Psychological Aspects of COVID-19 Vaccine Uptake: Principles and Empirical Strategies

A special issue of Vaccines (ISSN 2076-393X). This special issue belongs to the section "COVID-19 Vaccines and Vaccination".

Deadline for manuscript submissions: closed (31 December 2021) | Viewed by 273999

Special Issue Editors

Department of Behavioral Sciences, Ruppin Academic Center, Emeq Hefer 4025000, Israel
Interests: health behaviors; eHealth literacy; goal adjustment
1. Perdana University-Royal College of Surgeons in Ireland School of Medicine, Perdana University, Kuala Lumpur 50490, Malaysia
2. Department of Health Psychology, Royal College of Surgeons in Ireland, D02 YN77 Dublin, Ireland
Interests: population health; aging; behavior change

Special Issue Information

Dear Colleagues,

As you are all well aware, developing a vaccine for COVID-19 is our best hope for successfully confronting the current global epidemic.

However, coming up with an effective vaccine (or several of them) is not enough: People need to actually take the vaccine. As with many health behaviors, the recommendation and availability of a product is the first step, but implementation ultimately depends on the cooperation of the individuals addressed. Hence, while biomedical scientific knowledge is useful for devising vaccines, basic and applied scientific knowledge of human behavior is required for the successful implementation of vaccination.

Reluctance, hesitancy, and rejection of vaccines have been an ongoing issue worldwide since the late 1990s. Scholarly attention has been directed to understanding the factors driving these behaviors, spanning from demographics to attitudes, individual differences, and persuasion approaches.

To achieve a more extensive understanding of recent scientific knowledge as it applies to possible COVID-19-related vaccines, this Special Issue will focus on the critical issues, challenges, successes, and new ways of thinking about uptake of a COVID-19 vaccine.

We invite you to contribute with an original report, observation or review, highlighting (i) prevalence of acceptance, hesitancy or refusal to accept a COVID-19 vaccine; (ii) associated attributes or factors driving hesitancy/refusal ranging from the personal and relational to the community and cultural; (iii) experimental work testing intention/behavior change in relation to the uptake vaccination; and (iv) the influence of media on the decision-making process—from literacy to social media.

Qualitative and quantitative methods are invited. Manuscripts will follow standard kournal peer-review practices, and those accepted for publication will appear in the Special Issue on “Psychological Aspects of COVID-19 Vaccine Uptake”.

Prof. Dr. Efrat Neter
Prof. Dr. Karen Morgan 
Guest Editors

Manuscript Submission Information

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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 hesitancy
  • vaccination refusal
  • vaccination barriers
  • intervention
  • decision aids
  • risk perception

Published Papers (27 papers)

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18 pages, 3475 KiB  
Article
An Online Experiment of NHS Information Framing on Mothers’ Vaccination Intention of Children against COVID-19
by Audrey L. Van Hoecke and Jet G. Sanders
Vaccines 2022, 10(5), 720; https://doi.org/10.3390/vaccines10050720 - 04 May 2022
Cited by 3 | Viewed by 2338
Abstract
Children under the age of 5, will likely all be offered vaccination against SARS-CoV-2 soon. Parental concerns over vaccination of children are long standing and could impede the success of a vaccination campaign. In the UK, a trusted source to inform vaccination choices [...] Read more.
Children under the age of 5, will likely all be offered vaccination against SARS-CoV-2 soon. Parental concerns over vaccination of children are long standing and could impede the success of a vaccination campaign. In the UK, a trusted source to inform vaccination choices is the NHS website. Here we used a randomized controlled experiment of framing effects in NHS information content for COVID-19 and flu with 550 mothers under the age of 5. We compared both vaccination offers following two commonly used frames in vaccination informational campaigns: alerting to the risks of no vaccination for the child itself vs. those in their community. We find that vaccination intention was twice as high when risks to the child are emphasized, relative to risks to the community. Exploratory analyses suggest that these effects may differ between white and non-white mothers. Whilst communication directed at adult vaccination against COVID-19 generally focuses on risks of infecting others, communication about vaccination of children may benefit from emphasizing risks to the children themselves. This pattern is in line with flu vaccination research from pre-COVID-19 times. Full article
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10 pages, 1379 KiB  
Article
COVID-19 Vaccination Improved Psychological Distress (Anxiety and Depression Scores) in Chronic Kidney Disease Patients: A Prospective Study
by Helena Garcia-Llana, Nayara Panizo, Lorena Gandía, Marisa Orti, Elena Giménez-Civera, Claudia Forquet, Luis D’Marco, Maria Jesús Puchades, Mari Sargsyan, Irina Sanchís, Carmen Ribera, Mª Inés Marco, Cristela Moncho Ferrá, Carmen María Pérez-Baylach, Begoña Bonilla, Francesc Moncho Francés, Elisa Perez-Bernat, Asunción Sancho and Jose Luis Górriz
Vaccines 2022, 10(2), 299; https://doi.org/10.3390/vaccines10020299 - 16 Feb 2022
Cited by 6 | Viewed by 2646
Abstract
The purpose of the study is to analyze the impact of vaccination against SARS-CoV-2 on anxiety and depression scores in patients with different modalities of chronic kidney disease. One hundred and seventeen renal patients (50 hemodialysis patients, 13 peritoneal dialysis patients, 32 kidney [...] Read more.
The purpose of the study is to analyze the impact of vaccination against SARS-CoV-2 on anxiety and depression scores in patients with different modalities of chronic kidney disease. One hundred and seventeen renal patients (50 hemodialysis patients, 13 peritoneal dialysis patients, 32 kidney transplants, and 22 advanced chronic kidney disease patients at pre-dialysis care) were evaluated for depression, anxiety, health-related quality of life (HRQOL), and perceived fears and resources with standardized (Hospital Anxiety and Depression Scale (HADS)) and self-reported questionnaires. The measure points were before vaccination and 15 days after vaccination. The main finding of the study was that there was a decrease in the global mean of normal scores for anxiety and depression symptoms in chronic kidney disease patients post-vaccination. We did not find statistically significant differences in depression or anxiety scores, nor any HRQOL differences between the treatment groups. The three main fears reported by the participants at baseline were those of adverse effects, not getting the vaccine, and lack of information. These findings highlight the potential interest of assessing psychological variables related to the impact of vaccination against SARS-CoV-2. New studies will be required to assess the impact of comprehensive vaccine coverage and its psychological impact. Full article
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12 pages, 1124 KiB  
Article
Declared Intention (Not) to Be Vaccinated against COVID-19, and Actual Behavior—The Longitudinal Study in the Polish Sample
by Jozef Maciuszek, Mateusz Polak and Katarzyna Stasiuk
Vaccines 2022, 10(2), 147; https://doi.org/10.3390/vaccines10020147 - 20 Jan 2022
Cited by 8 | Viewed by 2098
Abstract
AIMS: The aim of the study was to investigate the relation between declared intention to get/not get vaccinated against COVID-19, prior to the start of the global vaccination program, and actual vaccine uptake. Moreover, reasons for getting vaccinated or rejecting it were measured [...] Read more.
AIMS: The aim of the study was to investigate the relation between declared intention to get/not get vaccinated against COVID-19, prior to the start of the global vaccination program, and actual vaccine uptake. Moreover, reasons for getting vaccinated or rejecting it were measured along with declared intent and behavior. METHODS: Within a longitudinal design, a representative sample of 918 Polish people was surveyed in February 2021 and August 2021. In February 2021, participants were asked about their intention to get vaccinated against COVID-19 and the reasons behind it. In August 2021, the same group was asked about having been vaccinated, along with the reasons. RESULTS: A significant pro-vaccine shift from declared intent to behavior was observed, with many participants turning away from being anti-vaccine or undecided and getting vaccinated. Significant correlations with attitudes toward general mandatory vaccination of children were found. Increased support for anti-vaccine arguments was seen over time in the unvaccinated sample, and decreased support for pro-vaccine arguments was seen in the vaccinated sample. Several key arguments for and against vaccination were identified. CONCLUSIONS: Declared attitude toward COVID-19 vaccination is not fully consistent with vaccination behavior. Pro-vaccine changes in attitudes of previously anti-vaccine and undecided individuals indicate that these groups may be influenced to potentially accept the COVID-19 vaccination over time. Full article
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11 pages, 490 KiB  
Article
Cyberchondria, Fear of COVID-19, and Risk Perception Mediate the Association between Problematic Social Media Use and Intention to Get a COVID-19 Vaccine
by Daniel Kwasi Ahorsu, Chung-Ying Lin, Zainab Alimoradi, Mark D. Griffiths, Hsin-Pao Chen, Anders Broström, Toomas Timpka and Amir H. Pakpour
Vaccines 2022, 10(1), 122; https://doi.org/10.3390/vaccines10010122 - 14 Jan 2022
Cited by 22 | Viewed by 4416
Abstract
Vaccination is the most effective way to control the COVID-19 pandemic, but vaccination hesitancy threatens this effort worldwide. Consequently, there is a need to understand what influences individuals’ intention to get a COVID-19 vaccine. Restriction of information gathering on societal developments to social [...] Read more.
Vaccination is the most effective way to control the COVID-19 pandemic, but vaccination hesitancy threatens this effort worldwide. Consequently, there is a need to understand what influences individuals’ intention to get a COVID-19 vaccine. Restriction of information gathering on societal developments to social media may influence attitudes towards COVID-19 vaccination through exposure to disinformation and imbalanced arguments. The present study examined the association between problematic social media use and intention to get the COVID-19 vaccine, taking into account the mediating roles of cyberchondria, fear of COVID-19, and COVID-19 risk perception. In a cross-sectional survey study, a total of 10,843 residents of Qazvin City, Iran completed measures on problematic social media use, fear of COVID-19, cyberchondria, COVID-19 risk perception, and intention to get a COVID-19 vaccine. The data were analyzed using structural equation modeling (SEM). The results showed that there was no direct association between problematic social media use and intention to get a COVID-19 vaccine. Nonetheless, cyberchondria, fear of COVID-19, and COVID-19 risk perception (each or serially) mediated associations between problematic social media use and intention to get a COVID-19 vaccine. These results add to the understanding of the role of problematic social media use in COVID-19 vaccine hesitancy, i.e., it is not the quantity of social media use per se that matters. This knowledge of the mediating roles of cyberchondria, fear of COVID-19, and COVID-19 risk perception can be used by public health experts and policymakers when planning educational interventions and other initiatives in COVID-19 vaccination programs. Full article
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10 pages, 963 KiB  
Article
Body Appreciation as a Factor Associated with College Students’ Willingness to Receive Future COVID-19 Vaccines
by Zi-Han Liu, Wei Bai, Hong Cai, Shou Liu, Xu Chen, Han Qi, Rui Liu, Teris Cheung, Zhaohui Su, Todd Jackson, Sha Sha and Yu-Tao Xiang
Vaccines 2021, 9(11), 1285; https://doi.org/10.3390/vaccines9111285 - 05 Nov 2021
Cited by 3 | Viewed by 2021
Abstract
Background: Following the initial manufacture of COVID-19 vaccines, numerous studies have investigated factors that influence people’s vaccination intentions. However, no studies have examined links of vaccination attitudes with body-related attitudes, especially body appreciation. To address this gap in the literature, we conducted this [...] Read more.
Background: Following the initial manufacture of COVID-19 vaccines, numerous studies have investigated factors that influence people’s vaccination intentions. However, no studies have examined links of vaccination attitudes with body-related attitudes, especially body appreciation. To address this gap in the literature, we conducted this study to disentangle the relationship between college students’ COVID-19 vaccination intentions and body appreciation. Method: A cross-sectional study was conducted among Chinese college students. Participants completed the Body Appreciation Scale-2 (BAS-2) and other questionnaire measures of demographics, intentions to be vaccinated, and attitudes toward COVID-19 vaccination programs. Results: A total of 2058 college students participated in this study. Students who were willing to get COVID-19 vaccines had significantly higher BAS-2 scores than did those who were unwilling to receive a vaccine (3.61 ± 0.84 vs. 3.34 ± 0.92, p < 0.001). A hierarchical multiple logistic regression analysis was performed to test the association between body appreciation and COVID-19 vaccine intentions when controlling for other covariates; elevated BAS-2 scores were associated with greater willingness to receive COVID-19 vaccines (OR = 1.250, 95%CI: 1.112–1.406, p < 0.001), independent of other significant influences. Conclusion: Our study was the first to reveal that body appreciation is a significant factor related to college students’ COVID-19 vaccination intentions. Public health interventions designed to improve people’s body-appreciation levels may help in efforts to promote universal immunization. Full article
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15 pages, 1383 KiB  
Article
COVID-19 Vaccination Attitudes, Perceptions, and Side Effect Experiences in Malaysia: Do Age, Gender, and Vaccine Type Matter?
by Mohamed Hassan Elnaem, Nor Hidayah Mohd Taufek, Norny Syafinaz Ab Rahman, Nor Ilyani Mohd Nazar, Che Suraya Zin, Wesley Nuffer and Christopher John Turner
Vaccines 2021, 9(10), 1156; https://doi.org/10.3390/vaccines9101156 - 09 Oct 2021
Cited by 43 | Viewed by 9822
Abstract
This study aimed to investigate the attitudes, perceptions, and experiences of side effects with the COVID-19 vaccines in Malaysia among participants in the National Vaccination Program. A cross-sectional survey was conducted among a sample of vaccine-eligible and vaccinated individuals in Malaysia between May [...] Read more.
This study aimed to investigate the attitudes, perceptions, and experiences of side effects with the COVID-19 vaccines in Malaysia among participants in the National Vaccination Program. A cross-sectional survey was conducted among a sample of vaccine-eligible and vaccinated individuals in Malaysia between May and July 2021. A total of 428 respondents completed the survey. A vast majority (98.6%) of the respondents had registered to be vaccinated. Twenty participants (4.7%) expressed concerns about either registering or receiving the COVID-19 vaccination, mainly due to their uncertainty of vaccine safety. Approximately 77.5% received their vaccinations. Of them, 76.8% had experienced vaccine-related side effects. About 40% of the side effects occurred more with the second dose, particularly those who received the Pfizer-BioNTech vaccine (p < 0.001). Pain at the injection site (61.1%) and tiredness (48.8%) were the most reported side effects. Compared to those aged ≥60 years, all age groups were more likely to exhibit vaccine-related side effects; meanwhile, males (OR: 0.51, 95% CI: 0.27–0.93) were less likely to experience side effects than females. Those who received the Sinovac vaccine were at lower risk of experiencing side effects (OR: 0.08, 95% CI: 0.03–0.22) and were more likely to report fewer side effects than Pfizer-BioNTech (p = 0.012) and Oxford-AstraZeneca groups (p= 0.001). The overall attitudes toward the COVID-19 vaccination program were positive. Several differences in the experiences of vaccine-related side effects, in terms of prevalence and numbers, were attributed to age, gender, and received vaccine type. Full article
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13 pages, 1271 KiB  
Article
Persuasive Messages Will Not Increase COVID-19 Vaccine Acceptance: Evidence from a Nationwide Online Experiment
by Raman Kachurka, Michał Krawczyk and Joanna Rachubik
Vaccines 2021, 9(10), 1113; https://doi.org/10.3390/vaccines9101113 - 30 Sep 2021
Cited by 18 | Viewed by 19270
Abstract
Although mass vaccination is the best way out of the pandemic, the share of skeptics is substantial in most countries. Social campaigns can emphasize the many arguments that potentially increase acceptance for vaccines: e.g., that they have been developed, tested, and recommended by [...] Read more.
Although mass vaccination is the best way out of the pandemic, the share of skeptics is substantial in most countries. Social campaigns can emphasize the many arguments that potentially increase acceptance for vaccines: e.g., that they have been developed, tested, and recommended by doctors and scientists; and that they are safe, effective, and in demand. We verified the effectiveness of such messages in an online experiment conducted in February and March 2021 with a sample of almost six thousand adult Poles, which was nationally representative in terms of key demographic variables. We presented respondents with different sets of information about vaccinating against COVID-19. After reading the information bundle, they indicated whether they would be willing to be vaccinated. We also asked them to justify their answers and indicate who or what might change their opinion. Finally, we elicited a number of individual characteristics and opinions. We found that nearly 45% of the respondents were unwilling to be vaccinated, and none of the popular messages we used was effective in reducing this hesitancy. We also observed a number of significant correlates of vaccination attitudes, with men, older, wealthier, and non-religious individuals, those with higher education, and those trusting science rather than COVID-19 conspiracy theories being more willing to be vaccinated. We discuss important consequences for campaigns aimed at reducing COVID-19 vaccine hesitancy. Full article
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15 pages, 311 KiB  
Article
Oxford COVID-19 Vaccine Hesitancy in School Principals: Impacts of Gender, Well-Being, and Coronavirus-Related Health Literacy
by Tuyen Van Duong, Cheng-Yu Lin, Sheng-Chih Chen, Yung-Kai Huang, Orkan Okan, Kevin Dadaczynski and Chih-Feng Lai
Vaccines 2021, 9(9), 985; https://doi.org/10.3390/vaccines9090985 - 03 Sep 2021
Cited by 25 | Viewed by 6963
Abstract
Purposes: To explore the associated factors of COVID-19 vaccine hesitancy and examine psychometric properties of the coronavirus-related health literacy questionnaire (HLS-COVID-Q22) and Oxford COVID-19 Vaccine Hesitancy questionnaire. Methods: An online survey was conducted from 23 June to 16 July 2021 on 387 school [...] Read more.
Purposes: To explore the associated factors of COVID-19 vaccine hesitancy and examine psychometric properties of the coronavirus-related health literacy questionnaire (HLS-COVID-Q22) and Oxford COVID-19 Vaccine Hesitancy questionnaire. Methods: An online survey was conducted from 23 June to 16 July 2021 on 387 school principals across Taiwan. Data collection included socio-demographic characteristics, information related to work, physical and mental health, COVID-19 related perceptions, sense of coherence, coronavirus-related health literacy, and vaccine hesitancy. Principal component analysis, correlation analysis, linear regression models were used for validating HLS-COVID-Q22, Oxford COVID-19 Vaccine Hesitancy, and examining the associations. Results: HLS-COVID-Q22 and Oxford COVID-19 Vaccine Hesitancy were found with satisfactory construct validity (items loaded on one component with factor loading values range 0.57 to 0.81, and 0.51 to 0.78), satisfactory convergent validity (item-scale correlations range 0.60 to 0.79, and 0.65 to 0.74), high internal consistency (Cronbach’s alpha = 0.96 and 0.90), and without floor or ceiling effects (percentages of possibly lowest score and highest score <15%), respectively. Low scores of vaccine hesitancy were found in male principals (regression coefficient, B, −0.69; 95% confidence interval, 95%CI, −1.29, −0.10; p = 0.023), principals with better well-being (B, −0.25; 95%CI, −0.47, −0.03; p = 0.029), and higher HLS-COVID-Q22 (B, −1.22; 95%CI, −1.89, −0.54; p < 0.001). Conclusions: HLS-COVID-Q22 and Oxford COVID-19 Vaccine Hesitancy were valid and reliable tools. Male principals and those with better well-being, and higher health literacy had a lower level of vaccine hesitancy. Improving principals’ health literacy and well-being is suggested to be a strategic approach to increase vaccine acceptance for themselves, their staff, and students. Full article
16 pages, 887 KiB  
Article
To Get Vaccinated, or Not to Get Vaccinated, That Is the Question: Illness Representations about COVID-19 and Perceptions about COVID-19 Vaccination as Predictors of COVID-19 Vaccination Willingness among Young Adults in The Netherlands
by Manja Vollmann and Christel Salewski
Vaccines 2021, 9(9), 941; https://doi.org/10.3390/vaccines9090941 - 24 Aug 2021
Cited by 15 | Viewed by 4502
Abstract
Mass vaccination is considered necessary to reduce the spread of COVID-19; however, vaccination willingness was found to be especially low among young adults. Therefore, based on the extended Common Sense Model, the unique effects and the interplay of illness representations about COVID-19 and [...] Read more.
Mass vaccination is considered necessary to reduce the spread of COVID-19; however, vaccination willingness was found to be especially low among young adults. Therefore, based on the extended Common Sense Model, the unique effects and the interplay of illness representations about COVID-19 and perceptions about COVID-19 vaccination in explaining COVID-19 vaccination willingness was investigated using a cross-sectional design. An online survey measuring the relevant variables was filled in by 584 participants (69.9% female) between 18 and 34 years. Correlation analyses showed that all illness representation dimensions except from timeline and both dimensions of vaccination perceptions were related to vaccination willingness. The mediation analysis revealed that less personal control, more prevention control, more concerns about COVID-19 as well as more perceived necessity of and fewer concerns about the vaccination were directly related to higher vaccination willingness. Additionally, prevention control was indirectly related to higher vaccination willingness through stronger perceptions of necessity of the vaccination. The extended Common Sense Model proved to be useful in the context of illness prevention. Campaigns to improve vaccination rates should aim at increasing the perception that COVID-19 is preventable through vaccination and the personal need of the vaccination as well as at decreasing concerns about the vaccination. Full article
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15 pages, 1501 KiB  
Article
Factors Affecting Hesitancy to mRNA and Viral Vector COVID-19 Vaccines among College Students in Italy
by Laura Salerno, Lucia Craxì, Emanuele Amodio and Gianluca Lo Coco
Vaccines 2021, 9(8), 927; https://doi.org/10.3390/vaccines9080927 - 19 Aug 2021
Cited by 42 | Viewed by 5503
Abstract
Vaccine hesitancy (VH) may be significant in jeopardizing efforts to mass containment of COVID-19. A cross-sectional survey was carried out on a sample of 2667 Italian college students, before the COVID-19 vaccines became available for this age group (from 7 May to 31 [...] Read more.
Vaccine hesitancy (VH) may be significant in jeopardizing efforts to mass containment of COVID-19. A cross-sectional survey was carried out on a sample of 2667 Italian college students, before the COVID-19 vaccines became available for this age group (from 7 May to 31 May 2021). An online survey was created to obtain information about socio-demographic, health-related, and psychological factors linked to mRNA and viral vector COVID-19 vaccines. Statistically significant higher VH (30.4%) and vaccine resistance (12.2%) rates were found for viral vector than mRNA COVID-19 vaccines (7.2% and 1.0%, respectively; p < 0.001). Factors related to viral vector VH were partially different from those related to mRNA VH. Students with greater endorsement on conspiracy statements and negative attitudes toward the vaccine had higher odds of being vaccine-hesitant or -resistant. Students who had received a previous COVID-19 test and who scored higher on the agreeableness personality dimension had lower odds to be vaccine-hesitant or -resistant. The willingness to choose the vaccine was related to the viral vector but not to the mRNA VH. Taking into consideration the factors involved in vaccine hesitancy/resistance in college students could represent a key public health strategy to increase vaccine coverage and reduce viral spreading. Full article
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11 pages, 733 KiB  
Article
“Vaccine Passports” May Backfire: Findings from a Cross-Sectional Study in the UK and Israel on Willingness to Get Vaccinated against COVID-19
by Talya Porat, Ryan Burnell, Rafael A. Calvo, Elizabeth Ford, Priya Paudyal, Weston L. Baxter and Avi Parush
Vaccines 2021, 9(8), 902; https://doi.org/10.3390/vaccines9080902 - 14 Aug 2021
Cited by 30 | Viewed by 28708
Abstract
Domestic “vaccine passports” are being implemented across the world as a way of increasing vaccinated people’s freedom of movement and to encourage vaccination. However, these vaccine passports may affect people’s vaccination decisions in unintended and undesirable ways. This cross-sectional study investigated whether people’s [...] Read more.
Domestic “vaccine passports” are being implemented across the world as a way of increasing vaccinated people’s freedom of movement and to encourage vaccination. However, these vaccine passports may affect people’s vaccination decisions in unintended and undesirable ways. This cross-sectional study investigated whether people’s willingness and motivation to get vaccinated relate to their psychological needs (autonomy, competence and relatedness), and how vaccine passports might affect these needs. Across two countries and 1358 participants, we found that need frustration—particularly autonomy frustration—was associated with lower willingness to get vaccinated and with a shift from self-determined to external motivation. In Israel (a country with vaccine passports), people reported greater autonomy frustration than in the UK (a country without vaccine passports). Our findings suggest that control measures, such as domestic vaccine passports, may have detrimental effects on people’s autonomy, motivation, and willingness to get vaccinated. Policies should strive to achieve a highly vaccinated population by supporting individuals’ autonomous motivation to get vaccinated and using messages of autonomy and relatedness, rather than applying pressure and external controls. Full article
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10 pages, 264 KiB  
Article
Denial of Justification for Vaccination: Its Multiple Related Variables and Impacts on Intention to Get Vaccinated against COVID-19
by Yen-Ju Lin, Wen-Jiun Chou, Yu-Ping Chang and Cheng-Fang Yen
Vaccines 2021, 9(8), 822; https://doi.org/10.3390/vaccines9080822 - 25 Jul 2021
Cited by 4 | Viewed by 3697
Abstract
The aims of the present study were (1) to identify the variables related to denying the justification for vaccination during the coronavirus disease 2019 (COVID-19) pandemic in Taiwan and (2) to examine the associations of such denial with perceived risk of COVID-19 and [...] Read more.
The aims of the present study were (1) to identify the variables related to denying the justification for vaccination during the coronavirus disease 2019 (COVID-19) pandemic in Taiwan and (2) to examine the associations of such denial with perceived risk of COVID-19 and the extrinsic and intrinsic intentions to get vaccinated against COVID-19. We recruited 1047 participants by using a Facebook advertisement. We investigated whether the participants denied justification for vaccination as well as their sociodemographic characteristics, mental health status, sources of information about COVID-19 vaccination, perceived risk of COVID-19, and extrinsic and intrinsic intentions to get vaccinated against COVID-19. The results indicated that 20.0% of the participants denied justification for vaccination. Participants who were older, had an educational level below college, were not health care workers, were in poor general mental health state, or did not obtain information about COVID-19 vaccination from the Internet were more likely to deny justification for vaccination. Denial was negatively associated with both extrinsic and intrinsic intentions to get vaccinated against COVID-19 but not associated with the perceived risk of COVID-19. Multiple variables related to denying the justification for vaccination; the denial was negatively associated with the intention to get vaccinated against COVID-19. Full article
21 pages, 2292 KiB  
Article
Who Is Willing to Get Vaccinated? A Study into the Psychological, Socio-Demographic, and Cultural Determinants of COVID-19 Vaccination Intentions
by Mattia Giuliani, Anna Ichino, Alice Bonomi, Riccardo Martoni, Stefania Cammino and Alessandra Gorini
Vaccines 2021, 9(8), 810; https://doi.org/10.3390/vaccines9080810 - 21 Jul 2021
Cited by 26 | Viewed by 4868
Abstract
Crucial to the success of the COVID-19 vaccination campaign is the rate of people who adhere to it. This study aimed to investigate the reasons underlying people’s willingness to get vaccinated in a sample of Italian adults, considering the effects of different individual [...] Read more.
Crucial to the success of the COVID-19 vaccination campaign is the rate of people who adhere to it. This study aimed to investigate the reasons underlying people’s willingness to get vaccinated in a sample of Italian adults, considering the effects of different individual characteristics and psychological variables upon positive vs. negative/hesitant vaccination intentions, as well as subjects’ self-reported motivations for such intentions. An anonymous cross-sectional survey was distributed online in February 2021. The results showed that trust in science, number of vaccinations received in 2019, and belief that COVID-19 is more severe than the common flu, were associated with positive vaccination intentions. “Chance externality” health locus of control showed both direct and indirect effects upon positive vaccination intentions. Anxiety symptoms and participants’ perceived psychological status also showed indirect positive effects. Subjects’ self-reported motivations varied interestingly across positive vs. negative/hesitant intentions. Implications of these findings for identifying effective pro-vaccination messages are discussed in the final section of the paper. Full article
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10 pages, 1069 KiB  
Article
Exploring Psychological Factors for COVID-19 Vaccination Intention in Taiwan
by Shih-Yu Lo, Shu-Chu Sarrina Li and Tai-Yee Wu
Vaccines 2021, 9(7), 764; https://doi.org/10.3390/vaccines9070764 - 08 Jul 2021
Cited by 5 | Viewed by 4031
Abstract
To underpin the psychological factors for vaccination intention, we explored the variables related to positive and negative attitudes toward COVID-19 vaccination in Taiwan. The data were collected via an online survey platform with a sample size of 1100 in April 2021. We found [...] Read more.
To underpin the psychological factors for vaccination intention, we explored the variables related to positive and negative attitudes toward COVID-19 vaccination in Taiwan. The data were collected via an online survey platform with a sample size of 1100 in April 2021. We found that people’s interpretations of the origin of the virus were relevant. People who tended to believe that the virus was artificially created felt powerless and were more concerned about the possible side-effects of the vaccines, which was negatively associated with their vaccination intention. The source of vaccine recommendation was found to be relevant to vaccination intention. People’s vaccination intention was highest if the vaccines were recommended by health professionals, followed by friends and the government, and then mainstream media and social media. The analysis of the demographic variables showed that men tended to be more receptive to vaccines than women. Our findings should provide insights into developing communication strategies to effectively promote vaccination intentions. Full article
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13 pages, 2025 KiB  
Article
A National Survey to Assess the COVID-19 Vaccine-Related Conspiracy Beliefs, Acceptability, Preference, and Willingness to Pay among the General Population of Pakistan
by Muhammad Subhan Arshad, Iltaf Hussain, Tahir Mahmood, Khezar Hayat, Abdul Majeed, Imran Imran, Hamid Saeed, Muhammad Omer Iqbal, Muhammad Uzair, Anees ur Rehman, Waseem Ashraf, Areeba Usman, Shahzada Khurram Syed, Muqarrab Akbar, Muhammad Omer Chaudhry, Basit Ramzan, Muhammad Islam, Muhammad Usman Saleem, Waleed Shakeel, Iram Iqbal, Furqan Hashmi and Muhammad Fawad Rasooladd Show full author list remove Hide full author list
Vaccines 2021, 9(7), 720; https://doi.org/10.3390/vaccines9070720 - 01 Jul 2021
Cited by 45 | Viewed by 8338
Abstract
The current study aims to assess the beliefs of the general public in Pakistan towards conspiracy theories, acceptance, willingness to pay, and preference for the COVID-19 vaccine. A cross-sectional study was conducted through an online self-administered questionnaire during January 2021. The Chi-square test [...] Read more.
The current study aims to assess the beliefs of the general public in Pakistan towards conspiracy theories, acceptance, willingness to pay, and preference for the COVID-19 vaccine. A cross-sectional study was conducted through an online self-administered questionnaire during January 2021. The Chi-square test or Fisher exact test was utilized for statistical data analysis. A total of 2158 respondents completed the questionnaire, among them 1192 (55.2%) were male with 23.87 (SD: ±6.23) years as mean age. The conspiracy beliefs circulating regarding the COVID-19 vaccine were believed by 9.3% to 28.4% of the study participants. Among them, 1040 (48.2%) agreed to vaccinate on its availability while 934 (43.3%) reported the Chinese vaccine as their preference. The conspiracy beliefs of the participants were significantly associated with acceptance of the COVID-19 vaccine. The existence of conspiracy beliefs and low vaccine acceptance among the general population is a serious threat to successful COVID-19 vaccination. Full article
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15 pages, 726 KiB  
Article
Predictors of Intention to Vaccinate against COVID-19 in the General Public in Hong Kong: Findings from a Population-Based, Cross-Sectional Survey
by Elsie Yan, Daniel W. L. Lai and Vincent W. P. Lee
Vaccines 2021, 9(7), 696; https://doi.org/10.3390/vaccines9070696 - 25 Jun 2021
Cited by 31 | Viewed by 5562
Abstract
Vaccination is one of the most effective ways to stop the spread of COVID-19. Understanding factors associated with intention to receive COVID-19 vaccines is the key to a successful vaccination programme. This cross-sectional study explored the rate of vaccination intention and identified its [...] Read more.
Vaccination is one of the most effective ways to stop the spread of COVID-19. Understanding factors associated with intention to receive COVID-19 vaccines is the key to a successful vaccination programme. This cross-sectional study explored the rate of vaccination intention and identified its predictors using the health belief model (HBM) in the general population in Hong Kong during the pandemic. Data were collected between December 2020 and January 2021 via telephone surveys. Hierarchical logistic regression analysis was used to identify factors associated with intention to receive COVID-19 vaccines. A total of 1255 adults (>18 years, 53% female) completed the telephone survey. Overall, 42% indicated an intention to vaccinate, 31.5% showed vaccine hesitancy, and 26.5% reported refusal to receive any COVID-19 vaccines. Individuals who were men, older in age, working, with past experiences of other pandemics, less concerned with the vaccine safety, with poorer knowledge about COVID-19, and having greater levels of perceived susceptibility, self-efficacy, cues to action, and acceptance of governmental preventive measures related to COVID-19 were significantly more likely to report an intention to vaccinate. The low intention among the Hong Kong population reflects the importance of developing effective vaccination promotion campaigns with the predictors identified in this study. Full article
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10 pages, 238 KiB  
Article
Factors Influencing SARS-CoV-2 Vaccine Acceptance and Hesitancy in a Population-Based Sample in Italy
by Marco Del Riccio, Sara Boccalini, Lisa Rigon, Massimiliano Alberto Biamonte, Giuseppe Albora, Duccio Giorgetti, Paolo Bonanni and Angela Bechini
Vaccines 2021, 9(6), 633; https://doi.org/10.3390/vaccines9060633 - 10 Jun 2021
Cited by 36 | Viewed by 3801
Abstract
Vaccination against SARS-CoV-2 represents an effective and safe tool to protect the population against the disease; however, COVID-19 vaccine hesitancy could be a major barrier to achieving herd immunity. Despite the severity of the current pandemic, the population’s intention to get vaccinated against [...] Read more.
Vaccination against SARS-CoV-2 represents an effective and safe tool to protect the population against the disease; however, COVID-19 vaccine hesitancy could be a major barrier to achieving herd immunity. Despite the severity of the current pandemic, the population’s intention to get vaccinated against COVID-19 is still not clear. The aim of this study was to evaluate the intention to get vaccinated against COVID-19 among a convenience sample of the general population resident in Italy and the factors associated with hesitancy and acceptance of the vaccine in the context of the current pandemic before the rolling out of COVID-19 vaccines. An anonymous online survey was diffused among a general adult population living in Italy. Participants aged 18 or older and living in Italy were considered eligible. Incomplete questionnaires were excluded. Overall, 7605 valid questionnaires were collected. Most of the participants (81.9%) were inclined to get vaccinated; male sex (OR 1.38, 95% CI 1.12–1.71), a high level of trust in institutions (OR 3.93, 95% CI 2.04–7.83), and personal beliefs about high safety of COVID-19 vaccines (OR 56.33, 95% CI 31.57–105.87) were found to be among the significant predictors of COVID-19 acceptance. These data could help design larger studies to address the problem of COVID-19 vaccine hesitancy in the current pandemic. Full article
23 pages, 3417 KiB  
Article
Side Effects and Perceptions Following COVID-19 Vaccination in Jordan: A Randomized, Cross-Sectional Study Implementing Machine Learning for Predicting Severity of Side Effects
by Ma’mon M. Hatmal, Mohammad A. I. Al-Hatamleh, Amin N. Olaimat, Malik Hatmal, Dina M. Alhaj-Qasem, Tamadur M. Olaimat and Rohimah Mohamud
Vaccines 2021, 9(6), 556; https://doi.org/10.3390/vaccines9060556 - 26 May 2021
Cited by 134 | Viewed by 33850
Abstract
Background: Since the coronavirus disease 2019 (COVID-19) was declared a pandemic, there was no doubt that vaccination is the ideal protocol to tackle it. Within a year, a few COVID-19 vaccines have been developed and authorized. This unparalleled initiative in developing vaccines created [...] Read more.
Background: Since the coronavirus disease 2019 (COVID-19) was declared a pandemic, there was no doubt that vaccination is the ideal protocol to tackle it. Within a year, a few COVID-19 vaccines have been developed and authorized. This unparalleled initiative in developing vaccines created many uncertainties looming around the efficacy and safety of these vaccines. This study aimed to assess the side effects and perceptions following COVID-19 vaccination in Jordan. Methods: A cross-sectional study was conducted by distributing an online survey targeted toward Jordan inhabitants who received any COVID-19 vaccines. Data were statistically analyzed and certain machine learning (ML) tools, including multilayer perceptron (MLP), eXtreme gradient boosting (XGBoost), random forest (RF), and K-star were used to predict the severity of side effects. Results: A total of 2213 participants were involved in the study after receiving Sinopharm, AstraZeneca, Pfizer-BioNTech, and other vaccines (38.2%, 31%, 27.3%, and 3.5%, respectively). Generally, most of the post-vaccination side effects were common and non-life-threatening (e.g., fatigue, chills, dizziness, fever, headache, joint pain, and myalgia). Only 10% of participants suffered from severe side effects; while 39% and 21% of participants had moderate and mild side effects, respectively. Despite the substantial variations between these vaccines in the presence and severity of side effects, the statistical analysis indicated that these vaccines might provide the same protection against COVID-19 infection. Finally, around 52.9% of participants suffered before vaccination from vaccine hesitancy and anxiety; while after vaccination, 95.5% of participants have advised others to get vaccinated, 80% felt more reassured, and 67% believed that COVID-19 vaccines are safe in the long term. Furthermore, based on the type of vaccine, demographic data, and side effects, the RF, XGBoost, and MLP gave both high accuracies (0.80, 0.79, and 0.70, respectively) and Cohen’s kappa values (0.71, 0.70, and 0.56, respectively). Conclusions: The present study confirmed that the authorized COVID-19 vaccines are safe and getting vaccinated makes people more reassured. Most of the post-vaccination side effects are mild to moderate, which are signs that body’s immune system is building protection. ML can also be used to predict the severity of side effects based on the input data; predicted severe cases may require more medical attention or even hospitalization. Full article
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10 pages, 224 KiB  
Article
Intention to Be Vaccinated for COVID-19 among Italian Nurses during the Pandemic
by Marco Trabucco Aurilio, Francesco Saverio Mennini, Simone Gazzillo, Laura Massini, Matteo Bolcato, Alessandro Feola, Cristiana Ferrari and Luca Coppeta
Vaccines 2021, 9(5), 500; https://doi.org/10.3390/vaccines9050500 - 12 May 2021
Cited by 43 | Viewed by 3382
Abstract
Background: While the COVID-19 pandemic has spread globally, health systems are overwhelmed by both direct and indirect mortality from other treatable conditions. COVID-19 vaccination was crucial to preventing and eliminating the disease, so vaccine development for COVID-19 was fast-tracked worldwide. Despite the fact [...] Read more.
Background: While the COVID-19 pandemic has spread globally, health systems are overwhelmed by both direct and indirect mortality from other treatable conditions. COVID-19 vaccination was crucial to preventing and eliminating the disease, so vaccine development for COVID-19 was fast-tracked worldwide. Despite the fact that vaccination is commonly recognized as the most effective approach, according to the World Health Organization (WHO), vaccine hesitancy is a global health issue. Methods: We conducted a cross-sectional online survey of nurses in four different regions in Italy between 20 and 28 December 2020 to obtain data on the acceptance of the upcoming COVID-19 vaccination in order to plan specific interventions to increase the rate of vaccine coverage. Results: A total of 531 out of the 5000 nurses invited completed the online questionnaire. Most of the nurses enrolled in the study (73.4%) were female. Among the nurses, 91.5% intended to accept vaccination, whereas 2.3% were opposed and 6.2% were undecided. Female sex and confidence in vaccine efficacy represent the main predictors of vaccine intention among the study population using a logistic regression model, while other factors including vaccine safety concerns (side effects) were non-significant. Conclusions: Despite the availability of a safe and effective vaccine, intention to be vaccinated was suboptimal among nurses in our sample. We also found a significant number of people undecided as to whether to accept the vaccine. Contrary to expectations, concerns about the safety of the vaccine were not found to affect the acceptance rate; nurses’ perception of vaccine efficacy and female sex were the main influencing factors on attitudes toward vaccination in our sample. Since the success of the COVID-19 immunization plan depends on the uptake rate, these findings are of great interest for public health policies. Interventions aimed at increasing employee awareness of vaccination efficacy should be promoted among nurses in order to increase the number of vaccinated people. Full article
22 pages, 2772 KiB  
Article
Effect of Information about COVID-19 Vaccine Effectiveness and Side Effects on Behavioural Intentions: Two Online Experiments
by John R. Kerr, Alexandra L. J. Freeman, Theresa M. Marteau and Sander van der Linden
Vaccines 2021, 9(4), 379; https://doi.org/10.3390/vaccines9040379 - 13 Apr 2021
Cited by 76 | Viewed by 22619
Abstract
The success of mass COVID-19 vaccination campaigns rests on widespread uptake. However, although vaccinations provide good protection, they do not offer full immunity and while they likely reduce transmission of the virus to others, the extent of this remains uncertain. This produces a [...] Read more.
The success of mass COVID-19 vaccination campaigns rests on widespread uptake. However, although vaccinations provide good protection, they do not offer full immunity and while they likely reduce transmission of the virus to others, the extent of this remains uncertain. This produces a dilemma for communicators who wish to be transparent about benefits and harms and encourage continued caution in vaccinated individuals but not undermine confidence in an important public health measure. In two large pre-registered experimental studies on quota-sampled UK public participants we investigate the effects of providing transparent communication—including uncertainty—about vaccination effectiveness on decision-making. In Study 1 (n = 2097) we report that detailed information about COVID-19 vaccines, including results of clinical trials, does not have a significant impact on beliefs about the efficacy of such vaccines, concerns over side effects, or intentions to receive a vaccine. Study 2 (n = 2217) addressed concerns that highlighting the need to maintain protective behaviours (e.g., social distancing) post-vaccination may lower perceptions of vaccine efficacy and willingness to receive a vaccine. We do not find evidence of this: transparent messages did not significantly reduce perceptions of vaccine efficacy, and in some cases increased perceptions of efficacy. We again report no main effect of messages on intentions to receive a vaccine. The results of both studies suggest that transparently informing people of the limitations of vaccinations does not reduce intentions to be vaccinated but neither does it increase intentions to engage in protective behaviours post-vaccination. Full article
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14 pages, 894 KiB  
Article
A Descriptive-Multivariate Analysis of Community Knowledge, Confidence, and Trust in COVID-19 Clinical Trials among Healthcare Workers in Uganda
by Keneth Iceland Kasozi, Anne Laudisoit, Lawrence Obado Osuwat, Gaber El-Saber Batiha, Naif E. Al Omairi, Eric Aigbogun, Herbert Izo Ninsiima, Ibe Michael Usman, Lisa M. DeTora, Ewan Thomas MacLeod, Halima Nalugo, Francis P. Crawley, Barbara E. Bierer, Daniel Chans Mwandah, Charles Drago Kato, Kenedy Kiyimba, Emmanuel Tiyo Ayikobua, Linda Lillian, Kevin Matama, Shui Ching Nelly Mak, David Onanyang, Theophilus Pius, David Paul Nalumenya, Robinson Ssebuufu, Nina Olivia Rugambwa, Grace Henry Musoke, Kevin Bardosh, Juma John Ochieng, Fred Ssempijja, Patrick Kyamanywa, Gabriel Tumwine, Khalid J. Alzahrani and Susan Christina Welburnadd Show full author list remove Hide full author list
Vaccines 2021, 9(3), 253; https://doi.org/10.3390/vaccines9030253 - 12 Mar 2021
Cited by 18 | Viewed by 8208
Abstract
Background—misinformation and mistrust often undermines community vaccine uptake, yet information in rural communities, especially of developing countries, is scarce. This study aimed to identify major challenges associated with coronavirus disease 2019 (COVID-19) vaccine clinical trials among healthcare workers and staff in Uganda. Methods—a [...] Read more.
Background—misinformation and mistrust often undermines community vaccine uptake, yet information in rural communities, especially of developing countries, is scarce. This study aimed to identify major challenges associated with coronavirus disease 2019 (COVID-19) vaccine clinical trials among healthcare workers and staff in Uganda. Methods—a rapid exploratory survey was conducted over 5 weeks among 260 respondents (66% male) from healthcare centers across the country using an online questionnaire. Twenty-seven questions assessed knowledge, confidence, and trust scores on COVID-19 vaccine clinical trials from participants in 46 districts in Uganda. Results—we found low levels of knowledge (i.e., confusing COVID-19 with Ebola) with males being more informed than females (OR = 1.5, 95% CI: 0.7–3.0), and mistrust associated with policy decisions to promote herbal treatments in Uganda and the rushed international clinical trials, highlighting challenges for the upcoming Oxford–AstraZeneca vaccinations. Knowledge, confidence and trust scores were higher among the least educated (certificate vs. bachelor degree holders). We also found a high level of skepticism and possible community resistance to DNA recombinant vaccines, such as the Oxford–AstraZeneca vaccine. Preference for herbal treatments (38/260; 14.6%, 95% CI: 10.7–19.3) currently being promoted by the Ugandan government raises major policy concerns. High fear and mistrust for COVID-19 vaccine clinical trials was more common among wealthier participants and more affluent regions of the country. Conclusion—our study found that knowledge, confidence, and trust in COVID-19 vaccines was low among healthcare workers in Uganda, especially those with higher wealth and educational status. There is a need to increase transparency and inclusive participation to address these issues before new trials of COVID-19 vaccines are initiated. Full article
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12 pages, 1013 KiB  
Article
Who Should Get COVID-19 Vaccine First? A Survey to Evaluate Hospital Workers’ Opinion
by Lucia Craxì, Alessandra Casuccio, Emanuele Amodio and Vincenzo Restivo
Vaccines 2021, 9(3), 189; https://doi.org/10.3390/vaccines9030189 - 25 Feb 2021
Cited by 26 | Viewed by 3980
Abstract
Prospective planning of COVID-19 vaccines allocation will be essential to maximize public health and societal benefits while preserving equity. Decisions about how to allocate limited supplies of vaccines need to be clear about the criteria used in setting priorities, with a specific commitment [...] Read more.
Prospective planning of COVID-19 vaccines allocation will be essential to maximize public health and societal benefits while preserving equity. Decisions about how to allocate limited supplies of vaccines need to be clear about the criteria used in setting priorities, with a specific commitment to transparency and communication. The aim of our study was to think through these competing demands, focusing on the opinion of healthcare workers (HCWs). The primary endpoint of the study was to assess the opinion of all the HCWs in a University based Italian Hospital about the fairest priority order to COVID 19 vaccines and to understand on which criteria the prioritization preferences of HCWs are implicitly based. The secondary endpoints were to assess whether HCWs approach differs from national guidelines and to assess the attitude of HCWs towards mandatory vaccination. An online survey accounting with multiple choice single answer questions and ranking questions was administered to all the HCWs of the University Hospital P. Giaccone of Palermo (Italy) and completed by a total of 465 participants. Almost all respondents confirmed the need for prioritization in COVID-19 vaccination for HCWs (n = 444; 95.5%), essential services and law enforcement (both n = 428; 92%). Clinically vulnerable individuals, HCWs and population over 65 years have been considered the first three groups to be involved in getting vaccination, being indicated as first position group by 26.5%, 32.5% and 21.9% of respondents, respectively. A large majority of respondents (85%) asked for a consistent, transparent and detailed order of priority at a national level. After adjusting for potential confounding due to sex and age, physicians have been found to be statistically significantly associated with the choice of mandatory vaccination (odds ratio (OR): 10.2; 95% confidence interval (CI) = 2.7–39.1) or with other strategies different from voluntary (OR = 7.2; 95% CI = 1.9–27.3). The broad consensus expressed by respondents towards mandatory vaccination for HCWs is extremely relevant at a time when vaccination hesitation is one of the biggest obstacles to achieving herd immunity. Data show a mismatch in the position attributed to long-term care residents compared to the position of absolute priority assigned by most of national distribution plans, impelling us to reflect on the issue of maximizing benefit from limited healthcare resources. Our findings clearly indicate a preference for COVID-19 frontline health professionals as the first tier of recipients, since they better meet all the criteria (higher risk, immediate system stability). As the guidelines are likely to directly affect a considerable number of citizens, our results call for policy interventions to inform people on the ethical rationale behind vaccine distribution decisions, to avoid resentment and feelings of unfairness. Full article
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8 pages, 780 KiB  
Article
Willingness to Receive COVID-19 Vaccination in Japan
by Takeshi Yoda and Hironobu Katsuyama
Vaccines 2021, 9(1), 48; https://doi.org/10.3390/vaccines9010048 - 14 Jan 2021
Cited by 188 | Viewed by 14385
Abstract
In the wake of the COVID-19 pandemic, vaccines are being developed by many countries for the safety of their population. However, people of various nations have revealed hesitancy towards being vaccinated, citing reasons such as side effects, safety, a lack of trust in [...] Read more.
In the wake of the COVID-19 pandemic, vaccines are being developed by many countries for the safety of their population. However, people of various nations have revealed hesitancy towards being vaccinated, citing reasons such as side effects, safety, a lack of trust in vaccine effectiveness, etc. This study aimed to explore the willingness of people in Japan to be vaccinated or not be vaccinated and the reasons for either decision. A sample of 1100 respondents was drawn from an internet research panel, and a questionnaire survey was administered to evaluate their willingness to be vaccinated by gender, age group, place of living, and underlying illness history. After using descriptive statistics and the chi-squared test to evaluate categorical variables, 65.7% of the participants indicated a willingness to be vaccinated; among them were older age groups, those in rural areas, and those with underlying medical conditions. In addition, males showed less hesitancy towards being vaccinated. Although selectivity bias exists, this study is the first to examine the willingness of Japanese people to be vaccinated. Since vaccine hesitancy and refusal ratio were found to be higher in Japan than in other countries, policy efforts are needed to make the country’s vaccination program viable. Full article
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16 pages, 1305 KiB  
Article
High Rates of COVID-19 Vaccine Hesitancy and Its Association with Conspiracy Beliefs: A Study in Jordan and Kuwait among Other Arab Countries
by Malik Sallam, Deema Dababseh, Huda Eid, Kholoud Al-Mahzoum, Ayat Al-Haidar, Duaa Taim, Alaa Yaseen, Nidaa A. Ababneh, Faris G. Bakri and Azmi Mahafzah
Vaccines 2021, 9(1), 42; https://doi.org/10.3390/vaccines9010042 - 12 Jan 2021
Cited by 425 | Viewed by 30233
Abstract
Vaccination could be an effective strategy for slowing the spread of the current coronavirus disease 2019 (COVID-19) pandemic. Vaccine hesitancy could pose a serious problem for COVID-19 prevention, due to the spread of misinformation surrounding the ongoing pandemic. The aim of this study [...] Read more.
Vaccination could be an effective strategy for slowing the spread of the current coronavirus disease 2019 (COVID-19) pandemic. Vaccine hesitancy could pose a serious problem for COVID-19 prevention, due to the spread of misinformation surrounding the ongoing pandemic. The aim of this study was to assess the attitudes towards the prospective COVID-19 vaccines among the general public in Jordan, Kuwait and other Arab countries. We also aimed to assess the association between COVID-19 vaccine acceptance and conspiracy beliefs. This study used an online survey distributed in December 2020, with items assessing conspiracies regarding COVID-19’s origin and vaccination. Attitudes towards COVID-19 vaccines were assessed using the Vaccine Conspiracy Belief Scale (VCBS), with higher scores indicating a greater belief in vaccine conspiracy. A total of 3414 respondents completed the survey, the majority being residents of Jordan (n = 2173, 63.6%), Kuwait (n = 771, 22.6%) and Saudi Arabia (n = 154, 4.5%). The acceptance rates for COVID-19 and influenza vaccines were 29.4% and 30.9%, respectively. Males, respondents with higher educational levels and those with histories of chronic disease had higher rates of COVID-19 vaccine acceptance. Beliefs that COVID-19 vaccines are intended to inject microchips into recipients and that the vaccines are related to infertility were found in 27.7% and 23.4% of respondents, respectively. Higher VCBS scores were found among females, respondents with lower educational levels and respondents relying on social media platforms as the main source of information. The high rates of vaccine hesitancy in Jordan and Kuwait, among other Arab countries, are alarming. They could hinder the proper control of COVID-19 in the region. The harmful effect of COVID-19 misinformation and conspiracy beliefs was manifested in vaccine hesitancy. This may represent a massive obstacle to the successful control of the pandemic. A reliance on social media as the main source of information about COVID-19 vaccines was associated with vaccine hesitancy. This should alert governments, policy makers and the general public to the importance of vigilant fact checking. Full article
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9 pages, 236 KiB  
Article
Social Patterning and Stability of Intention to Accept a COVID-19 Vaccine in Scotland: Will Those Most at Risk Accept a Vaccine?
by Lynn Williams, Paul Flowers, Julie McLeod, David Young, Lesley Rollins and The CATALYST Project Team
Vaccines 2021, 9(1), 17; https://doi.org/10.3390/vaccines9010017 - 04 Jan 2021
Cited by 61 | Viewed by 6827
Abstract
Vaccination is central to controlling COVID-19. Its success relies on having safe and effective vaccines and also on high levels of uptake by the public over time. Addressing questions of population-level acceptability, stability of acceptance, and sub-population variation in acceptability are imperative. Using [...] Read more.
Vaccination is central to controlling COVID-19. Its success relies on having safe and effective vaccines and also on high levels of uptake by the public over time. Addressing questions of population-level acceptability, stability of acceptance, and sub-population variation in acceptability are imperative. Using a prospective design, a repeated measures two-wave online survey was conducted to assess key sociodemographic variables and intention to accept a COVID-19 vaccine. The first survey (Time 1) was completed by 3436 people during the period of national lockdown in Scotland and the second survey (n = 2016) was completed two months later (Time 2) when restrictions had been eased. In the first survey, 74% reported being willing to receive a COVID-19 vaccine. Logistic regression analyses showed that there were clear sociodemographic differences in intention to accept a vaccine for COVID-19 with intention being higher in participants of white ethnicity as compared with Black, Asian, and minority ethnic (BAME) groups, and in those with higher income levels and higher education levels. Intention was also higher in those who had “shielding” status due to underlying medical conditions. Our results suggest that future interventions, such as mass media and social marketing, need to be targeted at a range of sub-populations and diverse communities. Full article

Review

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20 pages, 1373 KiB  
Review
Transmission of Vaccination Attitudes and Uptake Based on Social Contagion Theory: A Scoping Review
by Pinelopi Konstantinou, Katerina Georgiou, Navin Kumar, Maria Kyprianidou, Christos Nicolaides, Maria Karekla and Angelos P. Kassianos
Vaccines 2021, 9(6), 607; https://doi.org/10.3390/vaccines9060607 - 05 Jun 2021
Cited by 31 | Viewed by 7994
Abstract
Vaccine hesitancy is a complex health problem, with various factors involved including the influence of an individual’s network. According to the Social Contagion Theory, attitudes and behaviours of an individual can be contagious to others in their social networks. This scoping review aims [...] Read more.
Vaccine hesitancy is a complex health problem, with various factors involved including the influence of an individual’s network. According to the Social Contagion Theory, attitudes and behaviours of an individual can be contagious to others in their social networks. This scoping review aims to collate evidence on how attitudes and vaccination uptake are spread within social networks. Databases of PubMed, PsycINFO, Embase, and Scopus were searched with the full text of 24 studies being screened. A narrative synthesis approach was used to collate the evidence and interpret findings. Eleven cross-sectional studies were included. Participants held more positive vaccination attitudes and greater likelihood to get vaccinated or vaccinate their child when they were frequently exposed to positive attitudes and frequently discussing vaccinations with family and friends. We also observed that vaccination uptake was decreased when family and friends were hesitant to take the vaccine. Homophily—the tendency of similar individuals to be connected in a social network—was identified as a significant factor that drives the results, especially with respect to race and ethnicity. This review highlights the key role that social networks play in shaping attitudes and vaccination uptake. Public health authorities should tailor interventions and involve family and friends to result in greater vaccination uptake. Full article
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26 pages, 742 KiB  
Review
A Rapid Systematic Review of Public Responses to Health Messages Encouraging Vaccination against Infectious Diseases in a Pandemic or Epidemic
by Sadie Lawes-Wickwar, Daniela Ghio, Mei Yee Tang, Chris Keyworth, Sabina Stanescu, Juliette Westbrook, Elizabeth Jenkinson, Angelos P. Kassianos, Daniel Scanlan, Natalie Garnett, Lynn Laidlaw, Neil Howlett, Natalie Carr, Natalia Stanulewicz, Ella Guest, Daniella Watson, Lisa Sutherland, Lucie Byrne-Davis, Angel Chater, Jo Hart, Christopher J. Armitage, Gillian W. Shorter, Vivien Swanson and Tracy Eptonadd Show full author list remove Hide full author list
Vaccines 2021, 9(2), 72; https://doi.org/10.3390/vaccines9020072 - 20 Jan 2021
Cited by 45 | Viewed by 12576
Abstract
Public health teams need to understand how the public responds to vaccination messages in a pandemic or epidemic to inform successful campaigns encouraging the uptake of new vaccines as they become available. A rapid systematic review was performed by searching PsycINFO, MEDLINE, healthevidence.org, [...] Read more.
Public health teams need to understand how the public responds to vaccination messages in a pandemic or epidemic to inform successful campaigns encouraging the uptake of new vaccines as they become available. A rapid systematic review was performed by searching PsycINFO, MEDLINE, healthevidence.org, OSF Preprints and PsyArXiv Preprints in May 2020 for studies including at least one health message promoting vaccine uptake of airborne-, droplet- and fomite-spread viruses. Included studies were assessed for quality using the Mixed Methods Appraisal Tool (MMAT) or the Assessment of Multiple Systematic Reviews (AMSTAR), and for patient and public involvement (PPI) in the research. Thirty-five articles were included. Most reported messages for seasonal influenza (n = 11; 31%) or H1N1 (n = 11; 31%). Evidence from moderate to high quality studies for improving vaccine uptake included providing information about virus risks and vaccination safety, as well as addressing vaccine misunderstandings, offering vaccination reminders, including vaccination clinic details, and delivering mixed media campaigns across hospitals or communities. Behavioural influences (beliefs and intentions) were improved when: shorter, risk-reducing or relative risk framing messages were used; the benefits of vaccination to society were emphasised; and beliefs about capability and concerns among target populations (e.g., vaccine safety) were addressed. Clear, credible, messages in a language target groups can understand were associated with higher acceptability. Two studies (6%) described PPI in the research process. Future campaigns should consider the beliefs and information needs of target populations in their design, including ensuring that vaccine eligibility and availability is clear, and messages are accessible. More high quality research is needed to demonstrate the effects of messaging interventions on actual vaccine uptake. Full article
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