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If a COVID-19 vaccine becomes available in [country], would you take it? Disaggre- gated by subgroups
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Background
As vaccination campaigns are deployed worldwide, addressing vaccine hesitancy is of critical importance to ensure sufficient immunization coverage. We analyzed COVID-19 vaccine acceptance across 15 samples covering ten low- and middle- income countries (LMICs) in Asia, Africa, and South America, and two higher income countries (Russia an...
Contexts in source publication
Context 1
... nudges that help citizens convert intentions into actions. Reminder messages from healthcare providers and messages alerting patients that vaccines have been reserved for them at an upcoming appointment may provide a low-cost encouragement to initiate and complete two-dose COVID-19 vaccinations, as was found in two recent large-scale studies in 9 . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in ...Similar publications
COVID-19 vaccination has started throughout the globe. The vaccination program has also begun in most Asian countries. This paper analyzed the Asian-origin COVID-19 vaccines and vaccination program status in Asia till March 2021 under three sections. In the first section, we mapped the approved vaccines that originated from Asia, their technologica...
Citations
... 52 Interestingly, research involving 10 LMICs has shown that individuals in these countries are more likely to accept COVID-19 vaccines (on average 80%) than those in the United States (65%) or Russia (30%). 53 Also, based on the findings from a study that evaluates the willingness to be vaccinated in all the Eight regions in Bangladesh among 3646 participants based on a household survey revealed that 74.6% of respondents indicated their acceptance to be vaccinated, 54 but vaccine hesitancy was higher among the rural, semiurban, slum, elderly, and low-educated populations. 54 In another study conducted in Ghana among the 2734 people in all the 16 regions of the country found that 82.8% of respondents were willing to take a COVID-19 vaccine, while 9.7% were hesitant. ...
... 59 In another survey of COVID-19 vaccine hesitancy in 10 LMIC's countries including Africa, Asia, and Latin America, it was revealed that respondents identified that health system as the most trustworthy source of information to help them make informed decisions on whether to take the COVID-19 vaccine. 53 In a recently conducted survey that evaluated the role of trust in improving access to, use of, and outcomes from public health programs, participants indicated a greater likelihood of accepting the COVID-19 vaccine if recommended by their healthcare provider. 60 Besides, it has been suggested that effective collaboration among healthcare workers and with the members of their respective communities will have a positive impact in overcoming vaccine hesitancy. ...
... 52 Interestingly, research involving 10 LMICs has shown that individuals in these countries are more likely to accept COVID-19 vaccines (on average 80%) than those in the United States (65%) or Russia (30%). 53 Also, based on the findings from a study that evaluates the willingness to be vaccinated in all the Eight regions in Bangladesh among 3646 participants based on a household survey revealed that 74.6% of respondents indicated their acceptance to be vaccinated, 54 but vaccine hesitancy was higher among the rural, semiurban, slum, elderly, and low-educated populations. 54 In another study conducted in Ghana among the 2734 people in all the 16 regions of the country found that 82.8% of respondents were willing to take a COVID-19 vaccine, while 9.7% were hesitant. ...
... 59 In another survey of COVID-19 vaccine hesitancy in 10 LMIC's countries including Africa, Asia, and Latin America, it was revealed that respondents identified that health system as the most trustworthy source of information to help them make informed decisions on whether to take the COVID-19 vaccine. 53 In a recently conducted survey that evaluated the role of trust in improving access to, use of, and outcomes from public health programs, participants indicated a greater likelihood of accepting the COVID-19 vaccine if recommended by their healthcare provider. 60 Besides, it has been suggested that effective collaboration among healthcare workers and with the members of their respective communities will have a positive impact in overcoming vaccine hesitancy. ...
The Coronavirus Disease 2019 (COVID‐19) pandemic is a global public health threat ravaging the health systems. In low and middle‐income countries (LMICs), COVID‐19 and several other challenges concurrently worsen the health outcome indicators. Interestingly, vaccines have been identified as the most reliable and cost‐effective public health intervention, and the governments in LMICs have instituted an array of plans to ensure every eligible person gets vaccinated. However, there is still considerable apathy around the use of the available COVID‐19 vaccines in LMICs which is impeding the fight against the COVID‐19 pandemic. In this paper, we explore the multiple interrelated factors behind low COVID‐19 vaccination coverage in LMICs. It is therefore recommended that the governments in LMICs embrace multicomponent and wide‐ranging strategies. This should involve utilising community‐based approaches such as community pharmacy‐led vaccination to promote community access to COVID‐19 vaccines and to revive trust in national health authorities by offering population‐specific, target‐driven, transparent, and timely communication to the community who they serve about the safety and efficacy of the COVID‐19 vaccine. Communication strategies should be tailored to reflect diverse political orientations as this can enhance vaccine acceptance. Additionally, local political parties and representative should be engaged in broad alliances to facilitate community mobilisation and support for vaccination campaigns. Also, relevant Nongovernmental Organisations and Community‐based Organisations should institute programs at the grassroots that incorporate the gatekeepers to the community aimed at influencing population behaviour regarding COVID‐19 vaccine hesitancy. Besides, the public health department in the ministry of health in LMICs should create more awareness, through social and mass media, particularly in the rural, semi‐urban, and slum communities about the pivotal role of vaccination. Thus, we opined that these strategies will help LMICs achieve the COVID‐19 vaccination target and further reposition the healthcare systems, and promote other public health interventions now and in the future.
... 92 Similar studies in Mozambique, Rwanda, Sierra Leone, Uganda, Cameroon, and Burkina Faso showed that vaccine safety, effectiveness, and side effects were significant concerns. 93,94 These concerns strengthened when reports of Deep Vein Thrombosis (DVT) and some notable deaths were linked to AstraZeneca and Johnson and Johnson vaccines. [95][96][97][98][99][100] Also, the subsequent suspension of AstraZeneca and Johnston and Johnston, 101,102 , and the South African report on the effectiveness of the vaccines, 103 Recently, ongoing research in vaccinology continues to push the boundaries of what is possible, with the potential for new vaccines against emerging infectious diseases and the development of more effective vaccines against existing diseases. ...
The coronavirus 2019 (COVID-19) pandemic has impacted Sub-Saharan African health systems, caused economic downturns, and put governments under intense pressure to deliver hope to their citizens. However, the unknowns of the SARS-CoV-2 virus are a concern for many experts. This paper discusses lessons from Sub-Saharan African countries and lessons from other countries regarding pandemic management. The paper identifies five lessons from Africa's management of the COVID-19 pandemic: mutation of the SARS-CoV-2 virus, COVID-19 vaccines waning over time, the threat of vaccine hesitancy in Africa, reliance on vertical health systems and lack of knowledge on political determinants of health by African leaders. Finally, drawing lessons from the current COVID-19 pandemic response from Sub-Saharan African governments and some countries could help them improve their response to the ongoing COVID-19 pandemic.
... The COVID-19 pandemic is expected to disrupt daily life until an effective vaccine is widely accepted. There is growing global concern about vaccine hesitancy-the widespread reluctance to take safe and recommended vaccines [1,2]. Vaccine hesitancy becomes more complex as new SARS-CoV-2 variants emerge and new vaccines come to market. ...
... Vaccine hesitancy becomes more complex as new SARS-CoV-2 variants emerge and new vaccines come to market. Several studies have documented COVID-19 vaccine hesitancy and acceptance using cross-sectional data [2][3][4][5][6][7]. Less is known, however, about how vaccine hesitancy changes to acceptance. ...
... One key driver of vaccine acceptance appears to be concern about vaccine safety and effectiveness, reflecting the rapid pace of vaccine development and worries about mild, yet common and transient side effects [2,12]. This is related to another major determinant: trust in government, health authorities, and healthcare workers [12,13]. ...
This study uses longitudinal data to profile psychological characteristics of COVID-19 vaccine advocates, resisters, and converts. We conducted a two-wave longitudinal survey (Nwave1 = 3190, Nwave2 = 2193) in Hong Kong using stratified quota sampling. Among those who completed both survey waves, 458 (30.5%) were classified as vaccine advocates, 295 (19.7%) were vaccine resisters, and 621 (41.4%) were vaccine converts (who shifted away from hesitancy). Compared to advocates, resisters were more likely to be female, those without children, between 40 and 49 years old, democratic voters, and those with poor health. Highly educated individuals, non-democrats, and those in good health were more likely to convert from hesitancy to acceptance. Public trust in authorities and confidence in vaccine were the primary factors related to vaccine uptake. Those who were more confident in vaccine, those who increased in information consumption and risk perceptions towards the pandemic, and those who decreased in their trust of health professionals were more likely to convert. Our study complements the emerging global picture of COVID-19 vaccine acceptance by focusing on changes in vaccine hesitancy during the pandemic.
... Addressing the aforementioned factors may promote a positive attitude and high intention to be vaccinated. Besides, COVID-19 vaccine recommendation by health care providers was a positive mediating factor towards its uptake among participants in several low-and middle-income countries [16] and among US adults [12]. Adequate understanding of clients by health care professionals is therefore crucial before they can effectively communicate the need for vaccines [17]. ...
Objective: To assess vaccination attitude and its associated factors among people with chronic health conditions.
Methods: In this cross-sectional study, participants were 423 patients with chronic medical conditions. Data were collected on socio-demographic and COVID-19-related characteristics, via Open Data Kit software. A Vaccination Attitudes Examination (VAX) Scale was adopted. The main outcome was vaccine attitude status defined as positive if a VAX sum score was above the median value; otherwise, non-positive. Data were analysed using Chi-square and multivariate logistic regression analyses, at 5% level of significance.
Results: Overall proportion of patients with a positive attitude towards COVID-19 vaccination uptake was 46.6%. The most influential factor towards positive attitude was rating the government high in handling the pandemic. Other factors were education, income, COVID-19 knowledge and living room arrangement ( p < 0.05).
Conclusion: Less than half of people living with a chronic medical condition had a positive attitude towards the COVID-19 vaccine. The attitudes are strongly mediated by confidence in the government. The government could promote a positive vaccine attitude by improving the clarity of health instructions that shows government transparency and effective communication. These are critical tools for maintaining public trust and confidence.
... However, perception of vaccination, intention, and willingness plays a crucial role in the vaccine uptake during the pandemic. In a comparison across various countries, willingness to take the vaccination in low-and middle-income countries in Africa, South Asia, and Latin America was found to be an average of 80.3% in the previous study (39). In the UK, a similar finding of high willingness (88.8%) to take COVID-19 vaccination was reported (40). ...
Introduction
It is clear that medical science has advanced much in the past few decades with the development of vaccines and this is even true for the novel coronavirus outbreak. By late 2020, COVID-19 vaccines were starting to be approved by national and global regulators, and across 2021, there was a global rollout of several vaccines. Despite rolling out vaccination programs successfully, there has been a cause of concern regarding uptake of vaccine due to vaccine hesitancy. In tackling the vaccine hesitancy and improving the overall vaccination rates, digital health literacy (DHL) could play a major role. Therefore, the aim of this study is to assess the digital health literacy and its relevance to the COVID-19 vaccination.
Methods
An internet-based cross-sectional survey was conducted from April to August 2021 using convenience sampling among people from different countries. Participants were asked about their level of intention to the COVID-19 vaccine. Participants completed the Digital Health Literacy Instrument (DHLI), which was adapted in the context of the COVID Health Literacy Network. Cross-tabulation and logistic regression were used for analysis purpose.
Results
Overall, the mean DHL score was 35.1 (SD = 6.9, Range = 12–48). The mean DHL score for those who answered “Yes” for “support for national vaccination schedule” was 36.1 (SD 6.7) compared to 32.5 (SD 6.8) for those who either answered “No” or “Don't know”. Factors including country, place of residence, education, employment, and income were associated with the intention for vaccination. Odds of vaccine intention were higher in urban respondents (OR-1.46; C.I.-1.30–1.64) than in rural respondents. Further, higher competency in assessing the relevance of online information resulted in significantly higher intention for vaccine uptake.
Conclusion
Priority should be given to improving DHL and vaccination awareness programs targeting rural areas, lower education level, lower income, and unemployed groups.
... Not surprisingly, people differed in their reaction to this unprecedented situation. Some were willing to be vaccinated while others were more hesitant and still questioning the vaccines safety and the trustworthiness of information regarding their efficacy (15)(16)(17). In the Kingdom of Saudi Arabia (KSA), parents were generally positive toward children's COVID-19 vaccination, but compared to routine vaccination, they were more hesitant toward COVID-19 vaccination (6 vs. 27%) (18). ...
Abstract:
Background: With the rapid surge of SARS-CoV-2 Omicron variant, we aimed to assess parents’ perceptions of the COVID-19 vaccines and the psychological antecedents of vaccinations during the first month of the Omicron spread.
Methods: A cross-sectional online survey in Saudi Arabia was conducted (December 20, 2021-January 7, 2022). Convenience sampling was used to invite participants through several social media platforms, including WhatsApp, Twitter, and email lists. We utilized the validated 5C Scale, which evaluates five psychological factors influencing vaccination intention and behavior: confidence, complacency, constraints, calculation, and collective responsibility.
Results: Of the 1340 respondents, 61.3% received two doses of the COVID-19 vaccine, while 35% received an additional booster dose. 54% were unwilling to vaccinate their children aged 5-11, and 57.2% were unwilling to give the additional booster vaccine to children aged 12-18. Respondents had higher scores on the construct of collective responsibility, followed by calculation, confidence, complacency, and finally constraints. Confidence in vaccines was associated with willingness to vaccinate children and positively correlated with collective responsibility (p<0.010). Complacency about COVID-19 was associated with unwillingness to vaccinate older children (12-18 years) and with increased constraints and calculation scores (p<0.010). While increasing constraints scores did not correlate with decreased willingness to vaccinate children (p=0.140), they did correlate negatively with confidence and collective responsibility (p<0.010).
Conclusions: The findings demonstrate the relationship between the five antecedents of vaccination, the importance of confidence in vaccines, and a sense of collective responsibility in parents’ intention to vaccinate their children. Campaigns addressing constraints and collective responsibility could help influence the public’s vaccination behavior.
... The questionnaire was formulated based on the previous reports (17)(18)(19)(20)(21)(22)(23)(24) and the opinion of experts in infectious diseases. Before the actual survey, we conducted a smallscale pre-survey on the target population and modified the survey questions and layout format after the feedback from the participants. ...
High vaccination coverage is essential to prevent and control the spread of the COVID-19 epidemic. Currently, the real-world acceptance of COVID-19 vaccines among adolescents aged 12–17 years in China has not been reported. We aimed to assess the acceptance rate of COVID-19 vaccination among adolescents in eastern China and to identify factors associated with the intention to get vaccinated against COVID-19. We conduct a cross-sectional questionnaire survey among adolescents from three provinces in the eastern part of China from 16 August to 28 October 2021. The questionnaires were distributed to 2,100 students, and 2,048 students completed the questionnaires. The results showed that 98.4% (2,016/2,048) of adolescents had received at least one dose of the COVID-19 vaccine and 1.6% (32/2,048) declined the vaccination. The participants from rural districts, or whose parents were vaccinated, were more likely to accept the vaccine. The main reason for declining vaccination was worry about vaccine safety (25%). The main adverse event after the vaccination was pain at the injection site. In conclusion, the vaccine coverage rate reached 98.4% among the adolescents in this study, which met the criteria for herd immunity to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The high vaccination rate is beneficial to the prevention and control of the COVID-19 pandemic.
... Latin America and the Caribbean (LAC) is one of the regions most affected by the pandemic (17), and the need to prioritize access to vaccines against COVID-19 (18) has been called for in low-and middle-income countries. Countries such as Mexico, Brazil, and Peru are among those with the highest number of cases and deaths from this disease in the world (2). ...
Background
The Latin American and Caribbean (LAC) region has been one of the regions most affected by the COVID-19 pandemic, with countries presenting some of the highest numbers of cases and deaths from this disease in the world. Despite this, vaccination intention is not homogeneous in the region, and no study has evaluated the influence of the mass media on vaccination intention. The objective of this study was to evaluate the association between the use of mass media to learn about COVID-19 and the non-intention of vaccination against COVID-19 in LAC countries.
Methods
An analysis of secondary data from a Massachusetts Institute of Technology (MIT) survey was conducted in collaboration with Facebook on people's beliefs, behaviors, and norms regarding COVID-19. Crude and adjusted prevalence ratios (aPR) with their respective 95% confidence intervals (95%CI) were calculated to evaluate the association between the use of mass media and non-vaccination intention using generalized linear models of the Poisson family with logarithmic link.
Results
A total of 350,322 Facebook users over the age of 18 from LAC countries were included. 50.0% were men, 28.4% were between 18 and 30 years old, 41.4% had a high school education level, 86.1% lived in the city and 34.4% reported good health condition. The prevalence of using the mass media to learn about COVID-19 was mostly through mixed media (65.8%). The non-intention of vaccination was 10.8%. A higher prevalence of not intending to be vaccinated against COVID-19 was found in those who used traditional media (aPR = 1.36; 95%CI: 1.29–1.44; p < 0.001) and digital media (aPR = 1.70; 95%CI: 1.24–2.33; p = 0.003) compared to those using mixed media.
Conclusion
We found an association between the type of mass media used to learn about COVID-19 and the non-intention of vaccination. The use of only traditional or digital information sources were associated with a higher probability of non-intention to vaccinate compared to the use of both sources.
... Most people can get the COVID-19 vaccine without worrying about vaccinationassociated severe adverse events (6). However, vaccine hesitancy (VH) persists as countries around the world vigorously promote COVID-19 vaccines (7)(8)(9)(10)(11)(12). The WHO defines VH as a "delay in acceptance or refusal of vaccination despite availability of vaccination services" (13), which was listed as one of the ten threats to global health in 2019 (3). ...
... Japan's survey shows that 11.3% of the population has VH (10). The vaccine hesitancy rate in the United States is about 35.4%, and the vaccine hesitancy rate in low-and middle-income countries in Asia, Africa, and South America is about 19.7% (11). China's surveys show that the hesitant rate of COVID-19 vaccines among domestic residents is about 8.4-35.5% (7,14,15). ...
Background
During the COVID-19 pandemic, vaccine hesitancy (VH) on COVID-19 vaccination still exists in different populations, which has a negative impact on epidemic prevention and control. The objectives were to explore college students' willingness to vaccinate, determine the factors influencing the vaccination behavior of students with COVID-19 vaccine hesitancy, and provide a basis for improving the compliance of college students with COVID-19 vaccination.
Methods
The universities in Wuhan are categorized into three levels according to their comprehensive strength and randomly sampled at each level, of which ten universities were selected. A self-designed anonymous electronic questionnaire was distributed online from May 12 to 31, 2021 to investigate the hesitancy, vaccination status, and influencing factors of COVID-19 vaccination among college students in Wuhan.
Results
Of the 1,617 participants (1,825 students received the electronic questionnaire) surveyed, 19.0% reported COVID-19 vaccine hesitancy. Among the vaccine-hesitant students, 40.1% were vaccinated against COVID-19. The binary logistic regression analysis shows that families' attitudes “Uncertain” (odds ratio (OR) = 0.258 [0.132–0.503]), vaccination risk psychology (OR = 0.242 [0.079–0.747]) and wait-and-see mentality (OR = 0.171 [0.068–0.468]) are negative factors for the vaccination behavior of hesitant students, while herd mentality (OR = 7.512 [2.718–20.767]) and uncertainty of free policy's impact on vaccine trust (OR = 3.412 [1.547–7.527]) are positive factors.
Conclusion
The vaccine hesitancy among college students in Wuhan was relatively high. Family support, herd mentality and free vaccination strategies can help improve vaccination among hesitant students, while vaccination risk psychology and “wait-and-see” psychology reduce the possibility of vaccination. The vaccination strategy of college students should be strengthened from the perspective of social psychological construction.
