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Who gets COVID-19 booster vaccination? Trust in public health institutions and promotion strategies post-pandemic in the Republic of Korea
... Au et al. (2023) and Hong (2023) also investigate the cultural dimensions that govern public behavior towards vaccination during major societal emergencies such as the COVID-19 crisis. A study by Choi et al. (2023) explores the relationship between trust in public health institutions and vaccination-related behaviors, highlighting the critical role of institutional trust in public health initiatives. As analyzed by Gumbi and Baba (2024) and Abayomi (2024), the crisis of political trust and legitimacy during the COVID-19 pandemic can have significant implications for vaccination behavior. ...
... This erosion of trust in government can weaken public confidence in the administration and efficacy of vaccination programs, further complicating efforts to achieve widespread vaccine uptake (Bullock et al. 2022;Chaudhuri et al. 2022;Fleury-Bahi et al. 2023;Moosa et al. 2022;Robinson et al. 2022;Teng et al. 2022). This phenomenon, which complicates the relationship between public health policy and community compliance, is detailed in the research by Choi et al. (2023), who emphasize the critical influence of institutional trust on healthrelated behaviors and decision-making processes within communities. ...
... This method aligns with the conventional approach documented in existing literature on vaccination. This analysis takes into account a range of socioeconomic and demographic variables that, based on prior discussions, have the potential to influence behaviors related to vaccine uptake (e.g., Choi et al. 2023). These variables encompass demographic and socio-economic characteristics such as personal income (on a 1-12 scale), education levels (on a 1-5 scale), age (on a 1-6 scale), and political orientation (on a 1 = left-10 = right scale). ...
This study investigates the influence of perceived inequality on vaccination behaviors within the social context of South Korea. It explores how perceptions of inequality affect trust in science and society, subsequently impacting vaccination behaviors. The first analysis utilizes path analysis to identify both direct and indirect effects of perceived inequality on COVID-19 vaccine-related attitudes, mediated by trust in science and society. This provides foundational insights into these relationships at the individual level. The second analysis expands the scope to district-level data, analyzing influenza vaccination records from 2015 to 2021 to validate and enhance the initial findings. These results suggest that the public uses perceptions of inequality and regional economic disparity as heuristics in vaccination decisions. This study contributes to academic discourse by elucidating factors influencing vaccination behavior. It highlights the critical role of subjective sense of inequality in shaping public health policy, especially in response to emerging infectious diseases and future pandemics.
... This is the first survey on the coverage rates of COVID-19 booster vaccines in populations living in the areas with the lowest and highest risk of environmental exposure in Thailand after the COVID-19 outbreak. Our results found that more than 63% of the Thai population received a booster dose (three or more vaccine doses) because of the Korean population's trust with 69% of booster doses (three or more vaccine doses) because the population trusts that public health organizations have an important commitment to COVID-19 vaccination and updating booster vaccines during the post-pandemic era [48]. Moreover, it could be seen that the level of booster doses received declined during the post-COVID-19 period within the same study area, by 69.4% in one related study [25] to 51.1% in the current research due to a reduced fear of COVID-19 [49]. ...
... As a result, the ongoing COVID-19 pandemic could have set off an alarm and initiated behavioral changes in terms of both the environment and health [39]. Specifically, continued preventive behaviors regarding the booster doses will be required for the management of COVID-19 [48]. Hence, a policy of routine immunization with an environmental awareness campaign will create a parallel leading to infectious disease control after a pandemic to achieve sustainable health development. ...
This study aimed to identify the influence of environmental risk exposure levels on the predictive factors of COVID-19 booster dose vaccination in an urban Thai population in the post-pandemic era. Six study locations, including the three provinces with the highest environmental risk levels and the three provinces with the lowest environmental risk levels, were selected by calculating the environmental risk exposure indexes. Participants from the capital district of each province were chosen via the simple random sampling technique and interviewed using a structured questionnaire. A total of 1315 individuals were included in a sample in this study, and the best predictors of booster dose vaccination were determined using multiple regression analysis. The results showed that a high level of environmental risk exposure occurred in the provinces with a high number of total days exceeding the limits set for PM10 and high rates of mortality for lung cancer. The number of COVID-19 booster vaccinations given amount to 43.4% of the population during the post-COVID-19 pandemic period. Our multivariate analysis indicated that individuals in the working age group (≥25 years old); those with higher education (diploma degree and above); full-time employment (government and private sectors); those with high monthly incomes (≥USD144.1); and those in areas with the lowest risk level of environmental exposure significantly contributed to the number of booster dose vaccinations given during the post-pandemic period. To summarize, the rate of COVID-19 booster dose vaccination acceptance in Thailand was influenced by socio-economic factors with environmental concerns. These findings improve our understating of both the global pandemic and how environmental exposure affects behavioral change patterns and could improve the effectiveness of post-pandemic management.
... We also contribute to the literature that investigates potential barriers and determinants of (general) vaccination uptake and prevention, ranging from socio-demographic factors, social norms and beliefs, and previous experiences [29][30][31], people's level of religiosity [32,33] or cognitive factors such as susceptibility and severity [34]. At the aggregate level, the literature emphasizes the role of the trustworthiness of public organizations or institutions [35][36][37], cost of vaccines [38], and anticipated consequences of non-pharmaceutical interventions [39]. Furthermore, Böhm and Betsch [40] and Böhm, Betsch, and Korn [41] find that pro-social concerns increase vaccination uptake. ...
Background
Even though the COVID-19 vaccination roll-out in general can be considered as one of the most successful public health campaigns in the history of medicine, general vaccination hesitancy has remained an issue of concern throughout the world. We add to a deeper understanding of vaccination hesitancy by identifying what drives primary vaccination and booster uptake, as well as adherence to simple preventive measures such as physical distancing by investigating the role of Dark Triad personality traits, i.e. Machiavellianism, narcissism, and psychopathy.
Methods
We investigate data from Germany and the United Kingdom from the European Covid Survey which was collected from 23 December 2021 to 10 January 2022. Logit regressions and random effects regressions were performed to study the effect of dark personality traits on COVID-19-related prevention.
Results
We find a statistically significant association between Dark Triad personality traits and prevention efforts, primary vaccinations, and booster uptake against COVID-19. Specifically, individuals scoring high in psychopathy are associated with a lower likelihood of having received primary immunization. The marginal effect amounts to 3.31%-points. High narcissistic personality traits are correlated with a substantially higher likelihood (4.52%-points) to refuse booster shots after having received the primary vaccinations. Dark Triad personality traits may be relevant factors associated with vaccine-related decision-making. In addition, individuals with higher psychopathic tendencies report significantly lower engagement in other simple preventive behavior, while higher scores in narcissism are associated with higher reported adherence to simple preventive measures.
Conclusions
Our findings highlight the crucial role that personality plays in pandemic-related prevention. Policymakers, health professionals, and those in charge of health messaging may take these factors into account when devising communication strategies to improve the vaccination uptake and adherence to preventive behaviors. Future pandemics and public health crises would benefit from targeted, nuanced approaches to public health messaging to promote greater public adherence and public health.
... 31,32 As immunity wanes over time, there is an increasing necessity for new vaccines, specifically tailored to these emerging variants. 33,34 Periodic vaccination with these updated vaccines is essential to maintain effective protection against COVID-19. 24 Post-COVID-19 pandemic studies have frequently pointed to vaccine safety concerns as a primary factor in vaccination hesitancy. ...
This research examines the low rate of co-administration of influenza and COVID-19 vaccines among seniors aged 65 and older in Korea, despite recommendations from authorities and academia worldwide. The study aimed to understand the influence of general characteristics and health beliefs on the vaccination choices of seniors, who were categorized into four groups based on their vaccination status: influenza only, COVID-19 only, both, or neither. A total of 400 participants, aged 65 and above, were selected through proportional stratified random sampling from five major Korean regions for a survey conducted between November 24th and December 15th, 2023. The results indicated no significant differences in general characteristics across these groups. However, regarding the health beliefs showed significant differences in perceived susceptibility and self-efficacy between the influenza-only and co-administration groups. Higher levels of perceived susceptibility and self-efficacy were associated with choosing co-administration. Contrary to previous studies focusing on safety concerns as a primary factor in vaccine hesitancy, this study highlights the role of individual health-related beliefs, particularly perceived susceptibility and self-efficacy, as critical in influencing the decision for co-administration among the elderly in Korea.
... We also contribute to the literature that investigates potential barriers and determinants of (general) vaccination uptake and prevention, ranging from socio-demographic factors, social norms and beliefs, and previous experiences [58,73,71], peopleŠs level of religiosity [62,33] or cognitive factors such as susceptibility and severity [3]. At the aggregate level, the literature emphasizes the role of the trustworthiness of public organizations or institutions [19,55,15], cost of vaccines [38], and anticipated consequences of non-pharmaceutical interventions [43]. Furthermore, Böhm and Betsch [8] and Böhm, Betsch, and Korn [9] Ąnd that pro-social concerns increase vaccination uptake. ...
Background: Even though the COVID-19 vaccination roll-out in general can be considered as one of the most successful public health campaigns in the history of medicine, general vaccination hesitancy has remained an issue of concern throughout the world. We add to a deeper understanding of vaccination hesitancy by identifying what drives primary vaccination and booster uptake, as well as adherence to simple preventive measures such as physical distancing by investigating the role of Dark Triad personality traits, i.e. Machiavellianism, narcissism, and psychopathy.
Methods: We investigate data from Germany and the United Kingdom from the European Covid Survey which was collected from 23 December 2021 to 10 January 2022. Logit regressions and random effects regressions were performed to study the effect of dark personality traits on COVID-19-related prevention.
Results: We show that Dark Triad personality traits have a substantial impact on prevention efforts, primary vaccinations and booster uptake against COVID-19. Specifically, individuals scoring high in psychopathy have significantly less likely received primary immunization. The difference amounts to 10.5%-points. High narcissistic personality traits imply a substantially higher likelihood (15.3%-points) to refuse booster shots after having received the primary vaccinations. Therefore, the Dark Triad personality traits may constitute a special case in the demand for vaccines. In addition, individuals with higher psychopathic tendencies engage significantly less in other simple preventive behavior, while higher scores in narcissism lead to higher reported adherence to simple preventive measures.
Conclusions: Our findings highlight the crucial role that personality plays in pandemic related prevention. Policymakers, health professionals, and those in charge of health messaging may take these factors into account when devising communication strategies to improve the vaccination uptake and adherence to preventive behaviors. Future pandemics and public health crises would benefit from targeted, nuanced approaches to public health messaging to promote greater public adherence and public health.
Objectives:
This study aimed to investigate the combined effects of individual, household, and community-level factors on coronavirus disease 2019 (COVID-19) vaccination intention using a multilevel analysis.
Methods:
This cross-sectional study analyzed raw data from the 2021 Korea Community Health Survey and regional statistics from 255 health centers, with a final sample of 229,216 individuals. Multilevel analysis was conducted, focusing on individual, household, and community-level factors. Individual-level factors included demographics, health status, and COVID-19 concerns; household-level factors included income and marital status; and community-level factors included city type and vaccination rates.
Results:
At the individual level, significant differences were observed across all variables. At the household level, higher vaccination intention was associated with households of 4 or more members and a monthly income of 4 million Korean won or more. At the community level, higher flu vaccination rates, greater concern about COVID-19 infection, and higher COVID-19 vaccination rates were linked to increased vaccination intention.
Conclusion:
This study highlights that COVID-19 vaccination intention is influenced by factors at the individual, household, and community levels. Vaccination strategies that integrate household and community-level approaches may be more effective. Policymakers should consider both individual and social health factors when designing vaccination policies.
This chapter addresses one lesson (among many) from the COVIZ-19 pandemic: trust and public communication of science-based evidence are crucial in the management of public health crises. It is a lesson all countries need to grasp to equip themselves with the governance tools required to prevent, as far as possible, the escalation of future infectious disease outbreaks into pandemics. The analysis is based on the community informed concept and illustrated by comparative cross-national empirical evidence--available up to 31 Dec 2023--on the governance of the COVID-19 pandemic. The data are from 20 countries selected from the full score range of the World Bank's Worldwide Governance Indicators. The key findings from this study are: (1) A public health crisis cannot be managed successfully by a country's health authorities alone, irrespective of the quality and sophistication of its health care services. (2) The health authorities need to work together as partners with the at-risk population in the design and implementation of an effective preventive and containment strategy. (3) The at-risk population is most likely to consent to cooperate in the implementation of a preventive and containment strategy if they trust the information from the health authorities; if they are kept well-informed about the authorities' prevention and containment strategy and its progress; if they are offered incentives to cooperate; and if they are invited to participate by contributing their knowledge and voluntary assistance when needed. (4) The at-risk population's trust in the health authorities cannot be instilled overnight. Countries where segments of the population have low or no trust in their government are more likely to dismiss, resist or oppose the implementation of a strict pandemic prevention and control strategy, particularly regulations perceived as intrusive (for example facemask wearing, restricted physical distance, quarantine, and vaccination).
Vaccination is a key public health strategy that is known to be effective in mitigating the risk of infection and severe disease. However, in the context of the COVID-19 pandemic, the percentage (<50%) of Malaysians who have received a booster for the COVID-19 vaccine has remained stagnant over a year. This study aimed to determine the prevalence of and the factors associated with hesitancy toward the second dose of booster for the COVID-19 vaccine. A web-based cross-sectional study was conducted from August to November 2022. The Oxford Vaccine Hesitancy Scale was used to assess the hesitancy toward the second dose of booster for the COVID-19 vaccine. Simple and multiple factors logistic regressions were used to determine the predictors of hesitancy. A p-value less than 0.05 was considered to be statistically significant. Data from 798 respondents were included in the analysis. The prevalence of hesitancy toward the second booster of the COVID-19 vaccine was 26.7%. The predictors of second-booster hesitancy were older age (AOR = 1.040, 95 CI = 1.022, 1.058), having received the third dose (first booster) because of instruction by the government (AOR = 2.125, 95% CI = 1.380, 3.274), concern about serious long term side effects of the vaccine (AOR = 4.010, 95% CI = 2.218, 7.250), and opinions of close friends and immediate family members that the booster is harmful (AOR = 2.201, 95% CI = 1.280, 3.785). Conversely, factors that appear to reduce vaccine booster hesitancy were acceptance of the third dose due to the high number of cases and the increasing rate of infection (AOR = 0.548, 95% CI = 0.317, 0.947), the belief that the vaccine will decrease the risk of getting the infection (AOR = 0.491, 95% CI = 0.277, 0.870), and opinions of close friends and immediate family members that the booster is helpful (AOR = 0.479, 95% CI = 0.273, 0.840). In conclusion, more than one-fifth of Malaysians were hesitant to take the second booster of the COVID-19 vaccine. This suggests that appropriate steps that increase vaccine acceptance, taking into consideration the findings of the present study, are needed to address this issue and to foster more positive attitudes toward vaccination. The survey was available in three main languages but limited to people with internet access; hence, it would likely be biased toward younger adults and social media users and exclude those with limited or no internet access, in particular older people. Therefore, the results are not representative of the Malaysian population at large and caution should be exercised when interpreting the findings.
Objective
Women of childbearing age, including pregnant and breastfeeding women, report higher COVID-19 vaccine hesitancy, but reasons for this hesitancy are unknown. We explored factors influencing vaccine decision-making among women of childbearing age in Victoria, Australia to inform strategies to increase COVID-19 vaccine uptake.
Methods
Twenty-four women aged 18-40 years were interviewed July-October 2021. Interview data were analyzed thematically using an inductive, constructivist approach.
Results
Of 24 participants, 14 (57%) were vaccine-hesitant, of whom 10/14 pregnant or breastfeeding. Six key themes were identified: weighing up perceived risks for self and baby; availability of information; change and contradictions; vaccination above everything; practical issues – hurdles of inconvenience. Vaccine-hesitant women’s concerns included safety in pregnancy, breastfeeding and fertility effects. Some participants expressed a loss of trust in healthcare providers following vaccine mandates.
Conclusions
Public health campaigns and communication should be tailored to address specific concerns to increase COVID-19 vaccine uptake and prevent negative COVID-19 outcomes for women of childbearing age. Findings suggest that effective strategies to address hesitancy in this group may include providing robust short- and long-term safety data across fertility, birth outcomes and child development following COVID-19 vaccination. Other supportive strategies may include systemic changes like making childcare available at vaccination points (where practical), and using data linkage infrastructure to track post-vaccination outcomes.
With over 58 million cases and 6 million deaths by August 2022, the Coronavirus disease 2019 (COVID-19), causing severe acute respiratory syndrome coronavirus 2 (SARs-CoV-2), has had an insurmountable impact on the world’s population. This is one of the worst health crises since 1918’s influenza pandemic. There are four subvariants of Omicron; BA.1, BA.1.1, BA.2 and BA.3. As a result of new mutations in its spike protein, most of which occur in its receptor binding site, the Omicron variant appears to be more transmissible and less resistant to vaccination and antibody response. Understanding Omicron’s virology and mutations is essential to developing diagnostic and therapeutic methods. A thorough assessment of control measures, as well as timely adjustment of control measures, requires addressing such issues as re-infection risk, vaccine response, booster vaccine doses, and the increased rate of Omicron infections. This review article aims to look at the current information about the different types of SARs-CoV-2, focusing on the new subtype BA.2.75.
As the global pandemic perpetuates, keeping the population vaccinated will be imperative to maintain societal protection from the SARS-CoV-2 (COVID-19) virus. However, while empirical evidence regarding predictors of the intention to receive a first COVID-19 vaccine has amassed, our understanding regarding the psychological and behavioral drivers of continued COVID-19 vaccination remains limited. In this pre-registered study (UK: AsPredicted#78370|Australia: AsPredicted#81667), factors predicting the intention to receive a COVID-19 booster vaccine were investigated in two adult samples from the UK (N = 1222) and Australia (N = 1197) that were nationally representative on factors of age, gender, and geographic location. High levels of booster intent were found (73% and 67%, respectively). Exploratory Structural Equation Modelling (ESEM) revealed three key predictors of the intention to receive a booster vaccine that emerged across both UK and Australian samples: concern regarding the COVID-19 virus, positive perceptions of the COVID-19 vaccines, and the perceived severity of side effects experienced to the last COVID-19 vaccine dose. Several additional factors (age, months since the last COVID-19 vaccine, familiarity with side effects, and regularly receiving the influenza vaccine) were present in the Australian dataset. These findings provide important evidence that targeting psychological perceptions of the COVID-19 vaccine and virus may serve to maintain participation in the COVID-19 vaccination programme, paving the way for future behavioural research in this area.
(1) Objective: To explore Chinese residents’ willingness to receive COVID-19 vaccine booster shots and identify predictors of the level of willingness based on the health belief model (HBM). (2) Methods: The snowball sampling method was used to distribute online questionnaires. A chi-square test was used to analyze the relationship between different variables. The causal relationship between HBM-related factors and booster vaccination intentions was explored by Structural equation modeling (SEM). (3) Results: A total of 898 complete responses were included; 64.3% had already received the booster injection. Most respondents intended to vaccinate themselves, while 16.1% were hesitant. Nearly half of the respondents chose to take the booster injection to support China’s vaccination policy. Using the SEM, perceived susceptibility and perceived barriers were found to have a negative effect on booster vaccination intentions, whereas perceived benefit and cues to action positively affected booster vaccination intentions in the HBM. (4) Conclusions: Factors included in this study have different effects on the willingness to take the COVID-19 booster injections. Sociodemographic characteristics and characteristics of participants’ COVID-19 vaccination have a significant effect on the willingness to receive vaccine booster shots. The HBM constructs can serve as good predictors of the acceptance of vaccine booster shots with the exception of perceived severity, which may benefit health officials in terms of conducting targeted strategies in vaccine programs.
Given the concerns of waning immunity from the primary COVID-19 vaccines and the first booster dose, we conducted an online cross-sectional study in May 2022 to investigate willingness to receive a second COVID-19 booster dose or a new COVID-19 vaccine and its associated factors. Overall, 62% of the participants were willing to be vaccinated, 25.8% were unsure, and 12.3% were unwilling to be vaccinated. The main reasons against accepting a second COVID-19 booster dose/new COVID-19 vaccine were concerns about the side effects and the effectiveness and the opinion that further vaccination is unnecessary. Males, younger individuals, participants without a previous COVID-19 diagnosis, and those with good/very good self-perceived physical health were significantly more frequently willing to receive a second COVID-19 booster dose or a new COVID-19 vaccine. Additionally, increased fear of the COVID-19, increased trust in COVID-19 vaccinations, and decreased fear of a second booster dose or a new COVID-19 vaccine was associated with increased willingness. Our results show some hesitancy and unwillingness toward further COVID-19 vaccination and indicate that the fear of COVID-19 and trust in COVID-19 vaccination affects public opinion.
Objective: The COVID-19 pandemic is still continuing throughout the world, with newer genetic variants regularly appearing from different parts of the world. Considering the waning of immunity against COVID-19 infection even with two doses of the COVID-19 vaccine, regulatory authorities have authorised booster COVID-19 vaccination in many countries, especially for vulnerable populations, including healthcare workers. The current study analysed factors predicting the third (booster) dose of COVID-19 vaccine intention, including the health belief model (HBM), among the healthcare workers in Saudi Arabia. Methods: The current study was a cross-sectional online survey performed from 1st October 2021 to 30th November 2021, using a questionnaire prepared in GoogleTM form among healthcare workers in Saudi Arabia. The questionnaire asked demographic factors, COVID-19 experience of participants, subjective assessment of health, intention of COVID-19 booster dose vaccination, preferences for local/foreign-made vaccines, and health belief of the study population related to COVID-19 infection and COVID-19 booster dose. Results: This study received 2059 complete responses. The study population reported mixed health belief with respect to the susceptibility of COVID-19 infection, and higher health belief perception regarding the severity. The perceptions of the study participants regarding the benefits of COVID-19 booster dose were positive. There were few barriers to COVID-19 booster dose expressed by study participants. A total of 1464 (71.1%) study participants reported positive intent for receiving a COVID-19 booster dose. The study showed significant association between definite intention to receive a booster dose and nationality (p = 0.001), marital status (p = 0.017), gender (p < 0.001), education level (p = 0.001), monthly income (p < 0.001), and co-morbid medical illness (p = 0.045). The perception of the COVID-19 booster vaccine as a good idea to minimise worries about getting COVID-19 (OR = 2.28, CI 1.89–2.76), and perceptions that receiving the third (booster) dose reduces the risk of COVID-19 infection and associated complications (OR= 2.69, CI = 2.17–3.34), of the perceived benefit construct of HBM, predicted significantly higher definite intention to receive a booster dose. The concern with the safety of the vaccine (OR= 0.40, CI 0.34–0.47) under the perceived barriers construct of HBM predicted as significantly higher no definite intention to receive a booster dose. Conclusions: The results of the present study can guide policy makers in their efforts to promote booster doses of COVID-19 vaccination among the healthcare workers in Saudi Arabia.
We investigated how perceived risk and protective behaviors changed as the Coronavirus epidemic progressed. A longitudinal sample of 538 people responded to a COVID-19 risk perception questionnaire during the outbreak and post-epidemic periods. Using Structural Equation Modeling (SEM), we examined the mean level change of selected constructs and differences in their relationships. We tested a risk perception pathway in which affective attitude, informed by experience, shaped risk perceptions and protective behaviors. The model also postulated a social pathway in which cultural worldviews, like individualism and hierarchy, predicted risk perceptions and protective behaviors through social norms. Latent mean difference analyses revealed a decrease in social distancing behaviors and an increase in hygiene-cleanliness, corresponding to a reduction in risk perceptions and social norms and a rise in direct and indirect experience, while affective attitude remained substantially stable. Cross-sectional and longitudinal path analyses showed that affective risk perception, primarily informed by affective attitude, and social norms promoted behavior consistency regardless of epidemic contingencies. Instead, analytic risk perceptions were linked to protective behaviors only during the outbreak. Although risk perceptions dropped over time, analytic risk perceptions dropped more steeply than affective risk perceptions. Our findings supported the distinction between affective and deliberative processes in risk perception, reinforcing the view that affective reactions are needed to deploy analytic processes. Our study also supports the claim that perceived social norms are essential to understanding cultural worldview-related protective behaviors variability.
Coronavirus disease ‐2019 (COVID‐19) is an ongoing pandemic that affected around 27 million confirmed cases of COVID‐19, including more than 5 million deaths. However, on 24th November 2021, the world health organization (WHO) announced a new SARS‐CoV‐2 variant designated as the B.1.1.529 a variant of concern (VOC) and the variant has been named as “Omicron”. Available preliminary evidence suggests that, as compared to previous VOCs, it has an increased risk of infectivity. Studies have shown that protection from various vaccines effectiveness against hospitalization and death from severe COVID‐19 disease is decreasing slowly after a two‐dose schedule of COVID‐19 vaccines. In response to experiencing a new COVID‐19 variant and ongoing resurgence of cases importance of COVID‐19 vaccine booster dose and durability of the effect of the third dose of vaccine against Covid‐19 Omicron variant is controversial yet. Hence here we have done a systematic search in Pub Med, Google Scholar and MedRXiv database, from inception to January 2022 using the MeSH terms and keywords “Corona Virus Disease‐2019 OR COVID‐19 AND Omicron AND COVID‐19 Booster Vaccine”. We have identified a total of 21 published studies. We have reviewed all the eligible available studies on the effectiveness of the COVID‐19 vaccine booster shots against the Omicron variant. This article is protected by copyright. All rights reserved.
Currently, the SARS-CoV-2 has been spread worldwide as the Omicron variant. This variant is a heavily mutated virus and designated as a variant of concern by the World Health Organization (WHO). WHO cautioned that the Omicron variant of SARS-CoV-2 held a very high risk of infection, reigniting anxieties about the economy's recovery from the two-year pandemic. The extensively mutated Omicron variant is likely to spread internationally, posing a high risk of infection surges with serious repercussions in some areas. According to preliminary data, the Omicron variant of SARS-CoV-2 has a higher risk of reinfection. On the other hand, whether the current COVID-19 vaccines could effectively resistant the new strain is still under investigation. However, there is very limited information on the current situation of the Omicron variant, such as genomics, transmissibility, efficacy of vaccines, treatment, and management. This review focused on the genomics, transmission, and effectiveness of vaccines against the Omicron variant, which will be helpful for further investigation of a new variant of SARS-CoV-2.
We estimated the trends and correlates of vaccine hesitancy, and its association with subsequent vaccine uptake among 5,458 adults in the United States. Participants belonged to the CHASING COVID Cohort, a national longitudinal study. Trends and correlates of vaccine hesitancy were examined longitudinally in eight interview rounds from October 2020 to July 2021. We also estimated the association between willingness to vaccinate and subsequent vaccine uptake through July 2021. Vaccine delay and refusal decreased from 51% and 8% in October 2020 to 8% and 6% in July 2021, respectively. Compared to Non-Hispanic (NH) White participants, NH Black and Hispanic participants had higher adjusted odds ratios (aOR) for both vaccine delay (aOR: 2.0 [95% CI: 1.5, 2.7] for NH Black and 1.3 [95% CI: 1.0, 1.7] for Hispanic) and vaccine refusal (aOR: 2.5 [95% CI: 1.8, 3.6] for NH Black and 1.4 [95% CI: 1.0, 2.0] for Hispanic) in June 2021. COVID-19 vaccine hesitancy was associated with lower odds of subsequent vaccine uptake (aOR: 0.15, 95% CI: 0.13, 0.18 for vaccine-delayers and aOR: 0.02; 95% CI: 0.01, 0.03 for vaccine-refusers compared to vaccine-willing participants), adjusted for sociodemographic factors and COVID-19 history. Vaccination awareness and distribution efforts should focus on vaccine delayers.
Aim
We conducted a systematic review and meta-analysis to analyse gender differences in COVID-19 vaccination intentions.
Subject and methods
PubMed, Web of Science and PsycInfo were searched (November 2020 to January 2021) for studies reporting absolute frequencies of COVID-19 vaccination intentions by gender. Averaged odds ratios comparing vaccination intentions among men and women were computed. Descriptive analyses of the studies were reported.
Results
Sixty studies were included in the review and data from 46 studies (n = 141,550) were available for meta-analysis. A majority (58%) of papers reported men to have higher intentions to get vaccinated against COVID-19. Meta-analytic calculations showed that significantly fewer women stated that they would get vaccinated than men, OR 1.41 (95% CI 1.28 to 1.55). This effect was evident in several countries, and the difference was bigger in samples of health care workers than in unspecified general population samples.
Conclusion
This systematic review and meta-analysis found lower vaccination intentions among women than men. This difference is discussed in the light of recent data on actual vaccination rates in different countries.
Background: It is widely believed that vaccine hesitancy is prevalent. Achievement of COVID-19 vaccination depends upon public willingness towards immunization against this disease. This study aimed at revealing the underlying situation regarding community hesitancy for COVID-19 vaccine. This study was conducted to determine the level of acceptance of COVID-19 vaccine uptake among community and to seek association between socio-demographic factors and various perceptions about COVID-19 vaccine. Methods and Materials: A cross-sectional study was carried out on 390 health-care providers and general Pakistani people of age 20 years and above through non probability snowball sampling. An online questionnaire was used to gather data. The socio-demographic variables along with various Original Research Article Memon et al.; JPRI, 33(58B): 108-117, 2021; Article no.JPRI.77382 109 concepts regarding intentions to take vaccine as well as hesitancy for the same were tried to bring on the surface. The p-value ≤ 0.05 was considered statistically significant. Results: This study reveals that 61.28% of participants desired to get vaccinated. There was significant association between the desire to get vaccination with participant's age & occupation (p-value < 0.01). The significant association between the positive views of the health-care providers and the other study subjects (p<0.00) is highly encouraging. The other socio-demographic variables have varied effect on vaccine uptake intentions and hesitancy and require further research on this subject. Conclusion: The study conducted on three hundred & ninety respondents consistently reveals the significant association between the positive views of the health care providers and the other study subjects with the p-values lesser than 0.001. The study concludes that other socio-demographic fabric of the community showed varied effect on COVID 19 vaccine uptake intentions and hesitancy. Recommendation: 1. The broad based qualitative research is strongly recommended in order to better seek the community insights & perceptions regarding this public health issue. 2. The large number of Community people although want to get vaccinated against covid-19, still there is a widespread prevalent doubts about this vaccine as being not so safe for them. Such type of doubts among community necessitate that some counselling sessions be conducted in order to remove uncertainties among common people. Motivations of people need to be raised so as to increase the coverage of covid-19 vaccination.
Since COVID-19 vaccine uptake was found to be especially low among young adults, the present study investigated COVID-19 risk perception as predictor of COVID-19 vaccination intention and actual COVID-19 vaccine uptake among this age group. More specifically, it was tested whether cognitive risk perception predicts vaccination uptake successively via affective risk perception and vaccination intention. In total, 680 students (65.9% female) between 17 and 28 years participated in this longitudinal online study. COVID-19 cognitive and affective risk perception, COVID-19 vaccination intention, and actual COVID-19 vaccine uptake were measured in t1: November/December 2020, t2: March 2021, and t3: June/July 2021, respectively. The mediation analysis revealed a significant indirect effect of perceived severity at t1 on vaccine uptake at t3 via worry at t1 and vaccination intention at t2. Stronger perceptions of perceived severity of COVID-19 were related to more worry about COVID-19, which led to a higher vaccination intention, which, in turn, increased the chance of COVID-19 vaccine uptake. To increase vaccine uptake among young adults it might be fruitful to emphasize the severity of COVID-19. However, one should take into account that tapping into fear works best when messages also include efficacy statements.
Background
Ethiopia has received 2.2 million doses of COVID-19 vaccine from the COVID-19 Vaccines Global Access (COVAX) facility and planned to vaccinate 20% of its population by the end of 2021. However, evidence on the current uptake of the vaccine in our country is scanty. Therefore, this study aimed to assess COVID-19 vaccine uptake and associated factors among health professionals in Ethiopia.
Methods
A national online cross-sectional E-survey was conducted on COVID-19 vaccine Uptake and associated factors among health professionals in Ethiopia from June 1 to 30, 2021. A semi-structured questionnaire was created on Google forms and disseminated online. The snowball sampling technique through the authors’ network with Ethiopian residents on the popular social media like Facebook, telegram, and email was used. Descriptive statistics were performed. Multivariable logistic regression analysis was performed using Statistical Package for Social Sciences version 25, and all variables with P-value <0.05 and adjusted odds ratio at 95% CI were used to declare the predictors of the outcome variable.
Results
A total of 522 health professionals participated in the survey, of which about 324 (62.1%) of them were vaccinated with any of the COVID-19 vaccines at least once. The study indicated that COVID-19 vaccine uptake was associated with age range from 35 to 44 years [AOR = 12.97, 95% CI: 2.36–71.21], age beyond 45 years [AOR = 18.95, 95% CI = 2.04–36.29], being male [AOR = 2.91, 95% CI = 1.05,8.09], being only an academician [AOR = 0.23, 95% CI: 0.10–0.49], academicians working in University hospitals [AOR = 0.19, 95% CI: 0.05–0.83], perceiving their family as healthy [AOR = 4.40, 95% CI: 2.21–8.75], no history of receiving other vaccine before as an adult [AOR = 4.07, 95% CI: 2.07–8.01] and no history of contact with confirmed COVID-19 patients or clients [AOR = 0.42, 95% CI: 0.20–0.86].
Conclusion
The study found that COVID-19 vaccine uptake among health professionals was low. This was not sufficient to achieve herd immunity as at least nine out of ten health professionals are required for herd immunity. Ages, sex, place of work, perceived family health status, previous experience of receiving a vaccine as an adult and history of contact with COVID-19 clients or patients were the factors that influence the vaccine uptake among health professionals in Ethiopia. Hence, decision makers and health managers should consider instituting mandatory vaccination for health professionals and design strategies for the provision of the vaccine.
The uptake of the COVID-19 vaccine will determine the trajectory for improved population health and economic recovery from the COVID-19 pandemic. Identifying factors associated with vaccine acceptance is imperative as public health officials strategize to improve uptake. In this study, we identified predictors of vaccine willingness and acceptance using univariate logistic regression to model predictors and calculate odds ratios. Participants (N = 946) who reported greater vaccine willingness were male, older, and had a higher level of education and income. Behaviors indicative of reducing the spread of COVID-19 (e.g., testing) and perceived risk of COVID-19 infection were associated with vaccine willingness, as were participants who believed they were “highly likely” to be infected (by a factor of 8). Education tailored to demographic groups with low vaccine uptake should focus on the high degree of communicability associated with COVID-19. Implementing mobile healthcare screenings could remove barriers to healthcare, thereby improving health equity.
Background
The battle against the 2019 novel coronavirus (COVID-19) has not concluded. Despite the availability of vaccines, the high prevalence of vaccine hesitancy represents a significant challenge to public health, and raising vaccine acceptance among the public is critical. Although media has become an increasingly popular source of COVID-19 vaccine-related information, the question of whether and how media use is related to the public’s vaccine hesitancy warrants exploration.
Objective
This study aimed to (1) examine the level of COVID-19 vaccine hesitancy, (2) identify factors associated with COVID-19 vaccine hesitancy, and (3) explore the direct and indirect relationship between media use and vaccine hesitancy through psychological factors.
MethodsA month before COVID-19 vaccination was initiated in South Korea, we conducted a cross-sectional web-based survey over 6 days (January 20-25, 2021). This study included 1016 participants, and a logit model for regression analyzed associations between sociodemographic factors, health-related factors, psychological factors, and media use toward one’s COVID-19 vaccine hesitancy. Additionally, we conducted a path analysis to examine the indirect effects of media use on vaccine hesitancy by using psychological factors (ie, perceived risk of COVID-19 infection, perceived benefits, and perceived barriers of COVID-19 vaccination).
ResultsAmong the participants (N=1016), 53.3% (541/1016) hesitated to take the COVID-19 vaccine, while 46.7% (475/1016) agreed to accept the vaccine. Of the sociodemographic factors, female gender (odds ratio [OR] 1.967, 95% CI 1.36-2.86; P
This study aimed to assess the correlation between political ideologies, government trust, and COVID-19 vaccine hesitancy in South Korea during the COVID-19 pandemic. A cross-sectional survey was conducted among South Korea’s general population and 1000 respondents (aged 18 years and older) were included. We used multivariate logistic regression models to identify the factors associated with vaccine hesitancy. Respondents who self-identified as liberal or held “no political opinion” had higher rates of vaccine hesitancy than conservative respondents. People’s trust in the government’s countermeasures was associated with vaccination. Respondents who had risk perceptions (affective and cognitive) of COVID-19 had lower rates of vaccine hesitancy. Perceptions that the vaccine was not safe and being aged 18–29, 30–39, or 40–49 were associated with a higher probability of vaccine hesitancy. This study found that even if vaccine safety and risk perceptions toward COVID-19 were adjusted, self-rated political ideologies and government trust was associated with COVID-19 vaccine hesitancy. More effort to communicate with those who are liberal or no political opinion, younger, and have lower level of trust in the government are required to dissolve vaccine hesitancy. Further studies should analyze the mechanism of COVID-19 vaccine uptake for effective herd immunity.
Vaccine hesitancy is the primary barrier to controlling the COVID-19 pandemic in South Korea. We used logistic multivariate regression modeling to investigate (1) the prevalence and reasons for COVID-19 vaccine hesitancy, (2) sub-groups that had higher rates of vaccine hesitancy, and (3) vaccine hesitancy predictors. We used a national survey of representatively sampled households (n = 13,021 adults) from October to December 2020. A self-report questionnaire asked about vaccination intention and reasons for hesitancy and gathered data on socio-demographic, demographic, psychological, and experiential factors. Our study indicated that 39.8% of the participants answered that they hesitated or refused to be vaccinated. The most common reason for vaccine hesitancy was a lack of confidence in the COVID-19 vaccine (77.9%). Less or no fear of COVID-19 (OR = 2.08, 95% CI = 1.92–2.26; OR = 1.79, 95% CI = 1.54–2.08), unstable job status (OR = 1.42, 95% CI = 1.18–1.70), decreased family income (OR = 1.40, 95% CI = 1.21–1.61), and worsening health status (OR = 1.38, 95% CI = 1.13–1.68) were predictors of vaccine hesitancy. Younger age, no religious affiliation, political conservatism, and lower family income were also significantly associated with vaccine hesitancy. Effective health communication and policies need to consider the target subgroup population and predictors of vaccine hesitancy to attain herd immunity at an early stage.
The long-term success of New Zealand’s Covid-19 elimination plan and the re-opening of fortress New Zealand rests on high population uptake of the Covid-19 vaccine. Understanding factors that contribute to vaccine hesitancy – and potential inequities in access and uptake – are consequently essential for the efficacy of the national immunisation programme which began rolling out to the general population in July 2021. Prior research on the New Zealand context has documented socio-demographic disparities in Covid-19 vaccine hesitancy (Horizon Research, 2020; Prickett, Habibi and Atatoa Carr, 2021; Thaker, 2021). However, little research has been undertaken to examine how psychosocial elements – such as people’s trust in institutions – might be associated with people’s vaccine intent and cast some light on the reasons underpinning their intent.
Background
On July 30, 2021, the administration of a third (booster) dose of the BNT162b2 messenger RNA vaccine (Pfizer–BioNTech) was approved in Israel for persons who were 60 years of age or older and who had received a second dose of vaccine at least 5 months earlier. Data are needed regarding the effect of the booster dose on the rate of confirmed coronavirus 2019 disease (Covid-19) and the rate of severe illness.
Methods
We extracted data for the period from July 30 through August 31, 2021, from the Israeli Ministry of Health database regarding 1,137,804 persons who were 60 years of age or older and had been fully vaccinated (i.e., had received two doses of BNT162b2) at least 5 months earlier. In the primary analysis, we compared the rate of confirmed Covid-19 and the rate of severe illness between those who had received a booster injection at least 12 days earlier (booster group) and those who had not received a booster injection (nonbooster group). In a secondary analysis, we evaluated the rate of infection 4 to 6 days after the booster dose as compared with the rate at least 12 days after the booster. In all the analyses, we used Poisson regression after adjusting for possible confounding factors.
Results
At least 12 days after the booster dose, the rate of confirmed infection was lower in the booster group than in the nonbooster group by a factor of 11.3 (95% confidence interval [CI], 10.4 to 12.3); the rate of severe illness was lower by a factor of 19.5 (95% CI, 12.9 to 29.5). In a secondary analysis, the rate of confirmed infection at least 12 days after vaccination was lower than the rate after 4 to 6 days by a factor of 5.4 (95% CI, 4.8 to 6.1).
Conclusions
In this study involving participants who were 60 years of age or older and had received two doses of the BNT162b2 vaccine at least 5 months earlier, we found that the rates of confirmed Covid-19 and severe illness were substantially lower among those who received a booster (third) dose of the BNT162b2 vaccine.
Background
COVID-19 has had a devastating impact and efforts are being made to speed up vaccinations. The growing problem of vaccine hesitancy may affect the uptake of COVID-19 vaccine. We examined the individual, communication and social determinants associated with vaccines uptake.
Methods
Data come from a nationwide online probability-based panel of 1012 representative adults in the United States and the survey was conducted before the vaccines were available. People under the federal poverty level and racial and ethnic minorities were oversampled. Our outcome variables of interest were likelihood of vaccinating self and likelihood of vaccinating people under one’s care (such as children) measuring behavioral intentions. Independent variables included perceptions of risk, exposure to different media for COVID-19 news, political party identification, confidence in scientists and social determinants of health. Logistic regression analysis was used to ascertain the effects of independent variables on the two outcome variables.
Results
The results indicated that 68 and 65% agreed to get the vaccine for themselves and people under their care, respectively. Risk perceptions (severity of and susceptibility to COVID-19) were significantly associated with vaccine uptake. People who relied on “conservative” news outlets, Republicans, and who had low confidence in scientists are least likely to vaccinate self or children. Non-Hispanic Blacks and those with least schooling were also less likely to receive vaccine for themselves or people in their care.
Conclusions
Our study identified race/ethnicity, risk perceptions, exposure to different media for COVID-19 news, party identification and confidence in scientists as factors that would be affecting COVID-19 vaccine uptake. The good news is that these are addressable through strategic public health communications, but a lot of work remains to be done with some urgency.
Introduction: Since the end of 2020, the first officially approved vaccines against COVID-19 are available and vaccination roll out has started worldwide. As high vaccination rates are necessary to reach herd immunity and overcome the pandemic, it is important to identify sociodemographic characteristics that are associated with vaccination intention or hesitancy. The goal of our review was to analyze whether there are gender differences in the intention to get vaccinated against COVID-19.
Method: We conducted a systematic review and meta-analytical calculations to analyze gender differences in the COVID-19 vaccination intention. PubMed, Web of Science and PsycInfo were repeatedly searched between November 19th 2020 and January 7th 2021 for studies reporting absolute frequencies in COVID-19 vaccination intention separated by gender or statistical tests for gender differences. A quality appraisal was conducted and averaged odds ratios comparing vaccine intenders among men and women were computed via meta-analyses.
Results: Sixty studies were included in the review and data for 46 studies were available for meta-analytic computations. A majority (58.3%) of papers reported men to have higher intentions to get the COVID-19 vaccine. Meta-analytic calculations of 46 studies (n = 141 550) showed that significantly more men stated that they would get vaccinated, OR of 1.41 (95% CI: 1.28 to 1.55 respectively). Findings suggest that this effect is evident in several countries around the world and that the difference is bigger in samples of health care workers than in unspecified general population samples.
Conclusion: This systematic review and meta-analysis provides evidence that men are more willing to have the COVID-19 vaccine. The reasons for the lower vaccination intentions of women should be investigated and addressed. Heterogeneity of data and representativeness of samples have to be considered when interpreting the results.
Several coronavirus disease 2019 (COVID-19) vaccines are currently in human trials. In June 2020, we surveyed 13,426 people in 19 countries to determine potential acceptance rates and factors influencing acceptance of a COVID-19 vaccine. Of these, 71.5% of participants reported that they would be very or somewhat likely to take a COVID-19 vaccine, and 61.4% reported that they would accept their employer’s recommendation to do so. Differences in acceptance rates ranged from almost 90% (in China) to less than 55% (in Russia). Respondents reporting higher levels of trust in information from government sources were more likely to accept a vaccine and take their employer’s advice to do so.
Trust between governors and the governed is seen as essential to facilitating good governance. This claim has become a prominent contention during the coronavirus pandemic. The crisis also presents a unique test of key hypotheses in the trust literature. Moreover, understanding the dynamics of trust, how it facilitates and hinders policy responses, and also the likely effects of these responses on trust, are going to be fundamental questions in policy and trust research in the future. In this paper, we review the early literature on the coronavirus pandemic and political and social trust, summarise their findings, and highlight key challenges for future research. We show how the studies shed light on trust’s association with implementation of government measures, public compliance with them, mortality rates, and the effect of government action on levels of trust. We also urge caution given the varying ways of measuring trust and operationalising the impact of the pandemic, the existence of common issues with quantitative studies, and the relatively limited geographical scope of studies to date. We argue that it is going to be important to have a holistic understanding of these dynamics, using mixed-methods research as well as the quantitative studies we review here.
Rationale and Objective
It is well established that people who use complementary and alternative medicines (CAM) are, on the whole, more vaccine hesitant. One possible conclusion that can be drawn from this is that trusting CAM results in people becoming more vaccine hesitant. An alternative possibility is that vaccine hesitancy and use of CAM are both downstream consequences of a third factor: distrust in conventional treatments. We conducted analyses designed to disentangle these two possibilities.
Method
We measured vaccine hesitancy and CAM use in a representative sample of Spanish residents (N = 5200). We also measured their trust in three CAM interventions (acupuncture, reiki, homeopathy) and two conventional medical interventions (chemotherapy and antidepressants).
Results
Vaccine hesitancy was strongly associated with (dis)trust in conventional medicine, and this relationship was particularly strong among CAM users. In contrast, trust in CAM was a relatively weak predictor of vaccine hesitancy, and the relationship was equally weak regardless of whether or not participants themselves had a history of using CAM.
Conclusions
The implication for practitioners and policy makers is that CAM is not necessarily a major obstacle to people's willingness to vaccinate, and that the more proximal obstacle is people's mistrust of conventional treatments.
Europe is increasingly described as the region in the world with the least confidence in vaccination, and particularly in the safety of vaccines. The aim of this systematic literature review was to gather and summarise all peer-reviewed and grey literature published about determinants of Human Papillomavirus (HPV) vaccine hesitancy in Europe. Ten thematic categories were identified across the 103 articles which were included in the review. Participants from European studies most commonly reported issues with the quantity and quality of information available about HPV vaccination; followed by concerns about potential side effects of the vaccine; and mistrust of health authorities, healthcare workers, and new vaccines. Comparative analyses indicated that confidence determinants differed by country and population groups. This evidence supports the need to develop context-specific interventions to improve confidence in HPV vaccination and design community engagement strategies aiming to build public trust.
Contested reports associating the MMR vaccine with autism have resulted in diminished confidence and uptake of the vaccine in the UK. This postal survey of parent's decisions, attitudes and use of information about MMR immunisation was constructed from questions derived from in-depth qualitative work. The setting was a Primary Care Trust in northeast England (N=996). Both MMR-accepting and refusing parents were supportive of immunisation, yet the high level of concern about the safety of the vaccine expressed even by parents who had immunised their children is worrying in its implications for public confidence and trust in health care. The findings suggest that the ability of practitioners to provide effective professional advice about MMR vaccine could be undermined if a government were to directly promote the vaccine to parents. Practitioners should continue to provide parents with accurate information, while communicating respect for parents' intentions to protect their children's health.
In December 2002, the US Government implemented policy to immunize health workers, first responders, and military personnel against smallpox in preparation for a possible bioterrorist attack. Self-reported vaccination data are commonly used in epidemiologic research and may be used to determine vaccination status in a public health emergency. To establish a measure of reliability, the agreement between self-reported smallpox vaccination and electronic vaccination records was examined using data from the Millennium Cohort Study. Descriptive measures and a kappa statistic were calculated for data from 54,066 Millennium Cohort Study participants. Multivariable modeling adjusting for potential confounders was used to investigate vaccination agreement status and health metrics, as measured by the Short Form 36-Item Health Survey for Veterans (SF-36V) and hospitalization data. Substantial agreement (kappa =0.62) was found between self-report and electronic recording of smallpox vaccination. Of all participants with an electronic record of smallpox vaccination, 90% self-reported being vaccinated; and of all participants with no electronic record of vaccination, 82% self-reported not receiving a vaccination. There was no significant difference in hospitalization experience prior to questionnaire completion between vaccinated and unvaccinated participants. While overall scores on the SF-36V suggested a healthy population, participants whose self-reported vaccination status did not match electronic records had slightly lower adjusted mean scores for some scales. These results indicate strong reliability in self-reported smallpox vaccination and also suggest that discordant reporting of smallpox vaccination is not associated with substantial differences in health among Millennium Cohort participants.
Background
Mitigation of the COVID-19 pandemic requires continued uptake of SARS-CoV-2 vaccines. To increase vaccination intention and uptake, key determinants of primary and booster vaccination need to be understood and potential effects of vaccination policies examined.
Design
Using experimental data collected in Germany in February 2022 ( N = 2701), this study investigated 1) predictors of primary and booster vaccination and 2) potential effects of policies combining vaccination mandates and monetary incentives.
Results
Compared with unvaccinated participants, those with primary vaccination were less complacent, more often understood the collective protection afforded by vaccination, and less often endorsed conspiracy-based misinformation. Compared with participants with primary vaccination, boosted individuals were even less complacent, exhibited fewer conspiracy-based beliefs, perceived fewer constraints by prioritizing vaccination over other things, and more often favored compliance with official vaccination recommendations. Support for and reactance about vaccination mandates depended on vaccination status rather than policy characteristics, regardless of mandate type or incentives (up to 500 EUR). While unvaccinated individuals rejected policy provisions and declined vaccination, boosted individuals indicated mid-level support for mandates and showed high vaccination intention. Among vaccinated individuals, higher incentives of up to 2000 EUR had a considerable positive effect on the willingness to get boosted, especially in the absence of a mandate.
Conclusions
While mandates may be needed to increase primary vaccination, our results indicate that financial incentives could be an alternative to promote booster uptake. However, combining both measures for the same target group seems inadvisable in most cases.
Highlights
Unvaccinated individuals and people with primary and booster vaccinations differ on psychological dimensions, calling for tailored immunization campaigns. Vaccination intentions depend on vaccination status rather than on mandatory or incentivizing policies. Incentives are unlikely to persuade unvaccinated individuals but may increase booster uptake. Positive effects of incentives decrease when vaccination is mandatory, advising against combination.
Study goal
This study examines the sources of COVID-19 vaccine hesitancy and refusal in Americans by decomposing different forms of government trust/mistrust including trust in Trump and mistrust in public health institutions.
Methods
Using linear panel regression models with data from 5,446 US adults (37,761 responses) from the Understanding America Survey, the likelihoods of vaccine hesitancy, uptake, and trust in various information sources were examined.
Results and conclusion
We find that the likelihoods of hesitancy and having negative perceptions of COVID-19 vaccines were consistently much higher among PHI mistrusters, showing even a stronger hesitancy than Trump trusters. This tendency has persisted over time, resulting in only 49% of PHI mistrusters having been vaccinated in the most recent survey wave. However, a large portion of PHI mistrusters still trusted physicians, family, and friends. These findings suggest that mistrust in PHIs is a salient predictor of vaccine hesitancy and reduced uptake on its own, which is compounded by trust in Trump.
The pandemic has disrupted public health and social well-being for more than two years. With the vaccine efficacy waning over time and the spread of new variants, a booster becomes increasingly imperative. This study investigates predictors of the American public's COVID-19 booster intention. A national survey was conducted from September 23rd to October 31st, 2021, on a representative sample. The survey data is merged with state-level indicators of vaccination rate, case rate, political context, and economic recovery. Multilevel regression modeling is adopted for statistical estimation. Results show that a higher proportion of vaccinated people in the network is positively related to one's chance of getting the booster (β = 0.593, p = 0.000). In comparison, a higher proportion of infected people in the network is negatively related to one's intention to become boosted (β = −0.240, p = 0.039). Additionally, the higher educated (β = 0.080, p = 0.001) and older (β = 0.004, p = 0.013) were more likely to say they would get the booster than their counterparts. Meanwhile, the odds of people taking the COVID-19 booster decrease by 3.541 points (p = 0.002) for each unit increase in the case rate at the state level. This study articulates that individual intention to take the booster is a function of their personal characteristics and is also rooted in social networks. These findings contribute to the literature and have policy implications. Knowledge of the profiles among people who intend to take/refuse the booster provides essential information to leverage certain factors and maximize booster uptake to mitigate the pandemic's devastating impact.
A large group of people are receptive to COVID skeptic messages which can be linked to lower levels of perceived risk and uncompliant behavior. Using a survey instrument targeting young adults, which we repeated during the second and fourth waves of COVID-19, we explored how various psychological factors affect risk perception and to what degree can these be linked to COVID skepticism. Our results suggest that higher skepticism is very strongly associated with a lower risk perception. Skepticism also mediates the effects of well-known antecedents of risk perception, such as individualism, pro-social attitudes and trust in scientists. We found that contracting the virus is associated with increased risk perception and increased skepticism, which is contradictory, but understandable considering our sample composition. Among those who had a family member or a friend contracting the virus we observed higher levels of perceived risk and lower skepticism. The longitudinal nature of our research highlights that the influence of trust in scientists and government are dependent on the public discourse, which naturally develops over time. Differences in risk perception based on gender, which is well established in the literature and significant in our first sample, have diminished by the time of our second sample, suggesting this effect could be crowded out as people’s understanding grows and beliefs form about the virus. The findings emphasize the importance of assessing skepticism not only for researchers studying COVID related risk perception and its psychological predictors, but also for policy makers combating hazardous scenarios like the pandemic.
Background:
A rapid increase in coronavirus disease 2019 (Covid-19) cases due to the omicron (B.1.1.529) variant of severe acute respiratory syndrome coronavirus 2 in highly vaccinated populations has aroused concerns about the effectiveness of current vaccines.
Methods:
We used a test-negative case-control design to estimate vaccine effectiveness against symptomatic disease caused by the omicron and delta (B.1.617.2) variants in England. Vaccine effectiveness was calculated after primary immunization with two doses of BNT162b2 (Pfizer-BioNTech), ChAdOx1 nCoV-19 (AstraZeneca), or mRNA-1273 (Moderna) vaccine and after a booster dose of BNT162b2, ChAdOx1 nCoV-19, or mRNA-1273.
Results:
Between November 27, 2021, and January 12, 2022, a total of 886,774 eligible persons infected with the omicron variant, 204,154 eligible persons infected with the delta variant, and 1,572,621 eligible test-negative controls were identified. At all time points investigated and for all combinations of primary course and booster vaccines, vaccine effectiveness against symptomatic disease was higher for the delta variant than for the omicron variant. No effect against the omicron variant was noted from 20 weeks after two ChAdOx1 nCoV-19 doses, whereas vaccine effectiveness after two BNT162b2 doses was 65.5% (95% confidence interval [CI], 63.9 to 67.0) at 2 to 4 weeks, dropping to 8.8% (95% CI, 7.0 to 10.5) at 25 or more weeks. Among ChAdOx1 nCoV-19 primary course recipients, vaccine effectiveness increased to 62.4% (95% CI, 61.8 to 63.0) at 2 to 4 weeks after a BNT162b2 booster before decreasing to 39.6% (95% CI, 38.0 to 41.1) at 10 or more weeks. Among BNT162b2 primary course recipients, vaccine effectiveness increased to 67.2% (95% CI, 66.5 to 67.8) at 2 to 4 weeks after a BNT162b2 booster before declining to 45.7% (95% CI, 44.7 to 46.7) at 10 or more weeks. Vaccine effectiveness after a ChAdOx1 nCoV-19 primary course increased to 70.1% (95% CI, 69.5 to 70.7) at 2 to 4 weeks after an mRNA-1273 booster and decreased to 60.9% (95% CI, 59.7 to 62.1) at 5 to 9 weeks. After a BNT162b2 primary course, the mRNA-1273 booster increased vaccine effectiveness to 73.9% (95% CI, 73.1 to 74.6) at 2 to 4 weeks; vaccine effectiveness fell to 64.4% (95% CI, 62.6 to 66.1) at 5 to 9 weeks.
Conclusions:
Primary immunization with two doses of ChAdOx1 nCoV-19 or BNT162b2 vaccine provided limited protection against symptomatic disease caused by the omicron variant. A BNT162b2 or mRNA-1273 booster after either the ChAdOx1 nCoV-19 or BNT162b2 primary course substantially increased protection, but that protection waned over time. (Funded by the U.K. Health Security Agency.).
This paper provides a consolidated overview of public and healthcare professionals' attitudes towards vaccination in Europe by bringing together for the first time evidence across various vaccines, countries and populations. The paper relies on an extensive review of empirical literature published in English after 2009, as well as an analysis of unpublished market research data from member companies of Vaccines Europe. Our synthesis suggests that hesitant attitudes to vaccination are prevalent and may be increasing since the influenza pandemic of 2009. We define hesitancy as an expression of concern or doubt about the value or safety of vaccination. This means that hesitant attitudes are not confined only to those who refuse vaccination or those who encourage others to refuse vaccination. For many people, vaccination attitudes are shaped not just by healthcare professionals but also by an array of other information sources, including online and social media sources. We find that healthcare professionals report increasing challenges to building a trustful relationship with patients, through which they might otherwise allay concerns and reassure hesitant patients. We also find a range of reasons for vaccination attitudes, only some of which can be characterised as being related to lack of awareness or misinformation. Reasons that relate to issues of mistrust are cited more commonly in the literature than reasons that relate to information deficit. The importance of trust in the institutions involved with vaccination is discussed in terms of implications for researchers and policy-makers; we suggest that rebuilding this trust is a multi-stakeholder problem requiring a co-ordinated strategy.
We evaluated influenza vaccination status as determined by self-report and a regional, real-time immunization registry during two influenza seasons when subjects were enrolled in a study to estimate vaccine effectiveness. We enrolled 2907 patients during the two consecutive seasons. The sensitivity and specificity of self-reported influenza vaccination when compared to immunization registry records were 95% and 90%, respectively. The positive predictive value of self-reported vaccination was 89% and negative predictive value was 96%. In our study population, self-reported influenza vaccine status was a sensitive and fairly specific indicator of actual vaccine status. Misclassification was more common among young children.
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