Exploring perceptions of vaccine safety: an Italian national survey on different COVID-19 vaccine formulations.

Predictors of confidence and trust in government and institutions during the COVID-19 response in Australia

Background:Vaccine hesitancy can limit the benefits of available vaccines in halting the spread of COVID-19 pandemic. Previously published studies paid little attention to Arab countries, which has a population of over 440 million. In this study, we present the results of the first large-scale multinational study that measures vaccine hesitancy among Arab-speaking subjects.Methods:An online survey in Arabic was conducted from 14 January 2021 to 29 January 2021. It consisted of 17 questions capturing demographic data, acceptance of COVID-19 vaccine, attitudes toward the need for COVID-19 vaccination and associated health policies, and reasons for vaccination hesitancy. R software v.4.0.2 was used for data analysis and visualization.Results:The survey recruited 36,220 eligible participants (61.1% males, 38.9% females, mean age 32.6 ± 10.8 years) from all the 23 Arab countries and territories (83.4%) and 122 other countries (16.6%). Our analysis shows a significant rate of vaccine hesitancy among Arabs in and outside the Arab region (83% and 81%, respectively). The most cited reasons for hesitancy are concerns about side effects and distrust in health care policies, vaccine expedited production, published studies and vaccine producing companies. We also found that female participants, those who are 30–59 years old, those with no chronic diseases, those with lower level of academic education, and those who do not know the type of vaccine authorized in their countries are more hesitant to receive COVID-19 vaccination. On the other hand, participants who regularly receive the influenza vaccine, health care workers, and those from countries with higher rates of COVID-19 infections showed more vaccination willingness. Interactive representation of our results is posted on our project website at https://mainapp.shinyapps.io/CVHAA.Conclusions:Our results show higher vaccine hesitancy and refusal among Arab subjects, related mainly to distrust and concerns about side effects. Health authorities and Arab scientific community have to transparently address these concerns to improve vaccine acceptance.Funding:This study received no funding.

Background: COVID-19 is a global pandemic and vaccination efforts may be impeded by vaccine hesitancy. The present study examined willingness to receive a COVID-19 vaccine, the associated reasons for willingness/unwillingness, and vaccine safety perceptions in a cross-sectional assessment of community adults in Ontario.Methods: One thousand three hundred sixty seven individuals (60.6% female, mean age = 37.5%) participated in this study between January 15, 2021 and February 15, 2021. Perceptions of vaccine safety and reasons for willingness/unwillingness to receive the COVID-19 vaccine were investigated using an online assessment. Perceptions were investigated in general and by age, sex and education using analysis of variance.Results: Overall, 82.8% of the sample reported they were willing to receive a COVID-19 vaccine and 17.2% reported they were unwilling. The three most common reasons for unwillingness were long-term side effects (65.5%), immediate side effects (60.5%), and lack of trust in the vaccine (55.2%). Vaccine willingness significantly differed by sex and education level, with female participants and those with less than a bachelor's degree being more likely to report unwillingness. Perception of COVID-19 vaccine safety was significantly lower (−10.3%) than vaccines in general and differed by age, sex and education, with females, older adults, and individuals with less than a bachelor's degree reporting lower perceived COVID-19 vaccine safety.Conclusion: In this sample of community adults, the COVID-19 vaccine hesitancy rate was less than one in five individuals, but with higher rates in population subgroups. Targeting public health messaging to females and individuals with less than bachelor's degree, and addressing concerns about long-term and immediate side effects may increase vaccine uptake.

The quest for more COVID-19 vaccinations in Africa

Healthcare workers (HCWs) are a priority group for coronavirus disease 2019 (COVID-19) and influenza vaccination. We evaluated sociodemographic and occupational factors, attitudes, and knowledge associated with the uptake of primary and booster doses of COVID-19 and seasonal influenza vaccines among HCWs. Between February 2022 and February 2023, we administered a structured questionnaire to HCWs in 3 Albanian hospitals who were enrolled in a multiyear cohort study. The questionnaire assessed participants' knowledge, confidence, and attitudes toward COVID-19 and seasonal influenza vaccines, and included questions on COVID-19 and influenza vaccination history, perceptions of vaccine safety and effectiveness, and factors influencing vaccine decision-making. We included 1456 HCWs. Their median age was 44 (interquartile range: 33-53) and 77.3% were female. Overall, 20.7% were physicians, 47.0% nurses or midwives, and 21.5% support staff. In all, 93.6% received a COVID-19 primary vaccine series, 20% a COVID-19 booster, and 23.7% received an influenza vaccine in the 2022-2023 season. In the multivariable analysis, male HCWs were more likely to receive COVID-19 boosters (adjusted odds ratio [aOR] 2.08; 95% confidence interval [CI]: 1.55-2.80). However, they were less likely to receive influenza vaccines (aOR 0.69; 95% CI: .51-.95). Medical doctors were more likely to receive COVID-19 vaccine doses, while nurses had higher uptake of the influenza vaccine (aOR 1.87; 95% CI: 1.30-2.68). Confidence in the safety and effectivity of both vaccines was positively associated with vaccine uptake. Among HCWs, primary series COVID-19 vaccine coverage was high, but COVID-19 booster doses and seasonal influenza vaccines were low. Findings related to age and sex differences among HCW groups with low vaccine uptake, as well as their knowledge and attitudes toward vaccines, should inform targeted strategies to improve COVID-19 and influenza vaccine uptake, particularly among younger HCWs, female HCWs, and nonphysicians.

With the arrival of vaccines against the novel coronavirus in late 2020, the issue of how vaccines should be distributed and which groups should be prioritized has become salient. We study popular attitudes toward the distribution of COVID‐19 vaccines and how these have changed over the course of the pandemic in Switzerland, drawing on data from two rounds of an original public opinion survey conducted in the spring and winter of 2020. We find that the public supports prioritizing vulnerable groups such as health care workers or the elderly. We also find a notable degree of cross‐generational solidarity: younger age cohorts prioritize the elderly, while older groups prioritize (typically younger) health care workers. We then examine whether this finding is not in fact driven by vaccine hesitancy. This is not the case for older age groups, whose solidarity thus seems to be genuine. Vaccine hesitancy is an issue among younger groups, however.

Objectives Vaccine hesitancy is a major hurdle for stopping the COVID-19 pandemic. Recently, fear of vaccine side effects created widespread concern and paused global vaccination efforts. Many studies find that how medical risks are framed and communicated can influence individuals' perceptions and behavior, yet there is little evidence on how the communication of COVID-19 vaccine side-effect risks influences vaccine intentions. The primary objective of our study is to evaluate how the framing of vaccine-side effect risks impacts individuals' vaccine intentions and perceptions of vaccine safety. The study will assess the impact of 3 dimensions of side-effect framing: Qualitative risk labels: Determine whether attaching a qualitative risk label (e.g. adding "very low risk" next to the actual numerical risk) impacts individuals' willingness to take a vaccine and their perceptions of its safety. Comparison groups: Determine how framing side-effect risks in comparison to other causes of mortality (COVID-19 mortality and motor vehicle mortality) impacts individuals’ willingness to take a vaccine and their perceptions of its safety. How the comparison risks are presented: Determine whether comparisons to other causes of mortality are presented on an absolute or relative scale impacts individuals’ willingness to take a vaccine and their perceptions of its safety. Secondarily, we will also randomize a subset of individuals to receive the "status-quo" framing, where the vaccine side-effect risks are presented like how they were presented in the media. We will then compare vaccine intentions and perceptions of vaccine safety between the status-quo and the pooled intervention group samples to provide some insight into how "harmful" the status-quo framing was. Ultimately, we believe that our results will provide the some of the first experimental evidence on how the communication of COVID-19 vaccine risks may impact the public's willingness to be vaccinated and can inform future efforts to increase vaccination rates. Trial design Our study is an online-based randomized controlled trial designed to evaluate the effect of different vaccine side-effect framings on COVID-19 vaccine intentions and perceived safety for a hypothetical COVID-19 vaccine. Using a factorial design, we will experimentally assess the impact of 3 risk framing strategies, varying whether the risk is presented: (1) with a qualitative label, (2) whether the risk is presented with a comparison risk, and (3) for comparison cases, whether the comparison is in absolute or relative terms. We will also randomize a portion of respondents to a status quo framing where the side effect risk mimics the media's communication in early April 2021. Participants This will be an online study setting. We will use Prolific to recruit participants and host our study on the Gorilla platform. To be eligible, participants must be 18 years old or over (male, female, or other), have current residence in the US or UK, and be able to speak English. Participants will be excluded from the study if they do not meet our inclusion criteria. Intervention and comparator Our study content will consist of five pages presented to individuals online. Page 1 will explain the purpose of the study and contain the consent information. Page 2 will contain basic sociodemographic questions, including participants' age, sex, and schooling level. Page 3 will set up the experiment by telling individuals that we will describe a hypothetical new COVID-19 vaccine and that we would like to know how likely they would be to take the vaccine and how safe they think the vaccine is. On this page, we will also encourage individuals to respond truthfully and remind them that their answers are confidential and cannot be linked back to any personal identifying information. Page 4 will be the main experimental slide, where we will present individuals with information on the vaccine, varying how the vaccination risk is communicated based on which experimental framing arm they are randomized to. We will factorially randomize across the following factors in the following order (separately by country). First, we will determine whether individuals are randomized to the status quo framing, or the intervention framings (1500 respondents to the status quo, and 4500 to the intervention). Among those randomized to the intervention framing, we will randomize (equal allocation) whether the side effect is presented without a comparison, with a comparison to COVID-19 mortality, or with a comparison to motor vehicle mortality. We will then factorially randomize (equal allocation) whether the risk is presented with a qualitative risk label or not (e.g. "very low risk"). To ensure that the factors are independent of one another, we will do this by randomizing individuals to the risk labels within strata of the comparison group factor. Lastly, among those randomized to the comparison group, we will factorially randomize whether the risk is presented as an absolute or relative comparison. As previously, we will ensure independence by doing this randomization within strata of comparison group*risk labelling. This entire design is visualized in the full protocol. The experimental text for each arm is: Arm 1: With regards to side effects, so far 8 individuals have developed potentially life-threatening blood clots. This is among the approximately 7 million adults that have received the vaccine so far. Arm 2: With regards to side effects, 1 out of 100,000 vaccinated individuals may develop serious blood clots. Arm 3: With regards to side effects, 1 out of 100,000 vaccinated individuals may develop serious blood clots (very low risk). Arm 4: Text for USA participants: With regards to side effects, 1 out of 100,000 vaccinated individuals may develop serious blood clots. As a reference, 170 out of every 100,000 unvaccinated Americans died of COVID-19 based on data from the past year. Text for UK participants: With regards to side effects, 1 out of 100,000 vaccinated individuals may develop serious blood clots. As a reference, 108 out of every 100,000 unvaccinated individuals in the UK died of COVID-19 based on data from the past year. Arm 5: Text for USA participants: With regards to side effects, 1 out of 100,000 vaccinated individuals may develop serious blood clots. As a reference, this is 1/170th of the risk of COVID-19 mortality among unvaccinated Americans based on data from the past year. Text for UK participants: With regards to side effects, 1 out of 100,000 vaccinated individuals may develop serious blood clots. As a reference, this is 1/108th of the risk of COVID-19 mortality among unvaccinated individuals in the UK based on data from the past year. Arm 6: Text for USA participants: With regards to side effects, 1 out of 100,000 vaccinated individuals may develop serious blood clots (very low risk). As a reference, 170 out of every 100,000 unvaccinated Americans died of COVID-19 based on data from the past year. Text for UK participants: With regards to side effects, 1 out of 100,000 vaccinated individuals may develop serious blood clots (very low risk). As a reference, 108 out of every 100,000 unvaccinated individuals in the UK died of COVID-19 based on data from the past year. Arm 7: Text for USA participants: With regards to side effects, 1 out of 100,000 vaccinated individuals may develop serious blood clots (very low risk). As a refere

Confronting the evolution and expansion of anti-vaccine activism in the USA in the COVID-19 era

BackgroundInfluenza and COVID-19 vaccinations are recommended for health care personnel (HCP) in Thailand, but uptake depends on HCP perceptions and motivations.MethodsTo assess factors associated with self-reported influenza vaccination in the most recent season and intention to receive future COVID-19 vaccination annually, HCP from 16 hospitals across eight Thailand provinces were surveyed during December 2023 through January 2024. Additional survey variables included demographic and occupational characteristics, prior experiences with vaccination, perceptions of disease severity and vaccine safety and effectiveness. Multilevel mixed effect multivariable logistic regression was used, accounting for variability at provincial and hospital levels.ResultsOverall, 2,180 HCP were surveyed. Three-quarters (74.8%) reported influenza vaccination in the most recent season, and 58.1% intended to receive COVID-19 vaccination annually in the future. Previous influenza vaccination was strongly associated with reported vaccination in the current season (adjusted odds ratio [aOR] 2.94, 95% confidence interval [CI] 2.68–3.23). For future COVID-19 vaccination, perceived vaccine safety was strongly associated (aOR 3.49, 95% CI 3.18–3.84). Perceived disease severity was higher for COVID-19 than for influenza, but perceived vaccine safety and effectiveness were higher for influenza than for COVID-19. The most common barrier to influenza vaccination was insufficient time to get vaccinated (23.7%); whereas the most common barrier for COVID-19 vaccination was vaccine safety concern (30.0%).ConclusionsImproving vaccination coverage among HCP might need different approaches for influenza and COVID-19 vaccines. Improving convenience might be especially important for increasing influenza vaccination coverage, whereas providing reassurance about COVID-19 vaccine safety might be especially important for COVID-19.

AimsAfter the approval of the paediatric COVID-19 vaccines, the uptake was slower compared to the teenagers and adults in Singapore. Studies have shown that parents with higher social media usage...

<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.

Pediatric Vaccine Hesitancy and COVID-19

COVID-19 and influenza vaccine Hesitancy among adults hospitalized in the United States, 2019-2022.

Background With the availability of COVID-19 vaccines, vaccine hesitancy (VH) poses a great challenge to achieving herd immunity. Since young adults are usually asymptomatic, they may be less inclined to follow social distancing and mask-wearing guidelines. This study aimed at (i) quantifying VH among university students and (ii) investigating its determinants to identify barriers and predisposing factors to COVID-19 vaccination. Methods Students physically attending Sapienza University of Rome during April 2021 were invited to take part in an online survey. The questionnaire explored sociodemographic variables, COVID-19 experience, attitude towards preventive measures, and COVID-19 vaccination. Hesitancy was measured as the complement to 10 of students' intention to get vaccinated and was modeled through zero-inflated negative binomial regression analysis. Results Overall, 1949 students were surveyed. Most were females (59.9%) and aged 23.8±4.9 years on average. A great proportion reported no (76.8%) or slight hesitancy (15.7%). At multivariable analysis, in the count part, being more scared for the pandemic (IRR=0.94, 95%CI: 0.89-0.98), rating COVID-19 as more severe (IRR=0.93, 95%CI: 0.89-0.98) and being Italian rather than non-Italian (IRR=0.68, 95%CI: 0.54-0.85) were associated with lower VH, but no influence was found for age, sex, self-perceived risk of infection, and being a medical student. In the logit part, rating the vaccines as safe (b: 0.92, 95%CI: 0.75-1.10) or effective (b: 0.30, 95%CI: 0.14-0.45) decreased the likelihood of being hesitant. Conclusions A few factors seemed to influence the intention to get vaccinated against COVID-19, including vaccine safety and effectiveness. Hence, attention should be given to planning effective communication about the vaccine profile in order to maintain and improve the public's confidence. Also, partnerships should be established among the stakeholders to ensure coordinated information sharing and dissemination. Key messages Almost one-quarter of the surveyed students reported VH to some extent, and a few factors seemed to play a role in the vaccination decision-making process. Among others, the perceived vaccine safety and effectiveness seemed to influence VH. Attention should be given to planning effective communication about the vaccines’ profile.

Background: During the COVID-19 pandemic, vaccine hesitancy was high in Tanzania. Reasons for vaccine hesitancy included skepticism about vaccine safety and efficacy. Nonetheless, by March 2023, following concerted efforts, Tanzania reported reaching a national COVID-19 vaccination coverage of 52.5% among adults. We analyzed COVID-19 vaccination status and perceived vaccine safety among adults aged ≥ 18 years using data from the Tanzania HIV Impact Survey (THIS) 2022–2023. Methods: The THIS 2022–2023 was a nationally representative, cross-sectional household survey with a stratified two-stage cluster design. Descriptive analyses were conducted to determine the proportion of adults who self-reported receiving the COVID-19 vaccine andcompleting the primary vaccine series, and to assess vaccine safety perceptions. Analyses were weighted for non-response and accounted for complex survey design. Results: Of 32,777 adults, 20.0% (95% confidence interval (CI): 18.9–21.1) reported receiving more than one COVID-19 vaccine dose. Of those, 82.9% (95% CI: 81.3–84.5) completed the primary vaccination series. The proportion of adults who reported vaccination increased with age from 12.5% among 18–24 year olds to 29.0% among those aged 55–64 years. Among adults living with HIV (ALHIV), 49.6% (95% CI: 47.1–52.1) were vaccinated, and vaccination rates increased with longer duration on antiretroviral therapy. Adults who perceived the vaccines as safe (27.9%, 95% CI: 26.4–29.3) were 10 times more likely to report being vaccinated than those who perceived the vaccines as “not at all safe” (2.7%, 95% CI: 2.0–3.6). Conclusions: The COVID-19 vaccination coverage in Tanzania among adults ≥ 18 years as measured through the THIS 2022–2023 was less than half the national COVID-19 vaccine coverage reported in March 2023. ALHIV were more likely than the general population to be vaccinated. The substantial difference in vaccination rates between those who perceived the vaccines as safe versus unsafe highlights the importance of safety perception for vaccine uptake.