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A special issue of Vaccines (ISSN 2076-393X). This special issue belongs to the section "Human Vaccines and Public Health".

Deadline for manuscript submissions: 31 July 2024 | Viewed by 19751

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Special Issue Editors

Prof. Dr. Gulzar H. Shah

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Guest Editor

Department of Health Policy and Community Health, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA 30460, USA
Interests: HIV/AIDS services and programs; eHealth and public health informatics; data improvement tools; practice-based public health services and systems research (PHSSR); public health finances
Special Issues, Collections and Topics in MDPI journals

Dr. Tran Ha Nguyen

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Guest Editor

Department of Interdisciplinary Health Sciences, College of Allied Health Sciences, Augusta University, Augusta, GA 30912, USA
Interests: clinical immunology/chemistry; health disparities/equity; immigrant health; chronic disease prevention; health information technology

Special Issue Information

Dear Colleagues,

Vaccine development has been recognized as one of the most outstanding public health achievements. The success of vaccines did not stop at controlling and eliminating communicable diseases but has extended to preventing non-communicable diseases, such as cancers of the liver (hepatitis B vaccine) and cervix (human papillomavirus) and gastric cancers (Helicobacter pylori). Recently, it has been recognized as the single most effective tool in curbing the spread of COVID-19. Vaccine hesitancy and disparities in vaccine acceptance go back to the development of the first vaccine for smallpox in the 18^th century. Despite overwhelming evidence of the success of vaccines in preventing diseases, vaccine hesitancy remains a lingering issue. In 2019, The World Health Organization named vaccine hesitancy among the top ten global health threats. In the world of rapid international transport and contact between populations, there is potential for the worldwide spread of new infectious diseases or reinvigoration of those previously controlled or eliminated. The latest vaccine hesitancy concerns the COVID-19 pandemic, stemming from conspiracy theories, the infodemic, and political rhetoric, particularly when viewed in the context of a history of ethical issues with medical interventions.

Defined as a “delay in acceptance or refusal of vaccines despite availability of vaccine services” [1], vaccine hesitancy can be a function of system- and individual-level factors that point to the broader issue of inequitable distribution of social, economic, and cultural determinants of health beliefs and health outcomes.

Vaccines, a premier open access peer-reviewed journal, invites submissions for a Special Issue that aims to publish scientific evidence addressing the root causes of vaccine hesitancy and barriers to vaccine acceptance, especially with a lens of health equity and social determinants of vaccine acceptance. We welcome research manuscripts, reviews, and short communication, including but not limited to themes listed below:

Individual-level factors associated with vaccine hesitancy, including sociodemographic characteristics, cultural and religious beliefs about vaccines, perception about efficacy, effectiveness, and risks, and access and affordability barriers;
Innovations in addressing barriers to vaccine acceptance;
System-level social determinants of vaccine hesitancy;
Evaluation of vaccine hesitancy among different populations, especially vulnerable groups;
Long- and short-term impacts of vaccine hesitancy;
Addressing vaccine hesitancy through policy;
Interventions focusing on effective communications to increase vaccine acceptance among different populations.

The above are merely examples of themes. Articles on any aspect of vaccine hesitancy will be considered for this Special Issue.

Reference

[1]. MacDonald, N.E.; SAGE Working Group on Vaccine Hesitancy. Vaccine hesitancy: Definition, scope and determinants. Vaccine. 2015;33(34):4161-4164. doi:10.1016/j.vaccine.2015.04.036

Prof. Dr. Gulzar H. Shah
Dr. Tran Ha Nguyen
Guest Editors

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. Vaccines 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 2700 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

vaccination
vaccine hesitancy
vaccine acceptance
vaccine communication
disease prevention
vaccine refusal
inequities in vaccine literacy

Published Papers (13 papers)

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16 pages, 4297 KiB

Open AccessArticle

The Association between Parental Child Vaccination Refusal Rate and the Impact of Mass Vaccination against COVID-19 in Kazakhstan: An Interrupted Time Series Analysis with Predictive Modelling of Nationwide Data Sources from 2013 to 2022

by Madina Abenova, Askhat Shaltynov, Ulzhan Jamedinova, Erlan Ospanov and Yuliya Semenova

Vaccines 2024, 12(4), 429; https://doi.org/10.3390/vaccines12040429 - 17 Apr 2024

Viewed by 390

Abstract

Despite well-established evidence supporting vaccination efficacy in reducing morbidity and mortality among infants and children, there is a global challenge with an increasing number of childhood vaccination refusals. This issue has intensified, especially during the COVID-19 pandemic. Our study aims to forecast mandatory childhood vaccination refusal trends in Kazakhstan until 2030, assessing the impact of mass COVID-19 vaccination on these rates. Utilizing annual official statistical data from 2013 to 2022 provided by the Ministry of Health of Kazakhstan, the study reveals a significant surge in refusals during the pandemic and post-pandemic periods, reaching record levels of 42,282 cases in 2021 and 44,180 cases in 2022. Notably, refusal rates sharply rose in specific regions, like Aktobe (13.9 times increase) and Atyrau (4.29 times increase), emphasizing the need for increased public healthcare attention in these areas. However, despite a decade of data, our forecasting analysis indicates a lack of volatility in childhood vaccine refusal trends for all vaccine types up to 2030, highlighting the statistical significance of the obtained results. The increasing trend in vaccine refusals underscores the necessity to enhance crisis response and support health initiatives, particularly in regions where a substantial rise in refusals has been observed in recent years. Full article

(This article belongs to the Special Issue Vaccine Hesitancy)

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14 pages, 229 KiB

Open AccessArticle

Information Consumption, Trust Dynamics and COVID-19 Vaccine Hesitancy among Older Adults: Implications for Health Messaging

by Yiyi Wu and Mark Brennan-Ing

Vaccines 2023, 11(11), 1668; https://doi.org/10.3390/vaccines11111668 - 31 Oct 2023

Cited by 1 | Viewed by 1082

Abstract

Staying well informed about the evolving COVID-19 pandemic and vaccine recommendations is vital for older adults, especially for low-income older adults, who have been disproportionately impacted by the pandemic. However, the overwhelming infodemic poses a significant challenge, affecting vaccine decision-making. This study explores how a group of predominantly low-income older adults navigate health information and how their trust in information and vaccines evolves throughout the pandemic. Our objective is to provide insights that will guide future public health messaging for this demographic. Analyzing qualitative data from 77 older adults (aged 65 to 94) collected through focus groups and interviews, our findings reveal that participants’ experiences with information overload eroded their trust in authority, leading to vaccine hesitancy. Moreover, the need for a booster has affected belief in vaccine safety and efficacy. As participants lost faith in the media and authoritative sources, they increasingly leaned on personal networks for guidance. These results underscore the urgent necessity for clear, unambiguous ongoing vaccine guidance to restore institutional trust among older adults. Additionally, recognizing the influential role of direct networks in vaccine decisions, integrating care workers, service providers, and peer-to-peer support into health messaging mechanisms could prove valuable. Full article

(This article belongs to the Special Issue Vaccine Hesitancy)

19 pages, 527 KiB

Open AccessArticle

Exploring Community Perceptions of COVID-19 and Vaccine Hesitancy in Selected Cities of Ethiopia: A Qualitative Study

by Mulugeta Tamire, Teferi Abegaz, Samson Wakuma Abaya, Leuel Lisanwork, Lehageru Gizachew, Ebba Abate, Shu-Hua Wang, Wondwossen Gebreyes and Abera Kumie

Vaccines 2023, 11(10), 1511; https://doi.org/10.3390/vaccines11101511 - 22 Sep 2023

Viewed by 1030

Abstract

Even though the COVID-19 vaccine has been available and free of charge to the targeted population in Ethiopia, the vaccination rate was lower than needed to achieve herd immunity at community level. This study aimed to explore community perceptions of COVID-19 and vaccine hesitancy in selected cities of Ethiopia involving 70 in-depth interviews and 28 focused group discussions. The audio-taped data were transcribed verbatim, translated into English, and analyzed using a qualitative content analysis approach using the ATLAS.ti software version 8. The findings revealed that COVID-19 was perceived as evil and caused fear and frustration upon its emergence. The community initially used traditional remedies for its prevention but later transitioned to employing non-pharmaceutical interventions. The primary reasons for vaccine hesitancy were misinformation and misconceptions, such as connecting the vaccine with the mark of the beast, a lack of trust due to the multiple vaccine types, a shorter production timeline resulting in distrust of its effectiveness, and a fear of pain and side effects. Based on our findings, we recommend monitoring the use of social media and countering misinformation with the correct information and continuous public health campaigns. Further studies should be conducted to assess the types and magnitude of impacts from the myths and misconceptions on vaccination uptake. Full article

(This article belongs to the Special Issue Vaccine Hesitancy)

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17 pages, 681 KiB

Open AccessArticle

The Relationship between Substance Use Stigma and COVID-19 Vaccine Hesitancy

by Natasha Powell, Bruce Taylor, Anna Hotton, Phoebe Lamuda, Elizabeth Flanagan, Maria Pyra, Russell Brewer, O’Dell Johnson, Harold A. Pollack and John A. Schneider

Vaccines 2023, 11(7), 1194; https://doi.org/10.3390/vaccines11071194 - 03 Jul 2023

Viewed by 1516

Abstract

Two parallel public health epidemics affecting the United States include the COVID-19 pandemic and a rise in substance use disorders (SUDs). Limited research has examined the potential relationship between these two epidemics. Our objective was therefore to perform an exploratory study in order to examine the association between public stigma toward people with a past history of opioid, methamphetamine, cocaine, and alcohol use disorder and COVID-19 vaccine hesitancy. A national sample of U.S. adults (N = 6515) completed a survey which assessed the degree of negative perceptions toward individuals with a past history of substance use disorders (referred to as substance use stigma) and COVID-19 vaccine hesitancy, along with variables such as racial prejudice, source of health news, and other demographics. We evaluated four multivariable logistic regression models to predict COVID-19 vaccine hesitancy, utilizing substance use stigma toward opioids, methamphetamine, cocaine, and alcohol use as independent variables. We found that COVID-19 vaccine hesitancy was positively associated with substance use stigma toward opioid (AOR = 1.34, p < 0.05), methamphetamine (AOR = 1.40, p < 0.01), and cocaine (AOR = 1.28, p < 0.05) use, but not alcohol use (AOR = 1.06, n.s.). Predictive models that incorporate substance use stigma may therefore improve our ability to identify individuals that may benefit from vaccine hesitancy interventions. Future research to understand the underlying reasons behind the association between substance use stigma and COVID-19 vaccine hesitancy may help us to construct combined interventions which address belief systems that promote both substance use stigma and vaccine hesitancy. Full article

(This article belongs to the Special Issue Vaccine Hesitancy)

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12 pages, 286 KiB

Open AccessArticle

A Parent Version of the Motors of COVID-19 Vaccination Acceptance Scale for Assessing Parents’ Motivation to Have Their Children Vaccinated

by Chung-Ying Lin, Ray C. Hsiao, Yu-Min Chen and Cheng-Fang Yen

Vaccines 2023, 11(7), 1192; https://doi.org/10.3390/vaccines11071192 - 03 Jul 2023

Cited by 5 | Viewed by 1261

Abstract

Parents’ motivation to vaccinate their children against coronavirus disease 2019 (COVID-19) plays a crucial role in the uptake of COVID-19 vaccines among children. The Motors of COVID-19 Vaccination Acceptance Scale (MoVac-COVID19S) is a valuable tool for assessing individuals’ vaccination-related attitudes and the factors influencing their decision to be vaccinated against COVID-19. This study adapted the MoVac-COVID19S to create a parent version (P-MoVac-COVID19S) and examined the psychometric soundness of two P-MoVac-COVID19S versions (a 9-item version (P-MoVac-COVID19S-9) and a 12-item version (P-MoVac-COVID19S-12)) for assessing parents’ motivation to vaccinate their children. A total of 550 parents completed the P-MoVac-COVID19S and a questionnaire assessing the factors that impact parents’ intention to allow their children to receive the COVID-19 vaccine using a vaccine acceptance scale. We enquired about the level of parental worry regarding the adverse effects of COVID-19 vaccines on children’s health and the number of COVID-19 vaccine doses received by parents. The factor structures of the P-MoVac-COVID19S-9 and P-MoVac-COVID19S-12 were examined using confirmatory factor analysis. The internal consistency, test–retest reliability, and concurrent validity of the P-MoVac-COVID19S were also examined. The results revealed that the P-MoVac-COVID19S-12 has a four-factor structure, which aligns well with the theoretical framework of the cognitive model of empowerment; the P-MoVac-COVID19S-9 has a one-factor structure. Both the P-MoVac-COVID19S-9 and P-MoVac-COVID19S-12 had good internal consistency and test–retest reliability and acceptable concurrent validity. The results of this study demonstrated that the P-MoVac-COVID19S is a reliable and valid instrument for assessing parent’s motivation to vaccinate their children against COVID-19. Full article

(This article belongs to the Special Issue Vaccine Hesitancy)

11 pages, 263 KiB

Open AccessArticle

Anxiety, Optimism, and COVID-19 Vaccine Hesitancy among Students in a University in Southern Thailand during the 2021 Academic Year

by Patcharawan Kaewkrajang, Chonnakarn Jatchavala and Tharntip Sangsuwan

Vaccines 2023, 11(7), 1157; https://doi.org/10.3390/vaccines11071157 - 26 Jun 2023

Cited by 1 | Viewed by 1307

Abstract

This study examined the prevalence of COVID-19 vaccine hesitancy and its associated factors, including anxiety and optimism, surrounding the COVID-19 pandemic among Thai university students. An online observational cross-sectional study was conducted between November and December 2021. Descriptive analyses and logistic regression were performed using R. In total, 409 university students participated in the study. Most reported high anxiety levels (69.4%), while more than half also expressed high levels of optimism associated with the COVID-19 pandemic (51.1%). Only 4.4% were unvaccinated, among whom 50% were hesitant to receive vaccination (2.2%). Per statistical analysis, those who perceived the available vaccines as low safety were significantly associated with a higher risk of vaccine hesitancy (p = 0.03). In contrast, those who reported that they would likely to receive the COVID-19 vaccine if recommended to by their doctors or pharmacists were significantly associated with lower vaccine hesitancy (p = 0.048). However, both anxiety and optimism regarding the COVID-19 pandemic were not associated with vaccine hesitancy. Thus, healthcare workers play an important role in COVID-19 vaccination counseling to prevent transmission. Health education during the pandemic should focus on COVID-19 infection as well as COVID-19 vaccines, including their safety and their adverse effects. Full article

(This article belongs to the Special Issue Vaccine Hesitancy)

10 pages, 378 KiB

Open AccessArticle

Acceptance, Advocacy, and Perception of Health Care Providers on COVID-19 Vaccine: Comparing Early Stage of COVID-19 Vaccination with Latter Stage in the Eastern Region of Saudi Arabia

by Eman M. Almusalami, Mohammed I. Al-Bazroun, Amal I. Alhasawi, Fatimah S. Alahmed, Zahra M. Al-Muslim, Lubana I. Al-Bazroun, Maryam Muslim, Chandni Saha, Elbert Kay, Zeyad A. Alzahrani, Gasmelseed Y. Ahmed and Abbas Al Mutair

Vaccines 2023, 11(2), 488; https://doi.org/10.3390/vaccines11020488 - 20 Feb 2023

Cited by 1 | Viewed by 1926

Abstract

Vaccination of healthcare providers has recently gained focused attention of public health officials. As HCPs have direct contact with the population, and HCPs significantly influence the population, this study aimed to compare the acceptance rate, advocacy rate, and beliefs about the COVID-19 vaccine among HCPs in two time periods. In this repeated cross-sectional study, different HCPs were assessed in two periods ten months apart, i.e., November to December 2020 and September to October 2021, which were before and after COVID-19 vaccine approval by authorities. The study was conducted in Qatif Central Hospital, Eastern Region of Saudi Arabia. There were 609 respondents: 236 participants in the first period and 373 participants in the second period. Only 13 participants did not get the COVID-19 vaccine. There was around a 40% difference in the acceptance rate between the two study periods; the latter period was higher at 94.7%. Furthermore, 24.1% was the difference between the willingness to advocate the COVID-19 vaccine for others; the first period had a lower percentage (60.1%). Overall, results of the study showed that vaccine hesitancy, as well as the willingness to advocate for the vaccine, were improved between the pre-vaccine approval period and post-vaccine approval period, showing that the efforts made by the government improved COVID-19 acceptance and advocacy among HCPs. However, vaccine hesitancy is not a new issue, and for a better understanding of HCPs’ beliefs, a qualitative study is needed. Full article

(This article belongs to the Special Issue Vaccine Hesitancy)

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16 pages, 922 KiB

Open AccessArticle

Investigating Attitudes, Motivations and Key Influencers for COVID-19 Vaccination Uptake among Late Adopters in Urban Zimbabwe

by Azure Tariro Makadzange, Patricia Gundidza, Charles Lau, Janan Dietrich, Nellie Myburgh, Nyasha Elose, Wilmot James, Lawrence Stanberry and Chiratidzo Ndhlovu

Vaccines 2023, 11(2), 411; https://doi.org/10.3390/vaccines11020411 - 10 Feb 2023

Viewed by 1792

Abstract

The rapid development of vaccines in response to the COVID-19 pandemic has provided an effective tool for the management of COVID-19. However, in many African countries there has been a poor uptake of COVID-19 vaccines with only 32.5% first vaccine dose coverage compared to the WHO global target of 70%. As vaccine access improves, one of the important drivers of low uptake has been vaccine hesitancy, driven by levels of confidence, convenience, and complacency. Between 4 January–11 February 2022, we conducted a survey of vaccine late adopters to assess factors that influenced adults in Harare, Zimbabwe to present for their first COVID-19 vaccine dose almost 12 months after the vaccination program began. Of the 1016 adults enrolled, 50% were female and 12.4% had HIV co-infection. Binary logistic regression models were developed to understand factors associated with vaccine confidence. Women were more likely to have negative views about the COVID-19 vaccine compared to men (OR 1.51 (95%CI 1.16, 1.97, p = 0.002). Older adults (≥40 years) compared with youth (18–25 years) were more likely to have ‘major concerns’ about vaccines. When asked about their concerns, 602 (59.3%) considered immediate side effects as a major concern and 520 (52.1%) were concerned about long-term health effects. People living with HIV (PLWH) were more likely to perceive vaccines as safe (OR 1.71 (95%CI: 1.07, 2.74, p = 0.025) and effective (1.68 (95%CI: 1.07, 2.64, p = 0.026). Internet users were less likely to perceive vaccines as safe (OR 0.72 (95% CI: 0.55, 0.95, p = 0.021) compared to non-Internet users; and social media was a more likely source of information for youth and those with higher education. Family members were the primary key influencers for 560 (55.2%) participants. The most important reason for receiving the COVID-19 vaccine for 715 (70.4%) participants was the protection of individual health. Improving vaccine coverage will need targeted communication strategies that address negative perceptions of vaccines and associated safety and effectiveness concerns. Leveraging normative behavior as a social motivator for vaccination will be important, as close social networks are key influences of vaccination. Full article

(This article belongs to the Special Issue Vaccine Hesitancy)

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14 pages, 247 KiB

Open AccessArticle

COVID-19 Vaccination Rollout: Aspects of Hesitancy in South Africa

by Bent Steenberg, Andile Sokani, Nellie Myburgh, Portia Mutevedzi and Shabir A. Madhi

Vaccines 2023, 11(2), 407; https://doi.org/10.3390/vaccines11020407 - 10 Feb 2023

Cited by 1 | Viewed by 1637

Abstract

Across the globe, comprehensive COVID-19 vaccination programs have been rolled out. Naturally, it remains paramount for efficiency to ensure uptake. Hypothetical vaccine acceptability in South Africa was high prior to the availability of inoculation in August 2020—three-quarters stated intent to immunize nationally. However, 24 months on, less than one-third have finished their vaccination on a national average, and in the sprawling South Western Townships (Soweto), this figure remains troublingly low with as many as four in every five still hesitant. Medical anthropologists have recently portrayed how COVID-19’s jumbled mediatization produces a ‘field of suspicion’ casting serious doubt on authorities and vaccines through misinformation and counterfactual claims, which fuels ‘othering’ and fosters hesitancy. It follows that intent to immunize cannot be used to predict uptake. Here, we take this conceptual framework one step further and illustrate how South African context-specific factors imbricate to amplify uncertainty and fear due the productive nature of communicability, which transforms othering into racialization and exacerbates existing societal polarizations. We also encounter Africanized forms of conspiracy theories and find their narrational roots in colonization and racism. Finally, we discuss semblances with HIV and how the COVID-19 pandemic’s biomedicalization may inadvertently have led to vaccine resistance due to medical pluralism and cultural/spiritual practices endemic to the townships. Full article

(This article belongs to the Special Issue Vaccine Hesitancy)

21 pages, 1061 KiB

Open AccessArticle

Validity and Reliability of the COVID-19 Knowledge, Attitude and Behavior Scale

by Serol Deveci, Celalettin Cevik, Hakan Baydur, Fatih Onsuz, Selma Tosun and Alp Ergor

Vaccines 2023, 11(2), 317; https://doi.org/10.3390/vaccines11020317 - 31 Jan 2023

Viewed by 2017

Abstract

Background: The aim of this research is to develop a scale that will evaluate the knowledge, attitudes and behaviors of employees about COVID-19 and to test its validity and reliability. Methodology: The methodological type of research was used between August–November 2020, under observation in organized industrial zones. Information was collected from a total of 543 employees. Confirmatory factor analysis and correlation analysis were performed for the value, item–total correlations and construct validity. SPSS 25.0 (IBM Inc., Armonk, NY, USA), Jasp 0.14 (University of Amsterdam) and Lisrel 9.1(Scientific Software International, Inc., Chapel Hill, NC, USA) programs were used in the analysis. Results: 83.1% of the participants in the study are male, the average age is 37.4 ± 8.0, 76.1% are married, and 49.4% are high school graduates. The Cronbach alpha value of the COVID-19 information part is 0.86 in total, the contamination information dimension is 0.71 and the protection information dimension is 0.84. The COVID-19 attitude section consists of four sub-dimensions and 13 items classified within the framework of the health belief model. In summary, the goodness of fit values for the knowledge, attitude and behavior sections, respectively, are: RMSEA values 0.05, 0.03 and 0.04; CFI values 0.98, 0.98 and 0.99; GFI values 0.97, 0.97 and 0.99. Conclusions: It has been determined that the internal consistency of the COVID-19 knowledge, attitude and behavior scale conducted on employees is high and compatible, and its validity findings are sufficient. The scale is recommended as an applicable tool to measure COVID-19 knowledge, attitudes and behaviors. Full article

(This article belongs to the Special Issue Vaccine Hesitancy)

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13 pages, 1751 KiB

Open AccessArticle

Declared Intention to Vaccinate against COVID-19 and Actual Vaccination—The Role of Trust in Science, Conspiratorial Thinking and Religiosity

by Józef Maciuszek, Mateusz Polak, Katarzyna Stasiuk and Jerzy Rosiński

Vaccines 2023, 11(2), 262; https://doi.org/10.3390/vaccines11020262 - 25 Jan 2023

Cited by 5 | Viewed by 1197

Abstract

AIMS: The study aims to investigate how trust in science, conspiratorial thinking, and religiosity affected people’s declared willingness to vaccinate against COVID-19 at the onset of the vaccination program in Poland, their actual vaccination, and the consistency between intention and vaccination. METHODS: In a longitudinal design, a representative sample of 918 members of the Polish general population was polled at the beginning of the vaccination program (February 2021) and polled again after 6 months of mass vaccination (August 2021). We measured the willingness to vaccinate, actual vaccination after 6 months, and individual variables—trust in science, conspiratorial thinking and religiosity. RESULTS: The actual vaccination rate was higher than the declared intent, especially in the initially undecided and unwilling groups. Higher Trust in science and lower Conspiratorial Thinking were associated with declared intent to vaccinate and actual vaccination, while Religiosity was not clearly associated with vaccination. CONCLUSIONS: Declared willingness to vaccinate is not an effective indicator of actual vaccination. Trust in science and Conspiratorial thinking are important factors associated with vaccine hesitancy. There may be a possibility to influence those unwilling to vaccinate and that are undecided to eventually get vaccinated. Full article

(This article belongs to the Special Issue Vaccine Hesitancy)

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15 pages, 1450 KiB

Open AccessArticle

Parental Seasonal Influenza Vaccine Hesitancy and Associated Factors in Shanghai, China, during the COVID-19 Pandemic: A Cross-Sectional Study

by Jingyi Fan, Chuchu Ye, Yuanping Wang, Hui Qi, Dong Li, Jun Mao, Hongmei Xu, Xiaojin Shi, Weiping Zhu and Yixin Zhou

Vaccines 2022, 10(12), 2109; https://doi.org/10.3390/vaccines10122109 - 09 Dec 2022

Cited by 9 | Viewed by 1864

Abstract

Background: Seasonal influenza may overlap with the COVID-19 pandemic, and children are one of the priority populations for influenza vaccination in China, yet vaccine coverage has been low. This study aimed to investigate the extent of parental influenza vaccine hesitancy (IVH) and to explore the associated factors. Methods: The study was conducted in Shanghai, China, from 1 June 2022 to 31 July 2022, using an anonymous questionnaire to survey a random sample of parents of children aged six months to 14 years. Binary logistic regression models were used to identify factors associated with IVH. Results: Of the 5016 parents, 34.05% had IVH. Multivariate analysis showed that after adjustment for non-modifiable markers (i.e., sociodemographic, health status, and past vaccination status), being affected by negative influenza vaccine news and having higher “complacency” were positively associated with parental IVH. Higher knowledge of influenza vaccination, being recommended by healthcare workers (HCWs), people around having a positive attitude toward influenza vaccine and having higher levels of “confidence” and “convenience” were negatively associated with parental IVH. Conclusions: In China, public health education aimed at modifying vaccination-related attitudes and beliefs, as well as knowledge and societal influences, could help reduce influenza vaccination hesitancy. Full article

(This article belongs to the Special Issue Vaccine Hesitancy)

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15 pages, 651 KiB

Open AccessSystematic Review

COVID-19 Vaccination Hesitancy in Autoimmune Disease Patients: Policy Action and Ethical Considerations

by Nardeen Shafik, Jennifer E. Akpo, Kristie C. Waterfield and William A. Mase

Vaccines 2023, 11(8), 1283; https://doi.org/10.3390/vaccines11081283 - 26 Jul 2023

Cited by 1 | Viewed by 1024

Abstract

As COVID-19 vaccination guidelines were issued by Advisory Committee on Immunization Practices (ACIP) and the Centers for Diseases Control and Prevention (CDC) across the US, each state and clinical provider instituted vaccine implementation and education policies and protocols for high-risk populations. However, current research has shown that while people with autoimmune diseases were listed by ACIP and CDC as a COVID-19 high-risk population, the rate of adherence to implementation and education protocols, as well as the prioritization of this sub-population as a high-risk group, varied among the clinicians and vaccinators thus impacting the hesitancy towards the COVID-19 vaccine and a correlation to low vaccination rates. The purpose of this review was to explore factors of COVID-19 vaccination hesitancy in people living with autoimmune diseases in relation to current implementation and education policies and protocols, as well as ethical and contextual factors, while providing possible implications. COVID-19 vaccine hesitancy in people living with autoimmune disease was greater than in the general population, as demonstrated by increased levels of overall mistrust and fear of potential risk and harmful side effects. Evidence has shown that COVID-19 vaccination is safe and effective for patients with autoimmune diseases. Additionally, the benefits of COVID-19 vaccination outweigh its potential risks and adverse effects in this population. However, the non-adherence to policy and protocols, especially community education protocols, by those providing the vaccination have a negative impact on the overall perception of the vaccine and needs to be addressed at local and state levels in order to protect this population. Future research should provide strategies to guide collaborative efforts between government and local agencies in providing tailored vaccination campaigns to this population. In parallel with policy, COVID-19 vaccination intervention implementation and educational protocols should be developed with evidence-based guidelines for public health and clinical professionals that are targeted at this vulnerable high-risk population. Full article

(This article belongs to the Special Issue Vaccine Hesitancy)

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