Changes in Parental Attitudes Toward COVID-19 Vaccination and Routine Childhood Vaccination During the COVID-19 Pandemic: Repeated Cross-sectional Survey Study

BackgroundIt was reported that one in four parents were hesitant about vaccinating their children in China. Previous studies have revealed a declining trend in the vaccine willingness rate in China. There is a need to monitor the level of parental vaccine hesitancy toward routine childhood vaccination and hesitancy toward the COVID-19 vaccine during the ongoing COVID-19 pandemic.ObjectiveThis study aims to assess changes in trends of parental attitudes toward routine childhood vaccines and COVID-19 vaccinations across different time periods in China.MethodsThree waves of cross-sectional surveys were conducted on parents residing in Wuxi City in Jiangsu Province, China from September to October 2020, February to March 2021, and May to June 2021. Participants were recruited from immunization clinics. Chi-square tests were used to compare the results of the three surveys, controlling for sociodemographic factors. Binary and multivariable logistic regression analysis was used to examine factors related to parental vaccine hesitancy and COVID-19 vaccine willingness.ResultsOverall, 2881, 1038, and 1183 participants were included in the survey’s three waves. Using the Vaccine Hesitancy Scale, 7.8% (225/2881), 15.1% (157/1038), and 5.5% (65/1183) of parents showed hesitancy to childhood vaccination (P<.001), and 59.3% (1709/2881), 64.6% (671/1038), and 92% (1088/1183) of parents agreed to receive a COVID-19 vaccine themselves in the first, second, and third surveys, respectively (P<.001). In all three surveys, “concerns about vaccine safety and side effects” was the most common reason for refusal.ConclusionsThere has been an increasing acceptance of COVID-19 vaccination in Wuxi City, China. Effective interventions are needed to mitigate public concerns about vaccine safety.     

Reasons for COVID-19 Vaccine Hesitancy Among Chinese People Living With HIV/AIDS: Structural Equation Modeling Analysis

BackgroundMany countries and organizations recommended people living with HIV/AIDS (PLWHA) receive the COVID-19 vaccine. However, vaccine hesitancy still exists and becomes a barrier for promoting COVID-19 vaccination among PLWHA.ObjectiveThis study aims to investigate factors that contributed to COVID-19 vaccine hesitancy among PLWHA.MethodsThe study used a multicenter cross-sectional design and an online survey mode. We recruited PLWHA aged 18-65 years from 5 metropolitan cities in China between January 2021 and February 2021. Participants completed an online survey through Golden Data, a widely used encrypted web-based survey platform. Multiple linear regression models were used to assess the background characteristics in relation to COVID-19 vaccine hesitancy, and structural equation modeling was performed to assess the relationships among perceived benefits, perceived risks, self-efficacy, subjective norms, and COVID-19 vaccine hesitancy.ResultsAmong 1735 participants, 41.61% (722/1735) reported COVID-19 vaccine hesitancy. Older age, no other vaccinations in the past 3 years, and having chronic disease history were positively associated with COVID-19 vaccine hesitancy. Structural equation modeling revealed a direct relationship of perceived benefits, perceived risks, and subjective norms with self-efficacy and vaccine hesitancy and an indirect relationship of perceived benefits, perceived risks, and subjective norms with vaccine hesitancy. Moreover, self-efficacy toward COVID-19 vaccination was low. PLWHA had concerns of HIV disclosure during COVID-19 vaccination. Family member support could have an impact on COVID-19 vaccination decision-making.ConclusionsCOVID-19 vaccine hesitancy was high among PLWHA in China. To reduce COVID-19 vaccine hesitancy, programs and strategies should be adopted to eliminate the concerns for COVID-19 vaccination, disseminate accurate information on the safety and efficacy of the COVID-19 vaccine, encourage family member support for COVID-19 vaccination, and improve PLWHA’s trust of medical professionals.     

Examining the Utility of Social Media in COVID-19 Vaccination: Unsupervised Learning of 672,133 Twitter Posts

BackgroundAlthough COVID-19 vaccines have recently become available, efforts in global mass vaccination can be hampered by the widespread issue of vaccine hesitancy.ObjectiveThe aim of this study was to use social media data to capture close-to-real-time public perspectives and sentiments regarding COVID-19 vaccines, with the intention to understand the key issues that have captured public attention, as well as the barriers and facilitators to successful COVID-19 vaccination.MethodsTwitter was searched for tweets related to “COVID-19” and “vaccine” over an 11-week period after November 18, 2020, following a press release regarding the first effective vaccine. An unsupervised machine learning approach (ie, structural topic modeling) was used to identify topics from tweets, with each topic further grouped into themes using manually conducted thematic analysis as well as guided by the theoretical framework of the COM-B (capability, opportunity, and motivation components of behavior) model. Sentiment analysis of the tweets was also performed using the rule-based machine learning model VADER (Valence Aware Dictionary and Sentiment Reasoner).ResultsTweets related to COVID-19 vaccines were posted by individuals around the world (N=672,133). Six overarching themes were identified: (1) emotional reactions related to COVID-19 vaccines (19.3%), (2) public concerns related to COVID-19 vaccines (19.6%), (3) discussions about news items related to COVID-19 vaccines (13.3%), (4) public health communications about COVID-19 vaccines (10.3%), (5) discussions about approaches to COVID-19 vaccination drives (17.1%), and (6) discussions about the distribution of COVID-19 vaccines (20.3%). Tweets with negative sentiments largely fell within the themes of emotional reactions and public concerns related to COVID-19 vaccines. Tweets related to facilitators of vaccination showed temporal variations over time, while tweets related to barriers remained largely constant throughout the study period.ConclusionsThe findings from this study may facilitate the formulation of comprehensive strategies to improve COVID-19 vaccine uptake; they highlight the key processes that require attention in the planning of COVID-19 vaccination and provide feedback on evolving barriers and facilitators in ongoing vaccination drives to allow for further policy tweaks. The findings also illustrate three key roles of social media in COVID-19 vaccination, as follows: surveillance and monitoring, a communication platform, and evaluation of government responses.     

COVID-19 vaccination hesitancy among Americans with disabilities aged 18-65: An exploratory analysis

BackgroundIt is important for people with disabilities to be vaccinated against COVID-19 because, as a group, they are at increased risk of severe outcomes. While there are multiple vaccines available to prevent COVID-19, a considerable proportion of Americans report some hesitancy to becoming vaccinated, including people with disabilities.ObjectiveWe conducted a study to explore what factors may contribute to COVID-19 vaccination hesitancy among Americans with disabilities.MethodsWe used Amazon's Mechanical Turk to survey 439 people with disabilities (ages 18+) about their concerns of the COVID-19 disease, vaccines, and hesitancy toward vaccination to learn more about factors that influence vaccination hesitancy. Concerns about vaccines were analyzed as a composite variable representing different dimensions such as: side effects, too new, developed too quickly, influenced by politics, and effectiveness.ResultsResults from a logistic regression indicate that concern about vaccines was the most significant predictor of hesitancy, even after considering demographic, economic, and geographic factors. Concerns about getting COVID-19, getting tested for COVID-19, trust in experts, education, and being a Democrat were negatively associated with hesitancy.ConclusionsThese findings indicate that some groups of individuals may be more vaccination hesitant because they are more concerned about vaccine safety than COVID-19 infection. Public health messaging that focuses on the risks of vaccines relative to the risks of COVID-19 might be one strategy to reduce hesitancy and increase vaccination uptake. Messaging should also be tailored to specific disabilities (i.e. physical, mental, sensory), written in plain language, and disseminated in accessible formats.     

Factors affecting COVID-19 vaccine hesitancy among healthcare providers in 23 countries

BackgroundSeveral early COVID-19 studies aimed to assess the potential acceptance of a vaccine among healthcare providers, but relatively few studies of this population have been published since the vaccines became widely available. Vaccine safety, speed of development, and low perceived disease risk were commonly cited as factors for COVID-19 vaccine hesitancy among this group.Purpose and methodsIn a secondary analysis based on a cross-sectional, structured survey, the authors aimed to assess the associations between self-reported vaccine hesitancy and a number of sociodemographic and COVID-19 vaccine perception factors using data from 3,295 healthcare providers (physicians, nurses, community health workers, other healthcare providers) in 23 countries.Findings494 (15.0%) of the participants reported vaccine hesitancy, of whom 132 (4.0%) would outright refuse to accept a COVID-19 vaccine. Physicians were the least hesitant. Vaccine hesitancy was more likely to occur among those with less than the median income and, to a lesser degree, younger age. Safety and risk concerns and lack of trust that vaccines would be equitably distributed were strongly associated with hesitancy, less so were concerns about the efficacy of COVID-19 vaccines.InterpretationFindings suggest a need to address safety and risk concerns through tailored messaging, training, and/or incentive approaches among healthcare providers, as well as the need for international and national vaccination efforts to ensure equitable distribution.     

Compliance,procrastination and refusal: American COVID-19 vaccination trust and value orientation

IntroductionCOVID-19 vaccine hesitancy studies, most of which were completed prior to the release of the vaccine, speculated on factors that might influence inoculation intention when a vaccine was introduced. This paper examines actual vaccination decisions among US residents after COVID-19 vaccines were approved, with a focus on trust in vaccine effectiveness, increased trust in government pandemic response, and individual-versus-collective value orientation.MethodThe data set was from the Kaiser Family Foundation COVID-19 Vaccine Monitor, a nationally representative sample reflecting the opinions of 1519 American adults aged 18 and above. Data were collected in September 2021—approximately nine months after the first COVID-19 vaccines were approved for distribution. Indicators of trust in vaccine effectiveness included individual opinions regarding breakthrough infections and vaccine boosters. Increased trust in government indicated approval of official COVID-19 responses, and value orientation denoted respondent emphasis on personal choice versus protecting the health of others. We established three categories of a vaccine hesitancy dependent variable: none, some, and full rejection. A multinomial regression analysis was employed to compare vaccine hesitancy in three pairs of contrasting groups.ResultsWhile we noted distinct patterns in decision-making factors for each of the contrasting pairs, we also observed strong effects for trust in vaccine effectiveness and value orientation on vaccine decisions across all three. Both effects were more substantial than those associated with three control variables—social-demographic characteristics, political party affiliation, and health risk.ConclusionOur findings suggest that in order to increase vaccination rates, policymakers and influencers should focus on reducing individual scepticism over breakthrough infections and vaccine boosters, and on influencing a value orientation shift from personal choice to social responsibility.     

COVID-19 vaccine literacy and vaccine hesitancy among pregnant women and mothers of young children in Japan

BackgroundDelays in the spread of vaccination have been recognized as an urgent public health issue in the context of the COVID-19 pandemic. Vaccine literacy (VL) is a critical determinant of vaccine uptake; however, little is known about VL among pregnant women and mothers of young children.MethodsWe analyzed data from a nationwide, cross-sectional internet survey in Japan on VL and vaccine hesitancy, conducted with 1,639 pregnant women and 5,688 mothers of young children who had given birth after July 2019, between July 24 and August 30, 2021.ResultsVaccine hesitancy was observed in 51.1 % of pregnant women and 31.9 % of mothers of young children. The risk of vaccine hesitancy was significantly higher among pregnant women with lower interactive/critical skills (risk ratio [RR] 2.10, 95 % confidence interval [CI] 1.59, 2.78, p < 0.001), although functional skills did not significantly correlate with vaccine hesitancy. For mothers of young children, we found a significantly higher risk of vaccine hesitancy among those with low VL functional skills (RR 1.38, 95 % CI 1.19, 1.61), p < 0.001) and low interactive/critical skills (RR 1.29, 95 % CI 1.10, 1.50, p = 0.001).ConclusionsOur findings suggest that aiding individuals to correctly evaluate vaccine-related information is critical for improving vaccine acceptance rates among both pregnant women and mothers of young children. Meanwhile, improving the comprehensibility of communication toolkits may be important for women with children but have a limited effect among pregnant women.     

Vaccine hesitancy towards childhood immunisation amongst urban pregnant mothers in Malaysia

BackgroundVaccine hesitancy is a complex behaviour which involves various degrees of indecision about specific vaccines or vaccination uptake. Access to antenatal care had been associated with positive vaccine behavior.ObjectiveTo determine the prevalence of vaccine hesitancy towards childhood immunisation amongst urban pregnant mothers and the associated socio-demographic factors.MethodsA cross-sectional study was conducted among 1081 women who received antenatal care at a teaching hospital in Kuala Lumpur. Vaccine hesitancy was assessed using the Parent Attitudes about Childhood Vaccines (PACV) Survey in both English and validated Malay versions. The sociodemographic data of the mothers and their partners, source of vaccine information and reasons for hesitancy were analysed.ResultsEighty-six (8.0%) pregnant mothers were vaccine hesitant. Ethnicity, religion, number of children, educational level and employment status were significantly associated with vaccine hesitancy. Multivariable analysis showed that a low level of education was the most significant risk factor (p < 0.001), followed by religion (p = 0.03). Health professionals was the main source of information about vaccine. The non-vaccine hesitant women were more likely to seek information from health professionals, and health books and magazine. Fear of adverse side effects of vaccines was the predominant concern for all participants (58%) whilst fear of vaccination pain, preference for alternative medicine and lack of trust in the pharmaceutical industry were significant reasons given by the vaccine hesitant group. Partners’ ethnicity, a low educational level and a low income were significantly associated with vaccine hesitancy amongst pregnant mothers.ConclusionPrevalence of vaccine hesitancy amongst urban Malaysian pregnant women was relatively low. Muslim mothers are less likely to be vaccine hesitant. Educational level of mothers and their partners are the common determinant of vaccine hesitancy amongst antenatal mothers.     

Association between social vulnerability and COVID-19 vaccination hesitancy and vaccination in pregnant and postpartum individuals

ObjectiveTo evaluate the association of community-level social vulnerability with COVID-19 vaccine hesitancy and vaccination among pregnant and postpartum individuals.MethodsProspective cohort study assessing COVID-19 vaccine hesitancy among pregnant and postpartum individuals. We performed a baseline survey on COVID-19 vaccine hesitancy from 03/22/21 to 04/02/21, and a follow-up survey on COVD-19 vaccination status 3- to 6-months later. The primary exposure was the Centers for Disease Control and Prevention SVI (Social Vulnerability Index), measured in quartiles. Higher SVI quartiles indicated greater community-level social vulnerability with the lowest quartile (quartile 1) as the referent group. The primary outcome was COVID-19 vaccine hesitancy on the baseline survey (uncertainty or refusal of the vaccine), and the secondary outcome was self-report of not being vaccinated (unvaccinated) for COVID-19 on the follow-up survey.ResultsOf 456 assessed individuals, 46% reported COVID-19 vaccine hesitancy on the baseline survey; and of 290 individuals (290/456, 64%) who completed the follow-up survey, 48% (140/290) were unvaccinated. The frequency of baseline vaccine hesitancy ranged from 25% in quartile 1 (low SVI) to 68% in quartile 4 (high SVI), and being unvaccinated at follow-up ranged from 29% in quartile 1 to 77% in quartile 4. As social vulnerability increased, the risk of COVID-19 vaccine hesitancy at baseline increased (quartile 2 aRR (adjusted relative risk): 1.46; 95% CI:0.98 to 2.19; quartile 3 aRR: 1.86; 95% CI:1.28 to 2.71; and quartile 4 aRR: 2.24; 95% CI:1.56 to 3.21), as did the risk of being unvaccinated at follow-up (quartile 2 aRR: 1.00; 95% CI:0.66 to 1.51; quartile 3 aRR: 1.68; 95% CI:1.17 to 2.41; and quartile 4 aRR: 1.82; 95% CI:1.30 to 2.56).ConclusionsPregnant and postpartum individuals living in an area with higher community-level social vulnerability were more likely to report COVID-19 vaccine hesitancy and subsequently to be unvaccinated at follow-up.     

Factors associated with COVID-19 vaccination during June–October 2021: A multi-site prospective study

IntroductionVaccine hesitancy presents a challenge to COVID-19 control efforts. To identify beliefs associated with delayed vaccine uptake, we developed and implemented a vaccine hesitancy survey for the COVID-19 Community Research Partnership.MethodsIn June 2021, we assessed attitudes and beliefs associated with COVID-19 vaccination using an online survey. Self-reported vaccination data were requested daily through October 2021. We compared responses between vaccinated and unvaccinated respondents using absolute standardized mean differences (ASMD). We assessed validity and reliability using exploratory factor analysis and identified latent factors associated with a subset of survey items. Cox proportional hazards models and mediation analyses assessed predictors of subsequent vaccination among those initially unvaccinated.ResultsIn June 2021, 29,522 vaccinated and 1,272 unvaccinated participants completed surveys. Among those unvaccinated in June 2021, 559 (43.9 %) became vaccinated by October 31, 2021. In June, unvaccinated participants were less likely to feel “very concerned” about getting COVID-19 than vaccinated participants (10.6 % vs. 43.3 %, ASMD 0.792). Among those initially unvaccinated, greater intent to become vaccinated was associated with getting vaccinated and shorter time to vaccination. However, even among participants who reported no intention to become vaccinated, 28.5 % reported vaccination before study end. Two latent factors predicted subsequent vaccination—being ‘more receptive’ was derived from motivation to protect one’s own or others’ health and resume usual activities; being ‘less receptive’ was derived from concerns about COVID-19 vaccines. In a Cox model, both factors were partially mediated by vaccination intention.ConclusionThis study characterizes vaccine hesitant individuals and identifies predictors of eventual COVID-19 vaccination through October 31, 2021. Even individuals with no intention to be vaccinated can shift to vaccine uptake. Our data suggest factors of perceived severity of COVID-19 disease, vaccine safety, and trust in the vaccine development process are predictive of vaccination and may be important opportunities for ongoing interventions.     

COVID-19 Vaccine Perception in South Korea: Web Crawling Approach

BackgroundThe US Centers for Disease Control and Prevention and the World Health Organization emphasized vaccination against COVID-19 because physical distancing proved inadequate to mitigate death, illness, and massive economic loss.ObjectiveThis study aimed to investigate Korean citizens’ perceptions of vaccines by examining their views on COVID-19 vaccines, their positive and negative perceptions of each vaccine, and ways to enhance policies to increase vaccine acceptance.MethodsThis cross-sectional study analyzed posts on NAVER and Instagram to examine Korean citizens’ perception of COVID-19 vaccines. The keywords searched were “vaccine,” “AstraZeneca,” and “Pfizer.” In total 8100 posts in NAVER and 5291 posts in Instagram were sampled through web crawling. Morphology analysis was performed, overlapping or meaningless words were removed, sentiment analysis was implemented, and 3 public health professionals reviewed the results.ResultsThe findings revealed a negative perception of COVID-19 vaccines; of the words crawled, the proportion of negative words for AstraZeneca was 71.0% (476/670) and for Pfizer was 56.3% (498/885). Among words crawled with “vaccine,” “good” ranked first, with a frequency of 13.43% (312/2323). Meanwhile, “side effect” ranked highest, with a frequency of 29.2% (163/559) for “AstraZeneca,” but 0.6% (4/673) for “Pfizer.” With “vaccine,” positive words were more frequently used, whereas with “AstraZeneca” and “Pfizer” negative words were prevalent.ConclusionsThere is a negative perception of AstraZeneca and Pfizer vaccines in Korea, with 1 in 4 people refusing vaccination. To address this, accurate information needs to be shared about vaccines including AstraZeneca, and the experiences of those vaccinated. Furthermore, government communication about risk management is required to increase the AstraZeneca vaccination rate for herd immunity before the vaccine expires.     

The correlates and dynamics of COVID-19 vaccine-specific hesitancy

Most work on COVID-19 vaccine hesitancy has focused on its attitudinal and demographic correlates among individuals, but the characteristics of vaccines themselves also appear to be important. People are more willing to take vaccines with higher reported levels of efficacy and safety. Has this dynamic sparked comparative hesitancy towards specific COVID-19 vaccines? We conduct a series of cross-sectional survey experiments to test for brand-based differences in perceived effectiveness, perceived safety, and vaccination intention. Examining more than 6,200 individuals in a series of cross-sectional surveys, we find considerably more reluctance to take the AstraZeneca and Johnson & Johnson vaccines compared to those from Pfizer and Moderna if offered, despite all vaccines being approved and deemed safe and effective by a federal regulator. Comparative hesitancy towards these vaccines grew over the course of fielding as controversy arose over their link to extremely rare, but serious side effects. Comparative vaccine-specific hesitancy is strongest among people who are usually most open to mass vaccination efforts. Its effects are substantial: most respondents reported a willingness to wait months for their preferred vaccine rather than receive either the AstraZeneca or Johnson & Johnson vaccine immediately. Our findings call for additional research on the determinants and consequences of COVID-19 vaccine-specific hesitancy and communication strategies to minimize this challenge.     

Vaccination willingness,vaccine hesitancy,and estimated coverage at the first round of COVID-19 vaccination in China: A national cross-sectional study

BackgroundVaccination against coronavirus disease 2019 (COVID-19) has become an important public health solution. To date, there has been a lack of data on COVID-19 vaccination willingness, vaccine hesitancy, and vaccination coverage in China since the vaccine has become available.MethodsWe designed and implemented a cross-sectional, population-based online survey to evaluate the willingness, hesitancy, and coverage of the COVID-19 vaccine among the Chinese population. 8742 valid samples were recruited and classified as the vaccine-priority group (n = 3902; 44.6%) and the non-priority group (n = 4840; 55.4%).ResultsThe proportion of people’s trust in the vaccine, delivery system, and government were 69.0%, 78.0% and 81.3%, respectively. 67.1% of the participants were reportedly willing to accept the COVID-19 vaccination, while 9.0% refused it. 834 (35.5%) reported vaccine hesitancy, including acceptors with doubts (48.8%), refusers (39.4%), and delayers (11.8%). The current coverage was 34.4%, far from reaching the requirements of herd immunity. The predicted rate of COVID-19 vaccination was 64.9%, 68.9% and 81.1% based on the rates of vaccine hesitancy, willingness, and refusal, respectively.ConclusionsThe COVID-19 vaccine rate is far from reaching the requirements of herd immunity, which will require more flexible and comprehensive efforts to improve the population’s confidence and willingness to vaccinate. It should be highlighted that vaccination alone is insufficient to stop the pandemic; further efforts are needed not only to increase vaccination coverage but also to maintain non-specific prevention strategies.     

Vaccine hesitancy against COVID-19 vaccine over time in Nigeria

IntroductionWhile COVID-19 pandemic is an ongoing threat for our lives, the rapid development of effective vaccines against COVID-19 provided us hopes for manageable disease control. However, vaccine hesitancy across the globe is a concern which could attenuate efforts of disease control. This study examined the extent and trend of vaccine hesitancy in Nigeria.MethodsThe COVID-19 National Longitudinal Phone Survey conducted between 2020 and 2021 was used for the analysis. The extent and trend of vaccine hesitancy across different zones within Nigeria, over time, as well as reasons of the hesitancy were evaluated.ResultsVaccine hesitancy was more prevalent in southern zones, which on average have better socioeconomic status than northern zones. Overtime, vaccine hesitancy became more prevalent, and respondents became more resistant to the COVID-19 vaccine across the country.ConclusionWhile the nature of interventions to improve the uptake of COVID-19 vaccine should differ by regions due to differential barriers to vaccination, it might be important to prebunk and debunk any misinformation related to COVID-19 vaccine to mitigate the vaccine hesitancy across the country.     

Factors associated with parents' willingness to vaccinate their children against COVID-19: The LA pandemic surveillance cohort study

BackgroundChildren age 5–11 became eligible for COVID-19 vaccination in November 2021 in the United States, but vaccine uptake in this age group remains low. Understanding reasons why parents are hesitant to vaccinate their children may provide critical insights to help protect children from COVID-19 infection. This study examines factors associated with parents'' willingness to vaccinate their children.MethodsWe conducted a cross-sectional survey focusing on the Los Angeles County adult residents between March and June 2021. Our analytic sample focused on a subgroup of participants who self-report having a child. Predictors included parents'' vaccination status and beliefs about COVID-19. We used multivariable logistic regression analysis and calculated the predicted probabilities of parents'' willingness to vaccinate their children.ResultsParents (n = 401) who worried about catching the virus, had trust in vaccine development and the COVID-19 vaccine approval process, and vaccinated against COVID-19 were more likely to be willing to vaccinate their children. Socio-economic, racial and ethnic differences were no longer statistically significant in the adjusted model. Predicted probabilities of parents who were willing to vaccine their children were 55% among the vaccinated and 36% among the unvaccinated.ConclusionsParents'' intent to vaccinate their children is influenced by their perceived severity of the pandemic, trust in the vaccine development process, and their vaccination status, which can be the potential drivers of hesitancy to vaccinate their children.     

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.     

Parental attitudes in the pediatric emergency department about the COVID-19 vaccine

BackgroundCOVID-19 vaccinations are now recommended in the United States (U.S.) for children ≥ 6 months old. However, pediatric vaccination rates remain low, particularly in the Hispanic/Latinx population.ObjectiveUsing the 4C vaccine hesitancy framework (calculation, complacency, confidence, convenience), we examined parental attitudes in the emergency department (ED) towards COVID-19 vaccination, identified dimensions of parental vaccine hesitancy, and assessed parental willingness to have their child receive the COVID-19 vaccine.MethodsAs part of a larger multi-methods study examining influenza vaccine hesitancy, we conducted interviews that included questions about COVID-19 vaccine authorization for children. We used directed content analysis to extract qualitative themes from 3 groups of parents in the ED: Hispanic/Latinx Spanish speaking (HS), Hispanic/Latinx English speaking (HE), non-Hispanic/non-Latinx White English speaking (WE). Themes were triangulated with the Parent Attitudes about Childhood Vaccines (PACV) survey, where higher scores indicate increased vaccine hesitancy.ResultsFactors influencing vaccine hesitancy were mapped to the 4C framework from 58 sets of interviews and PACVs. HE and HS parents, compared to WE parents, had less knowledge about COVID-19 and its vaccine, and more beliefs in COVID-19 vaccine myths. However, both HS and HE parent groups were more inclined to endorse COVID-19 vaccine effectiveness as a reason to have their children vaccinated. HS parents felt that COVID-19 increased their fear of illnesses in general and were worried about confusing COVID-19 with other infections. Median PACV scores of HS (Mdn = 20) and HE (Mdn = 20) parent groups were higher than of WE parents (Mdn = 10), but parental willingness to have their child receive COVID-19 vaccination was similar across groups.ConclusionsHigher COVID-19 vaccine hesitancy among HS and HE parents compared to WE parents may be attributed to insufficient knowledge about COVID-19, its vaccine, along with COVID-19 vaccine myths. Efforts to provide targeted vaccine education to different populations is warranted.     

COVID-19 vaccine acceptance and its determinants among Vietnamese teachers: a web-based cross-sectional survey

ObjectivesThis paper aimed to describe acceptance of the COVID-19 vaccine and its determinants among Vietnamese teachers.MethodsThis was a web-based cross-sectional survey with a sample of 17,176 teachers from kindergarten to high school who currently reside in Vietnam. A participant who exhibited “acceptance” towards the vaccine gave the following response: “have the readiness to get COVID-19 vaccine”.ResultsAbout 88% of all participants were accepting of the COVID-19 vaccine, while 70.4% were willing to pay (WTP) for it. The vaccine acceptance rate increased by age with odds ratios (OR) of 1.65 (1.41–1.93), 1.96 (1.67–2.29), and 2.4 (1.95–2.95) for the age groups 30–39, 40–49, and 50–59 respectively, when compared to the 18–29 age group. Male were found to be more likely to accept the vaccination than females (OR = 1.16; 95% CI: 1.02–1.31); teachers without a chronic disease were 4.13 times (95% CI: 2.67–6.37) more likely to accept the vaccine than those with an underlying condition. Willingness to pay and beliefs about the safety and efficacy of the vaccine were major factors in driving participants'' responses.ConclusionA high proportion of COVID-19 vaccine acceptance is a promising indicator of high coverage among this priority group for vaccination. Communication campaigns should consider addressing determinants uncovered by this study to achieve better vaccine acceptance.