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Despite widely recognised effectiveness against the spread of COVID‐19, vaccine hesitancy persists. This systematic literature review aimed to clarify the definition and the operationalisation of the term 'vaccine hesitancy' and disclose the various psychosocial factors underlying this phenomenon. The results of studies conducted in European countries and in the United States after the vaccines became available were taken into account. The review was conducted according to the Preferred Reporting Items for Systematic Review and Meta‐Analyses statement. Twelve studies met the inclusion criteria and were reviewed. efinitions and measures of vaccine hesitancy differed across the studies, limiting their comparison. Nonetheless, by drawing on theoretical frameworks, we were able to identify several psychosocial variables in determining vaccine hesitancy. Our findings point to the need for a transdisciplinary approach to understanding the antecedents of vaccine hesitancy. A better understanding of the phenomenon may help to develop interventions and social policies to address a complex challenge such as vaccination hesitancy. [ABSTRACT FROM AUTHOR]

Introduction Design Methods Results Conclusions Clinical Relevance Vaccine hesitancy is a complex issue of global concern. As nurses play a vital role in delivering patient care and shaping public opinions on vaccines, interventions to address vaccine hesitancy in nursing are imperative. As such, identifying profiles of characteristics and attitudes contributing to hesitancy may help identify specific areas of focus to target tailored global vaccination uptake campaigns. The purpose of this study was to profile the characteristics and attitudes contributing to hesitancy toward COVID‐19 and Influenza vaccines in the nursing community.This multisite, cross‐sectional study recruited 1967 registered nurses and 1230 nursing students from the United Kingdom, Finland, and Italy between March and September 2023.Data collection involved an online survey adopting the Vaccination Attitudes Examination (VAX) Scale, the Bergen Social Media Addiction Scale, and questions pertaining to sociodemographic and occupational characteristics. A k‐means cluster analysis was used to identify various clusters of hesitancy based on the VAX Scale. One‐way ANOVA and chi‐square tests were used to identify significant differences in sociodemographic characteristics, occupational factors, vaccination attitudes, and social media usage between the clusters.Three distinct clusters were identified. Profile A showed high vaccine confidence, profile B displayed slight hesitancy, and profile C reported high levels of hesitancy. In profile C, higher levels of vaccine hesitancy were identified in younger, less experienced nurses with lower educational attainment. While older nurses with higher educational attainment, who were in senior roles, were more vaccine‐confident and had a consistent history of accepting the Influenza and COVID‐19 vaccinations (profile A). The study found Italian nurses highly hesitant (profile C), British nurses highly confident (profile A), and Finnish nurses evenly distributed between confident, slightly hesitant, and highly hesitant (profiles A, B, and C, respectively). In addition, more frequent usage of Instagram and TikTok was associated with vaccine hesitancy (profiles B and C), and LinkedIn and X were more common among vaccine‐confident individuals (profile A).This study has identified specific sociodemographic and occupational factors that are related to vaccine hesitancy in an international sample of nurses. Additionally, attitudes contributing to hesitancy were identified, with worries about unforeseen future effects of the vaccine being identified as a critical attitude that may undermine confidence and increase hesitancy in nursing. This study also sheds light on the influence that social media platforms have on vaccine hesitancy and, as such, indicates which platforms are effective to disseminate vaccination campaigns to global nursing communities.Global vaccination campaigns should focus on specific profiles and clusters to promote vaccination in the international nursing community. Empowering nurses early in their careers will help to instill positive vaccination behaviors, ensuring a sustained uptake of vaccinations throughout the individual's career and beyond, with an impact on promoting vaccination at the public health level as well. [ABSTRACT FROM AUTHOR]

Background Previous research on COVID-19 vaccination highlights future thoughts associated with possible Coronavirus infection and vaccine side effects as key predictors of vaccine hesitancy. Yet, research has focused on independent contributions of such future thoughts, neglecting their interactive aspects. Purpose We examined whether thoughts about two possible COVID-related futures (suffering from COVID-19 and vaccine side effects) interactively predict vaccine hesitancy and vaccination behavior among unvaccinated and vaccinated people. Importantly, we compared two forms of future thinking: beliefs or expectations (likelihood judgments) versus fantasies (free thoughts and images describing future events). Methods In Study 1, we conducted a longitudinal study with an unvaccinated group (N = 210). We assessed expectations versus fantasies about the two COVID-related futures as predictors. As outcome variables, we measured vaccine hesitancy, and 9 weeks later we assessed information seeking and vaccine uptake. Study 2 was a cross-sectional study comparing vaccine hesitancy of an unvaccinated group (N = 307) to that of a vaccinated group (N = 311). Results Study 1 found that more negative fantasies about COVID-19 impact and less negative fantasies about vaccine side effects interactively predicted lower vaccine hesitancy and more vaccine-related behaviors among unvaccinated people; no such interaction was observed between respective expectations. Study 2 replicated these results of Study 1. Additionally, for vaccinated people, low expectations of negative COVID-19 impact and high expectations of negative vaccine impact interactively predicted higher vaccine hesitancy, whereas no such interaction was observed for respective fantasies. Conclusions Research on vaccine hesitancy should explore interactions between future thinking about disease and about vaccine side effects. Importantly, there is much to be gained by distinguishing expectations versus fantasies: vaccination interventions aiming to boost vaccine uptake among unvaccinated people should tap into their negative future fantasies regarding both disease and vaccine side effects. [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.

Background Despite the availability of a vaccine to combat COVID-19 disease, vaccine hesitancy is still a major concern, notably in countries with developing healthcare systems such as Pakistan. Hence, this study considered the rationale for vaccine hesitancy in Pakistani university students and support staff, and the impact of gender, age, and education on vaccination hesitancy. Methods A cross-sectional study was conducted with randomly selected university students and supportive staff. An anonymous questionnaire collected data covering socio-demographic characteristics, vaccination status, current beliefs, and past vaccination history. Responses were assessed using descriptive analysis (p-value estimation and correlation/regression) and machine learning models applied to classify individuals based on their acceptance or vaccine hesitancy behavior and then used to predict the important variables associated with vaccine hesitancy. Results The survey of 847 participants revealed that 43% were vaccinated and 57% were vaccine hesitant; of which 37%, 38%, and 25% had safety and efficacy concerns, were afraid of side effects, or exhibited other complacency behavior regarding vaccination, respectively. Non-university educated people were significantly more hesitant than university-educated people (p = 0.033). Vaccine refusal was significantly higher in students than in supportive staff (p = 0.01). Correlation analysis revealed a strong association between key independent variables (the fear of side effects, mistrusted information, and low perceived disease risk without vaccination) and vaccine acceptance (dependent variable), as revealed by linear regression and a Structure Model Equation. Machine learning classified vaccine-hesitant and vaccine-acceptant individuals with commutative accuracy of 96% and 97%, respectively, using random forest and logistic regression. Logistic regression identified five predictors for vaccine hesitancy: low perceived disease risk without vaccination, mistrusted information, the fear of side effects, occupation, and education. Conclusion Education campaigns that cover the safety, efficacy, and importance of vaccination are needed to increase vaccination take-up to protect from COVID-19 disease.

Introduction: Human papillomavirus (HPV) causes cervical cancer, and HPV vaccination is highly effective in preventing vaccine-targeted HPV infection. However, low HPV vaccination coverage in Kisumu County, Kenya, at about 10% for the first dose, highlights the critical issue of vaccine hesitancy, particularly in low and middle-income countries. Methods: This study explores the concerns, myths and barriers to HPV vaccine uptake among adolescent girls (aged 10-14) enrolled at human immune-deficiency virus comprehensive care clinics and their parents in Kisumu County. Focused group discussions were conducted with 48 participants. Results: Content analysis revealed limited knowledge about the HPV vaccine and widespread misconceptions regarding its safety and efficacy. Financial constraints, injection fears and negative clinic experiences emerged as additional barriers. Conclusion: The findings emphasise the role of effective communication strategies, including engaging parents through written materials and involving them in decision-making, to dispel myths, provide accurate information and encourage HPV vaccination. Collaborative efforts with community stakeholders are crucial to improve vaccine coverage and ultimately reduce the cervical cancer burden. [ABSTRACT FROM AUTHOR]

Introduction The World Health Organization identified vaccine hesitancy as one of the top 10 threats to global health. Vaccine hesitancy is defined as a delay in acceptance or refusal of vaccination despite the availability of vaccination services. Because vaccine safety concerns are important contributors to hesitancy, people who have experienced adverse events following immunization (AEFI) may be at especially high risk for subsequent vaccine hesitancy. The Defense Health Agency Immunization Healthcare Division (DHA IHD) provides specialized vaccine care to persons who have experienced AEFI. The impact of this specialized vaccine care on subsequent vaccine hesitancy has not been fully explored. Materials and Methods A cohort of patients (n = 146) was identified among those who received consultative care from DHA IHD clinicians for AEFI concerns between April 2017 and September 2022. Analyses were restricted to non-uniformed beneficiaries of the Military Health System (MHS). Uniformed beneficiaries of the MHS were excluded from this analysis since vaccination mandates preclude the use of vaccine uptake as a measure of vaccine hesitancy. Outcomes were evaluated by reviewing MHS vaccination records after initial AEFI consultation through January 2023. Vaccine acceptance was considered the inverse of hesitancy, and was defined by: (a) receipt of any subsequent vaccination, (b) receipt of seasonal influenza vaccine, (c) receipt of subsequent doses of the AEFI-associated vaccine, if clinically recommended, and (d) receipt of COVID-19 vaccine. Results A diverse group of patients with a wide range of AEFI concerns received specialized vaccine care from DHA IHD clinicians during this period. Among the cohort, 78% of patients received any subsequent vaccination, 55.2% received seasonal influenza vaccine, 57.8% received a subsequent dose of their AEFI-associated vaccine when the vaccine was clinically recommended, and 48.9% received COVID-19 vaccine. The proportion of patients who received influenza vaccine exceeded the reported rate of influenza vaccine uptake by the general population during this time period. Conclusion Specialized vaccine care after AEFI concerns was associated with relatively high acceptance of subsequent vaccinations. The experiences of DHA IHD clinicians, in providing specialized vaccine care to AEFI patients, may serve as a model for other organizations that are working to reduce vaccine hesitancy, even beyond the MHS. [ABSTRACT FROM AUTHOR]

The SARS-CoV-2 pandemic has generated a considerable number of infections and associated morbidity and mortality across the world. Recovery from these infections, combined with the onset of large-scale vaccination, have led to rapidly-changing population-level immunological landscapes. In turn, these complexities have highlighted a number of important unknowns related to the breadth and strength of immunity following recovery or vaccination. Using simple mathematical models, we investigate the medium-term impacts of waning immunity against severe disease on immuno-epidemiological dynamics. We find that uncertainties in the duration of severity-blocking immunity (imparted by either infection or vaccination) can lead to a large range of medium-term population-level outcomes (i.e. infection characteristics and immune landscapes). Furthermore, we show that epidemiological dynamics are sensitive to the strength and duration of underlying host immune responses; this implies that determining infection levels from hospitalizations requires accurate estimates of these immune parameters. More durable vaccines both reduce these uncertainties and alleviate the burden of SARS-CoV-2 in pessimistic outcomes. However, heterogeneity in vaccine uptake drastically changes immune landscapes toward larger fractions of individuals with waned severity-blocking immunity. In particular, if hesitancy is substantial, more robust vaccines have almost no effects on population-level immuno-epidemiology, even if vaccination rates are compensatorily high among vaccine-adopters. This pessimistic scenario for vaccination heterogeneity arises because those few individuals that are vaccine-adopters are so readily re-vaccinated that the duration of vaccinal immunity has no appreciable consequences on their immune status. Furthermore, we find that this effect is heightened if vaccine-hesitants have increased transmissibility (e.g. due to riskier behavior). Overall, our results illustrate the necessity to characterize both transmission-blocking and severity-blocking immune time scales. Our findings also underline the importance of developing robust next-generation vaccines with equitable mass vaccine deployment. Author summary: While the SARS-CoV-2 outbreak continues, the deployment of vaccines in many regions has blunted the severity of SARS-CoV-2 infections and decreased hospitalizations. However, the medium-term impacts of the duration of severity-blocking immunity, and its potential interactions with heterogeneous vaccine uptake (e.g. from vaccine hesitancy) or more robust vaccines, remain unknown. To titrate these effects, we use immuno-epidemiological models to examine potential future scenarios. We find that sufficient vaccine hesitancy (and correspondingly higher vaccination rates among adopters) can rapidly increase the fraction of individuals infected after waned severity-blocking immunity even when robust vaccines are deployed. This result underlines that pharmaceutical developments for broadly protective vaccines should be combined with campaigns to increase vaccine uptake globally. We also show that this fraction is highly dependent on underlying immune uncertainties, which illustrates the importance of accurately measuring immune parameters for proper prediction based on hospitalization data. [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 distinction between beliefs and facts, as well as between science and pseudoscience, appears to be hazy in the post-truth era. This study draws inspiration from public discourse concerning the safety of COVID-19 vaccines during the pandemic, aiming to explore the narratives of COVID-19 vaccine skeptics within the Greek online public sphere.

Abstract Background Oral health professionals should have good COVID-19 vaccine literacy as should physicians and nurses. However, little is known about COVID-19 literacy and vaccine hesitancy among oral health professionals in Japan. Aims This study aimed to investigate the status of COVID-19 literacy and vaccine hesitancy among oral health professionals by comparing them with other healthcare workers (HCWs). Methods To compare these differences, a self-administered questionnaire-based survey of 596 staff members was conducted in March 2023 at schools, an affiliated hospital, and elderly care facilities after the staff who wished to receive it completed the fifth dose of COVID-19 vaccinations. Comparison between the recognition levels and number of vaccine doses among the HCWs were examined using the Kruskal–Wallis tests. Defining the third or lower doses of COVID-19 vaccine as vaccine hesitancy, factors associated with the hesitancy were examined using logistic regression analysis. Results In total, 408 (68.5%) participants were enrolled for the study. Dental hygienists’ COVID-19 literacy levels were lower compared to those of nurses and physicians. Dentists received a significantly lower number of vaccine doses than did physicians. Vaccine hesitancy was positively associated with younger age and higher concern about the adverse effects of the vaccine, but it was not associated with occupation. Conclusion Interventions to improve the low COVID-19 literacy and high COVID-19 vaccine hesitancy among oral health professionals, particularly young ones, are needed for COVID-19 and future pandemics.

BackgroundThe hesitation of healthcare professionals towards vaccines is becoming increasingly concerning, potentially undermining public confidence in vaccination programs. This study aimed to investigate the relationship between social responsibility, Prosocial tendency, and vaccine hesitancy among Chinese doctors, and to identify demographic factors associated with vaccine hesitancy.MethodA cross-sectional survey was conducted among 976 Chinese doctors. Participants completed a questionnaire to assess their sense of social responsibility, Prosocial tendency, and vaccine hesitancy. Demographic information, including age, gender, and marital status, was also collected. Correlation and mediation analyses were conducted to examine the relationships between the main variables.ResultsSocial responsibility was negatively correlated with vaccine hesitancy (r=-0.564, P

ObjectiveThis study aimed to investigate the evidence regarding vaccine hesitancy including refusal rate, associated factors, and potential strategies to reduce it.MethodsThis is a scoping review. Three main databases such as PubMed, Scopus, and Web of Science were searched from 1 January 2020 to 1 January 2023. All original studies in the English language that investigated one of our domains (vaccine hesitancy rate, factors associated with vaccine hesitancy, and the ways/interventions to overcome or decrease vaccine hesitancy) among the general population were included in this study. The data were charted using tables and figures. In addition, a content analysis was conducted using the 3C model of vaccine hesitancy (Confidence, Complacency, and Convenience) that was previously introduced by the WHO.ResultsFinally, 184 studies were included in this review. Of these, 165, 181, and 124 studies reported the vaccine hesitancy rate, associated factors, and interventions to reduce or overcome vaccine hesitancy, respectively. Factors affecting the hesitancy rate were categorized into 4 themes and 18 sub-themes (contextual factors, confidence barriers, complacency barriers, and convenience barriers).ConclusionVaccine hesitancy (VH) rate and the factors affecting it are different according to different populations, contexts, and data collection tools that need to be investigated in specific populations and contexts. The need to conduct studies at the national and international levels regarding the reasons for vaccine refusal, the factors affecting it, and ways to deal with it still remains. Designing a comprehensive tool will facilitate comparisons between different populations and different locations.

BackgroundHerpes zoster is more prevalent among the older adult due to the age-related immune decline, leading to significant pain and complications. Although vaccination effectively prevents viral infections, vaccine hesitancy remains a major barrier to achieving high vaccination rates.To address this, we conducted a qualitative survey using Vaccine Hesitancy Determinants Matrix and 5C model to understand and improve vaccination rates in this group.MethodsDescriptive qualitative research design based on the philosophical underpinnings of naturalistic inquiry and purposive sampling methodology was conducted on adults aged 50 and above, as well as community health workers. Data were collected through semi-structured, in-depth personal interviews. The interview outline was constructed following a comprehensive review of the literature and consideration of the theoretical framework.ResultsSeventeen adults over 50 years and four community healthcare workers were included in this study. The study found that information asymmetry in immunization planning was evident at all stages of vaccine supply, dissemination and demand. The main manifestations included limited access to authoritative information, insufficient community awareness of herpes zoster as a route of vaccination, insufficient vocational training, significant gaps in vaccine knowledge, and high levels of complacency among individual residents.ConclusionHerpes zoster vaccine hesitancy is prevalent among middle-aged and older adults in China due to information asymmetry, vaccine complacency, inadequate community services, and other multiple layers of factors. Public health strategies should aim to reduce cognitive biases and information gaps by disseminating diverse and credible vaccine information through social media, medical institutions, and offline channels to promote higher vaccination rates.

Background: Despite broad COVID-19 vaccination coverage in India, hesitancy persists, limiting the achievement of 100 % vaccination coverage across the country to prevent the ongoing transmission of the infection. We explored the key drivers of vaccine hesitancy among unvaccinated adults in semi-urban regions of Kerala, India. Method: ology: Semi-structured face-to-face interviews were conducted from April to May 2022, using purposive sampling to enroll participants with the help of Accredited Social Health Activist (ASHA) workers. Participation in the interviews was voluntary and was conducted at the participant's residence at a time convenient for the participants. Audio files of the interviews were transcribed verbatim, and the anonymized data underwent a multistage thematic analysis using the constant comparative method. Results: In our study with 35 unvaccinated individuals were interviewed. Identified factors for vaccine hesitancy were categorized into different themes: individual factors (35 %), vaccine-related factors (33.33 %), and social/environmental factors (31.67 %). Conclusions: Targeted communication strategies and behavioural change interventions need be employed to mitigate major drivers of vaccine hesitancy. Addressing vaccine hesitancy requires multifaceted strategies including community engagement, collaboration with alternative medical systems, healthcare worker education, prioritizing vulnerable populations, and transparent communication about vaccine safety and adverse events. Implementing these measures will help overcome barriers and enhance vaccine coverage.

ObjectivesThe present study aimed to assess influenza vaccine hesitancy and vaccine literacy levels among youth and adults in China, as well as the association between them.MethodsAn online cross-sectional survey was conducted in Mainland China. Participants’ total vaccine literacy and three sub-dimension vaccine literacy (knowledge literacy, competence literacy, and decision-making literacy) were assessed by a validated vaccine literacy scale. Having received influenza vaccination in the past three years or intending to accept it in next influenza season indicates less influenza vaccine hesitancy.ResultsAmong 997 participants, a sub-optimal vaccine literacy was observed, with a mean score of 66.83 ± 10.27. Regression models 1–4 revealed that participants with middle (aOR: 1.431, P=0.039, 95% CI: 1.018~2.010) or high (aOR: 1.651, P=0.006, 95% CI: 1.157~2.354) total vaccine literacy, as well as those with high competence literacy (aOR: 1.533, P=0.017, 95% CI: 1.079~2.180), or high decision-making literacy (aOR: 1.822, P=0.001, 95% CI: 1.261~2.632) were more likely to have been vaccinated against influenza at least once in past three years. However, those with a high knowledge literacy were associated with a lower influenza vaccine rate (aOR: 0.676, P=0.046, 95% CI: 0.460~0.994). Regression models 5–8 revealed that participants with middle (aOR: 1.661, P=0.008, 95% CI: 1.142~2.414) or high total vaccine literacy (aOR: 2.645, P=0.000, 95% CI: 1.774~3.942), as well as those with middle (aOR: 1.703, P=0.005, 95% CI: 1.177~2.464) or high competence literacy (aOR: 2.346, P=0.000, 95% CI: 1.159~3.461), or high decision-making literacy (aOR: 2.294, P=0.000, 95% CI: 1.531~3.436) were more likely to express the willingness to receive the influenza vaccine in the next influenza season.ConclusionThe participants’ influenza vaccine hesitancy was negatively associated with their total vaccine literacy levels and two of the three sub-dimensions: competence literacy and decision-making literacy. Knowledge literacy suggested a positive or no relationship with influenza vaccine hesitancy.

BackgroundThe coronavirus disease 2019 (COVID-19) continues to threaten human health, and health professionals, including nursing students, usually work in healthcare frontiers with a high risk of infection. Vaccination is currently one of the most effective preventive measures. This study aimed to explore the determinants of COVID-19 vaccine hesitancy in nursing students.MethodsIn November 2022, a sample of undergraduate nursing students was recruited from several medical schools in Anhui Province, China, and an online cross-sectional survey was conducted using the questionnaire star platform (Wenjuanxin). A Chi-square test was used to explore vaccine hesitancy among nursing students with different social demographic characteristics and vaccine attitudes. Binary logistic regression analysis was then used to determine the influence factors of vaccine hesitancy among nursing students.ResultsA total of 1,090 valid samples were collected in this study. Of these, 27.06% (295) of nursing students reported COVID-19 vaccine hesitancy. The results showed “the need to go out of town recently” (OR = 0.670), “very confident that the outbreak could be controlled sustainably” (OR = 0.393), “feeling at risk of infection” (OR = 0.658), “not being worried/being generally worried about the vaccine's safety” (OR = 0.226 and OR = 0.686, respectively), and “not being worried about the vaccine's effectiveness” (OR = 0.411). These five factors are protective factors associated with COVID-19 vaccine hesitancy in nursing students. The factors “considering the country completely safe from an outbreak” (OR = 3.436), “considering themselves safe because others are vaccinated” (OR = 2.239), and “Agreeing that other protective measures can be relaxed after vaccination with the COVID-19 vaccine” (OR = 2.007) are risk factors associated with COVID-19 vaccine hesitancy among nursing students (P < 0.05).ConclusionOverall, relatively few nursing students had COVID-19 vaccine hesitancy. Schools and relevant institutions still need to actively guide them to improve their confidence in the COVID-19 vaccine, strengthen the prevention and control measures of the epidemic, and improve their awareness of the crisis to improve the vaccination rate to reduce the COVID-19 vaccine hesitancy in nursing students.

The global health crisis triggered by the SARS-CoV-2 in 2019, known as the COVID-19 pandemic, prompted vaccination drives worldwide, including in India, to address the crisis. However, vaccine hesitancy remains a significant challenge to achieving vaccination goals. Hence, we conducted a systematic review and meta-analysis during 2021–2023 to estimate the prevalence of COVID-19 vaccine hesitancy among adults in India and identify associated factors. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Quality assessment was performed using the Joanna Briggs Institute checklist. Pooled prevalence estimates were calculated using a random-effects model. A total of 265 articles were identified, of which 21 full-text articles were included in the review. The pooled estimated prevalence of COVID-19 vaccine hesitancy among adults in India was found to be 28% (95% confidence interval: 27–29). Subgroup analysis revealed variations in hesitancy rates across different states, with higher rates observed in Jammu and Kashmir (44%), West Bengal (49%), and Maharashtra (39%). Gender-based analysis indicated higher hesitancy among males (36%) compared to females (26%). Among different study populations, medical students showed the lowest hesitancy rate (13%), whereas the general population exhibited the highest (34%). The findings suggest that vaccine hesitancy remains a significant concern in India, with one in four adults expressing hesitancy toward COVID-19 vaccination. Hesitancy rates vary across states, genders, and study populations. Addressing the factors contributing to hesitancy, such as safety concerns, lack of evidence, and misinformation, is crucial to enhance vaccine acceptance.

Aim: Today, vaccine hesitancy is one of the top 10 global health threats, which hinders adequate immunization coverage and herd immunity. The most recent global event that has led to a surge in vaccine hesitancy is the COVID-19 pandemic. COVID-19 vaccines have been studied extensively, but a sizable number of people continue to have misgivings towards COVID-19 vaccines. Materials and Methods: We performed a cross-sectional survey among adults across Tamil Nadu, India, to measure the frequency of vaccine hesitancy and to understand the factors contributing to it. Results: In our study population (n=1622), 49% were unwilling to get vaccinated. Hesitancy was higher among males when compared to females (54% vs. 41%) and among the older population when compared to the younger population (58% vs. 43%). The most preferred information sources regarding COVID-19 vaccines were television (38%), social media (25%), and newspapers (16%). Among the various social media platforms, WhatsApp was the most popular (33%), and Twitter was the least popular (2%). Half the population (52%) felt that herbal supplements were sufficient to provide immunity against COVID-19. The most common reason for hesitancy towards COVID-19 vaccination was the perception that the vaccine was not safe enough (52%). Conclusion: Our study shows that even after sufficient time had passed since the start of the pandemic, vaccine hesitancy in a progressive state such as Tamil Nadu was disturbingly high. This warrants the need for more efforts to educate the public about the necessity of vaccines.

Objectives: Vaccine hesitancy has been a barrier to achieving herd immunity during the coronavirus 2019 (COVID-19) pandemic. Having low socioeconomic status and education levels, and being a person of color, are associated with higher COVID-19 infection risk and worse outcomes. These same groups are associated with higher vaccine hesitancy. The state of Louisiana has one of the lowest vaccination rates in the country. In this study we aimed to identify demographic, perspective, and health behavior factors associated with vaccine hesitancy in emergency departments (ED) in Southeast Louisiana.Methods: A cross-sectional survey was distributed at three tertiary-care hospital EDs. Patients >18 years old and not in acute distress were recruited between April–July 2021. The 37-item questionnaire addressed socioeconomic demographics, social determinants of health, COVID-19 safety practices, thoughts and perceptions on COVID-19 and vaccines, sources of COVID-19 and vaccine information, and trust in the healthcare system.Results: Overall, 247 patients completed our survey. Of those, 29.6% reported they were vaccine hesitant. These respondents were significantly more likely, when compared to vaccine-acceptant respondents, to never have married, to have some college education, make less than

Despite the mass availability of COVID-19 vaccines in the United States, many Americans are still reluctant to take a vaccine as an outcome from exposure to misinformation. Additionally, while scholars have paid attention to COVID-19 vaccine hesitancy, the influence of general vaccine hesitancy for important viruses such as the flu has largely been ignored. Using nationally representative data from Pew Research Center's American Trends Panel survey (Wave 79), this study examined the relationship between perceived misinformation exposure, COVID-19 vaccine hesitancy, flu vaccine acceptance, political ideology, and demographic trends. The findings suggest that those who accepted the flu vaccine were less likely to be COVID-19 vaccine-hesitant. In addition, moderation analyses showed that perceived misinformation exposure increases COVID-19 vaccine hesitancy for conservatives and moderates but not for liberals. However, perceived misinformation exposure influences COVID-19 vaccine hesitancy among conservatives only if they are also flu vaccine-hesitant. Perceived misinformation exposure has no role in COVID-19 vaccine hesitancy if individuals (irrespective of political ideology) are regular with their flu vaccine. The results suggest that the effect of misinformation exposure on negative attitudes toward COVID-19 may be associated with generalized vaccine hesitancy (e.g., flu). The practical and theoretical implications are discussed.

Background and purposeRecent new mutations and increases in transmission of COVID-19 among adolescents and children highlight the importance of identifying which factors influence parental decisions regarding vaccinating their children. The current study aims to explore whether child vulnerability and parents' attitudes toward vaccines mediate the association between perceived financial well-being and vaccine hesitancy among parents.MethodA predictive, cross-sectional, multi-country online questionnaire was administered with a convenience sample of 6,073 parents (Australia, 2,734; Iran, 2,447; China, 523; Turkey, 369). Participants completed the Parent Attitude About Child Vaccines (PACV), the Child Vulnerability Scale (CVS), a Financial Well-being (FWB) measure, and Parental Vaccine Hesitancy (PVH) questionnaire.ResultsThe current study revealed that perceived financial well-being had significant and negative associations with parents' attitudes toward COVID-19 vaccines and child vulnerability among the Australian sample. Contrary to the Australian findings, results from Chinese participants indicated that financial well-being had significant and positive predictive effects on parent attitudes toward vaccines, child vulnerability, and parental vaccine hesitancy. The results of the Iranian sample revealed that parents' attitudes toward vaccines and child vulnerability significantly and negatively predicted parental vaccine hesitancy.ConclusionThe current study revealed that a parents' perceived financial well-being had a significant and negative relationship with parental attitudes about vaccines and child vulnerability; however, it did not significantly predict parental vaccine hesitancy among Turkish parents as it did for parents in Australia, Iran, and China. Findings of the study have policy implications for how certain countries may tailor their vaccine-related health messages to parents with low financial wellbeing and parents with vulnerable children.

ObjectivesVaccine 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.MethodsWe 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.ResultsAmong 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)].ConclusionsAmong 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.

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

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Background: The hesitation of healthcare professionals towards vaccines is becoming increasingly concerning, potentially undermining public confidence in vaccination programs. This study aimed to investigate the relationship between social responsibility, Prosocial tendency, and vaccine hesitancy among Chinese doctors, and to identify demographic factors associated with vaccine hesitancy. Method: A cross-sectional survey was conducted among 976 Chinese doctors. Participants completed a questionnaire to assess their sense of social responsibility, Prosocial tendency, and vaccine hesitancy. Demographic information, including age, gender, and marital status, was also collected. Correlation and mediation analyses were conducted to examine the relationships between the main variables. Results: Social responsibility was negatively correlated with vaccine hesitancy (r =-0.564, P <0.01) and positively correlated with Prosocial tendency (r =0.519, P <0.01). Prosocial tendency was negatively correlated with vaccine hesitancy (r =-0.505, P <0.01) and partially mediated the relationship between social responsibility and vaccine hesitancy. Younger age, female gender, and unmarried status were associated with higher levels of vaccine hesitancy. Conclusion: This study emphasized the important role of social responsibility and Prosocial tendency in reducing vaccine hesitancy among Chinese doctors. The findings suggest that interventions aimed at fostering a strong sense of social responsibility and promoting Prosocial tendency may effectively address vaccine hesitancy in this population. Additionally, targeted interventions focusing on young, female, and unmarried doctors may be necessary. [ABSTRACT FROM AUTHOR]

Background: South Africa faced challenges while implementing coronavirus disease 2019 (COVID-19) measures such as mass vaccination. Some people rejected or were hesitant to receive government-recommended vaccines. This study explored COVID-19 vaccination hesitancy among unvaccinated individuals in a primary care setting in Pretoria, South Africa. Methods: This was an exploratory phenomenological study that included one-on-one interviews with 12 individuals at Temba Community Health Centre in Pretoria, South Africa. Results: The research revealed five themes: perceptions of COVID-19 disease, perceptions of COVID-19 vaccine, factors related to non-vaccination, information sources about the COVID-19 vaccine, and long-term vaccination decisions. There were seven linked sub-themes. Conclusion: Overall, participants had a good understanding of COVID-19 disease, but limited knowledge about the vaccine, causing hesitancy to get vaccinated. Reasons for not getting vaccinated included health-related concerns, safety concerns, personal experiences, and social and political factors. Safety and health-related concerns were prevalent, with adverse vaccine outcomes being the most common concern. Most participants had experienced a historic encounter with a vaccine-related death or illness. Contribution: Vaccine hesitancy should be viewed as a powerful concern from the community, and a key source of worry for the health authorities over any vaccine-related doubt.

The aim of this paper is to propose an original analysis of the association between social status and attitudes toward COVID-19 vaccines regarding upper-secondary students in Italy. The research was conducted by administering an online survey on a probabilistic and stratified sample of 5,699 students, in the spring of 2021, when the vaccination campaign in Italy had been underway for only a few months. Following the bourdieusian perspective, we have used a multiple correspondence analysis to examine the polarization between pro-vaccine and anti-vaccine groups as the clash of stances that agents take in accordance with their position in the cultural field. Our results suggest that the construction of a negative school experience by the subordinate classes is the source of a lack of social recognition in the cultural field, which feeds an aversion to everything the main institutions in this field recommend should be done.

Abstract Background Despite nearly a quarter of Venezuelans remaining unvaccinated against coronavirus disease 2019 (COVID-19), the factors contributing to vaccine hesitancy in the country have not been thoroughly investigated. Methods A cross-sectional study was conducted from October 15th to 30th, 2022, using a knowledge, attitudes, and practices (KAP) survey to identify factors associated with COVID-19 vaccine hesitancy. Results The study analyzed data from 1,930 participants from all 24 states of Venezuela. The majority (93.4%) were vaccinated. The mean age was 40 years, predominantly female (67.3%), and held a university degree (70.6%). The mean KAP score was significantly higher among vaccinated individuals compared to unvaccinated ones (7.79 vs. 3.94 points for knowledge, 40 vs. 24 points for attitudes, and 16 vs. 10 points for practices, all p