COVID-19 vaccine hesitancy among health care worker-parents (HCWP) in Puducherry, India and its implications on their children: A cross sectional descriptive study

<h3>Context:</h3> Mass vaccination serves as a potential solution to combat the Coronavirus disease 2019 (COVID-19) pandemic, with vaccine hesitancy being a recognized impediment. Collection of data defining the characteristics of healthcare worker (HCW) attitudes towards the vaccine can provide insight into vaccine hesitancy. <h3>Objective:</h3> To determine HCWs’ attitudes regarding the COVID-19 vaccination and reasons for vaccine hesitancy. <h3>Study Design and Analysis:</h3> This cross-sectional study surveyed the attitudes of HCWs in Michigan using three-point agree/disagree scale questions. t-test and analysis of variance were used to measure HCWs’ attitudes towards the COVID-19 virus and vaccines. <h3>Population studied:</h3> 120 HCWs from Isabella, Saginaw, Sanilac, and Wayne counties in Michigan. <h3>Results:</h3> Most HCWs received (95.9%) and recommended (98.3%) the COVID-19 vaccine. The top three factors that HCWs cited for recommending a COVID-19 vaccine to a patient are: 1) Efficacy of the vaccine, 2) Current exposure to patients with active COVID-19 infection and risk of virus spread, and 3) Safety of vaccine and long-term follow-up. Being a female HCW (P=0.01) or being a HCW outside of the 55–64 years age range (P=0.036) was associated with increased concern of contracting COVID-19. Regarding the COVID-19 vaccines, our data demonstrated that: 1) HCWs who specialized in family medicine (P=0.028) were more likely to agree that there was adequate testing compared to those who did not specialize in family medicine; 2) White HCWs (P=0.024) were less concerned with the speed of development compared to non-white HCWs; 3) Of all age groups, HCWs aged 55-64 years (P=0.02) were the least concerned about side effects 4) Of all provider types, physicians (P=0.017) were the least concerned about long-term effects. <h3>Conclusion:</h3> Gender, age, ethnicity, provider type, and medical specialty showed statistically significant differences among attitudes towards the COVID-19 virus and vaccines. Vaccine hesitancy among HCWs can have negative effects on their patients. Focusing educational efforts on HCW demographics who are more likely to have negative attitudes can potentially decrease vaccine hesitancy.

Defining the characteristics of healthcare worker (HCW) attitudes toward the coronavirus disease 2019 (COVID-19) vaccine can provide insights into vaccine hesitancy. This study's goal is to determine HCWs' attitudes regarding the COVID-19 vaccination and reasons for vaccine hesitancy. This cross-sectional study surveyed HCWs working in institutions in Saginaw, Sanilac, and Wayne counties in Michigan (N = 120) using tipping-scale questions. Analysis of variance and t-test were used to measure HCWs' attitudes toward the COVID-19 virus and vaccines. Most HCWs received (95.9%) and recommended (98.3%) a COVID-19 vaccine. The top three factors that HCWs cited for recommending a COVID-19 vaccine were: (1) efficacy of the vaccine, (2) current exposure to patients with active COVID-19 infection and risk of virus spread, and (3) safety of vaccine and long-term follow-up. Female HCWs or HCWs aged 25-54 years were more concerned about contracting COVID-19. Physicians or HCWs aged 55-64 were less concerned regarding the effectiveness and side effects of the vaccine. Gender, age, ethnicity, provider type, and medical specialty showed statistically significant differences among COVID-19 attitudes. Focusing educational efforts on HCW demographics who are more likely to have negative attitudes can potentially decrease vaccine hesitancy.

Engaging Nursing Assistants to Enhance Receptivity to the Coronavirus Disease 2019 Vaccine

COVID-19 vaccine hesitancy and media channel use in Japan: could media campaigns be a possible solution?

As of March 2022, the COVID-19 vaccination rate in Chad approximated 1%. There are no published reports of COVID-19 vaccine hesitancy or beliefs in Chad. We aimed to study COVID-19 vaccine acceptance and hesitancy among community members, patients, and health care workers in urban Chad. We recruited a prospective convenience sample of adult patients, community members, and healthcare workers from N'Djamena, Chad between August-October 2021. Participants completed a 15-minute, 25-question survey instrument exploring demographic, social, and clinical variables related to COVID-19 and an adapted WHO SAGE Vaccine Hesitancy Survey. Primary outcomes were vaccine acceptance and vaccine hesitancy. Regression models were fit to assess associations between Vaccine Hesitancy Scale (VHS) scores, ranging from 10 (least hesitant) to 50 (most hesitant) points, and pre-selected variables of interest. An inductive thematic analysis was used to analyze the qualitative vaccine hesitancy responses. Of 508 participants (32% female; mean age 32 years), 162 were patients, 153 were community members, and 193 were healthcare workers. COVID-19 vaccine acceptance was significantly higher among patients (67%) than community members (44%) or healthcare workers (47%), p < .001. The average VHS score was 29 points (patients = 27.0, community members = 28.9, healthcare workers = 29.4), and more than one-third of participants were classified as highly vaccine hesitant (score >30 points). Knowing someone who died from COVID-19, believing local healthcare workers support vaccination, trusting the government, having a higher socioeconomic status (i.e. having electricity), and reporting medical comorbidities were each associated with less vaccine hesitancy (all p < .05). The vaccine concerns most frequently endorsed were: vaccine side effects (48%), efficacy (38%), safety (34%), concerns about the pharmaceutical industry (27%), and lack of government trust (21%). Four main themes arose from qualitative vaccine hesitancy responses (n = 116): education, trust, clinical concerns, and misinformation and false beliefs. Overall, COVID-19 vaccine acceptance was low, including among health care workers, and reasons for vaccine hesitancy were broad. We detail the most commonly reported concerns of urban Chadians for receiving the COVID-19 vaccine; we also identify subgroups most likely to endorse vaccine hesitancy. These analyses may inform future vaccination outreach campaigns in N'Djamena.

COVID-19 vaccine perceptions and hesitancy amongst parents of school-aged children during the pediatric vaccine rollout

The coronavirus disease 2019 (COVID-19) pandemic has created a national and global crisis. The United States has invested tremendous effort and resources to fast track severe acute respiratory syndrome coronavirus 2 vaccines from conception to market in 1 year, an amazing scientific achievement. Public health experts are now leading the distribution of COVID-19 vaccines. The Centers for Disease Control and Prevention (CDC) recommends that health care personnel be offered COVID-19 vaccination during the early phases of distribution. Health care personnel are broadly defined and include emergency medical service personnel, nurses and nursing assistants, physicians, technicians, therapists, dentists, dental hygienists and assistants, phlebotomists, pharmacists, students and trainees, contractual staff, dietary and food services staff, environmental services staff, and administrative staff. We strongly recommend that parents and family caregivers (collectively referred to as parents in this article) of children with medical complexity (CMC) be included in the early phases of vaccine distribution because they serve as essential frontline health care personnel.CMC have significant chronic health conditions that involve multiple organ systems, substantial health service needs, major functional limitations, and high health resource use. They have high levels of medical fragility, technology dependencies (tracheostomies, ventilators, feeding tubes, intrathecal baclofen infusion systems, and others), and psychosocial complexities. We identify CMC as those who have ≥3 organ systems affected (≥3 Feudtner chronic complex conditions), technology dependencies, and complex developmental disabilities.1 With delicately intertwined services from health and community programs, many parents care for their CMC at home. Without these parents, CMC would reside in care centers, hospitals, and ICUs. Thus, parents of CMC are essential health care personnel.CDC guidelines ask that all persons who test positive for COVID-19 be quarantined. Home care nurses who have prolonged close contact with COVID-19–positive CMC and families without full personal protective equipment are excluded from work.2 Long-term care centers are reticent to offer respite care for CMC that have been exposed to COVID-19. Community-based respite providers are in short supply. Who will care for CMC if their parents are unable to do so? Parents of CMC work without reserve. When they test positive for COVID-19, parents have little recourse but to render uninterrupted care for their CMC. Parents risk their own well-being for that of their CMC. It is our duty to mitigate their risk through vaccination.Parents of CMC perform as licensed health care personnel. They function as nurses in managing life-sustaining technologies and administering medications and as certified nursing assistants in caring for their children with disabilities. State Medicaid plans vary in how they implement options of home and community-based services to support care for persons with disabilities in their own homes.3 Some states recognize parents of CMC as formally employed certified nursing assistants, yet other states do not. Thus, some but not all parents of CMC are eligible for phase 1a COVID-19 vaccination. This inequity demands correction. The COVID-19 vaccine should be offered during early phases of distribution to all parents of CMC.More than 2.9 million US children have been infected with COVID-19.4 By vaccinating parents of CMC against COVID-19, we add a layer of protection for CMC and their parents while proceeding with pediatric vaccine development and cocooning our most medically fragile and complex pediatric population. As a vaccination strategy, cocooning can protect susceptible persons from infection by administering vaccines to those around them. It is an applicable strategy in hospitals, ambulatory care settings, and communities.5 Immunizing parents of CMC tightens the cocoon of their own homes.The CDC, with input from an independent panel of medical and public health experts on the Advisory Committee on Immunization Practices, has offered national recommendations on the distribution of COVID-19 vaccinations.6 The recommendations target 3 key goals: (1) to decrease death and serious disease as much as possible; (2) to preserve functioning of society; and (3) to reduce the extra burden COVID-19 is having on people already facing disparities.6 Additionally, recommendations uphold 4 ethical principles of vaccine distribution during initial phases of limited supply, including maximal benefit with minimal harm, justice, health care equity, and transparency.7 Aligning with these 3 core goals and 4 ethical principles, the CDC recommends that initial supplies of COVID-19 vaccine be allocated to health care personnel. We strongly recommend that parents of CMC be included in the early phases of vaccine distribution for health care personnel, thereby reducing the extra burden that families of CMC are experiencing related to COVID-19 and upholding ethical principles of beneficence, nonmaleficence, justice, and autonomy.CMC represent <1% of all US children, yet account for an estimated 30% of total pediatric health care costs, 56% of hospitalized patients, 82% of hospital days, and 86% of hospital charges in US children’s hospitals.1 They have the highest levels of medical fragility and intensive health care needs that drive them in and out of inpatient settings, particularly ICUs. These cost estimates do not include the cost of parents as (unemployed) health care providers for CMC. Parents of CMC prioritize the needs of their children over their own health and personal needs and often describe financial and social hardships.1 These hardships are at risk for escalation during the COVID-19 pandemic as families balance the complex medical and functional needs of their CMC with competing family and personal needs. COVID-19 has great potential to be a breaking point, and COVID-19 vaccination a promising tipping point.We commend the CDC for its rapid dissemination of guidelines for the distribution of COVID-19 vaccines and the strong collaborations of national and state leaders in this massive effort. We call for federal and state partners to recognize parents of CMC as essential, frontline health care personnel. We must offer COVID-19 vaccine during early phases of distribution to these parents. Identifying CMC for this intervention could be modeled after established processes of identifying children for palivizumab therapy for the prevention of severe respiratory syncytial virus infections, with pediatric providers supplying documentation of medical necessity on the basis of established complexity criteria. To guide busy pediatric providers in quickly identifying the CMC and their families, practices might begin with those children who are eligible for state Medicaid complexity and disability or technology waivers and those with home nursing services. Medical Homes can collaborate with families of CMC, family advocacy groups (Family Voices), generalist and subspecialist health care providers, educators, home nursing agencies, and public health programs to put policies into practice. This small change would affect <1% of US children and their families, yet it promises to have great impact.The COVID-19 pandemic and vaccine distribution heighten our national awareness of inequities in our health care system. Parents of CMC are among the most essential and least recognized group of health care providers, easily taken for granted because they cannot and will not demand sick time, vacation days, salaries or benefits; resignation and retirement are not options. We are called to address state-by-state variations in respite care, financial supports and waivers, educational and vocational services, and community-based programs that support the participation and inclusion of all persons across the life span. COVID-19 vaccination for parents of CMC is a simple next step along this continuum of supporting and sustaining family caregivers on whom our health care system depends.

Vaccination

Updated International Society of Geriatric Oncology COVID-19 working group recommendations on COVID-19 vaccination among older adults with cancer

COVID-19 and influenza vaccine hesitancy among college students

COVID-19 vaccines in pregnancy.

BackgroundCoronavirus disease (COVID-19) is an infectious disease caused by the severe acute respiratory syndrome coronavirus-2 and is believed to be transmitted through respiratory droplets and contacts. Currently, although there are approved COVID-19 treatments, vaccines have been developed against the disease. Vaccine apathy, however, can limit the success of vaccination. ObjectiveThe study investigated the knowledge of COVID-19 and apathetic behavior (hesitancy) towards vaccination among the mixed professional population of sub-urban dwellers in three senatorial districts of Benue State, A state, located in central Nigeria, and is known for its agricultural richness and diverse ethnic groups, including the Tiv, Idoma, and Igede. Like most states in Nigeria, it faces significant healthcare access challenges. MethodsThe research was a cross-sectional study involving self-administered structured questionnaire of 52 questions which were validated and included sections on demographic information, COVID-19 vaccination status, reasons for vaccine acceptance or hesitancy, and preferences for different types of COVID-19 vaccines. The data generated was subjected to descriptive statistics and Chi-square. Statistical significance was placed at p < 0.05. ResultA total of 500 questionnaires were administered; however 336 respondents representing 67.2% returned questionnaires. There was no statistical difference (p < 0.05) between health workers (55.4%) and non-health workers (44.6%). There exists an association between study sites, profession, and educational qualification, with knowledge of COVID-19 and accent to vaccination. A significant (p < 0.05) 76.2% acknowledge the existence and infectivity of COVID-19. Interestingly, 39.6% and 47.3% of the study population sanctioned social distancing and hand hygiene as COVID-19 preventive measures. Although 73.0% show knowledge of various COVID-19 vaccines and profess vaccination as a protective measure, however, 65.7% were unsure whether vaccination protects against the disease. Side effects from previous immunization and perceived inadequate knowledge of managing vaccination adverse effects were among the reasons for vaccine hesitancy. ConclusionVaccination and preventive measures are top priorities in diseases with no approved treatment. An urgent increase in the level of advocacy and awareness of the disease is needed because of high vaccine hesitancy among health workers that constitute a significant proportion of the study population.

Background Coronavirus disease 2019 (COVID-19) vaccine hesitancy or refusal has arisen as a major global public health concern. The aim of this study was to address the attitudes of patients with autoimmune and autoinflammatory rheumatological diseases (AIIRDs) about COVID-19 vaccination and investigate the factors that influence their decision. Methods This interview-based cross-sectional study was carried out on AIIRD patients at the period between 15 August and 15 September 2021. The questionnaire included socioeconomic data, intention to receive COVID-19 vaccine, AIIRD subtype, disease duration, associated comorbidities, history of COVID-19, beliefs and attitudes towards COVID-19, and conventional vaccination in general and COVID-19 vaccine in particular, in addition to COVID-19 vaccination status. Results A total of 206 AIIRD patients were included, with a mean age of 37.61 years (SD = 10.67), and 84% were females. The percentage of vaccine acceptance was 70.39%, while only 16.02% were hesitant and 13.59% were resistant to COVID-19 vaccination. About one-fourth of patients reported getting infected with COVID-19. Of them, 15.1% were hospitalized and 5.7% were admitted at the intensive care unit (ICU). Most of the AIIRD patients (77.2%) believed that they are at a higher risk of getting COVID-19. The main motivation for vaccine acceptance was the fear of being infected (41.4%). About 40% of vaccine nonacceptants fear about the serious side effects of COVID-19 vaccine. Conclusion There is a high acceptability rate of COVID-19 vaccination among AIIRD patients. Public health workers and policymakers must emphasize efficient COVID-19 vaccine acceptance messaging for all AIIRD patients.

Data on US caregiver perceptions on coronavirus disease 2019 (COVID-19) and COVID-19 vaccination are limited. We identified trends in and associations with COVID-19 vaccine hesitancy in caregivers of hospitalized children. Cross-sectional surveys on pediatric COVID-19 disease and vaccine attitudes, behaviors, and beliefs were administered across study years (December 8, 2020-April 5, 2021, November 30, 2021-March 15, 2022, and October 26, 2022-March 15, 2023). English and Spanish-speaking caregivers of hospitalized children ages 6 months to 11 years were included. General vaccine hesitancy was assessed using the Parent Attitudes about Childhood Vaccines survey. Of 1268 caregivers from diverse backgrounds, one-third vaccinated or intended to vaccinate their child. Half endorsed fear of their child receiving the COVID-19 vaccine and were concerned the vaccine was new. Over time, more believed "the COVID-19 vaccine does not work" and fewer agreed "children who are otherwise healthy can die from COVID-19." Study season (2022-2023), older child age, higher income, child receipt of influenza vaccine, caregiver receipt of COVID-19 vaccine, and not being worried about vaccine novelty were positively associated with child vaccination. Intent to vaccinate was negatively associated with study season (2022-2023), Parent Attitudes about Childhood Vaccines score ≥50, lack of child influenza and caregiver COVID-19 vaccination, lack of fear of their child "getting COVID-19" and being "worried that the COVID-19 vaccine is new." The majority who intended to vaccinate were willing to immunize before discharge. Vaccine novelty and perceived lack of need were associated with refusal. Caregiver COVID-19 and child influenza vaccine acceptance were positively associated with COVID-19 vaccine acceptance. The inpatient setting offers the opportunity to improve vaccine uptake.

Should women undergoing in vitro fertilization treatment or who are in the first trimester of pregnancy be vaccinated immediately against COVID-19