Abstract

A shortage of COVID-19 vaccines and reports of side-effects led several countries to recommend a heterologous regimen for second vaccine doses. This study aimed to describe the reasons behind individuals’ choices of a homologous or a heterologous second vaccination. This cross-sectional study enrolled individuals under 60 who had received a first dose of Vaxzevria and could choose between a homologous or heterologous regimen for their second dose. Quantitative (socio-demographic, clinical characteristics) and qualitative data were collected and analysed through a generalized linear model and thematic analysis, respectively. Of the 1437 individuals included in the analysis, the majority (76.1%) chose a heterologous second dose of the COVID-19 vaccination. More females chose a heterologous vaccination regimen (p = 0.003). Younger individuals also tended to choose heterologous vaccination (p < 0.001). The main motivation in favour of heterologous vaccination was to follow the Italian Ministry of Health recommendations (n = 118; 53.9%). This study showed that most individuals, mainly younger people and females, chose a heterologous dose of COVID-19 vaccination after their first viral vector vaccine. Heterologous vaccinations could be an effective public health measure to control the pandemic as they are a safe and efficient alternative to homologous regimens.

Highlights

  • Since the first months of 2020, the coronavirus disease 2019 (COVID-19) pandemic impacted the entire world severely

  • Out of the 1602 individuals aged

  • Of the 1437 individuals included in the analysis, the majority (76.1%) chose a heterologous COVID-19 vaccination regimen

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Summary

Introduction

Since the first months of 2020, the coronavirus disease 2019 (COVID-19) pandemic impacted the entire world severely. Many countries are still struggling with this global emergency [1]. Non-pharmaceutical interventions, such as social distancing, wearing personal protective equipment [2], quarantine, isolation, and lockdown measures have been at the forefront of outbreak control [3]. These measures were quickly strengthened, the outbreak continued to increase, causing severe consequences that negatively affected socio-economic activity [4] and health-related outcomes [5]. Despite all efforts made to limit virus transmission, active immunisation against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by vaccination is currently the cornerstone of global healthcare policies against COVID-19 [6].

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