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Vaccine Hesitancy and COVID-19
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Vaccine Hesitancy and COVID-19

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Infectious Disease Epidemiology".

Deadline for manuscript submissions: closed (31 December 2022) | Viewed by 90857

Special Issue Editor

Dr. Zahid Ahmad Butt

E-Mail Website
Guest Editor
School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada
Interests: HIV/HCV/HBV coinfections; vaccine preventable diseases; communicable and non-communicable disease syndemics; global health; big data; spatial analysis of complex data

Special Issue Information

Dear Colleagues,

As Section Editor-in-Chief of the Section Infectious Disease Epidemiology of the International Journal of Environmental Research and Public Health, it is my pleasure to invite you to contribute articles to the Special Issue of the journal dedicated to vaccine hesitancy and COVID-19.

Vaccination is one of the most significant public health interventions for reducing the burden of infectious diseases globally. Vaccines have been instrumental in tackling several preventable diseases, such as polio, tetanus, tuberculosis, measles, mumps, and rubella. In fact, the most significant achievement of vaccination has been the eradication of smallpox. Despite the continued success of vaccination in preventing infectious diseases, the spread of misinformation and antivaccination movements have led to increased vaccine hesitancy all over the world. According to the Strategic Advisory Group of Experts (SAGE) working group, vaccine hesitancy can be defined as the “delay in acceptance or refusal of vaccination despite the availability of vaccine services”. Vaccine hesitancy has increased worldwide due to different factors and barriers that should be addressed to improve the acceptance of global vaccination programs in both developed and developing countries. The issue of vaccine hesitancy has become even more important in the context of the ongoing COVID-19 pandemic. Therefore, it is imperative to conduct high-quality research that can examine and understand the factors related to vaccine hesitancy related to COVID-19.

This Special Issue of IJERPH is designed to enable the rapid publication and dissemination of innovative research with the aim of advancing the scientific knowledge and highlighting future perspectives on vaccine hesitancy associated with COVID-19 vaccines. We are interested in all aspects of COVID-19 research that relate to vaccine hesitancy. Potential topics on aspects of COVID-19 vaccine hesitancy are listed below under the Keywords/Topics section.

Dr. Zahid Butt
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Vaccine hesitancy, especially related to COVID-19
  • Willingness or intention to use COVID-19 vaccines
  • Misinformation and disinformation related to COVID-19 vaccines
  • Social media and vaccine hesitancy
  • Methodological approaches to understand COVID-19 hesitancy
  • Vaccine complacency, convenience, and confidence

Published Papers (24 papers)

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22 pages, 716 KiB  
Article
Diné (Navajo) Traditional Knowledge Holders’ Perspective of COVID-19
by Carmella B. Kahn, DeeDee James, Shawndeena George, Tressica Johnson, Michelle Kahn-John, Nicolette I. Teufel-Shone, Chassity Begay, Marissa Tutt and Mark C. Bauer
Int. J. Environ. Res. Public Health 2023, 20(4), 3728; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph20043728 - 20 Feb 2023
Cited by 1 | Viewed by 3004
Abstract
From the start of the COVID-19 pandemic on the Navajo Nation, Diné (Navajo) traditional knowledge holders (TKHs), such as medicine men and women and traditional practitioners, contributed their services and healing practices. Although TKHs are not always fully acknowledged in the western health [...] Read more.
From the start of the COVID-19 pandemic on the Navajo Nation, Diné (Navajo) traditional knowledge holders (TKHs), such as medicine men and women and traditional practitioners, contributed their services and healing practices. Although TKHs are not always fully acknowledged in the western health care system, they have an established role to protect and promote the health of Diné people. To date, their roles in mitigating the COVID-19 pandemic have not been fully explored. The purpose of this research was to understand the social and cultural contexts of the COVID-19 pandemic and vaccines based on the roles and perspectives of Diné TKHs. A multi-investigator consensus analysis was conducted by six American Indian researchers using interviews with TKHs collected between December 2021–January 2022. The Hózhó Resilience Model was used as a framework to analyze the data using four parent themes: COVID-19, harmony and relationships, spirituality, and respect for self and discipline. These parent themes were further organized into promoters and/or barriers for 12 sub-themes that emerged from the data, such as traditional knowledge, Diné identity, and vaccine. Overall, the analysis showed key factors that could be applied in pandemic planning and public health mitigation efforts based on the cultural perspective of TKHs. Full article
(This article belongs to the Special Issue Vaccine Hesitancy and COVID-19)
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13 pages, 676 KiB  
Article
Attitude of Parents of Children with Cerebral Palsy Towards COVID-19 Vaccination
by Ramy Mohamed Ghazy, Malik Sallam, Noha Fadl, Etwal Bouraad, Naglaa Youssef and Omnya Samy A. Ghoneim
Int. J. Environ. Res. Public Health 2023, 20(3), 1909; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph20031909 - 20 Jan 2023
Cited by 6 | Viewed by 1873
Abstract
Children with cerebral palsy (CP) are at a greater risk of respiratory complications from coronavirus disease 2019 (COVID-19). Therefore, this study aimed to assess COVID-19 vaccine hesitancy (VH) among parents of CP children in Egypt, using the Arabic version of the Parental Attitude [...] Read more.
Children with cerebral palsy (CP) are at a greater risk of respiratory complications from coronavirus disease 2019 (COVID-19). Therefore, this study aimed to assess COVID-19 vaccine hesitancy (VH) among parents of CP children in Egypt, using the Arabic version of the Parental Attitude about Childhood Vaccination (PACV) questionnaire. This cross-sectional survey study was conducted at the outpatient clinics of two hospitals in Cairo, Egypt. Parents of children with CP were recruited using a simple random sampling technique. A total of 321 parents were enrolled; more than half of them were mothers of the children (61.37%); and the majority were Egyptians (87.23%) and living in urban areas (84.42%). Nearly 70% of the parents were hesitant to administer the COVID-19 vaccine to their children. A multiple linear regression model revealed that the PACV mean scores were lower among the following categories: (1) parents who could pay back loans, compared to those who could not pay back loans and who reported insufficient income (β = −2.39, p = 0.030); (2) non-Egyptian parents (β = −1.54, p = 0.002); (3) those who were fully vaccinated against COVID-19 themselves or had the intention to receive the complete COVID-19 vaccination (β = −6.28, p < 0.001); (4) those who had the intention to give the COVID-19 vaccination to their children (β = −3.04, p < 0.001); and (5) parents whose children received routine vaccines (β = −2.86, p < 0.045). After adjusting for other covariates, the parental COVID-19 vaccine status (β = −6.28, p < 0.001) and parents who experienced a COVID-19-related death in the family (β = −1.75, p < 0.001) showed significantly lower mean PACV scores. However, higher mean PACV scores were reported among parents who had a COVID-19 infection (β = 2.77, p < 0.001) or who were not sure (β = 2.94, p < 0.001). Our findings suggest the need to increase COVID-19 vaccine acceptance among parents of vulnerable children to reduce the negative consequences of COVID-19. Full article
(This article belongs to the Special Issue Vaccine Hesitancy and COVID-19)
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12 pages, 489 KiB  
Article
Knowledge, Attitude, and Acceptance of Sinopharm and AstraZeneca’s COVID-19 Vaccines among Egyptian Population: A Cross-Sectional Study
by Marian S. Boshra, Marwa O. Elgendy, Lamiaa N Abdelaty, Mahmoud Tammam, Abdullah S. Alanazi, Abdulaziz Ibrahim Alzarea, Saud Alsahali and Rania M. Sarhan
Int. J. Environ. Res. Public Health 2022, 19(24), 16803; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph192416803 - 14 Dec 2022
Cited by 2 | Viewed by 1385
Abstract
Background: This study aimed to evaluate the Egyptian population’s preference and awareness related to available COVID-19 vaccines and to determine different factors that can affect beliefs concerning these vaccines. Methods: A cross-sectional web-based study was carried out among the general population in Egypt. [...] Read more.
Background: This study aimed to evaluate the Egyptian population’s preference and awareness related to available COVID-19 vaccines and to determine different factors that can affect beliefs concerning these vaccines. Methods: A cross-sectional web-based study was carried out among the general population in Egypt. Data collection was conducted via an online questionnaire. Results: About 426 subjects participated in the survey. Vaccine preference is nearly equally even (50%) among all respondents. There was no significant difference in vaccine preference according to age, gender, residence, educational level, or social status. About 50% of public respondents mentioned that both AstraZeneca and Sinopharm vaccines do not offer protection against new variant COVID-19 strains. Healthcare workers are the lowest respondents to agree that vaccines offer protection against new COVID-19 variants (10.9%) compared to unemployed respondents (20.3%) and other professions (68.8%) with a statistically significant difference (p < 0.005). Safety of vaccine administration among children below 18 showed statistical differences for gender and educational level predictors. Conclusions: Most of the study population has satisfying knowledge about the COVID-19 vaccine. Continuous awareness campaigns must be carried out so that the people’s background is updated with any new information that would help in raising the trust in vaccination. Full article
(This article belongs to the Special Issue Vaccine Hesitancy and COVID-19)
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12 pages, 742 KiB  
Article
COVID-19 Vaccine Hesitancy among U.S. Veterans Experiencing Homelessness in Transitional Housing
by June L. Gin, Michelle D. Balut and Aram Dobalian
Int. J. Environ. Res. Public Health 2022, 19(23), 15863; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph192315863 - 29 Nov 2022
Cited by 8 | Viewed by 1960
Abstract
Little is known about COVID-19 vaccine hesitancy and acceptance among individuals experiencing homelessness, despite their higher risk for morbidity and mortality from SARS-CoV-2. This study examines COVID-19 vaccination attitudes and uptake among U.S. military Veterans experiencing homelessness enrolled in transitional housing programs funded [...] Read more.
Little is known about COVID-19 vaccine hesitancy and acceptance among individuals experiencing homelessness, despite their higher risk for morbidity and mortality from SARS-CoV-2. This study examines COVID-19 vaccination attitudes and uptake among U.S. military Veterans experiencing homelessness enrolled in transitional housing programs funded by the U.S. Department of Veterans Affairs (VA). Telephone interviews were conducted with 20 Veterans in California, Florida, Iowa, Kentucky, and Massachusetts, USA (January–April 2021). A rapid analysis approach was used to identify and enumerate commonly occurring themes. Although 60% of interviewed Veterans either received the COVID-19 vaccine or were willing to do so, one-third expressed hesitancy to get vaccinated. COVID-19 vaccination attitudes (e.g., belief that the vaccines were inadequately tested), military experience, beliefs about influenza and other vaccines, and sources of information emerged as influential factors for COVID-19 vaccination uptake or hesitancy. Veterans in VA-funded homeless transitional housing programs are generally willing to be vaccinated. However, a substantial minority is reluctant to take the vaccine due to concerns about the COVID-19 vaccine and distrust of authority. Recommendations for increasing uptake include utilizing Veteran peers, homeless service providers, and healthcare providers as trusted messengers to improve confidence in the vaccine. Full article
(This article belongs to the Special Issue Vaccine Hesitancy and COVID-19)
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11 pages, 363 KiB  
Article
The Waning of BNT162b2 Vaccine Effectiveness for SARS-CoV-2 Infection Prevention over Time: A Test-Negative Study in Health Care Professionals of a Health Department from January 2021 to December 2021
by Natali Jiménez-Sepúlveda, Pablo Chico-Sánchez, José Miguel Castro-García, Isabel Escribano-Cañadas, Esperanza Merino-Lucas, Elena Ronda-Pérez, José Sánchez-Payá, Paula Gras-Valentí and on behalf of the COVID-19 Preventive Medicine Group
Int. J. Environ. Res. Public Health 2022, 19(21), 13884; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph192113884 - 25 Oct 2022
Cited by 1 | Viewed by 1501
Abstract
The duration of protection of vaccines against SARS-CoV-2 infection has been evaluated in previous studies, but uncertainty remains about the persistence of effectiveness over time and the ideal timing for booster doses. Therefore, the aim of this study was to evaluate BNT162b2 vaccine [...] Read more.
The duration of protection of vaccines against SARS-CoV-2 infection has been evaluated in previous studies, but uncertainty remains about the persistence of effectiveness over time and the ideal timing for booster doses. Therefore, the aim of this study was to evaluate BNT162b2 vaccine effectiveness against SARS-CoV-2 infection in health care workers (HCWs) at a tertiary hospital depending on time elapsed since the completion of a two-dose vaccination regimen. We conducted a case–control with negative test study between 25 January and 12 December 2021 that included 1404 HCWs who underwent an active infection diagnostic test (AIDT) to rule out SARS-CoV-2 infection due to COVID-19 suspicion or prior close contact with patients diagnosed with COVID-19. The adjusted vaccine effectiveness (aVE) for the prevention of SARS-CoV-2 infection 12 to 120 days after completing the full two-dose vaccination regimen was 91.9%. Then, aVE decreased to 63.7% between 121 to 240 days after completing the full two-dose regimen and to 37.2% after 241 days since the second dose. Vaccination against SARS-CoV-2 infection in HCWs remains highly effective after 12 to 120 days have elapsed since the administration of two doses of the BNT162b2 vaccine; however, effectiveness decreases as time elapses since its administration. Full article
(This article belongs to the Special Issue Vaccine Hesitancy and COVID-19)
26 pages, 5283 KiB  
Article
Revealing Public Opinion towards the COVID-19 Vaccine with Weibo Data in China: BertFDA-Based Model
by Jianping Zhu, Futian Weng, Muni Zhuang, Xin Lu, Xu Tan, Songjie Lin and Ruoyi Zhang
Int. J. Environ. Res. Public Health 2022, 19(20), 13248; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph192013248 - 14 Oct 2022
Cited by 10 | Viewed by 3182
Abstract
The COVID-19 pandemic has created unprecedented burdens on people’s health and subjective well-being. While countries around the world have established models to track and predict the affective states of COVID-19, identifying the topics of public discussion and sentiment evolution of the vaccine, particularly [...] Read more.
The COVID-19 pandemic has created unprecedented burdens on people’s health and subjective well-being. While countries around the world have established models to track and predict the affective states of COVID-19, identifying the topics of public discussion and sentiment evolution of the vaccine, particularly the differences in topics of concern between vaccine-support and vaccine-hesitant groups, remains scarce. Using social media data from the two years following the outbreak of COVID-19 (23 January 2020 to 23 January 2022), coupled with state-of-the-art natural language processing (NLP) techniques, we developed a public opinion analysis framework (BertFDA). First, using dynamic topic clustering on Weibo through the latent Dirichlet allocation (LDA) model, a total of 118 topics were generated in 24 months using 2,211,806 microblog posts. Second, by building an improved Bert pre-training model for sentiment classification, we provide evidence that public negative sentiment continued to decline in the early stages of COVID-19 vaccination. Third, by modeling and analyzing the microblog posts from the vaccine-support group and the vaccine-hesitant group, we discover that the vaccine-support group was more concerned about vaccine effectiveness and the reporting of news, reflecting greater group cohesion, whereas the vaccine-hesitant group was particularly concerned about the spread of coronavirus variants and vaccine side effects. Finally, we deployed different machine learning models to predict public opinion. Moreover, functional data analysis (FDA) is developed to build the functional sentiment curve, which can effectively capture the dynamic changes with the explicit function. This study can aid governments in developing effective interventions and education campaigns to boost vaccination rates. Full article
(This article belongs to the Special Issue Vaccine Hesitancy and COVID-19)
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9 pages, 336 KiB  
Article
Intention to Pay for Vaccination and Influencing Factors of General Residents: A National Cross-Sectional Study
by Weixin Zhang, Xin Shen, Ting Li, Nan Li, Yanyan Sun, Siyu Zhu, Nana Liu, Huifang Song, Kun Tang, Yujia Wang, Ying Zhang, Hui Cao, Yibo Wu, Yong Gan and Xinyao Zhang
Int. J. Environ. Res. Public Health 2022, 19(18), 11154; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph191811154 - 06 Sep 2022
Cited by 2 | Viewed by 1663
Abstract
Background: As an important part of the promotion of immunization programs and the suppression of infectious diseases, paid vaccines can prevent a variety of diseases and meet the needs of different populations. However, few studies focus on the public’s intention to pay for [...] Read more.
Background: As an important part of the promotion of immunization programs and the suppression of infectious diseases, paid vaccines can prevent a variety of diseases and meet the needs of different populations. However, few studies focus on the public’s intention to pay for vaccination. Methods: The survey was conducted from 10 July to 15 September 2021, adopting a cross-sectional survey in China. We used a multi-stage sampling strategy to recruit participators from 120 cities. Participants filled out questions which assessed their intentions to pay for vaccination. A linear regression analysis was given to identify the predictors associated with the subjects’ attitudes. Results: There were 11,031 residents who finished our questionnaire. Chinese residents’ intention to receive paid vaccines scored 74.5 points. Residents who were male (β = −0.03) and older (30–44 (β = −0.03) or 45–59 (β = −0.06) or ≥60 (β = −0.08)), living alone (β = −0.03), who had moderate to severe anxiety (β = −0.03) or severe anxiety (β = −0.03) were more likely to refuse vaccination, while those who lived in Western China (β = 0.03) who had higher PSSS scores and HLS-SF12 index might acquire the intention to pay for vaccination. Conclusions: The study found that gender, age, region, living alone, anxiety, social support, and health literacy were the main influencing factors of residents’ attitudes. Governments and health institutions should take targeted measures to improve the health literacy and mental health of the population in order to facilitate the implementation of vaccination withdrawal and immunization policies. Full article
(This article belongs to the Special Issue Vaccine Hesitancy and COVID-19)
12 pages, 349 KiB  
Article
Between Healthcare Practitioners and Clergy: Evangelicals and COVID-19 Vaccine Hesitancy
by Jeanine P. D. Guidry, Carrie A. Miller, Paul B. Perrin, Linnea I. Laestadius, Gina Zurlo, Matthew W. Savage, Michael Stevens, Bernard F. Fuemmeler, Candace W. Burton, Thomas Gültzow and Kellie E. Carlyle
Int. J. Environ. Res. Public Health 2022, 19(17), 11120; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph191711120 - 05 Sep 2022
Cited by 6 | Viewed by 2506
Abstract
Evangelical Christians are among the most hesitant to get the COVID-19 vaccine. This study examined the extent to which COVID-19 vaccination uptake among Evangelicals is explained by demographic characteristics, Health Belief Model constructs, and faith-based support factors. Survey research firm Qualtrics recruited 531 [...] Read more.
Evangelical Christians are among the most hesitant to get the COVID-19 vaccine. This study examined the extent to which COVID-19 vaccination uptake among Evangelicals is explained by demographic characteristics, Health Belief Model constructs, and faith-based support factors. Survey research firm Qualtrics recruited 531 U.S. adults and conducted a survey to explore predictors of COVID-19 vaccine uptake among people who self-identified as Evangelicals in September 2021. A logistic regression showed that those reporting high perceived benefits of the COVID-19 vaccine were more likely to be vaccinated, while those reporting high perceived barriers were less likely to be vaccinated. Those whose healthcare provider asked them about the vaccine were more likely to be vaccinated than those whose healthcare provider did not ask. Finally, while those who reported information seeking from religious leaders were less likely to be vaccinated, those who reported more faith-based support for vaccination were more likely to be vaccinated. In addition to beliefs about benefits and barriers to vaccination, the role of healthcare providers and clergy were important factors influencing vaccination status. Intervention efforts that capitalize on partnerships between health providers and clergy in supportive congregations may be able to reach undecided Evangelicals. Full article
(This article belongs to the Special Issue Vaccine Hesitancy and COVID-19)
11 pages, 723 KiB  
Article
Distrustful, Dissatisfied, and Conspiratorial: A Latent Profile Analysis of COVID-19 Vaccination Rejection
by Monika Lamot, Katja Kerman and Andrej Kirbiš
Int. J. Environ. Res. Public Health 2022, 19(16), 10096; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph191610096 - 15 Aug 2022
Cited by 11 | Viewed by 2520
Abstract
Trust in science and scientists, satisfaction with the national government, and endorsement of conspiracy theories are important factors in the decision to be vaccinated. In this study, we investigated whether there are different profiles of individuals depending on the above factors and whether [...] Read more.
Trust in science and scientists, satisfaction with the national government, and endorsement of conspiracy theories are important factors in the decision to be vaccinated. In this study, we investigated whether there are different profiles of individuals depending on the above factors and whether they differ in their sociodemographic composition. We used data from Round 10 of the European Social Survey for Slovenia, employing a nationally representative sample of 1252 participants. Based on latent profile analysis, three distinct profiles emerged: Profile 1 expressed moderate trust in science, satisfaction with government, and high endorsement of conspiracies; Profile 2 expressed low trust and satisfaction and moderate endorsement of conspiracies; Profile 3 expressed high trust and satisfaction and low beliefs in conspiracy theories. In addition, Profile 3 expressed the strongest support for vaccination and Profile 2 the lowest. Our results suggest that distrust, dissatisfaction, and the presence of conspiracy theories are the “perfect storm” for vaccination rejection. In contrast, despite conspiracy theories, a certain level of trust and satisfaction may reduce vaccination rejection. Full article
(This article belongs to the Special Issue Vaccine Hesitancy and COVID-19)
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14 pages, 805 KiB  
Article
Students’ Attitudes toward COVID-19 Vaccination: An Inter-University Study from Bulgaria
by Martina Moskova, Anelia Zasheva, Metodi Kunchev, Ivan Popivanov, Dimo Dimov, Virsavia Vaseva, Todor Kundurzhiev, Ilia Tsachev and Magdalena Baymakova
Int. J. Environ. Res. Public Health 2022, 19(16), 9779; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19169779 - 09 Aug 2022
Cited by 6 | Viewed by 1810
Abstract
In Bulgaria, vaccination coverage against the SARS-CoV-2 virus is low. The reasons for this fact are many and varied. The aim of the present study was to establish what the attitudes towards the COVID-19 vaccination process are among students from various specialties from [...] Read more.
In Bulgaria, vaccination coverage against the SARS-CoV-2 virus is low. The reasons for this fact are many and varied. The aim of the present study was to establish what the attitudes towards the COVID-19 vaccination process are among students from various specialties from several Bulgarian universities. In this research, 600 students participated, divided into two groups: Doctor of Medicine (MD) students (n = 300) and non-MD students, i.e., students of specialties, such as mathematics, engineering, finance and economics, law, human sciences, etc. (n = 300). Each respondent completed a questionnaire which was divided into three parts with closed questions. The mean age of all students was 21.19 ± 1.87 years (95% CI: 20.48–21.90). The female sex dominated among the analyzed participants (sex ratio: female/male = 1/0.85). Nearly 62% (371/600) of individuals declared that they have been COVID-19 vaccinated with at least one dose (p < 0.001). Overall, 33% of the participants sought information on vaccines from video sharing platforms and 36.0% (216/600) from social media platforms. From the conducted multivariable logistic regression the odds of vaccination against COVID-19 were 6.225 times higher in individuals with a positive attitude towards these vaccines than in people with a negative attitude towards them (p < 0.001). We have found that those students who trust the international health organizations had an OR of 2.365 (p = 0.004) to be SARS-CoV-2 vaccinated. We estimated that the odds of vaccination against SARS-CoV-2 among children were 4.794 times higher in parents (students) who had been vaccinated than in non-vaccinated parents (students) (p < 0.001). Our results could support the national public health organizations, the national educational/scientific systems, and the management of Bulgarian universities in making future decisions about the field of COVID-19 control and prevention. Full article
(This article belongs to the Special Issue Vaccine Hesitancy and COVID-19)
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12 pages, 681 KiB  
Article
Predictors of Uncertainty and Unwillingness to Receive the COVID-19 Vaccine in Men Who Have Sex with Men in France
by Youssoufa M. Ousseine, Sophie Vaux, Stéphanie Vandentorren, Isabelle Bonmarin, Karen Champenois, Nathalie Lydié and Annie Velter
Int. J. Environ. Res. Public Health 2022, 19(9), 5372; https://doi.org/10.3390/ijerph19095372 - 28 Apr 2022
Cited by 13 | Viewed by 1996
Abstract
The development of vaccines against COVID-19 has given hope to populations. Public acceptability of vaccination is a major driver in containing the disease. However, in marginalized and stigmatized populations, uncertainty and unwillingness may be a challenge. This study aimed to analyze the factors [...] Read more.
The development of vaccines against COVID-19 has given hope to populations. Public acceptability of vaccination is a major driver in containing the disease. However, in marginalized and stigmatized populations, uncertainty and unwillingness may be a challenge. This study aimed to analyze the factors associated with uncertainty and unwillingness to vaccinate against COVID-19 in men who have sex with men (MSM) living in France. The data used came from Rapport au Sexe (ERAS) 2021, a voluntary, cross-sectional, anonymous, self-administered, online survey conducted from 26 February to 11 April 2021. Among the 15,426 respondents included in the analysis, 60.5% were willing to vaccinate (these included persons already vaccinated), 17.5% were not, and 22% were uncertain. Factors independently associated with uncertainty and unwillingness were lower education level, low health literacy level, financial hardship, being under 30 years of age, and living in a rural area. HIV-positive MSM were less likely to report vaccination uncertainty and unwillingness than HIV-negative MSM and those with unknown serostatus. Although more impacted by COVID-19, socioeconomically vulnerable MSM were the sub-group most unwilling to vaccinate. To improve acceptability of COVID-19 vaccination in MSM, policy makers and researchers must increase access to and understanding of medical information by considering the general public’s health literacy when developing information sources. Moreover, a dedicated global care approach, which ensures these populations can be reached, is necessary. Full article
(This article belongs to the Special Issue Vaccine Hesitancy and COVID-19)
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20 pages, 2104 KiB  
Article
Adolescent COVID-19 Vaccine Decision-Making among Parents in Southern California
by Suellen Hopfer, Emilia J. Fields, Magdalen Ramirez, Sorina Neang Long, Heather C. Huszti, Adrijana Gombosev, Bernadette Boden-Albala, Dara H. Sorkin and Dan M. Cooper
Int. J. Environ. Res. Public Health 2022, 19(7), 4212; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19074212 - 01 Apr 2022
Cited by 6 | Viewed by 2907
Abstract
Adolescent COVID-19 vaccination has stalled at 53% in the United States. Vaccinating adolescents remains critical to preventing the continued transmission of COVID-19, the emergence of variants, and rare but serious disease in children, and it is the best preventive measure available to return [...] Read more.
Adolescent COVID-19 vaccination has stalled at 53% in the United States. Vaccinating adolescents remains critical to preventing the continued transmission of COVID-19, the emergence of variants, and rare but serious disease in children, and it is the best preventive measure available to return to in-person schooling. We investigated parent–adolescent COVID-19 vaccine decision-making. Between 24 February and 15 March 2021, we conducted surveys and 12 focus groups with 46 parent–adolescent dyads in Southern California. Parents and adolescents completed a survey prior to participation in a focus group discussion, which focused on exploring COVID-19 vaccine acceptance or uncertainty and was guided by the 5C vaccine hesitancy model. Parents uncertain about vaccinating adolescents expressed low vaccine confidence and high COVID-19 disease risk complacency. Parents who accepted COVID-19 vaccination for adolescents expressed high confidence in health authority vaccine recommendations, high perceived COVID-19 risk, and collective responsibility to vaccinate children. Additionally, unique pandemic-related factors of vaccine acceptance included vaccinating for emotional health, resuming social activities, and vaccine mandates. Among parents, 46% were willing to vaccinate their adolescent, 11% were not, and 43% were unsure. Among adolescents, 63% were willing to vaccinate. Despite vaccine availability, 47% of adolescents remain unvaccinated against COVID-19. Factors associated with vaccine uncertainty and acceptability inform health care practitioner, school, community, and public health messaging to reach parents and adolescents. Full article
(This article belongs to the Special Issue Vaccine Hesitancy and COVID-19)
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10 pages, 732 KiB  
Article
Willingness to Receive the COVID-19 Vaccination and the Psychological State of Japanese University Students: A Cross-Sectional Study
by Shogo Tsutsumi, Noriaki Maeda, Tsubasa Tashiro, Satoshi Arima, Rami Mizuta, Kazuki Fukui, Koichi Naito, Makoto Komiya and Yukio Urabe
Int. J. Environ. Res. Public Health 2022, 19(3), 1654; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19031654 - 31 Jan 2022
Cited by 7 | Viewed by 2769
Abstract
Vaccinations may be one of the solutions to end the COVID-19 pandemic. One’s psychological state may be strongly related to one’s willingness to be vaccinated. This study investigated the relationship between the psychological state of Japanese university students and their willingness to be [...] Read more.
Vaccinations may be one of the solutions to end the COVID-19 pandemic. One’s psychological state may be strongly related to one’s willingness to be vaccinated. This study investigated the relationship between the psychological state of Japanese university students and their willingness to be vaccinated. A self-report questionnaire on COVID-19, its vaccines (vaccination status, and perceived efficacy and safety), and psychological state (anxiety and depressive mood) was administered online, and 560 valid responses were obtained. The unvaccinated group reported significantly lower perceived vaccine effectiveness and importance than the vaccinated group. However, there were no differences in anxiety and depressive mood symptoms between the two groups. Multivariate logistic regression analysis was performed on the unvaccinated participants to identify the factors associated with their unwillingness to be vaccinated; there was a significant association between anxiety and unwillingness to receive the vaccine (p < 0.05). However, there was no significant association between depressive mood and unwillingness to receive the vaccine. The results suggest that timely psychological support for Japanese university students experiencing high levels of anxiety is important in accelerating vaccination programs. Full article
(This article belongs to the Special Issue Vaccine Hesitancy and COVID-19)
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14 pages, 542 KiB  
Article
Sociodemographic Factors Associated with Vaccine Hesitancy in Central Texas Immediately Prior to COVID-19 Vaccine Availability
by John R. Litaker, Naomi Tamez, Carlos Lopez Bray, Wesley Durkalski and Richard Taylor
Int. J. Environ. Res. Public Health 2022, 19(1), 368; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19010368 - 30 Dec 2021
Cited by 15 | Viewed by 2600
Abstract
Vaccine-induced herd immunity remains the best opportunity for ending the COVID-19 pandemic. However, COVID-19 vaccine hesitancy is a real concern. In this paper, we report on vaccine hesitancy in Central Texas immediately prior to the release of the two mRNA COVID-19 vaccines in [...] Read more.
Vaccine-induced herd immunity remains the best opportunity for ending the COVID-19 pandemic. However, COVID-19 vaccine hesitancy is a real concern. In this paper, we report on vaccine hesitancy in Central Texas immediately prior to the release of the two mRNA COVID-19 vaccines in late December 2020. A total of 1648 individuals 18 years or older with health insurance living in Central Texas completed a survey on sociodemographic factors and plans to obtain the COVID-19 vaccine. Of the respondents, 64.1% planned to obtain the COVID-19 vaccine. Logistic regression identified the following sociodemographic factors associated with vaccine hesitancy: Black or African American race (POR: 0.351, p < 0.001, 95% CI: 0.211, 0.584), female sex (POR: 0.650, p < 0.001, 95% CI: 0.518, 0.816), age of 35–49 years old (POR: 0.689, p = 0.004, 95% CI: 0.534, 0.890), annual household income of less than US$10,000 (POR: 0.565, p = 0.041, 95% CI: 0.327, 0.976), a high school education or less (POR: 0.565, p = 0.001, 95% CI: 0.401, 0.795), and a high school education but less than a 4-year college degree (POR: 0.572, p < 0.001, 95% CI: 0.442, 0.739). Real-world evidence provided by individuals on plans to get vaccinated can reveal COVID-19 vaccine hesitancy associated heterogeneity. Full article
(This article belongs to the Special Issue Vaccine Hesitancy and COVID-19)
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14 pages, 359 KiB  
Article
Does the COVID-19 Vaccine Still Work That “Most of the Confirmed Cases Had Been Vaccinated”? A Content Analysis of Vaccine Effectiveness Discussion on Sina Weibo during the Outbreak of COVID-19 in Nanjing
by Hao Gao, Qingting Zhao, Chuanlin Ning, Difan Guo, Jing Wu and Lina Li
Int. J. Environ. Res. Public Health 2022, 19(1), 241; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19010241 - 26 Dec 2021
Cited by 8 | Viewed by 4007
Abstract
In July 2021, breakthrough cases were reported in the outbreak of COVID-19 in Nanjing, sparking concern and discussion about the vaccine’s effectiveness and becoming a trending topic on Sina Weibo. In order to explore public attitudes towards the COVID-19 vaccine and their emotional [...] Read more.
In July 2021, breakthrough cases were reported in the outbreak of COVID-19 in Nanjing, sparking concern and discussion about the vaccine’s effectiveness and becoming a trending topic on Sina Weibo. In order to explore public attitudes towards the COVID-19 vaccine and their emotional orientations, we collected 1542 posts under the trending topic through data mining. We set up four categories of attitudes towards COVID-19 vaccines, and used a big data analysis tool to code and manually checked the coding results to complete the content analysis. The results showed that 45.14% of the Weibo posts (n = 1542) supported the COVID-19 vaccine, 12.97% were neutral, and 7.26% were doubtful, which indicated that the public did not question the vaccine’s effectiveness due to the breakthrough cases in Nanjing. There were 66.47% posts that reflected significant negative emotions. Among these, 50.44% of posts with negative emotions were directed towards the media, 25.07% towards the posting users, and 11.51% towards the public, which indicated that the negative emotions were not directed towards the COVID-19 vaccine. External sources outside the vaccine might cause vaccine hesitancy. Public opinions expressed in online media reflect the public’s cognition and attitude towards vaccines and their core needs in terms of information. Therefore, online public opinion monitoring could be an essential way to understand the opinions and attitudes towards public health issues. Full article
(This article belongs to the Special Issue Vaccine Hesitancy and COVID-19)
16 pages, 1033 KiB  
Article
COVID-19 Vaccine Early Skepticism, Misinformation and Informational Needs among Essential Workers in the USA
by Elena Savoia, Maxwell Su, Rachael Piltch-Loeb, Evelyn Masterson and Marcia A. Testa
Int. J. Environ. Res. Public Health 2021, 18(24), 13244; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182413244 - 15 Dec 2021
Cited by 6 | Viewed by 3716
Abstract
This study presents the results of a survey of 1591 hesitant U.S. essential workers, conducted over Pollfish in December 2020 when they were the only group eligible for the vaccine, aiming to describe their concerns regarding COVID-19 vaccine safety, effectiveness and distribution policies. [...] Read more.
This study presents the results of a survey of 1591 hesitant U.S. essential workers, conducted over Pollfish in December 2020 when they were the only group eligible for the vaccine, aiming to describe their concerns regarding COVID-19 vaccine safety, effectiveness and distribution policies. We computed frequencies using the SAS software for each answer, using chi-squared statistics and Cochran–Armitage trend tests to determine how informational needs differ by age, gender, level of education, race, source of COVID-19 information and levels of vaccine acceptance. The results of this study show that freedom of choice, equal access to the vaccine and being able to live a life with no restrictions once vaccinated were important concerns since the early days of the distribution campaign, with 53% (836/1591), 42% (669/1591) and 35% (559/1591) of hesitant respondents, respectively, indicating they would be more likely to receive the COVID-19 vaccine if they felt these issues were satisfactorily addressed. Early risk communication and immunization campaign strategies should address not only the reported efficacy and safety of new vaccines, but, as equally important, the population’s perceptions and beliefs regarding personal choice, effectiveness and adverse consequences. Full article
(This article belongs to the Special Issue Vaccine Hesitancy and COVID-19)
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10 pages, 326 KiB  
Article
Caregiver Willingness to Vaccinate Their Children against COVID-19 after Adult Vaccine Approval
by Ran D. Goldman, Danna Krupik, Samina Ali, Ahmed Mater, Jeanine E. Hall, Jeffrey N. Bone, Graham C. Thompson, Kenneth Yen, Mark A. Griffiths, Adi Klein, Eileen J. Klein, Julie C. Brown, Rakesh D. Mistry, Renana Gelernter and on behalf of the International COVID-19 Parental Attitude Study (COVIPAS) Group
Int. J. Environ. Res. Public Health 2021, 18(19), 10224; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph181910224 - 28 Sep 2021
Cited by 42 | Viewed by 4108
Abstract
Vaccines against COVID-19 are likely to be approved for children under 12 years in the near future. Understanding vaccine hesitancy in parents is essential for reaching herd immunity. A cross-sectional survey of caregivers in 12 emergency departments (ED) was undertaken in the U.S., [...] Read more.
Vaccines against COVID-19 are likely to be approved for children under 12 years in the near future. Understanding vaccine hesitancy in parents is essential for reaching herd immunity. A cross-sectional survey of caregivers in 12 emergency departments (ED) was undertaken in the U.S., Canada, and Israel. We compared reported willingness to vaccinate children against COVID-19 with an initial survey and post-adult COVID-19 vaccine approval. Multivariable logistic regression models were performed for all children and for those <12 years. A total of 1728 and 1041 surveys were completed in phases 1 and 2, respectively. Fewer caregivers planned to vaccinate against COVID-19 in phase 2 (64.5% and 59.7%, respectively; p = 0.002). The most significant positive predictor of willingness to vaccinate against COVID-19 was if the child was vaccinated per recommended local schedules. Fewer caregivers plan to vaccinate their children against COVID-19, despite vaccine approval for adults, compared to what was reported at the peak of the pandemic. Older caregivers who fully vaccinated their children were more likely to adopt vaccinating children. This study can inform target strategy design to implement adherence to a vaccination campaign. Full article
(This article belongs to the Special Issue Vaccine Hesitancy and COVID-19)
13 pages, 1462 KiB  
Article
To Vaccinate or Not to Vaccinate—This Is the Question among Swiss University Students
by Julia Dratva, Aylin Wagner, Annina Zysset and Thomas Volken
Int. J. Environ. Res. Public Health 2021, 18(17), 9210; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18179210 - 31 Aug 2021
Cited by 22 | Viewed by 3373
Abstract
The speed and innovation of the COVID-19 vaccine development has been accompanied by insecurity and skepticism. Young adults’ attitude to vaccination remains under investigation, although herd immunity cannot be reached without them. The HEalth in Students during the Corona pandemic study (HES-C) provided [...] Read more.
The speed and innovation of the COVID-19 vaccine development has been accompanied by insecurity and skepticism. Young adults’ attitude to vaccination remains under investigation, although herd immunity cannot be reached without them. The HEalth in Students during the Corona pandemic study (HES-C) provided the opportunity to investigate vaccination intention in 1478 students in the sixth survey wave (January 2021), including vaccination intention, psychological antecedents of vaccine hesitancy, trust in government’s vaccination strategy, and vaccination history. Associations with vaccination intention were analyzed with multivariate ordinal regression and predicted margins were calculated adjusting for gender, age, anxiety, health profession, and subjective health status. A third was decided (yes 25.1%, no 7.6%), and 68% were unsure about getting the COVID-19 vaccine when available. Next to demographic characteristics, vaccination history (influenza vaccination OR = 1.39; 95% CI: 1.06–1.83, travel vaccination OR = 1.29; 95% CI: 1.04–1.60), trust in vaccination strategy (OR = 2.40; 95% CI: 1.89–3.05), and 5C dimensions were associated with vaccination intention: confidence (OR = 2.52; 95% CI: 2.09–3.03), complacency (OR = 0.79; 95% CI: 0.66–0.96), calculation (OR = 0.79; 95% CI: 0.70–0.89), constraints (OR = 1.18; 95% CI: 0.99–1.41), and collective responsibility (OR = 4.47; 95% CI: 3.69–5.40). Addressing psychological antecedents and strengthening trust in official strategies through targeted campaigns and interventions may increase decisiveness and result in higher vaccination rates. Full article
(This article belongs to the Special Issue Vaccine Hesitancy and COVID-19)
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9 pages, 302 KiB  
Article
“The Risk Seems Too High”: Thoughts and Feelings about COVID-19 Vaccination
by Ramey Moore, Don E. Willis, Sumit K. Shah, Rachel S. Purvis, Xochitl Shields and Pearl A. McElfish
Int. J. Environ. Res. Public Health 2021, 18(16), 8690; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18168690 - 17 Aug 2021
Cited by 18 | Viewed by 3844
Abstract
The purpose of this study was to describe the thoughts and feelings of individuals expressing concerns about the COVID-19 vaccine. A qualitative descriptive study was conducted in order to examine the thoughts and feelings of participants who are hesitant about the COVID-19 vaccine. [...] Read more.
The purpose of this study was to describe the thoughts and feelings of individuals expressing concerns about the COVID-19 vaccine. A qualitative descriptive study was conducted in order to examine the thoughts and feelings of participants who are hesitant about the COVID-19 vaccine. Data were collected from 754 participants using an online instrument. Emergent themes included a lack of knowledge about the safety of the COVID-19 vaccine; concerns over the speed of development, testing, and approval of these vaccines; reluctance to be among the first vaccinated; concerns about the motivations of government actors, pharmaceutical companies, and others involved in producing the COVID-19 vaccine; and hesitancy about vaccines generally. Full article
(This article belongs to the Special Issue Vaccine Hesitancy and COVID-19)
10 pages, 319 KiB  
Communication
Factors Associated with Intention to Receive Vaccination against COVID-19 in Puerto Rico: An Online Survey of Adults
by Kyle Melin, Cheyu Zhang, Juan P. Zapata, Yonaira M. Rivera, Katie Fernandez, Enbal Shacham, Souhail M. Malavé-Rivera and Carlos E. Rodriguez-Diaz
Int. J. Environ. Res. Public Health 2021, 18(15), 7743; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18157743 - 21 Jul 2021
Cited by 5 | Viewed by 3915
Abstract
We conducted an online survey among adults in Puerto Rico to identify factors associated with the intention to receive vaccination against COVID-19. Sociodemographic variables were analyzed independently for association with intent to receive vaccination. Significant associations were included in the multivariate logistic regression [...] Read more.
We conducted an online survey among adults in Puerto Rico to identify factors associated with the intention to receive vaccination against COVID-19. Sociodemographic variables were analyzed independently for association with intent to receive vaccination. Significant associations were included in the multivariate logistic regression analysis. A total of 1016 responses were available for analysis. In the bivariate analysis, younger age, higher education, pre-COVID-19 employment, male sex, gay/bisexual identity, and single marital status were associated with increased intent to receive the vaccination. In the multivariate logistic regression, younger, male respondents, and those with higher educational attainment reported higher intent to receive the vaccination. Lower-income and living outside the San Juan metro region were associated with lower intent to receive the vaccination. National and international health organizations were identified as the most reliable sources of information, followed by healthcare professionals. These findings highlight the importance of considering sociodemographic characteristics and using trusted sources of information when designing COVID-19 vaccination public messaging. Full article
(This article belongs to the Special Issue Vaccine Hesitancy and COVID-19)

Review

Jump to: Research, Other

20 pages, 1091 KiB  
Review
Proposing a New Conceptual Syndemic Framework for COVID-19 Vaccine Hesitancy: A Narrative Review
by Bara’ Abdallah AlShurman and Zahid Ahmad Butt
Int. J. Environ. Res. Public Health 2023, 20(2), 1561; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph20021561 - 14 Jan 2023
Cited by 1 | Viewed by 2988
Abstract
Background: Discussions regarding syndemics have dominated research in recent years. Vaccine hesitancy has also been propelled to the forefront. In this narrative review, we aim to frame a novel syndemic framework to understand the interaction between vaccine hesitancy, COVID-19, and negative health outcomes. [...] Read more.
Background: Discussions regarding syndemics have dominated research in recent years. Vaccine hesitancy has also been propelled to the forefront. In this narrative review, we aim to frame a novel syndemic framework to understand the interaction between vaccine hesitancy, COVID-19, and negative health outcomes. Methods: A non-systematic electronic search was conducted in PubMed and Google Scholar. Search criteria were limited to articles published between November 2019 and June 2022. Articles related to the COVID-19 syndemic and vaccine hesitancy were included. Results: Our review revealed that the adherence to COVID-19 regulations—although they were effective in preventing COVID-19 transmission, cases, and deaths—created a dynamically unstable ‘vicious cycle’ between undesirable health, economic, and social outcomes. The “accumulation” of complex stressors decreased individuals’ cognitive flexibility and hindered them from making decisions and getting vaccinated. Furthermore, it increased individuals’ risk of acquiring COVID-19, losing their employment, increasing poverty, and decreasing healthcare utilization. We illustrated how the amalgamation of sociodemographic and contextual factors associated with COVID-19 might impact people’s vaccine decisions, making them more hesitant toward COVID-19 vaccination. Failing to receive vaccinations increases the chances of COVID-19 transmission, hospitalization, and other negative health outcomes. Conclusions: Understanding the interaction between these factors is essential to provide policymakers with inspiration to set appropriate interventions for promoting COVID-19 vaccination acceptance to decrease the overall burden of pandemics. Full article
(This article belongs to the Special Issue Vaccine Hesitancy and COVID-19)
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43 pages, 3274 KiB  
Review
What Demographic, Social, and Contextual Factors Influence the Intention to Use COVID-19 Vaccines: A Scoping Review
by Bara’ Abdallah AlShurman, Amber Fozia Khan, Christina Mac, Meerab Majeed and Zahid Ahmad Butt
Int. J. Environ. Res. Public Health 2021, 18(17), 9342; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18179342 - 04 Sep 2021
Cited by 89 | Viewed by 10672
Abstract
Background: During the COVID-19 crisis, an apparent growth in vaccine hesitancy has been noticed due to different factors and reasons. Therefore, this scoping review was performed to determine the prevalence of intention to use COVID-19 vaccines among adults aged 18–60, and to identify [...] Read more.
Background: During the COVID-19 crisis, an apparent growth in vaccine hesitancy has been noticed due to different factors and reasons. Therefore, this scoping review was performed to determine the prevalence of intention to use COVID-19 vaccines among adults aged 18–60, and to identify the demographic, social, and contextual factors that influence the intention to use COVID-19 vaccines. Methods: This scoping review was conducted by using the methodological framework for scoping review outlined by Arksey and O’Malley. A search strategy was carried out on four electronic databases: PubMed, Scopus, CINAHL, and PsycINFO. All peer-reviewed articles published between November 2019 and December 2020 were reviewed. Data were extracted to identify the prevalence of, and factors that influence, the intention to use COVID-19 vaccines. Results: A total of 48 relevant articles were identified for inclusion in the review. Outcomes presented fell into seven themes: demographics, social factors, vaccination beliefs and attitudes, vaccine-related perceptions, health-related perceptions, perceived barriers, and vaccine recommendations. Age, gender, education level, race/ethnicity, vaccine safety and effectiveness, influenza vaccination history, and self-protection from COVID-19 were the most prominent factors associated with intention to use COVID-19 vaccines. Furthermore, the majority of studies (n = 34/48) reported a relatively high prevalence of intention to get vaccinated against COVID-19, with a range from 60% to 93%. Conclusion: This scoping review enables the creation of demographic, social, and contextual constructs associated with intention to vaccinate among the adult population. These factors are likely to play a major role in any targeted vaccination programs, particularly COVID-19 vaccination. Thus, our review suggests focusing on the development of strategies to promote the intention to get vaccinated against COVID-19 and to overcome vaccine hesitancy and refusal. These strategies could include transparent communication, social media engagement, and the initiation of education programs. Full article
(This article belongs to the Special Issue Vaccine Hesitancy and COVID-19)
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14 pages, 586 KiB  
Review
Predictors of Vaccine Hesitancy: Implications for COVID-19 Public Health Messaging
by Amanda Hudson and William J. Montelpare
Int. J. Environ. Res. Public Health 2021, 18(15), 8054; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18158054 - 29 Jul 2021
Cited by 121 | Viewed by 13245
Abstract
Objectives: Successful immunization programs require strategic communication to increase confidence among individuals who are vaccine-hesitant. This paper reviews research on determinants of vaccine hesitancy with the objective of informing public health responses to COVID-19. Method: A literature review was conducted using a broad [...] Read more.
Objectives: Successful immunization programs require strategic communication to increase confidence among individuals who are vaccine-hesitant. This paper reviews research on determinants of vaccine hesitancy with the objective of informing public health responses to COVID-19. Method: A literature review was conducted using a broad search strategy. Articles were included if they were published in English and relevant to the topic of demographic and individual factors associated with vaccine hesitancy. Results and Discussion: Demographic determinants of vaccine hesitancy that emerged in the literature review were age, income, educational attainment, health literacy, rurality, and parental status. Individual difference factors included mistrust in authority, disgust sensitivity, and risk aversion. Conclusion: Meeting target immunization rates will require robust public health campaigns that speak to individuals who are vaccine-hesitant in their attitudes and behaviours. Based on the assortment of demographic and individual difference factors that contribute to vaccine hesitancy, public health communications must pursue a range of strategies to increase public confidence in available COVID-19 vaccines. Full article
(This article belongs to the Special Issue Vaccine Hesitancy and COVID-19)
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Other

Jump to: Research, Review

6 pages, 292 KiB  
Brief Report
COVID-19 Morbidity and Mortality in Social Networks: Does It Influence Vaccine Hesitancy?
by Jagdish Khubchandani, Sushil Sharma, James H. Price, Michael J. Wiblishauser and Fern J. Webb
Int. J. Environ. Res. Public Health 2021, 18(18), 9448; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18189448 - 07 Sep 2021
Cited by 20 | Viewed by 4403
Abstract
The impact of COVID-19 morbidity and mortality among family and friends on vaccination preferences is not well explored. A valid and reliable questionnaire was deployed online via mTurk to recruit a national random sample of adult Americans to understand COVID-19 vaccination preferences and [...] Read more.
The impact of COVID-19 morbidity and mortality among family and friends on vaccination preferences is not well explored. A valid and reliable questionnaire was deployed online via mTurk to recruit a national random sample of adult Americans to understand COVID-19 vaccination preferences and its relationship with COVID-19 infection in social networks. A total of 1602 individuals participated in the study where the majority had taken at least one dose of the COVID-19 vaccine (79%) and almost a tenth were planning to do so (10%) or did not want to take the vaccine (11%). Compared to those who knew family members or friends affected by COVID-19, those who did not know anyone infected with (AOR = 3.20), hospitalized for (AOR = 3.60), or died of COVID-19 (AOR = 2.97) had statistically significantly higher odds of refusing the vaccines. Most strategies for reducing COVID-19 vaccination hesitancy focus on highlighting the benefits of COVID-19 vaccines. We suggest that the dangers of not getting the vaccine should also be emphasized as many people who do not know someone who was affected with COVID-19 are also hesitant towards vaccination. These individuals may not fully appreciate the morbidity and mortality impact of COVID-19 infections and the messaging can be tailored to highlight the risk of not having vaccines. Full article
(This article belongs to the Special Issue Vaccine Hesitancy and COVID-19)
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