Public Psychobehavioral Responses towards Vaccination

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

Deadline for manuscript submissions: 30 April 2024 | Viewed by 14425

Special Issue Editor

Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia
Interests: vaccine hesitancy; vaccination; psychological; behavioral

Special Issue Information

Dear Colleagues, 

This Special Issue focuses on identifying important gaps in psychological and behavioral responses, exclusively focusing on, but not limited to, COVID-19 vaccination. Since the Food and Drug Administration (FDA) gave its full approval of the first COVID-19 vaccine, there has been an exponential growth in the number of publications on studies assessing the psychological and behavioral responses to COVID-19 vaccination throughout the world. Psychobehavioral responses to COVID-19 vaccination differ in people from specific cultures and countries. There are huge variations in the psychobehavioral responses to COVID-19 vaccination between countries, and even within them. Despite the large number of publications, significant information gaps still exist. Particularly, there has been a scarcity of studies conducted on neglected or marginalized populations. People living in poverty as well as vulnerable populations in society throughout the world are heavily burdened during the pandemic. There is still much to learn about their vaccination rates, vaccine acceptance, and respective psychobehavioral responses.

From the onset of the COVID-19 pandemic, much vaccine acceptance research has focused almost exclusively around COVID-19 vaccines. Throughout the pandemic, governments have implemented a variety of containment measures that impact the uptake of other vaccines and resulted in a reduction in routine immunization coverage. Relatively little has been published on vaccine coverage for other diseases, such as influenza, cervical cancer, cholera, diphtheria, hepatitis B, influenza, measles, and polio. Additionally, the intention to get other vaccines may likely modify during the pandemic. There is still an incomplete understanding of how the pandemic has altered people's trust in other vaccines. Vaccines are the cornerstone of the management of many infectious disease outbreaks. As nations struggle to control the COVID-19 pandemic, hesitancy against a vaccine that protects from other infectious diseases may potentially result in another disease outbreak during the COVID-19 pandemic. More evidence is warranted to provide a better understanding of the effects of the COVID-19 pandemic on the hesitancy linked to other vaccines to implement early corrective actions.

In short, vaccine hesitancy is a major barrier to vaccine uptake and the achievement of herd immunity. Understanding the psychobehavioral responses to vaccination is important to promote vaccine uptake. This Special Issue aims to gather an extensive understanding of the psychobehavioral response to all types of vaccines. Owing to your extensive knowledge and previous research experience, we invite you to contribute with an original report, or review, to highlight various aspects of psychological and behavioral responses to COVID-19 as well as other infectious disease vaccinations.

Prof. Dr. Li Ping Wong 
Guest Editor

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Keywords

  • vaccine hesitancy
  • vaccination
  • psychological
  • behavioral

Published Papers (9 papers)

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Research

16 pages, 315 KiB  
Article
Socioeconomic Inequalities in COVID-19 Vaccine Hesitancy and Uptake in Greece and Cyprus during the Pandemic
by Ioanna Irini Pouliasi, Andria Hadjikou, Konstantina Kouvari and Alexandros Heraclides
Vaccines 2023, 11(8), 1301; https://doi.org/10.3390/vaccines11081301 - 31 Jul 2023
Viewed by 1003
Abstract
Despite the rigorous investigation of the phenomenon of vaccine hesitancy and refusal during the COVID-19 pandemic, the socioeconomic determinants of this phenomenon remain poorly investigated on a global scale. Following proportional quota sampling, we conducted a population-based cross-sectional study. We recruited participants on-site [...] Read more.
Despite the rigorous investigation of the phenomenon of vaccine hesitancy and refusal during the COVID-19 pandemic, the socioeconomic determinants of this phenomenon remain poorly investigated on a global scale. Following proportional quota sampling, we conducted a population-based cross-sectional study. We recruited participants on-site and online from different settings, regions, and socioeconomic strata in two Eastern Mediterranean populations, Greece and Cyprus. Our approach provided a nationwide sample (n = 576) approaching the adult population structure of the two countries, with a slight underrepresentation of men and older people. Our results indicate clear socioeconomic differences in vaccine hesitancy and vaccination coverage, consistent with wider social inequalities in health. In particular, we reveal a clear socioeconomic gradient characterized by lower vaccine hesitancy and higher vaccination coverage, with increasing educational attainment and income. Additionally, participants residing in semi-urban areas show higher vaccine hesitancy and have lower vaccination coverage than those residing in urban and rural areas. Our results could inform Public Health approaches aiming to tackle the alarming phenomenon of vaccine hesitancy by enabling the targeting of population groups who are particularly vaccine-hesitant, rendering such approaches more targeted and effective while at the same time reducing inequalities in the control and prevention of infectious diseases. Full article
(This article belongs to the Special Issue Public Psychobehavioral Responses towards Vaccination)
12 pages, 787 KiB  
Article
Past and Future Influenza Vaccine Uptake Motivation: A Cross-Sectional Analysis among Italian Health Sciences Students
by Pasquale Stefanizzi, Sandro Provenzano, Omar Enzo Santangelo, Giulia Dallagiacoma and Vincenza Gianfredi
Vaccines 2023, 11(4), 717; https://doi.org/10.3390/vaccines11040717 - 23 Mar 2023
Cited by 4 | Viewed by 1095
Abstract
Despite its effectiveness in the prevention of seasonal flu, influenza vaccination uptake remains low, even among healthcare workers (HCWs), despite their occupational risk. The aim of this study was to explore the association between main reasons for accepting or refusing influenza vaccination and [...] Read more.
Despite its effectiveness in the prevention of seasonal flu, influenza vaccination uptake remains low, even among healthcare workers (HCWs), despite their occupational risk. The aim of this study was to explore the association between main reasons for accepting or refusing influenza vaccination and the decision to receive the vaccination during both previous and following year among health sciences students. A multi-center, cross-sectional study was performed using a validated online questionnaire. Data were analyzed by performing univariable and multivariable logistic analysis. Data from over 3000 participants showed that avoiding the spread of infection to family members and the general population (aOR: 43.55), as well as to patients (aOR: 16.56) were the main reasons associated with the highest probability of taking the influenza vaccination the following year. On the contrary, not considering influenza as a severe disease was the reason associated with the lowest probability for past (aOR: 0.17) and future vaccination (aOR: 0.01). Therefore, the importance of vaccination to protect others should always be the core of vaccination campaigns for health sciences students, together with tools to increase their awareness of the severity of this disease. Full article
(This article belongs to the Special Issue Public Psychobehavioral Responses towards Vaccination)
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11 pages, 265 KiB  
Article
Parental Decision Making Regarding COVID-19 Vaccines for Children under Age 5: Does Decision Self-Efficacy Play a Role?
by Jennifer D. Allen, Masako Matsunaga, Eunjung Lim, Gregory D. Zimet, Kimberly H. Nguyen and Holly B. Fontenot
Vaccines 2023, 11(2), 478; https://doi.org/10.3390/vaccines11020478 - 18 Feb 2023
Cited by 6 | Viewed by 1608
Abstract
Background: COVID-19 vaccines are now available under Emergency Use Authorization for children ages 6 months to 5 years. We examined parents’ intentions to vaccinate their children under the age of 5 years and assessed whether their confidence in making an informed decision about [...] Read more.
Background: COVID-19 vaccines are now available under Emergency Use Authorization for children ages 6 months to 5 years. We examined parents’ intentions to vaccinate their children under the age of 5 years and assessed whether their confidence in making an informed decision about vaccination (decision self-efficacy) was associated with these intentions. Method: We conducted a cross-sectional online survey of U.S. parents between 23 March and 5 April 2022. We examined associations between parental intention to vaccinate their young children (<age 5 years) and confidence in vaccine decision making (decision self-efficacy). A multivariable multinomial logistic regression model was used to obtain adjusted odds ratios (AORs) and 95% confidence intervals (CIs) of parental intention (categorized as intend to vaccinate, unsure, or do not intend to vaccinate). Results: Of the 591 parents in this sample, 49% indicated that they intended to vaccinate their child(ren), 29% reported that they would not, and 21% were undecided. In bivariate analyses, race/ethnicity, health insurance, flu vaccination in the past 12 months, and parental COVID-19 vaccination status were significantly related to parental intention to vaccinate their child(ren). In the multivariable analyses, which controlled for these factors, parents who intended to vaccinate their child(ren) had greater confidence in their ability to make informed decisions about COVID-19 vaccinations compared to those who were unsure about vaccination. Each one standard deviation in the Decision Self-Efficacy score was associated with a 39% increase in intention to vaccinate one’s child versus being unsure about vaccination (AOR 1.39, 95% CI 1.09, 1.77). Conclusions: Parents who are unsure about vaccinating their children against COVID-19 may benefit from interventions designed to increase their ability to obtain, understand, and utilize information to make informed decisions. Full article
(This article belongs to the Special Issue Public Psychobehavioral Responses towards Vaccination)
11 pages, 1580 KiB  
Article
Acceptance and Preference for COVID-19 Vaccine among Japanese Residents at Early Stage of the Epidemic in Japan
by Jiwen Wu, Guoxi Cai, Yi Fan, Kazuhiko Arima, Yulan Lin, Liping Wong, Zhuo Zhang, Taro Yamamoto, Kouichi Morita, Akira Yoshikawa, Yixiao Lu and Kiyoshi Aoyagi
Vaccines 2023, 11(1), 157; https://doi.org/10.3390/vaccines11010157 - 11 Jan 2023
Cited by 1 | Viewed by 1586
Abstract
Background: This study aimed to survey the attitudes toward COVID-19 vaccines and their acceptability among the Japanese public as soon as the United States Food and Drug Administration (FDA) authorized vaccines and their rollouts started around the world. Methods: An anonymous cross-sectional survey [...] Read more.
Background: This study aimed to survey the attitudes toward COVID-19 vaccines and their acceptability among the Japanese public as soon as the United States Food and Drug Administration (FDA) authorized vaccines and their rollouts started around the world. Methods: An anonymous cross-sectional survey was conducted in Japan between 4 January and 5 March 2021. A questionnaire was administered to evaluate attitudes toward COVID-19 vaccines according to demographic characteristics, vaccine characteristics, and vaccine production. Results: A total of 1037 completed responses were received. More than half (63.5%) of the participants responded positively (extremely likely/likely) toward COVID-19 vaccines. The highest acceptance to be vaccinated was discovered among the youngest age group. As expected, participants who had never delayed acceptance or refused the vaccine in their history of vaccination had a significantly higher willingness to be vaccinated against COVID-19 (p < 0.001). Females (OR = 2.66, 95% CI: 1.99–3.58) and participants who had ever delayed acceptance or refuse the vaccine (OR = 3.49, 95% CI: 2.42–5.05) had higher odds of COVID-19 vaccine hesitancy. Participants with a postgraduate degree (OR = 0.64, 95% CI: 0.40–1.00) presented the highest willingness to be vaccinated against COVID-19. More than two-thirds (72.9%, 95% CI: 70.4%–75.8%) of the participants did not mind a booster dose required following primary vaccination. A total of 63.2% (95% CI: 60.0%–66.0%) of the participants only accepted a nearly 90% effective or above vaccine at preventing COVID-19. At the same, 86.4% (95% CI: 84.4%–88.4%) of the participants reported only accepting a vaccine with minor side effects. Conclusions: The moderate levels of COVID-19 vaccine acceptance found in the early phase of the pandemic demonstrate that it is important to improve the implementation of effective management for vaccine promotion and the acceptability of the vaccine to slow or delay transmission. Full article
(This article belongs to the Special Issue Public Psychobehavioral Responses towards Vaccination)
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12 pages, 556 KiB  
Article
Changes in Attitudes toward COVID-19 Vaccination and Vaccine Uptake during Pandemic
by Ljiljana Markovic-Denic, Vladimir Nikolic, Nevenka Pavlovic, Gorica Maric, Aleksa Jovanovic, Aleksandra Nikolic, Vuk Marusic, Sandra Sipetic Grujicic and Tatjana Pekmezovic
Vaccines 2023, 11(1), 147; https://doi.org/10.3390/vaccines11010147 - 09 Jan 2023
Cited by 1 | Viewed by 1536
Abstract
The epidemic control approach was based on non-pharmacological measures in the first year of the COVID-19 pandemic, followed by vaccine uptake in the second year. Vaccine uptake depends on the individual attitude toward vaccination. The aim was to assess the changes in attitudes [...] Read more.
The epidemic control approach was based on non-pharmacological measures in the first year of the COVID-19 pandemic, followed by vaccine uptake in the second year. Vaccine uptake depends on the individual attitude toward vaccination. The aim was to assess the changes in attitudes regarding COVID-19 vaccine protection during the pandemic and to determine the vaccination uptake concerning these attitudes. A panel study on COVID-19 vaccine attitudes and vaccination against COVID-19 was conducted in Belgrade, Serbia. The first survey was carried out in May–June 2020, and the second survey was organized in August–September 2021. During the baseline testing performed in 2020, 64.4% of respondents believed that the future vaccine against COVID-19 could protect against the COVID-19 disease, while 9.7% thought that it could not, and 25.9% were unsure. One year later, in the second survey, the percentage of participants with positive attitudes was slightly lower (64.7% vs. 62.5%). However, negative attitudes turned positive in 34% of cases, and 28.9% became unsure about vaccine protection (p < 0.001). Out of the 390 participants included in the study, 79.7% were vaccinated against COVID-19 until follow-up. There is a statistically significant difference in vaccination uptake compared to the baseline attitude about the protection of the COVID-19 vaccine. The main finding of our study is that the majority of participants who were vaccine hesitant during the baseline testing changed their opinion during the follow-up period. Additionally, the baseline attitude about the protection of the COVID-19 vaccine has been shown to be a potential determinant of vaccination uptake. Full article
(This article belongs to the Special Issue Public Psychobehavioral Responses towards Vaccination)
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20 pages, 1162 KiB  
Article
Drivers of and Barriers to COVID-19 Vaccine Booster Dose Acceptance in Indonesia
by Harapan Harapan, Raisha Fathima, Hendrix Indra Kusuma, Samsul Anwar, Widhy Yudistira Nalapraya, Adityo Wibowo, Ketut Dewi Kumara Wati, Ayunda Medina, Anna Hanifa Defrita, Yesi Astri, Arie Prasetyowati, Nurfarahin Nurfarahin, Afriyani Khusna, Setya Oktariana, Sarifuddin Anwar, Milza Oka Yussar, Siti Khotimah, Bahagia Willibrordus Maria Nainggolan, Putri Rizki Amalia Badri, Raden Argarini, Wira Winardi, Rosaria Indah, Malik Sallam, Yogambigai Rajamoorthy, Abram L. Wagner and Mudatsir Mudatsiradd Show full author list remove Hide full author list
Vaccines 2022, 10(12), 1981; https://doi.org/10.3390/vaccines10121981 - 22 Nov 2022
Cited by 3 | Viewed by 2417
Abstract
Obtaining a booster dose of coronavirus disease 2019 (COVID-19) vaccine is required to maintain the protective level of neutralizing antibodies and therefore herd immunity in the community, and the success of booster dose programs depends on public acceptance. The aim of this study [...] Read more.
Obtaining a booster dose of coronavirus disease 2019 (COVID-19) vaccine is required to maintain the protective level of neutralizing antibodies and therefore herd immunity in the community, and the success of booster dose programs depends on public acceptance. The aim of this study was to determine the acceptance of a booster dose of COVID-19 vaccine and its drivers and barriers in Indonesia. A cross-sectional survey was conducted in the provinces of Indonesia between 1 and 15 August 2022. Individuals who completed the primary series of the COVID-19 vaccine were asked about their acceptance of a booster dose. Those who refused the booster dose were questioned about their reasons. A logistic regression was used to determine the determinants associated with rejection of a booster dose of COVID-19 vaccine. A total of 2935 respondents were included in the final analysis. With no information on the efficacy and safety of the COVID-19 vaccine, 95% of respondents agreed to receive a booster dose if it were provided for free by the government. This acceptance was reduced to only 50.3% if the vaccine had a 75% efficacy with a 20% chance of side effects. The adjusted logistic regression analysis indicated that there were eight factors associated with the rejection of the booster dose: age, marital status, religion, occupation, type of the first two vaccines received, knowledge regarding the importance of the booster dose, belief that natural immunity is sufficient to prevent COVID-19 and disbelief in the effectiveness of the booster dose. In conclusion, the hesitancy toward booster doses in Indonesia is influenced by some intrinsic factors such as lack of knowledge on the benefits of the booster dose, worries regarding the unexpected side effects and concerns about the halal status of the provided vaccines and extrinsic determinants such as the effectiveness and safety of the vaccine. These findings suggest the need for more campaigns and promotions regarding the booster dose benefits to increase its acceptance. Full article
(This article belongs to the Special Issue Public Psychobehavioral Responses towards Vaccination)
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15 pages, 800 KiB  
Article
How Motives Related to Benefits for Oneself and Others Would Affect COVID-19 Vaccination in a Hong Kong Chinese General Adult Population?
by Yanqiu Yu, Mason M. C. Lau and Joseph T. F. Lau
Vaccines 2022, 10(11), 1883; https://doi.org/10.3390/vaccines10111883 - 08 Nov 2022
Viewed by 1270
Abstract
Outcome expectancies involving self-directed and others-directed domains are potential determinants of completed or scheduled first-dose COVID-19 vaccination (CSFCV). This study investigated factors of CSFCV, including (a) self-directed motives [personal positive outcome expectancies (POE) and personal negative outcome expectancy (NOE)], and (b) others-directed motives [...] Read more.
Outcome expectancies involving self-directed and others-directed domains are potential determinants of completed or scheduled first-dose COVID-19 vaccination (CSFCV). This study investigated factors of CSFCV, including (a) self-directed motives [personal positive outcome expectancies (POE) and personal negative outcome expectancy (NOE)], and (b) others-directed motives (societal POE and the personality trait of prosociality). It also investigated the mediations of personal POE between societal POE and CSFCV, and moderations of prosociality between personal POE/personal NOE/societal POE and CSFCV. A cross-sectional population-based telephone survey interviewed 500 people aged 18–75 in Hong Kong in May 2021. The prevalence of CSFCV was 21.0%. Significant factors of CSFCV included personal POE (i.e., physical/practical/emotional/interpersonal benefit), personal NOE, and societal POE. The association between societal POE and CSFCV was fully mediated by the overall scale and some domains of personal POE. Furthermore, the association between physical benefit and CSFCV was stronger at lower levels of prosociality; prosociality showed a stronger effect on CSFCV at lower levels of physical benefit. The results suggest that self-directed motives might be more important than others-directed motives in affecting CSFCV. The findings require confirmations from longitudinal studies and cross-country comparisons. Full article
(This article belongs to the Special Issue Public Psychobehavioral Responses towards Vaccination)
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13 pages, 1085 KiB  
Article
Malaysian Parents’ Willingness to Vaccinate Their Children against COVID-19 Infection and Their Perception of mRNA COVID-19 Vaccines
by Li-Ping Wong, Hai-Yen Lee, Haridah Alias and Sazaly AbuBakar
Vaccines 2022, 10(11), 1790; https://doi.org/10.3390/vaccines10111790 - 25 Oct 2022
Cited by 4 | Viewed by 1601
Abstract
Little was known about Malaysian parental attitudes, beliefs, and intentions surrounding coronavirus disease 2019 (COVID-19) vaccines for children when the National COVID-19 Immunization Program for Children (PICKids) was launched in February 2021. A cross-sectional online survey-based study was carried out from 15 March [...] Read more.
Little was known about Malaysian parental attitudes, beliefs, and intentions surrounding coronavirus disease 2019 (COVID-19) vaccines for children when the National COVID-19 Immunization Program for Children (PICKids) was launched in February 2021. A cross-sectional online survey-based study was carried out from 15 March 2022 to 23 July 2022 on Malaysian parents/guardians of children between ages 5 and below 12 years old. A total of 15.7% reported being extremely willing, and 38.9% were somewhat willing to vaccinate children with a COVID-19 vaccine. Perceived low susceptibility to COVID-19 infection showed the greatest significant impact on vaccine acceptance (OR 35.46, 95% CI 15.26–82.40). Parents with a lower level of concern have a higher willingness for vaccination (OR 1.25, 95% CI 0.90–1.75). Of the parents that knew of the mRNA vaccine, 46.6% reported that they prefer their children to be vaccinated with conventional vaccines over mRNA vaccines. Poor knowledge about mRNA vaccines, lack of confidence in the mRNA technology, fear of unknown side effects, and perception that the mRNA vaccines contain microchips were significantly associated with a higher level of concern about their children receiving an mRNA vaccine. Public education campaigns to promote COVID-19 vaccination for children warrant addressing the concerns and knowledge deficits among vaccine-hesitant parents. Full article
(This article belongs to the Special Issue Public Psychobehavioral Responses towards Vaccination)
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12 pages, 268 KiB  
Article
Evaluation of Vaccine Hesitancy and Anxiety Levels among Hospital Cleaning Staff and Caregivers during COVID-19 Pandemic
by Sami Akbulut, Ayse Gokce, Gulseda Boz, Hasan Saritas, Selver Unsal, Ali Ozer, Mehmet Serdar Akbulut and Cemil Colak
Vaccines 2022, 10(9), 1426; https://doi.org/10.3390/vaccines10091426 - 30 Aug 2022
Cited by 7 | Viewed by 1599
Abstract
It is important to vaccinate individuals working in the field of health who are more at risk compared to society during the pandemic period. The aim of this study was to evaluate the vaccine hesitancy and anxiety levels of hospital cleaning staff and [...] Read more.
It is important to vaccinate individuals working in the field of health who are more at risk compared to society during the pandemic period. The aim of this study was to evaluate the vaccine hesitancy and anxiety levels of hospital cleaning staff and caregivers during the COVID-19 pandemic. This descriptive type cross-sectional study was conducted with 460 hospital cleaning staff and caregivers. Demographic and social characteristics form, Coronavirus Anxiety Scale (CAS), and Vaccine Hesitancy Scale (VHS) adapted to the pandemic were used in the questionnaire form used to collect the data of the study. It was determined that the rates of hesitation against the COVID-19 vaccine and childhood vaccine were 42.2% (n = 194) and 10.9% (n = 50), respectively. Less than half of the participants (44.6%) believe that the COVID-19 vaccine is protective. COVID-19 anxiety (CAS score ≥ 9 point) was detected in 19.6% of participants and statistically significant differences were found between patients with (n = 90) and without (n = 370) anxiety regarding gender (p < 0.001), working unit (p = 0.002), vaccination status (p = 0.023) and history of psychological disease (p = 0.023). It has been shown that the VHS-total scores of those who are not vaccinated, those who are hesitant about vaccination, those who do not think that the vaccine is protective, and those who state that there is no need for a legal obligation in vaccination are higher. When participants were asked about the most anxious situation during the COVID-19 period, the highest response rate was 62.4% for my parents’ exposure to COVID-19. The most anxious situation among participants is their parents’ exposure to COVID-19. Although participants are highly vaccinated, they have serious hesitancy about the COVID-19 vaccine. This study also showed that there was a parallel relationship between COVID-19 anxiety and vaccine hesitancy. Full article
(This article belongs to the Special Issue Public Psychobehavioral Responses towards Vaccination)
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