Willingness to get a COVID-19 Vaccine by Adverse Childhood Experiences History.

Willingness to get a COVID-19 Vaccine by Adverse Childhood Experiences History.

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Importance The success in ending the COVID-19 pandemic rests partly on the mass uptake of the COVID-19 vaccine. Little work has been done to understand vaccine willingness among older adolescents and young adults. This is important since this age group may be less likely to adhere to public health guidelines. Objective To understand willingness of...

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... to get a COVID-19 vaccine did not differ by sex, age group, or having a mental health condition, but differed by parent education, household income, financial burden due to the pandemic, selfreported knowledge of COVID-19, practicing social/physical distancing, and having a physical health condition. Table 2 displays respondents' willingness to get a COVID-19 vaccine by ACE history after adjusting for adolescent sex, adolescent age, and household income. The correlation between household income and household running out of money was conducted to assess multicollinearity in the models. ...

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... Since then, there has been substantial misinformation and vaccine hesitancy, despite widespread vaccination being critical to mitigating the pandemic. Uncertainty about the safety and efficacy of COVID-19 vaccines has impeded vaccination (Klein et al., 2021;Machingaidze and Wiysonge, 2021), with only 65% of adolescents and young adults indicating willingness to get a COVID-19 vaccine (Afifi et al., 2021), and as of April 20, 2022 only 58.9% of U.S. adolescents aged 12-17 have been fully vaccinated (CDC, 2022). Identifying factors that influence intentions to vaccinate and developing strategic interventions to increase adolescent uptake is essential to achieving "herd immunity" (FDA, 2021). ...
... This study is the first to our knowledge to examine COVID-19 vaccine hesitancy in adolescents with and without ADHD, and to examine potentially malleable social-contextual predictors of vaccine acceptance and confidence. Consistent with recent international studies of youth (Afifi et al., 2021;Brandt et al., 2021;Humer et al., 2021), 72.4% of all adolescents in our sample were willing to get vaccinated against COVID-19 and of these, 12.7% were at least partially vaccinated. However, adolescents with ADHD were more than twice as likely to report vaccine hesitancy (38.2% hesitant among ADHD vs. 18.7% among comparison adolescents) and less confidence in the safety of the vaccines compared to adolescents without ADHD (Cohen's d from 0.36 to 0.40). ...
... Adolescents who came from families with lower income levels or identified as Black and/or Latinx were more likely to be vaccine hesitant and report lower confidence in the safety of COVID-19 vaccines. This is in line with results from Afifi et al. (2021) and Humer et al. (2021), showing lower vaccine acceptance among lower income and racial/ethnic minority adolescents and emerging adults. Although family income and race/ethnicity did not significantly interact with ADHD, a main effect was found for all adolescents. ...
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Identifying factors that influence adolescent intentions for COVID-19 vaccination is essential for developing strategic interventions to increase uptake, particularly in subgroups of at-risk adolescents. Attention-deficit/hyperactivity disorder (ADHD) in adolescence is characterized by difficulties regulating attention and behavior, social impairment, and impulsive risk-taking behaviors, which may impact vaccine hesitancy and vaccine uptake. This study examined hesitancy toward COVID-19 vaccines among adolescents with and without ADHD, and explored how ADHD status interacted with malleable social mechanisms and other social determinants of health in predicting vaccine hesitancy. Participants were 196 U.S. adolescents (44.4% male), 45.6% diagnosed with ADHD. Adolescents reported their confidence and willingness toward COVID-19 vaccines from March to May 2021. Adolescents with ADHD reported greater hesitancy and less confidence in COVID-19 vaccine safety compared to adolescents without ADHD (p < .01). Only 61.8% of adolescents with ADHD reported vaccine acceptance, compared to 81.3% of adolescents without ADHD. For all adolescents, those who identified as Black or Latinx and with lower family income had greater hesitancy and reduced confidence, whereas greater COVID-19 concerns, media use, and perceived negative impact on relationships was associated with greater vaccination willingness. Social contextual processes significantly interacted with ADHD status such that for adolescents without ADHD, concerns about COVID-19 were associated with increased confidence in vaccine safety. Being noncompliant with social distancing guidelines was associated with greater vaccine hesitancy, only for adolescents with ADHD. A concerted effort is needed to increase trust, confidence, and social relevance among adolescents, especially those with ADHD and from lower socio-economic backgrounds.
... Moreover, our findings show that young people tend to believe that the potential side effects of receiving COVID-19 vaccinations are greater than the risks of contracting COVID-19. Young people are indeed more vulnerable to spreading COVID-19, given the increased likelihood of socialization and reduced compliance to the precautionary measures against COVID-19 [44][45][46]. Hence, specific promotional campaigns might particularly target young Hong Kong people aged between 25 and 44, with a low vaccine acceptance rate [9]. They are highly encouraged to receive the vaccination in order to maximize the benefits of indirect immunity for the elderly and chronic disease patients [47]. ...
... They are highly encouraged to receive the vaccination in order to maximize the benefits of indirect immunity for the elderly and chronic disease patients [47]. The existing data on safety and effectiveness of COVID-19 vaccines, as well as the severity of COVID-19 among young people, might be emphasized in the campaigns [44]. ...
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Objectives: enhancing uptake of COVID-19 vaccines is an important tool for managing the pandemic. However, in Hong Kong, the COVID-19 vaccination rate in the general population was unsatisfactory during the early phase of the vaccination program. This two-part study aimed to (i) identify barriers and facilitators to receiving vaccinations, and (ii) develop theoretically-informed implementation strategies for promoting uptake. Methods: in part 1, 45 Hong Kong residents who differed in their willingness to vaccinate (willing (n = 15), were unwilling (n = 15), and were hesitant (n = 15)), were interviewed individually in February 2021. They were invited to express their perceptions of receiving the COVID-19 vaccination. The theoretical domains framework (TDF) was applied to guide the interviews and analyses. Behavioral diagnoses from these findings were then used to develop theoretically-informed implementation strategies in part 2, composed of behavior change techniques (BCTs) informed by the established BCT taxonomy. Results: in part 1, the five main barriers were (i) concerns on severe and long-term side effects; (ii) low confidence in the safety and effectiveness due to concerns of their accelerated development; (iii) unclear information on logistical arrangements of the vaccination program; (iv) insufficient data on safety and effectiveness; and (v) perceived low protection ability conferred by the vaccines. The five main facilitators included (i) healthcare professionals' recommendations; (ii) news from TV, radio, and newspapers as main sources of trustworthy information; (iii) vaccine-related health education delivered by healthcare professionals; (iv) expectations of resuming to a normal social life; and (v) perceived benefits outweighing risks of mild and short-term side effects. Conclusions: seven implementation strategies were developed in part 2 based on the results above, namely (i) providing trustworthy vaccine-related information and scaling up the promotion; (ii) encouraging healthcare professionals to recommend vaccinations; (iii) giving incentives; (iv) using social influence approaches; (v) allowing a selection of COVID-19 vaccine brands; (vi) increasing accessibility for vaccinations; and (vii) emphasizing social responsibility.
... 7,8,16 Correlations between adolescent vaccine hesitancy and adverse vaccine histories, as well as lack of information, have been documented. 17 The South African Attitudes Survey (covering ages 16 years and older), found that vaccine hesitancy is linked to concerns around side-effects. 12 Some participants also discussed low risk perceptions of COVID-19, a finding that has been documented in the general South African population. ...
... Reliability and/or source of supply of vaccine and/or vaccination equipment were also mentioned. Moreover, the schedule of the vaccination program and mode of delivery (e.g., routine program or mass vaccination campaign) can affect the vaccine acceptance [12]. Generally, females, the young, and those of lower income or education level were consistently associated with less intention to be vaccinated [13]. ...
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Objectives To assess the amount of vaccine hesitancy and its determinants in relation to various demographic, social, and personal characteristics among the Saudi population. Study design Cross-sectional study. Methods we utilized a structured questionnaire on a five point-Likert scale that included immunization process awareness, perception towards immunization and factors leading to vaccine refusal. Results The study included 5965 participants characterized according to various demographical factors. The participant's knowledge, perception, and the factors affecting the decision of taking the vaccine were calculated. About 40.7% had enough information about COVID-19 vaccines and were willing to take it. The participant's perception towards COVID-19 vaccines is proportional to their knowledge and varied with the personal characteristics. Factors influencing vaccine use varied also with personal characteristics. Intent to be vaccinated was higher among older age groups, advanced education, retirees, and higher income persons (P < 0.001). Moreover, the influence of heterogeneity in personal perception towards COVID-19 vaccines has been discussed. Vaccine barriers scores were significantly higher among lower educational and income levels (P = 0.004). The leader's influence on vaccine decision was high (p < 0.001). The side effects of COVID-19 vaccine is the most important barrier to vaccine acceptance. Knowledge and perception score were consistently and significantly higher among the group who received their information from official websites, followed by those who had used both websites and social media (p < 0.001). Conclusion Additional approaches will be needed to effectively meet the needs of the hesitant population, particularly the safety and efficacy concerns, the speed of vaccine development, and the distrust in government and health organizations.
... The students with concerns included 31.6% who were hesitant and 8.4% who were resistant to receiving a COVID-19 vaccine. Our findings were similar to other nations: in countries such as Sweden, Canada, the US, and England, around 30-40% of adolescents would hesitate to accept a COVID-19 vaccination [20,[29][30][31]. ...
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To address the novel coronavirus disease (COVID-19) pandemic, development and regulatory evaluations have been accelerated for vaccines, authorizing emergency use. To anticipate vaccine preparedness in adolescents, we studied COVID-19 vaccination awareness and willingness to vaccinate before the vaccine became available. We conducted a cross-sectional survey among 9153 (4575 boys, 50%) students with a mean age of 14.2 years old in four cities in China to collect information on demographic characteristics and their COVID-19 vaccination concerns. Multinomial logistic regression was used to analyze the influencing factors of vaccine hesitancy (“not sure”) and resistance (“do not want it”). The results showed that 2891 (31.6%) were hesitant and 765 (8.4%) were resistant to being vaccinated. Additionally, multivariable analyses showed that vaccine hesitancy and vaccine resistance were associated with living in the Beijing area (OR = 1.62; 95% CI: 1.40–1.88; OR = 1.81; 95% CI: 1.44–2.28), lack of influenza vaccination experience (OR = 1.33; 95% CI: 1.14–1.55; OR = 1.57; 95% CI: 1.25–1.98), no perceived susceptibility (OR = 1.72; 95% CI: 1.50–1.97; OR = 3.57; 95% CI: 2.86–4.46), and perceiving no cues to action (OR = 3.24; 95% CI: 2.56–4.11; OR = 27.68; 95% CI: 21.81–35.13). Postulating a highly effective vaccine (OR = 0.84; 95% CI: 0.72–0.98; OR = 0.66; 95% CI: 0.52–0.83) decreased both vaccine hesitancy and resistance. Vaccine hesitancy alone was associated with girls (OR = 1.21; 95% CI: 1.09–1.36) and was less common among students boarding at school (OR = 0.79; 95% CI: 0.68–0.92), postulating convenient vaccine access (OR = 0.84; 95% CI: 0.73–0.96), and having doctors’ recommendation (OR = 0.86; 95% CI: 0.76–0.98). In conclusion, the results of the study showed that vaccine hesitancy among students in China was associated with limited health literacy and lower risk awareness. Our findings in China suggest that educating youth regarding COVID-19 and the safety and effectiveness of immunization help reduce concerns and increase vaccine confidence and acceptance.
... The students with concerns included 31.6% who were hesitant and 8.4% who were resistant to receiving a COVID-19 vaccine. Our findings were similar to other nations: in countries such as Sweden, Canada, the US, and England, around 30-40% of adolescents would hesitate to accept a COVID-19 vaccination [20,[29][30][31]. ...
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Insufficient fruit and vegetable intake (FVI) and low potassium intake are associated with many non-communicable diseases, but the association with early renal damage in children is uncertain. We aimed to identify the associations of early renal damage with insufficient FVI and daily potassium intake in a general pediatric population. We conducted four waves of urine assays based on our child cohort (PROC) study from October 2018 to November 2019 in Beijing, China. We investigated FVI and other lifestyle status via questionnaire surveys and measured urinary potassium, β2-microglobulin (β2-MG), and microalbumin (MA) excretion to assess daily potassium intake and renal damage among 1914 primary school children. The prevalence of insufficient FVI (
... Numerous population-based studies have identified an association between younger age and public health measure non-compliance (Valenti and Faraci, 2021;Coroiu et al., 2020). Despite COVID-19 vaccines (including booster shots) now being widely available in Canada, younger adults aged 18-39 have a lower rate of full vaccination (about 85%; only 35% with booster shots) than older adults, aged 60+ (90-95%; over 75% with booster shots) in Canada (Government of Canada, 2022), reflecting previous findings suggesting younger age is associated with greater COVID-19 vaccine hesitancy (Afifi et al., 2021;Ogilvie et al., 2021). ...
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Containing the COVID-19 pandemic is dependent on compliance with public health recommendations and mandates which is lower in younger compared to older adults. Furthermore, younger adults have demonstrated lower uptake of COVID-19 vaccines. The aim of this study was to assess preferences for COVID-19 related preventive health measures and vaccination and to explore their association with COVID-19 vaccine acceptability. Canadians aged 18-39 years were invited to participate in a web-based survey in August 2021. We used the Best-Worst-Scale (BWS) methodology to collect and analyze preference data and multivariable binary logistic regression to estimate associations with vaccine acceptability. Based on 266 complete responses, we found strong preferences for physical distancing and wearing face masks, as compared to general hygiene and respiratory etiquette. High vaccine accessibility independent of the location, receiving successive doses of the same vaccine brand and higher vaccine uptake of people in younger adults’ social circle were highly preferred. Higher preferences for mandates requiring proof of vaccination and altruistic motives focused on protecting others by getting vaccinated were associated with vaccine acceptability. As the COVID-19 pandemic waxes and wanes, studies using larger, nationally representative samples are needed to replicate and validate these results to assess preferences for health behaviors corresponding to the latest recommendations. The use of this methodology could provide public health authorities with a unique opportunity to develop targeted, preference-based messaging that aligns with the latest guidelines to effectively encourage compliance and COVID-19 vaccine uptake.
... Females were better than males at cooperating with epidemic prevention hygiene habits, reducing public activities, and helping others to prevent the epidemic, indicating a generally higher risk awareness of the disease; thus, they took COVID-19 more seriously and were more proactive with respect to preventive behaviors [6,7,50]. Moreover, the younger participants were less inclined to take COVID-19 preventive behavioral measures, which may be because younger groups are more prone to "optimistic bias", making them feel less vulnerable than others [51]. This misjudgment of risk would cause a lower perception of disease risk than older adults, thus lowering adherence to the preventive behaviors [52]. ...
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Purpose: Knowledge, attitude, and practice (KAP) models are often used by researchers in the field of public health to explore people’s healthy behaviors. Therefore, this study mainly explored the relationships among participants’ sociodemographic status, COVID-19 knowledge, affective attitudes, and preventive behaviors. Method: This study adopted an online survey, involving a total of 136 males and 204 females, and used a cross-sectional study to investigate the relationships between variables including gender, age, COVID-19 knowledge, positive affective attitudes (emotional wellbeing, psychological wellbeing, and social wellbeing), negative affective attitudes (negative self-perception and negative perceptions of life), and preventive behaviors (hygiene habits, reducing public activities, and helping others to prevent the epidemic). Results: The majority of participants in the study were knowledgeable about COVID-19. The mean COVID-19 knowledge score was 12.86 (SD = 1.34, range: 7–15 with a full score of 15), indicating a high level of knowledge. However, the key to decide whether participants adopt COVID-19 preventive behaviors was mainly their affective attitudes, especially positive affective attitudes (β = 0.18–0.25, p 0.05). In addition, the sociodemographic status of the participants revealed obvious differences in the preventive behaviors; females had better preventive behaviors than males such as cooperating with the epidemic prevention hygiene habits (t = −5.08, p
... Despite COVID-19 vaccines now being widely available, in Canada, younger adults, aged 18-39, have a lower rate of full vaccination (about 80%) than older adults, aged 60+ (90-95%) in Canada (8). This reflects the findings of multiple studies suggesting younger age is associated with greater COVID-19 vaccine hesitancy (9,10). Considering that younger adults' continue to be a vector for COVID-19 transmission, and even increasingly face severe consequences from infection with the rise of new variants (11), this is of great concern to public health authorities (12). ...
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Containing the COVID-19 pandemic is dependent on compliance with public health recommendations and mandates which is lower in younger compared to older adults. Furthermore, younger adults have demonstrated lower uptake of COVID-19 vaccines. The aim of this study was to assess preferences for COVID-19 related preventive health measures and vaccination and to explore their association with COVID-19 vaccine acceptability. Canadians aged 18-39 years were invited to participate in a web-based survey in August 2021. We used the Best-Worst-Scale (BWS) methodology to collect and analyze preference data and multivariable binary logistic regression to estimate associations with vaccine acceptability. Based on 266 complete responses, we found strong preferences for physical distancing and wearing face masks, as compared to general hygiene and respiratory etiquette. High vaccine accessibility independent of the location, receiving successive doses of the same vaccine brand and higher vaccine uptake of people in younger adults′ social circle were highly preferred. Higher preferences for mandates requiring proof of vaccination and altruistic motives for vaccination were associated with vaccine acceptability. As the COVID-19 pandemic waxes and wanes, studies using larger, nationally representative samples are needed to replicate and validate these results to assess preferences for health behaviors corresponding to the latest recommendations. The use of this methodology could provide public health authorities with a unique opportunity to develop targeted, preference-based messaging that aligns with the latest guidelines to effectively encourage compliance and COVID-19 vaccine uptake.
... Vaccine hesitancy, which refers to a set of attitudes and beliefs which may lead to delay or refusal of one or more vaccines despite their availability [8,9], poses a significant threat to achieving sufficient COVID-19 vaccination rates to mitigate the pandemic. Younger age has been associated with vaccine hesitancy [10][11][12][13][14]. Additionally, younger adults often experience mild or asymptomatic infections [15,16], and are more socially active. ...
Preprint
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BACKGROUND High COVID-19 vaccine uptake is crucial to containing the pandemic and reducing hospitalizations and deaths. Younger adults (aged 20-39) have demonstrated lower levels of vaccine uptake compared to older adults while being more likely to transmit the virus due to a higher number of social contacts. Consequently, this age group has been identified by public health authorities as a key target for vaccine uptake. Previous research has demonstrated that altruistic messaging and motivation is associated with vaccine acceptance. In this study, we evaluated the efficacy of a short, animated video that highlights altruistic reasons for COVID-19 vaccination to enhance vaccination intentions in unvaccinated Canadian younger adults. OBJECTIVE This study had two objectives: (1) to evaluate the within-group efficacy of an altruism-eliciting video intervention in increasing COVID-19 vaccination intentions amongst younger adults; and (2) to examine the video’s efficacy compared to a text-based intervention focused exclusively on non-vaccine related COVID-19 preventive health measures. METHODS Using a web-based survey in a pre-to-post, randomized control trial design, we recruited Canadians aged 20-39 who were not yet vaccinated against COVID-19 and randomized them in a 1:1 ratio to receive either the video intervention or an active text control. The video intervention was developed by our team in collaboration with a digital media company. The measurement of COVID-19 vaccination intentions before and after completing their assigned intervention was informed by the multi-stage Precaution Adoption Process Model. The McNemar’s Chi-square test was used to evaluate within-group changes of vaccine intentions. Exact tests of symmetry using pairwise McNemar tests were applied to evaluate changes in multi-staged intentions. Between-group vaccine intentions were assessed using the Pearson’s Chi-square test post intervention. RESULTS Within-group results for the video intervention arm showed that there was a significant change on intentions to receive the vaccine (χ^2(1) = 20.55, p < .001). The between-group difference in post-intervention intentions (χ^2(3) = 1.70, p = .637) was not significant. When administered the video intervention, we found that participants who had not thought about or were undecided about receiving a COVID-19 vaccine were more amenable to change than participants who had already decided not to vaccinate. CONCLUSIONS While the video intervention was limited in its effect on those who had firmly decided not to vaccinate, our study demonstrates that prosocial and altruistic messages could increase COVID-19 vaccine uptake, especially when targeted to younger adults who are undecided or unengaged regarding vaccination. This might indicate that altruistic messaging provides a “push” for those who are tentative towards, or removed from, the decision to receive the vaccine. The results of our study could also be applied to more current COVID-19 vaccination CLINICALTRIAL This study was registered on ClinicalTrials.gov (NCT04960228).