2019 (COVID-19) epidemic. Some patients with immune-related diseases, including inflammatory bowel disease (IBD) patients, however, may hesitate to be vaccinated for various reasons. Although several guidelines recommend vaccinating all IBD patients with inactivated SARS-CoV-2 vaccines, there is still a lack of real-world data on the safety of inactivated SARS-CoV-2 vaccines and COVID-19 vaccination rate in IBD patients. In this study, we investigated the reasons for hesitancy in COVID-19 vaccination, the COVID-19 vaccination rate, and the safety of SARS-CoV-2-inactivated vaccination in patients with IBD. Methods: This was a retrospective study. A total of 418 participants with IBD were enrolled to calculate the vaccination rates. A total of 232 patients with IBD who did not receive SARS-CoV-2 vaccination were recruited to investigate the reasons for hesitation. A follow-up survey of 151 IBD patients and 188 healthy participants who had received the SARS-CoV-2-inactivated vaccination was conducted to analyze adverse reactions. Results: The COVID-19 vaccination rate was 49.3% and almost half of the participants were 'Concerned about the safety of the vaccine (such as adverse reactions) due to IBD'. After SARS-CoV-2 vaccination, adverse reactions were mild or moderate. The adverse reactions in the IBD and non-IBD populations were roughly the same, and IBD medications did not increase the risk of adverse reactions. Conclusion: SARS-CoV-2-inactivated vaccination rates in IBD patients are still low and a significant proportion of patients are hesitant about the vaccine because of safety concerns. SARS-CoV-2-inactivated vaccination in patients with IBD appears to be safe. [ABSTRACT FROM AUTHOR]

Objective: Public health agencies have a critical role in providing effective messaging about mitigation strategies during a public health emergency. The objectives of this study were (1) to understand perceptions of COVID-19 vaccines, including concerns about side effects, safety, and effectiveness and how these perceptions influence vaccine decision-making among US adults and (2) to learn what messages might motivate vaccine uptake. Methods: In April and May 2021, we conducted 14 online focus groups with non-Hispanic English-speaking and English- and Spanish-speaking Hispanic adults (N = 99) not vaccinated against COVID-19. We oversampled adults aged 18-39 years and rural residents and systematically assessed 10 test messages. Researchers used a standardized guide and an a priori codebook for focus group discussions, coding transcripts, and thematic analysis. Results: Vaccine hesitancy factors included fear of the unknown; long-term side effects, including infertility; and beliefs that the vaccines were developed too quickly and were not sufficiently effective. Motivating factors for receiving vaccination included the ability to safely socialize and travel. Health care providers were considered important trusted messengers. Participants were critical of most messages tested. Messages that came across as "honest" about what is not yet known about COVID-19 vaccines were perceived more positively than other messages tested. Messages were seen as ineffective if perceived as vague or lacking in data and specificity. Conclusions: Messages that were simple and transparent about what is unknown about vaccines relative to emerging science were viewed most favorably. Health care providers, friends, and family were considered influential in vaccination decision-making. Findings underscore the benefits of research-informed strategies for developing and disseminating effective messages addressing critical issues in a public health emergency. [ABSTRACT FROM AUTHOR]

During the SARS-CoV2 pandemic vaccines were made available at a rapid pace in the United States (US) with support from the government. In Mississippi, vaccine hesitancy was marked. Across the country many areas of the US demonstrated reduced uptake regarding this specific vaccine due to a variety of reasons. Even with the efficacy of the vaccine indicative of a significant level of protection from mortality and serious morbidity, vaccine uptake and hesitancy were a significant concern. This study surveyed Mississippians on their willingness to take the vaccine or not, and in particular, investigated political ideology as a reason for vaccine hesitancy. Data was collected via an online survey and 589 adults (>18 years) responded. Those self-identifying as "Republican" were more than twice as likely to disagree that not getting the vaccine was a risk to their health and others (OR = 2.07, 95% CI 1.70, 2.54) as those who identified as "Democrat or independent" voters. Future health promotion efforts should specifically attempt to address this group in a more effective manner. [ABSTRACT FROM AUTHOR]

Introduction: Influenza and COVID-19 vaccination rates remain suboptimal, demanding new community-centric approaches that improve targeted counseling and increase vaccine uptake. Notably, racially diverse communities show high vaccine hesitancy, yet most existing vaccine studies focus on white, college-educated cohorts. Objective: Here, we identify factors influencing vaccination decisions of patients at Turtle Creek Primary Care clinic in Turtle Creek, PA, a racially-diverse borough. Design: A retrospective mixed-methods study of the predominantly non-white patient population at Turtle Creek Primary Care clinic, a clinic caring for >70% minority patients. Results: Fourteen factors emerged that patients reported were crucial to vaccine decision-making. Of these factors, top reasons for COVID-19 vaccine hesitancy were trust in vaccines, vaccine side effects, perceived vaccine knowledge, and faith/religion. Top reasons for influenza vaccine hesitancy were perceived need, vaccine side effects, trust in vaccines, and habitual behaviors. We also uncovered correlations between vaccine decision factors and sociodemographic factors. Participants > 65-years-old were more likely to cite personal safety in choosing to get the COVID-19 vaccine, while non-white participants were more likely to cite others' safety. Participants > 65-years-old were also more likely to cite personal safety in influenza vaccine decision-making, and non-female participants were more likely to cite perceived need for influenza vaccines. Conclusions: These data uncover targetable factors contributing to vaccine hesitancy and aid in developing community-centered, personalized vaccine education approaches in Turtle Creek and analogous minority communities. [ABSTRACT FROM AUTHOR]

Background: Although many Americans were anxious to see a vaccine developed to help restore a sense of normalcy to the COVID-19 pandemic, vaccine hesitancy is still a problem that hinders public health goals designed to stop the spread of the virus. With two mRNA vaccines available since early 2021 only 71% of Americans have received at least one dose of vaccine by November 30, 2021, with 60% of the population being fully vaccinated. Methods: This article discusses the risk factors of vaccine hesitancy, the factors influencing the unwillingness to accept vaccines approved and recognized as safe, characteristics of vaccine hesitancy among worker populations, and guidelines and resources for nurses. Conclusions and Application to Practice: The key for the nurse is to self-educate and proactively begin the discussion of vaccines with patients and co-workers, building trust with patients and peers, and helping motivate them to accept COVID-19 vaccines and make appointments to receive vaccinations. Overcoming the impact of low vaccination rates due to vaccine hesitancy is the first step toward closing the gap and achieving universal vaccination for all adults. [ABSTRACT FROM AUTHOR]

Objective: Little is known about parents' willingness to vaccinate their children against COVID-19. We assessed the prevalence of vaccine hesitancy among parents with a child or adolescent aged 12-15 years, examined predictors of parents' COVID-19 vaccine hesitancy, their reasons for resisting a pediatric COVID-19 vaccine, and the correlation between parents' intentions to vaccinate their child and the acceptance of a vaccine for themselves. Methods: We conducted a national online survey of 637 parents of a child or adolescent aged 12-15 years in March 2021, before COVID-19 vaccines had been approved for this age group. We assessed univariate predictors of vaccine hesitancy, and we used logistic regression analysis to assess independent effects of variables on vaccine hesitancy. Results: Nearly one-third (28.9%; 95% CI, 25.5%-32.5%) of respondents reported pediatric vaccine hesitancy. Vaccine-hesitant parents were less knowledgeable about vaccines, more accepting of vaccine conspiracies, and less worried about COVID-19 risks to their child's health than vaccine-accepting parents were. Vaccine hesitancy was higher among female (vs male), single (vs married/living as married), older (vs younger), low income (vs high income), non–college graduates (vs college graduates), and Republican (vs Democrat) parents. The primary concerns expressed by vaccine-hesitant parents pertained to vaccine safety rather than vaccine effectiveness. One-quarter of vaccine-hesitant parents preferred that their child obtain immunity through infection rather than vaccination. Non–vaccine-hesitant parents' reasons for vaccinating focused on protecting the health of their child and others. Childhood COVID-19 vaccine acceptance was strongly associated with parents' intentions to get the vaccine for themselves. Conclusion: A messaging strategy for effective public health interventions that includes educating the public about vaccination, countering misinformation about vaccine development and safety, and stressing the safety of approved COVID-19 vaccines may boost vaccine acceptance among vaccine-hesitant parents. [ABSTRACT FROM AUTHOR]

Trust plays an integral part in the effective functioning of public health systems. During the COVID-19 pandemic, distrust of public health fueled vaccine hesitancy and created additional barriers to immunization. Although most Americans have received at least one COVID-19 vaccine, the percentage of fully immunized adults remains suboptimal. To reach vaccine-hesitant communities, it is vital that public health be worthy of trust. As trusted members of their communities, community health workers (CHWs) can serve as ideal messengers and conversation partners for vaccination decision-making. We developed the Be REAL framework and training materials to prepare CHWs to work with vaccine-hesitant communities nationwide. Through the four steps of "Relate," "Explore," "Assist," and "Leave (the door open)," CHWs were taught to prioritize relationship building as a primary goal. In this shift from focusing on adherence to public health recommendations (e.g., get vaccinated) to building relationships, the value of vaccine uptake is secondary to the quality of the relationship being formed. The Be REAL framework facilitates CHWs harnessing the power they already possess. The goal of the Be REAL framework is to foster true partnership between CHWs and community members, which in turn can help increase trust in the broader public health system beyond adherence to a specific recommendation. [ABSTRACT FROM AUTHOR]

Objectives: COVID-19 vaccines are widely available, but uptake is suboptimal. To develop strategies to increase vaccination rates, we sought to (1) characterize adults initially hesitant to be vaccinated for COVID-19 who later received the vaccine and (2) identify factors associated with their vaccination decision. Methods: In January 2021, we conducted an online survey of US adults via Prolific that assessed vaccination intent, COVID-19–related knowledge and attitudes, and demographic characteristics. In May 2021, we recontacted respondents to assess vaccination status and factors influencing their vaccination decision. We used χ2 statistics and t tests to examine associations between respondents' vaccination status and their characteristics, knowledge, and attitudes. We analyzed reasons for vaccination using thematic analysis. Results: Of 756 initially vaccine-hesitant respondents, 529 (70.0%) completed the follow-up survey. Nearly half of those initially not sure about vaccination (47.3%, 112 of 237) were vaccinated at follow-up, while 21.2% (62 of 292) of those initially planning not to be vaccinated were vaccinated at follow-up. Of those initially not sure, higher educational attainment, greater knowledge of COVID-19, and a doctor's recommendation were associated with vaccination. Of those initially intending not to be vaccinated, male sex, Democratic political affiliation, receipt of an influenza shot within 5 years, being more worried about COVID-19, and having greater COVID-19 knowledge were associated with increased likelihood of being vaccinated. Of 167 respondents who gave reasons for vaccination, protecting oneself and others (59.9%), practical issues (29.9%), social influences (17.4%), and vaccine safety (13.8%) were the main reasons. Conclusion: Providing information on the protective value of vaccination, implementing rules that make remaining unvaccinated burdensome, making vaccination easy, and providing social support may influence vaccine-hesitant adults to accept vaccination. [ABSTRACT FROM AUTHOR]

This analysis investigates how age, race/ethnicity, and geographic location contributed to vaccine hesitancy in a sample of 645 New York City (NYC) Transport Workers Union (TWU), Local 100 members surveyed in August 2020. Union members ages 50+ were 46% less likely to be vaccine hesitant than their younger counterparts (OR 0.64; 95% CI 0.42, 0.97). Non-Whites (OR 3.95; 95% 2.44, 6.39) and those who did not report their race (OR 3.10; 95% CI 1.87, 5.12) were significantly more likely to be vaccine hesitant than Whites. Those who were not concerned about contracting COVID-19 in the community had 1.83 greater odds (95% CI 1.12, 2.98) of being vaccine hesitant than those who were concerned. Older respondents tended to reside in Queens while vaccine hesitant and non-White respondents were clustered in Brooklyn. General trends observed in COVID-19 vaccine hesitancy persist in a population of high risk, non-healthcare essential workers. [ABSTRACT FROM AUTHOR]

Purpose: To determine reasons for hesitancy towards COVID-19 vaccination and motivators to increase COVID-19 vaccine uptake among Black Americans. Design: Mixed-methods. Setting: Individual interviews in March-April 2021 Participants: Black adults (20-79 years) who attended a church in Boston, MA and identified as "vaccine hesitant" (n = 18). Methods: Individual in-depth Zoom interviews to elicit participant views on vaccines in general, specific reasons for COVID-19 vaccine hesitancy, and trusted sources of information. Participants were also asked about possible motivators that could increase COVID-19 vaccine uptake. Transcripts were de-identified and analyzed for major themes using an inductive approach. Results: Analysis included 18 complete interviews. Lack of trust in the government, healthcare, or pharmaceutical companies (n = 18), rushed development (n = 14), fear of side effects (n = 12), history of medical mistreatment (n = 12), and a perception of low risk of disease (n = 9) were the top-cited reasons for COVID-19 vaccine hesitancy. Motivators likely to increase COVID-19 vaccine uptake included more data (n = 17), friends and family getting vaccinated (not celebrities) (n = 11), and increased opportunities that come along with being vaccinated (n = 8). Conclusion: There were many reasons for COVID-19 vaccine hesitancy, as reported by participants who were all Black Americans in the Boston area. The public health challenge of increasing vaccine uptake in the Black community is nuanced and intervention efforts may be more successful if delivered by trusted members of the community and tailored to the needs of individuals. [ABSTRACT FROM AUTHOR]

Background: The coronavirus disease 2019 (COVID-19) pandemic has significantly impacted the health of pregnant women and their unborn babies. Objective: To explore the impact of COVID-19 on intrapartum care in Ethiopia. Design: A concurrent mixed-methods design was employed. Methods: An interrupted time series analysis was implemented using a Poisson regression model to estimate monthly changes in the incidence rates of institutional childbirth, instrumental vaginal birth, caesarean section, stillbirth, institutional neonatal death, institutional maternal death and availability of essential medical supplies before and during COVID-19. The dataset included data from all women who gave birth in 15 public hospitals, and the total number of childbirths in the cohort study before COVID-19 (12 months of data from March 2019 to February 2020) was 24,478, while during COVID-19 (6 months of data from March to August 2020), the total number of childbirths in the cohort study was 11,966, forming a combined final dataset of 36,444. Simultaneously, a descriptive qualitative study using a purposive sampling technique was conducted through in-depth interviews until data saturation was reached, with data were collected from 14 February to 10 May 2022. Data from the interviews were imported into NVivo 12 Plus to perform an inductive thematic analysis. Quantitative and qualitative data were integrated using joint display methods to identify corroboration or contradiction between the different forms of evidence. Results: Our findings indicate that the incidence rates of caesarean sections and instrumental vaginal births significantly increased in the first 6 months of COVID-19. Three themes were identified: ' Barriers to providing intrapartum care during COVID-19 ', ' Delays to provision of intrapartum care during COVID-19 ' and ' Inadequate COVID-19 preventive measures '. Conclusion: In combination, the three themes contributed to a considerable increase in neonatal and maternal deaths. Interventions such as fully equipped labour wards and obstetric triage systems are needed to restore disrupted maternal and perinatal care during the ongoing and future pandemics. In addition, stakeholders should inform the public that blood donations can help the community recover from recent shocks in emergency health and future pandemics. Further research should investigate the long-term impact of COVID-19 on maternity care and maternal and infant outcomes. [ABSTRACT FROM AUTHOR]

In December 2020, 11 months after identifying the first laboratory-confirmed case of COVID-19 in the United States, the U.S. Food and Drug Administration authorized emergency use of two COVID-19 vaccines. To prepare the public for a large-scale vaccination campaign and build confidence in COVID-19 vaccines, the U.S. Centers for Disease Control and Prevention (CDC) funded more than 200 partners and developed a national Vaccinate with Confidence (VwC) COVID-19 framework to support Americans in their decision to get vaccinated. The evolving nature of the pandemic and highly variable confidence in vaccines across populations has resulted in many unique complexities and challenges to reaching universally high vaccination coverage. Here, we describe how 23 professional health associations and national partner organizations, focused solely on building vaccine confidence, operationalized CDC's VwC COVID-19 framework from February 2021 to March 2022. Capturing how partners deployed and adapted their activities to meet a shifting pandemic landscape, which began with high demand for vaccines that waned over time, is an important first step to understanding how this new strategy was utilized and could be implemented for future surges in COVID-19 cases and other routine immunization efforts. Going forward, evaluation of partner activities should be prioritized to capture learnings and assess VwC program effectiveness. [ABSTRACT FROM AUTHOR]

Background: The success of vaccination campaigns against COVID-19 infection is vital for moving from a COVID-19 pandemic to an endemic scenario. We aimed to unravel the influence of the risk perception of epidemics along with individual and contextual factors on adherence to COVID-19 vaccination campaigns in Italy and Sweden. Methods: We compared the results of two nationwide surveys carried out in August 2021 across four domains of epidemic risk perception: perceived likelihood, perceived impact on the individual and perceived individual and authority knowledge. The roles of individual and contextual determinants were also explored. Results: The survey included 2144 participants in Sweden (52.3% women) and 2010 in Italy (52.6% women). In both countries, we found that trust in authorities was one of the main drivers of this process, with two-fold increased odds of being vaccinated. Being highly educated and having a higher relative income were associated with a higher adherence to the vaccination campaign (for relative income OR = 1.44, 95% CI 1.23–1.67 in Sweden and OR = 1.18, 95% CI 1.04–1.34 in Italy; for education OR = 1.90, 95% CI 1.30–2.77 in Sweden and OR = 1.47, 95% CI 1.09–1.97 in Italy), whereas a right and centre-right compared with a left and centre-left political orientation was negatively related to vaccination adherence (OR = 0.41, 95% CI 0.25–0.67 in Sweden and OR = 0.47, 95% CI 0.33–0.68 in Italy). Conclusions: Increasing trust in authorities, along with an equal global distribution of vaccine doses, can contribute to accelerating vaccination campaigns around the world and, in turn, to move towards an endemic scenario. [ABSTRACT FROM AUTHOR]

This study explores attitudes toward diphtheria-tetanus-acellular pertussis (DTaP), measles-mumps-rubella (MMR), influenza, and coronavirus disease 2019 (COVID-19) vaccines among English-speaking and Spanish-speaking parents of infants in a safety-net setting. Parents aged 18 years or older were recruited from outpatient clinics between December 2020 and December 2021. The interviews were then recorded, transcribed, translated, and qualitatively analyzed using the modified grounded theory. Thirty-two individuals participated (18 English-speaking and 14 Spanish-speaking). Almost all supported receiving routine childhood vaccines, DTaP, influenza, and MMR and believed that vaccines promote health. Vaccine concerns differed by each vaccine. Few participants expressed concerns about DTaP and MMR vaccines. Concerns around influenza vaccines often stemmed from personal experience and perceived increased risk of flu-like illnesses. Participants expressed the most concerns related to COVID-19 vaccinations, including age-based immunity of their infants. Based on these findings, future interventions to improve vaccine uptake may focus on benefits common to all vaccines, while addressing vaccine-specific concerns. [ABSTRACT FROM AUTHOR]

Background: Influenza (flu) and COVID-19 vaccination rates are subpar across the US, especially in racial and/or socioeconomic minority groups who are understudied in public health literature. Objective: The objective of this mixed-methods study was to elucidate attitudes of patients at the Turtle Creek Primary Care Center, a clinic that cares for ∼70% non-white patients, towards flu and COVID-19 vaccines, with the goal of establishing vaccine education gaps and increasing vaccine uptake in minority communities. Design/Patients: This study was conducted as a cross-sectional analysis. Authors completed 123 patient phone surveys of patients cared for at the Turtle Creek clinic inquiring about flu and COVID-19 infection status and vaccination uptake (August 26–October 10, 2021). Approach/Key Results: We found that rates of vaccination were subpar in the Turtle Creek community, with only 54% having received the COVID-19 vaccine and only 44% receiving the flu vaccine regularly. There was a strong association between COVID-19 and flu vaccine acceptance and a notable correlation between vaccine acceptance and age. When assessing how vaccine acceptance was influenced by trusted sources of information, those who cited trusting "medical professionals" and "word of mouth" had higher odds of COVID-19 vaccine acceptance but those who cited trusting "social media" had decreased odds of acceptance. Finally, we uncovered 14 common factors for either vaccine acceptance or refusal that clustered into four overarching themes of trust, need, safety, and availability. Conclusion: These data highlight the necessity of improved vaccine education and reveal targetable populations and approaches for disseminating vaccine information. [ABSTRACT FROM AUTHOR]

Aims: In this study, we examined the voluntary COVID-19 vaccine coverage among health care workers (HCWs) working in close patient contact. HCWs' beliefs about COVID-19 infection, their opinions of vaccination and reasons for having or declining the COVID-19 vaccination were also evaluated. Methods: In October 2021, a cross-sectional observational study was carried out in five hospitals in Central and Eastern Finland. The anonymous and voluntary survey was targeted at 5120 doctors and nurses working in close patient contact. Results: Some 1837 responses were included in the study. Ninety-seven per cent of the respondents had received at least one COVID-19 vaccine and 68% of the respondents agreed that all HCWs working in close patient contact should be vaccinated against COVID-19. Vaccination coverage and support for vaccination were higher among older HCWs and doctors. HCWs' main reasons for having the COVID vaccine were willingness to protect themselves, their family and their patients from COVID-19. Concerns about adverse reactions to the COVID-19 vaccine was the main reason for declining it. Conclusions: The overall COVID-19 vaccination coverage and support for vaccinations among HCWs working in close patient contact were high without actual mandatory policies being introduced. Prioritising HCWs for COVID-19 vaccinations and widespread vaccine availability, as well as low general vaccine hesitancy and high seasonal influenza vaccination coverage among the study population were check marks in achieving high COVID-19 vaccination coverage rapidly. [ABSTRACT FROM AUTHOR]

The emergence of COVID-19 spurred the fastest development of a vaccine in history. Yet, a large proportion of Americans remain hesitant to receive it. Our paper investigates how the social networks we inhabit might explain persistent vaccine hesitancy. We argue that the COVID-19 vaccination status of respondents' closest associates inhibits or motivates their decision to receive a COVID-19 vaccine. To test our argument, we conduct an original survey asking respondents a battery of questions about the people with whom individuals most frequently discuss vaccines and COVID-19. Our survey reports that individuals' discussion networks are polarized by vaccination status. Concurrently, there is a strong association between the social network's vaccination status and the respondent's vaccination status. This association is so robust that partisanship does not moderate the association between discussants' vaccination status and respondents' vaccination status. Together, our results imply that unvaccinated individuals remain hesitant because they face reinforcing social pressure from their closest associates. The unique timing of our survey, during an unprecedented vaccination campaign against a novel disease, offers a snapshot of how relationships may affect attitudes. [ABSTRACT FROM AUTHOR]

Future control of the coronavirus disease 2019 (COVID-19) pandemic is dependent on the uptake of the COVID-19 vaccine. Many factors have swayed the public's perception of this coronavirus and the new vaccinations, including misinformation, heightened emotions, and the divisive and tumultuous partisan climate. As such, vaccine hesitancy may be more prevalent for the COVID-19 vaccine than others. Healthcare workers are trusted sources of information and have the opportunity to influence an individual's choice to take the vaccine. For those who initially present as unwilling to be vaccinated, trying to persuade them with facts and scare tactics may cause more resistance. By using the communication approach of motivational interviewing, practitioners can support autonomy to reduce defensiveness, use a guiding style to elicit ambivalence and provide information, address personal agency to ensure that their patients understand that their efforts can reduce risk, and evoke a person's own argument for vaccination to decrease vaccine hesitancy. [ABSTRACT FROM AUTHOR]

Purpose: To examine user experiences in a moderated Facebook group intervention aimed at Coronavirus disease 2019 (COVID-19) vaccine promotion. Design: Facebook group members were given 2-3 vaccination posts/day for 28 days (four weeks). Posts were aimed at educating about COVID-19 vaccination, soliciting concerns around COVID-19 vaccination, and engaging members. Participants were surveyed about their experience at four weeks. Setting: Moderated Facebook group. Participants: Unvaccinated individuals who were randomized to the intervention group and completed four week follow-up (N = 216, 82.1%). Method: After four weeks, participants rated their experience in the Facebook group (eg, program satisfaction) and provided open-text responses about their satisfaction with the group. Free-text responses were dual coded and emergent themes were examined. Results: On average, participants were 37.0 years old (SD = 10.3), majority female (70.9%), and white (79.7%). The majority of participants were satisfied with the group (76.7%), agreed that other people were friendly (M = 5.58/7), and felt safe discussing health information (M = 3.96/5). Open-text responses revealed that participants liked the program because they thought the information was useful (27.7%), other members were friendly (16.1%), and the group was a safe place (13.8%). While many responded that there was nothing they did not like about the program (37.6%), nearly one-third (31.9%) reported disliking the program because it appeared to be too much in favor of vaccination and because other members came across as rude (7.1%). Those with conservative political views were less likely to be satisfied with the group (P =.04). Conclusion: Facebook groups represent an acceptable way to engage participants to improve vaccination against COVID-19. Some aspects of the Facebook group could be improved for future iterations. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study was to explore the experiences of Danish healthcare professionals who were hesitant about the COVID-19 vaccine. Methods: Interviews were conducted over the telephone in January and February 2021. Results: Healthcare professionals experienced the need to avoid impossible conversations about vaccine hesitancy with their colleagues. They felt a lack of knowledge of long-term experience with the vaccine and a need to balance trust in themselves and the authorities. Conclusions: Healthcare professionals who were hesitant towards the COVID-19 vaccine felt they had to keep their concerns to themselves and felt isolated and pressured by their managers. This study is especially important for managers, who must ensure a trusting working environment in which employees can discuss their concerns without feeling pressured. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has had a significant impact on communities across the United States (US). Three vaccines have now been granted Emergency Use Authorization by the Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC) for use in the US. However, barriers to vaccination exist, some of which are well documented in the literature, including lack of knowledge, fear, accessibility, mistrust in the healthcare system, and systemic and operational obstacles. Vaccine hesitancy in the US could potentially hinder all the efforts and resources being used to beat COVID-19, which has resulted in more than 594 000 deaths in the US per the CDC as of early June 2021. In order to overcome this pandemic, vaccine distribution and uptake is crucial. Pharmacists play a crucial role as healthcare providers as they can dismantle vaccine hesitancy and make an outstanding impact on the efforts to overcome this pandemic. [ABSTRACT FROM AUTHOR]

Objectives: Arkansas COVID-19 vaccine uptake has been lower than the national average. This study examined associations between sociodemographic factors and COVID-19 vaccine hesitancy, fear of infection, and protection self-efficacy. Methods: Adults either residing, having employment, or receiving health care in Arkansas (n = 754) participated in an online survey between October 30, 2020 and January 16, 2021. Participants were recruited in both rural and urban areas from 6 Arkansas primary care clinics. Survey questions addressed sociodemographic factors, COVID-19 infection fear, protection self-efficacy, and COVID-19 vaccine attitudes. Bivariate and multivariable logistic regression models were used to assess associations between dependent variables and respondents' sociodemographic characteristics, COVID-19 infection fear, and COVID-19 protection self-efficacy. Results: About 38% of participants reported COVID-19 vaccine hesitancy. Age, sex, race, and education were significantly associated with COVID-19 and general vaccine attitudes. Odds of COVID-19 vaccine hesitancy decreased as age increased (OR = 0.98; P <.01). Women had higher odds of COVID-19 vaccine hesitancy than men (OR = 1.52; P <.05). Respondents with a high school diploma and below and respondents with some college or a technical degree had greater odds of COVID-19 vaccine hesitancy (OR = 2.58; P <.001; and OR = 1.97; P <.01, respectively) compared to respondents with a 4-year college degree. Black/African American respondents had greater odds of COVID-19 vaccine hesitancy compared to White respondents (OR = 3.08; P <.001). No significant difference was observed among rural and urban respondents regarding COVID-19 vaccine hesitancy; however, respondents in rural areas were more likely to report low general vaccine trust compared to those in urban areas (OR = 1.87; P <.01). Respondents reporting no fear (OR = 5.51; P <.001) and very little fear (OR = 1.95; P <.05) of COVID-19 had greater odds of COVID-19 vaccine hesitancy compared to respondents who feared COVID-19 infection to a great extent. Conclusions: COVID-19 vaccine hesitancy and general trust in vaccines differ significantly among age, sex, race, and education. These trust and hesitancy patterns are challenges for achieving population immunity and follow similar patterns of vulnerability to COVID-19. Vaccination programs and interventions must consider these differences in COVID-19 vaccine hesitancy and general vaccine trust to alleviate COVID-19 disparities. Findings make a significant contribution in evaluating vaccine hesitancy among a large, diverse sample from a rural state. [ABSTRACT FROM AUTHOR]

Non-Hispanic Black (Black) and Hispanic/Latino (Latino) populations face an increased risk of COVID-19 infection, hospitalization, and death from COVID-19 relative to non-Hispanic White (White) populations. When COVID-19 vaccines became available in December 2020, Black and Latino adults were less likely than White adults to get vaccinated due to factors such as racial discrimination and structural barriers to uptake. In April 2021, the U.S. HHS COVID-19 public education campaign (the Campaign) was launched to promote vaccination through general and audience-tailored messaging. As of March 2022, Black and Latino adults had reached parity with White adults in COVID-19 vaccine uptake. This study evaluated the relationship between Campaign exposure and subsequent vaccine uptake among Black, Latino, and White adults in the United States and assessed whether participant race/ethnicity moderated the relationship between Campaign exposure and vaccine uptake. Campaign media delivery data was merged with survey data collected from a sample of U.S. adults (n = 2,923) over four waves from January 2021 to March 2022. Logistic regression analysis showed that cumulative Campaign digital impressions had a positive, statistically significant association with COVID-19 vaccine uptake, and that participant race/ethnicity moderated this association. Compared with White adults, the magnitude of the relationship between cumulative impressions and vaccination was greater among Black and Latino adults. Results from a simulation model suggested that the Campaign may have been responsible for closing 5.0% of the gap in COVID-19 vaccination by race/ethnicity from April to mid-September 2021. We discuss implications for future public education campaigns that aim to reduce health disparities. [ABSTRACT FROM AUTHOR]

Persuasion knowledge is personal knowledge about persuasion attempts that has an effect on the way people respond to these attempts. Persuasion attempts are made to effectively handling the Covid-19 pandemic, which is dependent on high public compliance with vaccination programs. Drawing on the idea of persuasion knowledge, we aimed at elaborating the various categories of perceived information gaps experienced by vaccine hesitants during the Covid-19 vaccination campaign. At the beginning of 2021 we conducted 20 in-depth interviews with Israelis who had decided not to be vaccinated against Covid-19. Analysis of the interviews revealed three main categories of information gaps experienced by the interviewees: missing information, manipulated information, and discrepant information. We analyzed how these are associated with distrust and may impair the persuasion efforts of governments and health authorities. Perceived information gaps, as part of persuasion knowledge, may increase negative responses, and therefore constitute an important factor in persuasion campaigns. [ABSTRACT FROM AUTHOR]

Background: Ghana was the first country to receive the coronavirus vaccination in West Africa from AstraZeneca or Oxford. Ghana plans to vaccinate 20 million out of the 32 million population and provide the necessary doses utilizing multilateral and bilateral agreements. As Ghana begins vaccinating its citizens, there is some skepticism about administering the coronavirus vaccine (CVV). This research aimed to analyze the socioeconomic and demographic characteristics influencing vaccine hesitancy (VH) and refusal among Ghanaians. Methods: The multinomial logistics regression model was employed to investigate the relationship between respondents' socio-demographic characteristics and VH. The research data were gathered between March to June 2021 through an online survey. Findings: The findings of this study indicated that approximately 92.75% of the 400 respondents have heard about CVV. The study suggests that less than 5% of the participants have so far received the CVV. Most of the respondents (36.8%) indicated rejecting the CVV. Interestingly, male participants [adjusted odds ratio (AOR) = 1.048; 95% confidence interval (CI): 0.532–2.063] with higher educational backgrounds (AOR = 2.11; 95% CI: 0.870–5.121) had higher odds of being CVV hesitant or refusers. Low economic class, rural settlers, unmarried individuals, and unemployed people also had higher odds of being VH or refusers. The survey also shows that most Ghanaians refused to receive the CVV because they did not trust the system to track the vaccine's side or adverse effects. Conclusion: Government can use social media platforms and other media platforms to effectively provide relevant information regarding the full benefit and risks of taking the virus. [ABSTRACT FROM AUTHOR]

Objectives: In May 2021, the Health Resources and Services Administration Health Center COVID-19 Vaccine Program (HCCVP) began supporting the national adolescent vaccination rollout for a safe return to in-person learning for children and adolescents from medically underserved communities. To understand the initial implementation of adolescent vaccinations, we estimated the number of vaccines administered through the HCCVP at the national and state level to adolescents aged 12-17 years, and we examined challenges and solutions in vaccine deployment. Methods: We analyzed data on vaccine administration, challenges, and solutions from the Health Center COVID-19 Survey during May 14–August 27, 2021, and we analyzed data on patients served from the 2019 Uniform Data System. National adolescent COVID-19 vaccination and population data came from CDC's COVID Data Tracker and the US Census Bureau's 2019 Current Population Survey. Results: HCCVP health centers administered >485 000 COVID-19 vaccine doses to adolescents during the study period, with variations across states. Health centers in 13 states and territories (Arizona, California, Colorado, Connecticut, Delaware, Maine, Massachusetts, Missouri, Nebraska, Nevada, Oregon, Virginia, and Puerto Rico) vaccinated more adolescents than their share of prepandemic adolescent patients. The most frequently reported challenges in vaccine administration were vaccine confidence and staffing availability. Conclusions: This assessment of the initial months of COVID-19 vaccine administration among adolescent health center patients suggests rapid response by health centers in several states, reaching beyond their adolescent patient population to support state-level pandemic response. Future research could examine processes to optimize strategic activation of health centers in public health emergency responses. [ABSTRACT FROM AUTHOR]

Background. Declared a "public health threat of international concern" by the World Health Organization, the COVID-19 virus has caused the deaths of over half a million individuals in the United States in just the first 23 months after detection. The vaccine has recently been introduced to reduce this public health threat. However, due, in part, to the rapidity with which the vaccine was developed, many individuals display vaccine hesitancy. Purpose. The current study examined the utility of the Protection Motivation Theory of Health (PMT) in predicting intentions to receive the COVID-19 vaccine. Method. One hundred twenty-nine unvaccinated respondents (drawn from an initial sample of 255 participants) completed a survey assessing the components of the PMT and intentions to receive the vaccine. Respondents could also provide an open-ended response regarding any concerns they had with the vaccine. Conclusions. The PMT accounted for 76% of the variance in vaccine intentions. Vulnerability, outcome efficaciousness, and maladaptive response rewards each accounted for unique variance. Open-ended responses reflecting concerns with the vaccine fell into 8 categories, with the most common being concern with the long-term side effects of the vaccine. These results suggest that public health campaigns promoting the vaccine should focus on vulnerability to COVID-19, protective functions of the vaccine, and overcoming what people perceive as benefits of not receiving the vaccine. [ABSTRACT FROM AUTHOR]

Objective: COVID-19 disproportionally affected Hispanic/Latinx populations exacerbating systemic health inequities. The pilot study aimed to explore barriers to COVID-19 vaccination across Hispanic/Latinx communities in Southern California. Methods: Cross-sectional survey of 200 participants to identify common barriers to vaccine hesitancy among Hispanics/Latinx individuals in Southern California utilizing a 14-item survey and questionnaire in English and Spanish. Results: Of the 200 participants that completed questionnaires, 37% identified a knowledge deficit, 8% identified misinformation, and 15% identified additional barriers such as awaiting appointments, immigration status, transportation issues, or religious reasons as barriers to not receiving the COVID-19 vaccine. Wald statistics denoted that household members with COVID-19 infection within the past 3 months saw a medical provider within the last year, wearing a mask in public often, and barriers to vaccination (not knowing enough about the vaccine) predicted vaccine. These variables indicated changes in the likelihood of obtaining vaccination. Conclusion: The most crucial factor for increasing vaccination rates was directly reaching out to the community and actively conducting surveys to address the barriers and concerns encountered by Hispanic/Latinx participants. [ABSTRACT FROM AUTHOR]

Limited studies are available on how decisions and perceptions on SARS-CoV-2 vaccination have changed since the start of vaccination availability. We performed a qualitative study to identify factors critical to SARS-CoV-2 vaccination decision making and how perspectives evolved among African American/Black, Native American, and Hispanic communities disproportionately affected by COVID-19 and social and economic disadvantage. We conducted 16 virtual meetings, with 232 participants in wave 1 meetings (December 2020) and with 206 returning participants in wave 2 meetings (January and February 2021). Wave 1 vaccine concerns in all communities included information needs, vaccine safety, and speed of vaccine development. Lack of trust in government and the pharmaceutical industry was influential, particularly among African American/Black and Native American participants. Participants showed more willingness to get vaccinated at wave 2 than at wave 1, indicating that many of their information needs had been addressed. Hesitancy remained greater among African American/Black and Native American participants than among Hispanic participants. Participants in all groups indicated that conversations tailored to their community and with those most trustworthy to them would be helpful. To overcome vaccine hesitancy, we propose a model of fully considered SARS-CoV-2 vaccine decision making, whereby public health departments supply information, align with community values and recognize lived experiences, offer support for decision making, and make vaccination easy and convenient. [ABSTRACT FROM AUTHOR]

Objectives: Emergency departments (EDs) could play an important role in the COVID-19 pandemic response by reaching patients who would otherwise not seek vaccination in the community. Prior to expanding COVID-19 vaccination to the acute care setting, we assessed ED patients' COVID-19 vaccine status, perspectives, and hypothetical receptivity to ED-based vaccination. Methods: From January 11 through March 31, 2021, we conducted a multisite (Albany Medical Center, Boston Medical Center, Buffalo General Hospital, University of Cincinnati Medical Center, and Upstate Medical Center), cross-sectional survey of ED patients, with embedded randomization for participants to receive 1 of 4 vignette vaccination messages (simple opt-in message, recommendation by the hospital, community-oriented message, and acknowledgment of vaccine hesitancy). Main outcomes included COVID-19 vaccination status, prior intention to be vaccinated, and receptivity to randomized hypothetical vignette messages. Results: Of 610 participants, 122 (20.0%) were vaccinated, 234 (38.4%) had prior intent to be vaccinated, 111 (18.2%) were unsure as to prior intent, and 143 (23.4%) had no prior intent to be vaccinated. Vaccine hesitancy (participants who were vaccine unsure or did not intend to receive the vaccine) was associated with the following: age <45 years, female, non-Hispanic Black, no primary health care, and no prior influenza vaccination. Overall, 364 of 565 (64.4%; 95% CI, 60.3%-68.4%) were willing to accept a hypothetical vaccination in the ED. Among participants with prior vaccine hesitancy, a simple opt-in message resulted in the highest acceptance rates to hypothetical vaccination (39.7%; 95% CI, 27.6%-52.8%). Conclusions: EDs have appropriate patient populations to initiate COVID-19 vaccination programs as a supplement to community efforts. A simple opt-in approach may offer the best messaging to reach vaccine-hesitant ED patients. [ABSTRACT FROM AUTHOR]

Objective: Inpatient vaccination is an opportunity to increase vaccine uptake among patients at high risk for severe COVID-19 illness. We designed and implemented a hospital-based COVID-19 vaccination program with the aim of increasing documentation of vaccine eligibility and COVID-19 vaccination to eligible inpatients before discharge. Methods: We integrated a templated note into the electronic medical records and trained health care personnel to screen inpatients and document COVID-19 vaccine eligibility at the Atlanta Veterans Affairs Medical Center. Vaccination staff deployed to inpatient wards administered the vaccine to eligible and consenting patients at the bedside. We calculated the number of inpatients whose vaccine eligibility was assessed and documented during a 4-week period after health care personnel were trained. We used the Wald χ2 test to compare the proportion of eligible patients who were vaccinated before discharge 4 weeks before (March 29–April 23, 2021) and 4 weeks after (May 3-28, 2021) the training period. Results: During the 4 weeks before the training period, COVID-19 vaccine eligibility was not routinely assessed and documented. Of 793 inpatients discharged during the 4 weeks after the training period, 470 (59%) had COVID-19 vaccine eligibility documented. Of 86 patients who were eligible for vaccination, 61 (71%) received COVID-19 vaccination before discharge. COVID-19 vaccination rates during hospitalization increased significantly from 16 of 769 inpatients (2%) during the 4 weeks before training to 61 of 793 inpatients (8%) during the 4 weeks after training (P <.001). Conclusion: An inpatient vaccination program that integrated COVID-19 vaccination into discharge planning increased vaccine screening and uptake. Future studies are needed to identify barriers to vaccination and strategies to increase vaccine uptake among those who are hesitant. [ABSTRACT FROM AUTHOR]