Sociodemographic and psychological correlates of COVID-19 vaccine hesitancy and resistance in the young adult population in Italy

BackgroundPrevious research has shown that young adults are more hesitant/resistant to COVID-19 vaccine uptake than older age groups, although the factors underlying this tendency are still under debate. The current study aimed to identify the sociodemographic and psychological correlates of vaccine hesitancy and resistance among young adults (18–40 years) during the nationwide COVID-19 vaccination campaign in Italy, the first country after China being hit by the pandemic and which suffered a large number of fatalities.MethodsThis is a cross-sectional, web-based study conducted in Italy using an ISO-certified international survey company (respondi.com). Data were collected on 1200 participants in June 2021.ResultsVaccine hesitancy/resistance was found for 25% of the sample. In multinomial logistic regression (N = 1159), being aged 30–40 years, residing in northern Italy, having lower educational and income level, being unemployed, and not knowing any friends/relatives diagnosed with COVID-19 were associated with higher odds of hesitancy or resistance. In multivariate analysis of variance (N = 1177), both vaccine hesitant and resistant young adults perceived significantly less social support from friends and family than vaccine accepting ones. Resistant individuals reported significantly higher levels of conspiracy theories and negative attitudes toward vaccines than their accepting and hesitant counterparts. Moreover, resistant individuals reported significantly lower levels of attachment to country and perceptions of a just government compared to accepting ones, with hesitant young adults scoring in between.ConclusionsOur findings support the idea that young adults with a hesitant (vs. resistant) attitude show a more nuanced and less extreme psychological profile. Public health messaging should capitalize on social media to provide accessible, transparent, and age-appropriate information concerning COVID-19 vaccine safety. Moreover, policy efforts improving the availability of social support systems are warranted to strengthen connectedness and foster trust in institutions amongst this particular segment of the population.     

Marketing the COVID-19 vaccine and the implications for public health

COVID-19 vaccines are new brands of consumer health technology being introduced to the market. Considering consumer behaviour approaches in this time of crisis, the risk of vaccine hesitancy, the call for more transparency and effective messaging to gain trust, and equitable distribution of this vaccine, this is unexplored theoretical terrain. This commentary takes a multidisciplinary approach to understand and theoretically explore the marketing, distribution, and acceptance of the COVID-19 vaccine. The paper integrates marketing principles, including advertisement and branding of consumer health technology with supply chain management, public affairs, and public health. A theoretical framework was presented to illustrate this relationship and key areas of concerns. The practical implications relevant to equity, ethics, education, employment, and the economic impact was presented.     

Characteristics associated with the willingness to receive a COVID-19 vaccine and an exploration of the general public's perceptions: A mixed-methods approach

Demographics and media discourse impact vaccine hesitancy. We explored the New Zealand public's perceptions of COVID-19 vaccines and associated media portrayal, and determined predictive factors associated with willingness to receive vaccines. A community cohort (N = 340) completed online surveys. A logistic regression explored whether characteristics predict willingness to receive the vaccine. Textual data were analysed thematically. Willingness to receive the vaccine was high (90%). Having a postgraduate degree (p =.026), trying to receive an influenza vaccine (p <.001) and fewer concerns (p <.001) predicted willingness. Health keyworkers (p <.001) were less willing. Participants wanted the vaccine for protection and returning to normality. Reasons against receiving vaccines regarded safety, efficacy, and an unclear roll-out plan. The media was reported to generally provide good/positive coverage, but also engage in unbalanced reporting and spreading misinformation. Education strategies should include collaborations between media and scientists and focus on distributing easy-to-access information. Health keyworkers should be reassured of testing/safety.     

A cross-sectional analysis of the association between social capital and willingness to get COVID-19 vaccine in Ontario,Canada

ObjectiveWe examine the role of social capital in intention to take the vaccine at the end of the first wave of the COVID-19 pandemic.MethodsThis study uses observational, cross-sectional data from the Ontario sample of the fall 2020 Canadian Community Health Survey (CCHS), a representative sample of the population with added questions relative to symptoms of COVID-19 and intentions to get vaccinated. Questions on social capital were asked to respondents from Ontario only, yielding a sample of 6516. Odds ratios (OR) and marginal effects at sample mean of an index of social capital (at the individual or aggregated level) on changes in intentions to get vaccinated are estimated from logistic regression models.ResultsIndividual-level social capital is associated with greater willingness to get vaccinated against COVID-19 (OR 1.09). Associations with aggregated-level social capital are less precisely estimated. Associations are the same for both males and females but vary across age categories: individual-level social capital is associated with higher willingness to get vaccinated among working-age respondents, but aggregate-level social capital is associated with higher willingness to get vaccinated among older adults.ConclusionVaccine hesitancy is not a random phenomenon, nor is it explained by individual characteristics such as education or income only. It also reflects the state of the social environment in which individuals live and public health messaging should take this into account if it is to be successful.Supplementary InformationThe online version contains supplementary material available at 10.17269/s41997-023-00746-9.     

Perceptions of the COVID-19 vaccine and willingness to receive vaccination among health workers in Nigeria

ObjectivesThe study aimed to examine health workers’ perceptions of the coronavirus disease 2019 vaccine in Nigeria and their willingness to receive the vaccine when it becomes available.Methods This multi-center cross-sectional study used non-probability convenience sampling to enroll 1,470 hospital workers aged 18 and above from 4 specialized hospitals. A structured and validated self-administered questionnaire was used for data collection. Data entry and analysis were conducted using IBM SPSS ver. 22.0.Results The mean age of respondents was 40±6 years. Only 53.5% of the health workers had positive perceptions of the COVID-19 vaccine, and only slightly more than half (55.5%) were willing to receive vaccination. Predictors of willingness to receive the COVID-19 vaccine included having a positive perception of the vaccine (adjusted odds ratio [AOR], 4.55; 95% confidence interval [CI], 3.50−5.69), perceiving a risk of contracting COVID-19 (AOR, 1.50; 95% CI, 1.25–3.98), having received tertiary education (AOR, 3.50; 95% CI, 1.40−6.86), and being a clinical health worker (AOR, 1.25; 95% CI, 1.01−1.68).Conclusion Perceptions of the COVID-19 vaccine and willingness to receive the vaccine were sub-optimal among this group. Educational interventions to improve health workers'' perceptions and attitudes toward the COVID-19 vaccine are needed.     

COVID-19 vaccine intention among young adults: Comparative results from a cross-sectional study in Canada and France

BackgroundHigh rates of COVID-19 vaccination uptake are required to attain community immunity. This study aims to identify factors associated with COVID-19 vaccine uncertainty and refusal among young adults, an underexplored population with regards to vaccine intention generally, in two high-income settings: Canada and France.MethodsA cross-sectional online survey was conducted from October to December 2020 among young adults ages 18–29 years (n = 6663) living in Canada (51.9%) and France (48.1%). Multinomial logistic regression analyses were performed to identify the sociodemographic and COVID-19-related measures (e.g., prevention behavior and perspectives, health-related concerns) associated with vaccine uncertainty and refusal. ?We conducted weighted analyses by age, gender and province/region of residence.ResultsIntention to accept vaccination was reported by 84.3% and 59.7% of the sample in Canada and France, respectively. Higher levels of vaccine uncertainty and refusal were observed in France compared to Canada (30.1% versus 11%, 10.2% versus 4.7%). In both countries, we found higher levels of vaccine acceptance among young adults who reported COVID-19 prevention actions. Vaccine uncertainty and refusal were associated with living in a rural area, having lower levels of educational attainment, not looking for information about COVID-19, not wearing a face mask, and reporting a lower level of concern for COVID-19′s impact on family. Participants who had been tested for COVID-19 were less likely to intend to refuse a vaccine.ConclusionsCOVID-19 vaccine acceptance was high among young adults in Canada and France during a time in which vaccines were approved for use. Targeted interventions to build confidence in demographic groups with greater hesitance (e.g., rural and with less personal experience with COVID-19) may further boost acceptance and improve equity as vaccine efforts continue to unfold.     

Preferences for COVID-19 vaccination information and location: Associations with vaccine hesitancy,race and ethnicity

This study examined the association between preferences for being informed about the COVID-19 vaccine and where to receive it with vaccination intent and race/ethnicity. We conducted an online survey, oversampling Black and Latino panel members. The 1668 participants were 53.2% female, 34.8% White, 33.3% Black, and 31.8% Latino. Participants who were vaccine hesitant (answered “not sure” or “no” to vaccination intent) were more likely to prefer a conversation with their doctor compared to those who answered “yes” (25.0% and 23.4% vs 7.8%, P < .001, respectively). Among participants who responded “not sure”, 61.8% prefer to be vaccinated at a doctor’s office, compared with 35.2% of those who responded “yes” (P < .001). Preferred location differed by race/ethnicity (P < .001) with 67.6% of Black “not sure” participants preferring a doctor’s office compared to 60.2% of Latino and 54.9% of White “not sure” participants. These findings underscore the need to integrate healthcare providers into COVID-19 vaccination programs.     

Older adults: panoramic view on the COVID-19 vaccination

In December 2020, COVID-19 vaccination started in many countries, with which the world community hopes to stop the further spread of the current pandemic. More than 90% of sick and deceased patients belong to the category of older adults (65 years and older). This category of the population is most vulnerable to infectious diseases, so vaccination is the most effective preventive strategy, the need for which for older adults is indisputable. Here we briefly summarize information about age-related changes in the immune system and present current data on their impact on the formation of the immune response to vaccination. Older age is accompanied by the process of biological aging accompanied by involution of the immune system with increased susceptibility to infections and a decrease in the effect of immunization. Therefore, in the ongoing mass COVID-19 vaccination, the older adults are a growing public health concern. The authors provide an overview of the various types of COVID-19 vaccines approved for mass immunization of the population by the end of 2020, including older adults, as well as an overview of strategies and platforms to improve the effectiveness of vaccination of this population. In the final part, the authors propose for discussion a system for assessing the safety and monitoring the effectiveness of COVID-19 vaccines for the older adults.     

Intention to participate in a COVID-19 vaccine clinical trial and to get vaccinated against COVID-19 in France during the pandemic

IntroductionThe world is facing the COVID-19 pandemic. The development of a vaccine is challenging. We aimed to determine the proportion of people who intend to get vaccinated against COVID-19 in France or to participate in a vaccine clinical trial.MethodsWe conducted an anonymous on-line survey from the 26th of March to the 20th of April 2020. Primary endpoints were the intention to get vaccinated against COVID-19 if a vaccine was available or participate in a vaccine clinical trial.ResultsThree thousand two hundred and fifty nine individuals answered the survey; women accounted for 67.4% of the respondents. According to their statements, 2.512 participants (77.6%, 95% CI 76.2–79%) will certainly or probably agree to get vaccinated against COVID-19. Older age, male gender, fear about COVID-19, being a healthcare worker and individual perceived risk were associated with COVID-19 vaccine acceptance. Vaccine hesitancy was associated with a decrease in COVID-19 vaccine acceptance. One thousand and five hundred and fifty respondents (47.6% 95% CI 45.9–49.3%) will certainly or probably agree to participate in a COVID-19 vaccine clinical trial. Older age, male gender, being a healthcare worker and individual perceived risk were associated with potential acceptance to participate in a COVID-19 vaccine clinical trial. Vaccine hesitancy was associated with refusal for participation in a COVID-19 vaccine clinical trial.ConclusionsNearly 75% and 48% of the survey respondents were respectively likely to accept vaccination or participation in a clinical trial against COVID-19. Vaccine hesitancy will be the major barrier to COVID-19 vaccine uptake.     

Christian nationalism and COVID-19 vaccine hesitancy and uptake

Understanding COVID-19 vaccine hesitancy and uptake is vital for informing public health interventions. Prior U.S. research has found that religious conservatism is positively associated with anti-vaccine attitudes. One of the strongest predictors of anti-vaccine attitudes in the U.S. is Christian nationalism—a U.S. cultural ideology that wants civic life to be permeated by their particular form of nationalist Christianity. However, there are no studies examining the relationship between Christian nationalism and COVID-19 vaccine hesitancy and uptake. Using a new nationally representative sample of U.S. adults, we find that Christian nationalism is one of the strongest predictors of COVID-19 vaccine hesitancy and is negatively associated with having received or planning to receive a COVID-19 vaccine. Since Christian nationalists make up approximately 20 percent of the population, these findings could have important implications for achieving herd immunity.     

新型冠状病毒肺炎疫情后公共卫生展望

新型冠状病毒肺炎疫情（新冠疫情）使全社会认识到公共卫生的重要性。公共卫生关系到公众健康和社会行为规范、公共安全和社会稳定、社会经济发展、国际政治格局和国际关系以及社会治理和精细化管理等。新冠疫情使人们对公共卫生有了新启示和新定位,要改革与完善公共卫生体系,强化病原的变异监测及预警,加强传染源的早期识别与发现,关注传播途...     

Views on COVID-19 and Use of Face Coverings Among U.S. Youth

PurposeLittle is known about the views of U.S. youth on COVID-19 or their use of face coverings. Closing this gap could facilitate messaging to promote COVID-19 risk mitigation behaviors.MethodsIn July 2020, a five-question text message survey was sent to 1,087 youth aged 14–24 years. Questions assessed youths' perceptions regarding the likelihood of contracting COVID-19, the potential impact of contracting COVID-19 on their lives, the possibility of spreading COVID-19 to others, and their use of face coverings around others with whom they do not live. Coding was conducted to assign responses to discrete categories and to identify common themes.ResultsOf 1,087 eligible participants, 797 (73.3%) were included in analyses. Of these participants, 27.3% believed they would likely contract COVID-19 in the next few months, 90.3% believed contracting COVID-19 would have a moderate or significant impact on their lives, 86.0% were moderately or very concerned about spreading COVID-19, and 89.2% reported wearing face coverings all or most of the time. Factors affecting face covering use included the desire to avoid contracting and spreading COVID-19, peer influence, and policy mandates.ConclusionsYouths' perceptions regarding the risk of contracting COVID-19 varied, but most believed their lives would be adversely impacted if this occurred. Most youth were concerned about spreading COVID-19 and wore face coverings, but many made exceptions to face covering use when around close contacts. Public health campaigns may be most effective if they leverage positive peer influence and appeal to youths' desire not to spread COVID-19 to others.     

Effect of the suspension of the J&J COVID-19 vaccine on vaccine hesitancy in the United States

On April 13, 2021, U.S. authorities announced an investigation into potential adverse events associated with the Johnson & Johnson (Janssen, J&J) COVID-19 vaccine and recommended “a pause in the use of this vaccine out of an abundance of caution.” We examined whether public attitudes toward COVID-19 vaccination shifted after this recommended suspension using an interrupted time series with data from the Census Bureau’s Household Pulse Survey, which was fielded bi-weekly between January 6 and April 26, 2021. We found no significant changes in trends of the proportion of the U.S. adult population hesitant about getting a COVID-19 vaccine, but a significant increase in concerns about safety and efficacy of COVID-19 vaccines among the already hesitant population.     

Conditionality of COVID-19 vaccine acceptance in European countries

The COVID-19 vaccine rollout has offered a powerful preventive measure to help control SARS-CoV-2 transmission. Nevertheless, long-standing public hesitation around vaccines heightened concerns that vaccine coverage would not achieve desired public health impacts, particularly in light of more contagious variants. This cross-sectional survey was conducted online just before the European vaccine rollout in December 2020 among 7000 respondents (aged 18–65) in Belgium, France, Germany, Italy, Spain, Sweden, and Ukraine. The survey included open text boxes for fuller explanation of responses. Overall, 56.9% of respondents would accept a COVID-19 vaccine, 19.0% would not, and 24.1% did not know or preferred not to say. By country, between 44% (France) and 66% (Italy) of respondents would accept a COVID-19 vaccine. Respondents expressed conditionality in open responses, voicing concerns about vaccine safety and mistrust of authorities. We highlight lessons learned about the dynamism of vaccine conditionality and persistence of safety concerns.     

Misinformation and COVID-19 vaccine hesitancy

BackgroundCOVID-19 vaccine hesitancy has emerged as a major public health challenge. Although medical and scientific misinformation has been known to fuel vaccine hesitancy in the past, misinformation surrounding COVID-19 seems to be rampant, and increasing evidence suggests that it is contributing to COVID-19 vaccine hesitancy today. The relationship between misinformation and COVID-19 vaccine hesitancy is complex, however, and it is relatively understudied.MethodsIn this article, we report qualitative data from two related but distinct studies from a larger project. Study 1 included semi-structured, open-ended interviews conducted in October–November 2020 via phone with 30 participants to investigate the relationship between misinformation and COVID-19 vaccine hesitancy. Study 1′s results then informed the design of open-ended questions for Study 2, an online survey conducted in May–June 2021 to consider the relationship between misinformation and vaccine hesitancy further. The data were examined with thematic analysis.ResultsStudy 1 led to the identification of positive and negative themes related to attitudes toward COVID-19 vaccines. In Study 2, responses from vaccine-hesitant participants included six categories of misinformation: medical, scientific, political, media, religious, and technological. Across both Study 1 and Study 2, six vaccine hesitancy themes were identified from the data: concerns about the vaccines’ future effects, doubts about the vaccines’ effectiveness, commercial profiteering, preference for natural immunity, personal freedom, and COVID-19 denial.ConclusionsThe relationship between misinformation and vaccine hesitancy is complicated. Various types of misinformation exist, with each related to a specific type of vaccine hesitancy-related attitude. Personal freedom and COVID-19 denial are vaccine attitudes of particular interest, representing important yet understudied phenomena. Medical and scientific approaches may not be sufficient to combat misinformation based in religion, media, or politics; and public health officials may benefit from partnering with experts from those fields to address harmful misinformation that is driving COVID-19 vaccine hesitancy.     

COVID-19 vaccine acceptance and its socio-demographic and emotional determinants: A multi-country cross-sectional study

BackgroundMultiple COVID-19 vaccines have now been licensed for human use, with other candidate vaccines in different stages of development. Effective and safe vaccines against COVID-19 have been essential in achieving global reductions in severe disease caused by severe acute respiratory coronavirus 2 (SARS-CoV-2), but multiple factors, including vaccine supply and vaccine confidence, continue to impact global uptake of COVID-19 vaccines. In this study, we explore determinants of COVID-19 vaccination intent across17 countries worldwide.MethodsIn this large-scale multi-country study, we explored intent to accept a COVID-19 vaccine and the socio-demographic and emotional determinants of uptake for 17 countries and over 19,000 individuals surveyed in June and July 2020 via nationally representative samples. We used Bayesian ordinal logistic regressions to probe the relationship between intent to accept a COVID-19 vaccine and individuals’ socio-demographic status, their confidence in COVID-19 vaccines, and their recent emotional status. Gibbs sampling was used for Bayesian model inference, with 95% Bayesian highest posterior density intervals used to capture uncertainty.FindingsIntent to accept a COVID-19 vaccine was found to be highest in India, where 77?8% (95% HPD, 75?5 to 80?0%) of respondents strongly agreeing that they would take a new COVID-19 vaccine if it were available. The Democratic Republic of Congo (15?5%, 12?2 to 18?6%) and France (26?4%, 23?7 to 29?2%) had the lowest share of respondents who strongly agreed that they would accept a COVID-19. Confidence in the safety, importance, and effectiveness of COVID-19 vaccines are the most widely informative determinants of vaccination intent. Socio-demographic and emotional determinants played a lesser role, with being male and having higher education associated with increased uptake intent in five countries and being fearful of catching COVID-19 also a strong determinant of uptake intent.InterpretationBarriers to COVID-19 vaccine acceptance are found to be country and context dependent. These findings highlight the importance of regular monitoring of COVID-19 vaccine confidence to identify groups less likely to vaccinate.     

Factors associated with COVID-19 vaccination intentions among adults in the deep South

The recent approval of several COVID-19 vaccines signals progress toward controlling the pandemic. Although social distancing and masking have been effective, vaccines are an important additional measure of protection to reduce COVID-19 spread. Adequate uptake is essential to reach herd immunity, estimated to be approximately 67%. However, vaccine hesitancy, the fast-tracked nature of the COVID-19 vaccines, and misinformation circulating through various forms of media have contributed to lower vaccination intention than desired. The current research study developed an online survey conducted via Facebook to explore the attitudes and perceptions of adult Alabama residents about COVID-19 and the COVID-19 vaccines. Of the 3,781 respondents, only 44.3% reported intent to receive a vaccine, with a large proportion reporting they were unsure (28.1%). Lack of intention to vaccinate was associated with low educational attainment, low COVID-19 knowledge levels, low income, and African American race. The current survey also explored participants’ influenza vaccine behavior as this information can also be used to inform successful COVID-19 vaccine distribution. Of the respondents, 56% report receiving the yearly influenza vaccine and the majority receive it at a pharmacy or healthcare provider office. This informs likely successful locations for COVID-19 vaccine distribution. Appropriate education targeted to populations most likely to refuse COVID-19 vaccination is essential to promote uptake. The information collected from the current study should be utilized to inform effective and efficient vaccine distribution strategies.