Correlates of COVID-19 Vaccine Acceptance, Hesitancy and Refusal among Employees of a Safety Net California County Health System with an Early and Aggressive Vaccination Program: Results from a Cross-Sectional Survey.
TL;DR: In this paper, an anonymous internet-based cross-sectional survey with direct solicitation among employees of a safety net health system was developed and implemented, where items queried demographic and health-related characteristics, experience with and knowledge of COVID-19, and determinants of decisions to vaccinate.
About: This article is published in Vaccine.The article was published on 2021-10-09 and is currently open access. It has received 15 citations till now. The article focuses on the topics: Health care.
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TL;DR: In this article , a systematic review aims to clarify vaccine hesitancy by analysing how it is operationalized, and proposes that VH should be defined as a state of indecisiveness regarding a vaccination decision.
Abstract: Vaccine hesitancy (VH) is considered a top-10 global health threat. The concept of VH has been described and applied inconsistently. This systematic review aims to clarify VH by analysing how it is operationalized. We searched PubMed, Embase and PsycINFO databases on 14 January 2022. We selected 422 studies containing operationalizations of VH for inclusion. One limitation is that studies of lower quality were not excluded. Our qualitative analysis reveals that VH is conceptualized as involving (1) cognitions or affect, (2) behaviour and (3) decision making. A wide variety of methods have been used to measure VH. Our findings indicate the varied and confusing use of the term VH, leading to an impracticable concept. We propose that VH should be defined as a state of indecisiveness regarding a vaccination decision.
26 citations
TL;DR: It is important to understand what drives health professionals to refuse getting vaccinated against COVID‐19, who have been in the frontline of this pandemic since its beginning and may be key actors to improve vaccine coverage among their patients.
Abstract: To contain the COVID‐19 pandemic, higher vaccination rates are essential. However, as vaccine hesitancy is a reality, it is important to understand what drives health professionals to refuse getting vaccinated against COVID‐19, who have been in the frontline of this pandemic since its beginning and may be key actors to improve vaccine coverage among their patients.
8 citations
TL;DR: In this paper , an anonymous questionnaire on the willingness of receiving Covid-19 vaccination was submitted to a sample of HWCs in the Dohuk Governorate, Iraqi Kurdistan Region.
Abstract: To investigate Covid-19 vaccine hesitancy among Iraqi healthcare workers-HCWs.Cross-sectional survey.In February 2021, an anonymous questionnaire on the willingness of receiving Covid-19 vaccination was submitted to a sample of HWCs in the Dohuk Governorate, Iraqi Kurdistan Region. Overall, 1704 questionnaires were analysed by means of univariate and multivariate statistics.The sample included 978 males and 726 females (Mean age: 36.9 ± 10.1), working in Primary Health Centres (65.8%) or in Public Hospitals (34.2%). Professions ranged from being physician/paramedics (39.3%) to administrative/laboratory staff (31.7%); 17.0% had attended up to secondary school, the rest had a higher education. Considering health conditions, 1.8% reported a poor health status and 11.5% a chronic disease.Overall, 475 people (27.9%) reported Covid-19 vaccine hesitancy, with fear of side-effects (41.4%) and lack of confidence in using the vaccine (23.5%) being the most common perceived barriers. Midwifes (61.1%) and assistant nurses (45.5%) were the most hesitant; physicians the less (12.3%). According to a binary logistic model, holding lower educational level (adjOR = 2.158; 95% CI:1.654-2.815), being female (adjOR = 1.622; 95% CI:1.289-2.040), having pre-existing chronic disease (adjOR = 1.954; 95% CI:1.280-2.983), and self-perceiving a poor health status (adjOR = 3.673; 95% CI:1.610-8.379) were independent predictors of higher odds of hesitancy.Covid-19 vaccine hesitancy among HCWs represents an important public health concern, since they play a paramount role for a successful vaccination campaign within the community. Our results show the need in Iraq to implement educational interventions for strengthening the confidence of HWCs towards the Covid-19 vaccine, therefore positively influencing the general public's attitude.
7 citations
TL;DR: In this paper , the authors conducted a statewide cross-sectional survey among 603 licensed nurses working in direct patient care to assess the vaccine attitudes and COVID-19 vaccine intent of California's registered nurses.
6 citations
TL;DR: In this paper , a review aimed to analyze HCWs' and public health professionals' sentiments toward COVID-19 vaccination and determinants across different countries, finding that older age, male gender, medical profession, higher education level, presence of comorbidities, and previous influenza vaccination were associated with vaccine acceptance.
Abstract: Vaccinations of healthcare workers (HCWs) aim to directly protect them from occupational diseases, and indirectly protect their patients and communities. However, studies increasingly highlight that HCWs can be vaccine hesitant. This review aims to analyze HCWs’ and public health professionals’ sentiments toward COVID-19 (Coronavirus Disease 2019) vaccination and determinants across different countries. A search strategy was conducted in PubMed using keywords such as “COVID-19”, “sentiment/acceptance”, “healthcare workers”, “vaccine hesitancy”, and “influenza”. A total of 56 articles were selected for in-depth analyses. The highest COVID-19 vaccination uptake was found in an Italian study (98.9%), and the lowest in Cyprus (30%). Older age, male gender, the medical profession, higher education level, presence of comorbidities, and previous influenza vaccination were associated with vaccine acceptance. Factors for low acceptance were perceived side effects of the vaccine, perceived lack of effectiveness and efficacy, and lack of information and knowledge. Factors for acceptance were knowledge, confidence in the vaccine, government, and health authorities, and increased perception of fear and susceptibility. All studies focused on healthcare providers; no studies focusing on public health professionals’ sentiments could be found, indicating a gap in research that needs to be addressed. Interventions must be implemented with vaccination campaigns to improve COVID-19 vaccine acceptance.
4 citations
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TL;DR: A range of clinical factors associated with COVID-19-related death is quantified in one of the largest cohort studies on this topic so far and includes people of white ethnicity, Black and South Asian people were at higher risk, even after adjustment for other factors.
Abstract: Coronavirus disease 2019 (COVID-19) has rapidly affected mortality worldwide1. There is unprecedented urgency to understand who is most at risk of severe outcomes, and this requires new approaches for the timely analysis of large datasets. Working on behalf of NHS England, we created OpenSAFELY-a secure health analytics platform that covers 40% of all patients in England and holds patient data within the existing data centre of a major vendor of primary care electronic health records. Here we used OpenSAFELY to examine factors associated with COVID-19-related death. Primary care records of 17,278,392 adults were pseudonymously linked to 10,926 COVID-19-related deaths. COVID-19-related death was associated with: being male (hazard ratio (HR) 1.59 (95% confidence interval 1.53-1.65)); greater age and deprivation (both with a strong gradient); diabetes; severe asthma; and various other medical conditions. Compared with people of white ethnicity, Black and South Asian people were at higher risk, even after adjustment for other factors (HR 1.48 (1.29-1.69) and 1.45 (1.32-1.58), respectively). We have quantified a range of clinical factors associated with COVID-19-related death in one of the largest cohort studies on this topic so far. More patient records are rapidly being added to OpenSAFELY, we will update and extend our results regularly.
4,263 citations
TL;DR: The results show a variety of factors as being associated with vaccine hesitancy but they do not allow for a complete classification and confirmation of their independent and relative strength of influence.
1,416 citations
TL;DR: This national survey explores factors associated with vaccine hesitancy and suggests that multipronged efforts will be needed to increase acceptance of a coronavirus disease 2019 vaccine.
Abstract: Background Coronavirus disease 2019 (COVID-19) has rapidly instigated a global pandemic. Vaccine development is proceeding at an unprecedented pace. Once available, it will be important to maximize vaccine uptake and coverage. Objective To assess intent to be vaccinated against COVID-19 among a representative sample of adults in the United States and identify predictors of and reasons for vaccine hesitancy. Design Cross-sectional survey, fielded from 16 through 20 April 2020. Setting Representative sample of adults residing in the United States. Participants Approximately 1000 adults drawn from the AmeriSpeak probability-based research panel, covering approximately 97% of the U.S. household population. Measurements Intent to be vaccinated against COVID-19 was measured with the question, "When a vaccine for the coronavirus becomes available, will you get vaccinated?" Response options were "yes," "no," and "not sure." Participants who responded "no" or "not sure" were asked to provide a reason. Results A total of 991 AmeriSpeak panel members responded. Overall, 57.6% of participants (n = 571) intended to be vaccinated, 31.6% (n = 313) were not sure, and 10.8% (n = 107) did not intend to be vaccinated. Factors independently associated with vaccine hesitancy (a response of "no" or "not sure") included younger age, Black race, lower educational attainment, and not having received the influenza vaccine in the prior year. Reasons for vaccine hesitancy included vaccine-specific concerns, a need for more information, antivaccine attitudes or beliefs, and a lack of trust. Limitations Participants' intent to be vaccinated was explored before a vaccine was available and when the pandemic was affecting a narrower swath of the United States. Questions about specific information or factors that might increase vaccination acceptance were not included. The survey response rate was 16.1%. Conclusion This national survey, conducted during the coronavirus pandemic, revealed that approximately 3 in 10 adults were not sure they would accept vaccination and 1 in 10 did not intend to be vaccinated against COVID-19. Targeted and multipronged efforts will be needed to increase acceptance of a COVID-19 vaccine when one becomes available. Primary funding source Agency for Healthcare Research and Quality.
895 citations
TL;DR: Many adults are willing to get a COVID-19 vaccine, though acceptability should be monitored as vaccine development continues.
791 citations
TL;DR: Many different psychological, contextual, sociodemographic and physical barriers that are specific to certain risk groups were identified and map knowledge gaps in understanding influenza vaccine hesitancy to derive directions for further research and inform interventions in this area.
Abstract: Background Influenza vaccine hesitancy is a significant threat to global efforts to reduce the burden of seasonal and pandemic influenza. Potential barriers of influenza vaccination need to be identified to inform interventions to raise awareness, influenza vaccine acceptance and uptake. Objective This review aims to (1) identify relevant studies and extract individual barriers of seasonal and pandemic influenza vaccination for risk groups and the general public; and (2) map knowledge gaps in understanding influenza vaccine hesitancy to derive directions for further research and inform interventions in this area. Methods Thirteen databases covering the areas of Medicine, Bioscience, Psychology, Sociology and Public Health were searched for peer-reviewed articles published between the years 2005 and 2016. Following the PRISMA approach, 470 articles were selected and analyzed for significant barriers to influenza vaccine uptake or intention. The barriers for different risk groups and flu types were clustered according to a conceptual framework based on the Theory of Planned Behavior and discussed using the 4C model of reasons for non-vaccination. Results Most studies were conducted in the American and European region. Health care personnel (HCP) and the general public were the most studied populations, while parental decisions for children at high risk were under-represented. This study also identifies understudied concepts. A lack of confidence, inconvenience, calculation and complacency were identified to different extents as barriers to influenza vaccine uptake in risk groups. Conclusion Many different psychological, contextual, sociodemographic and physical barriers that are specific to certain risk groups were identified. While most sociodemographic and physical variables may be significantly related to influenza vaccine hesitancy, they cannot be used to explain its emergence or intensity. Psychological determinants were meaningfully related to uptake and should therefore be measured in a valid and comparable way. A compendium of measurements for future use is suggested as supporting information.
738 citations