Scientific communication and vaccine hesitation: an analysis of the editorial line of a great Brazilian newspaper

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.

Background and ObjectiveVaccine hesitancy may be one of the greatest challenges to conquering the COVID-19 pandemic. Underserved communities across the U.S. have been suffering from the pandemic in unique ways, and vaccine hesitancy may exacerbate or prolong these issues. However, the prevalence of vaccine uptake and hesitancy in these vulnerable populations is unknown. The present study aimed to investigate: (1) prevalence of COVID vaccine uptake and COVID vaccine hesitancy in Delaware’s underserved communities; (2) factors (i.e., demographic, socioeconomic characteristics, as well as COVID-related behaviors) associated with vaccine hesitancy; and (3) specific concerns about COVID vaccines.Materials and MethodsData were extracted from a survey conducted in Delaware’s underserved communities from March 4, 2021 to May 25, 2021. Logistic regression analyses were used to assess factors associated with vaccine hesitancy.ResultsResults from our survey indicated that vaccine uptake is lower in Delaware’s underserved communities than Delaware overall and the national average. In addition, a considerable proportion of participants were categorized as vaccine hesitant. We also found that being black increased the likelihood of vaccine hesitancy for the COVID-19 vaccine, which is consistent with prior studies on vaccine hesitancy. Results also indicated that having been tested for COVID in the past decreased the odds of vaccine hesitancy. However, we did not find that demographic or socioeconomic characteristics played a role in vaccine hesitancy in Delaware’s underserved communities.Conclusion and RelevanceOur study represents a critial first step in understanding the determinants driving COVID vaccine uptake and hesitancy. Identifying key factors and causes for vaccine hesitancy may help in establishing novel strategies that counteract low vaccination rates in underserved communities.

BackgroundAlthough vaccination has been shown to be one of the most important interventions, COVID-19 vaccine hesitancy remains one of the top 10 global public health challenges worldwide.ObjectiveThe objective of this study is to investigate (1) major determinants of vaccine hesitancy, (2) changes in the determinants of vaccine hesitancy at different time periods, and (3) the potential factors affecting vaccine acceptance.MethodsThis study applied a mixed methods approach to explore the potential determinants contributing to vaccine hesitancy among the Taiwanese population. The quantitative design of this study involved using Google Trends search query data. We chose the search term “疫苗“ (vaccine), selected ”台灣” (Taiwan) as the location, and selected the period between December 18, 2020, and July 31, 2021. The rising keywords related to vaccine acceptance and hesitancy were collected. Based on the responses obtained from the qualitative study and the rising keywords obtained in Google Trends, the 3 most popular keywords related to vaccine hesitancy were identified and used as search queries in Google Trends between December 18, 2020, and July 31, 2021, to generate relative search volumes (RSVs). Lastly, autoregressive integrated moving average modeling was used to forecast the RSVs for the 3 keywords between May 29 and July 31, 2021. The estimated RSVs were compared to the observed RSVs in Google Trends within the same time frame.ResultsThe 4 prevailing factors responsible for COVID-19 vaccine acceptance and hesitancy were doubts about the government and manufacturers, side effects, deaths associated with vaccination, and efficacy of vaccination. During the vaccine observation period, “political role” was the overarching consideration leading to vaccine hesitancy. During the peak of the pandemic, side effects, death, and vaccine protection were the main factors contributing to vaccine hesitancy. The popularity of the 3 frequently searched keywords “side effects,” “vaccine associated deaths,” and “vaccine protection” continued to rise throughout the pandemic outbreak. Lastly, the highest Google search queries related to COVID-19 vaccines emerged as “side effects” prior to vaccination, deaths associated with vaccines during the period when single vaccines were available, and “side effects” and “vaccine protection” during the period when multiple vaccines were available.ConclusionsInvestigating the key factors influencing COVID-19 vaccine hesitancy appears to be a fundamental task that needs to be undertaken to ensure effective implementation of COVID-19 vaccination. Google Trends may be used as a complementary infoveillance tool by government agencies for future vaccine policy implementation and communication.

BackgroundReluctance of people to receive recommended vaccines is a growing concern, as distribution of vaccines is considered critical to ending the COVID-19 pandemic. There is little information regarding pregnant women’s views toward coronavirus vaccination in Japan. Therefore, we investigated the vaccination rate and reasons for vaccination and vaccine hesitancy among pregnant women in Japan.MethodsWe conducted a cross-sectional study involving 1,791 pregnant women using data from the Japan “COVID-19 and Society” Internet Survey, conducted from July to August 2021, and valid response from 1,621 respondents were analyzed. We defined participants with vaccine hesitancy as those who identified with the statement “I do not want to be vaccinated” or “I want to ‘wait and see’ before getting vaccinated.” Multivariate Poisson regression analysis was used to investigate the factors contributing to vaccine hesitancy.ResultsThe prevalence of vaccination and vaccine hesitancy among pregnant women was 13.4% (n = 217) and 50.9% (n = 825), respectively. The main reasons for hesitancy were concerns about adverse reactions and negative effects on the fetus and breastfeeding. Vaccine hesitancy was significantly associated with the lack of trust in the government (adjusted prevalence ratio, 1.26; 95% confidence interval, 1.03–1.54). Other factors, such as age, educational attainment, and state of emergency declaration, were not associated with vaccine hesitancy.ConclusionsCOVID-19 vaccination is not widespread among pregnant women in Japan, although many vaccines have been shown to be safe in pregnancy. Accurate information dissemination and boosting trust in the government may be important to address vaccine hesitancy among pregnant women.

COVID-19 vaccine hesitancy in adults with multiple sclerosis in the United States: A follow up survey during the initial vaccine rollout in 2021

IntroductionCOVID-19 vaccination is crucial for vulnerable people with underlying chronic conditions such as Alzheimer’s disease and related dementias (ADRD) and mild cognitive impairment (MCI). These individuals face unique challenges, including...

Lessons learned from COVID-19 vaccination implementation: How psychological antecedents of vaccinations mediate the relationship between vaccine literacy and vaccine hesitancy

The development and implementation of COVID-19 vaccines have been a breakthrough in controlling the pandemic. However, the vaccination coverage in most low-income countries remains very low due to critical vaccine shortage and profound hesitancy. In this scoping review, we aimed to assess COVID-19 vaccine uptake, acceptance, and hesitancy in Ethiopia and Tanzania. The search was made in PubMed, Scopus, Embase, and Web of Science. Only original research articles focusing on vaccine acceptance and hesitancy were included. The studies selected for a full read were analysed using a thematic analysis approach. A total of 76 articles were included in the study, with 74 of them coming from Ethiopia. The study found an increasing trend in vaccine uptake over time. However, there was also an increase in hesitancy and a decline in willingness to receive the vaccine. The willingness to receive the COVID-19 vaccine in Ethiopia ranged from 18.5 to 88%. The main reasons for "vaccine hesitancy" included fear of side effects, concerns about long-term safety, doubts about vaccine effectiveness, lack of information, vaccine fast-tracking, and religious beliefs. The study also found that younger individuals, females, and pregnant women were less willing to receive the vaccine. The adverse events reported among vaccinated individuals were mostly mild. Most of the studies operationalised vaccine acceptance-hesitancy as dichotomous variables. However, the historical, political, and socio-cultural context in which vaccine acceptance and hesitancy occur was not given any attention. While there is a good amount of data from Ethiopia describing patterns of vaccine acceptance and hesitancy among different populations over time, there is limited information from Tanzania due to the late arrival of the vaccine and limited published articles. We have observed a paradox involving two seemingly conflicting trends: an increase in vaccination rates/coverage and "anti-vax." Most studies have simplified vaccine acceptance-hesitancy as an "either-or" incident, without considering its dynamic nature and occurrence within a broader political, social, and cultural context. Therefore, it is crucial to explore approaches that can enhance our understanding of the vaccine acceptance-hesitancy phenomenon, in order to improve vaccine trust and uptake.

BackgroundThe urgency of the COVID-19 pandemic called upon the joint efforts from the scientific and private sectors to work together to track vaccine acceptance and prevention behaviors.MethodsOur study utilized individual responses to the Delphi Group at Carnegie Mellon University U.S. COVID-19 Trends and Impact Survey, in partnership with Facebook. We retrieved survey data from January 2021 to February 2022 (n = 13,426,245) to examine contextual and individual-level predictors of COVID-19 vaccine hesitancy, vaccination, and mask wearing in the United States. Adjusted logistic regression models were developed to examine individual and ZIP code predictors of COVID-19 vaccine hesitancy and vaccination status. Given the COVID-19 vaccine was rolled out in phases in the U.S. we conducted analyses stratified by time, January 2021-May 2021 (Time 1) and June 2021-February 2022 (Time 2).ResultsIn January 2021 only 9% of U.S. Facebook respondents reported receiving the COVID-19 vaccine, and 45% were vaccine hesitant. By February 2022, 80% of U.S. Facebook respondents were vaccinated and only 18% were vaccine hesitant. Individuals who were older, held higher educational degrees, worked in white collar jobs, wore a mask most or all the time, and identified as white and Asian had higher COVID-19 vaccination rates and lower vaccine hesitancy across Time 1 and Time 2. Essential workers and blue-collar occupations had lower COVID vaccinations and higher vaccine hesitancy. By Time 2, all adults were eligible for the COVID-19 vaccine, but blacks and multiracial individuals had lower vaccination and higher vaccine hesitancy compared to whites. Those 55 years and older and females had higher odds of wearing masks most or all the time. Protective service, construction, and installation and repair occupations had lower odds of wearing masks. ZIP Code level percentage of the population with a bachelors’ which was associated with mask wearing, higher vaccination, and lower vaccine hesitancy.ConclusionAssociations found in earlier phases of the pandemic were generally found to also be present later in the pandemic, indicating stability in inequities. Additionally, inequities in these important outcomes suggests more work is needed to bridge gaps to ensure that the burden of COVID-19 risk does not disproportionately fall upon subgroups of the population.

BackgroundMigration can be linked to the transmission of COVID-19. COVID-19 vaccine uptake and hesitancy among rural-to-urban migrant workers in China, the largest group of internal migrants in the world, has not been characterized.ObjectiveTo investigate COVID-19 vaccine uptake and identify vaccine hesitancy-associated factors among rural-to-urban migrant workers in the first round of COVID-19 vaccination in China.MethodsA cross-sectional questionnaire-based survey was conducted, including 14,917 participants. Socio-demographics, COVID-19 vaccine uptake, vaccine hesitancy and its associated factors based on Vaccine Hesitancy Determinants Matrix (VHDM) were applied for the survey. Data were principally analyzed by logistic regression analysis.ResultsThe COVID-19 vaccine uptake and vaccine hesitancy rates were 7.1% and 57.7%, respectively. Vaccine hesitancy was strongly associated with VHDM, including individual factors (female, higher annual income and fewer medical knowledge), group factors (less family support, friend support and public opinion support), COVID-19 epidemic factors (lower fatality, infection and emotional distress) and vaccine factors (less vaccine necessity, vaccine safety, vaccine efficacy, vaccine importance and vaccine reliability).ConclusionThe VHDM model has the potential utility in efforts to reduce COVID-19 vaccine hesitancy. Greater efforts should be put into addressing positive predictors associated with vaccine hesitancy.

Effective Approaches to Combat Vaccine Hesitancy.

COVID-19 vaccination disparities persist in the US, but few studies focus on Latinx sexual and gender minority (SGM) people. This study aimed to examine the factors shaping COVID-19 vaccine uptake and hesitancy among Latinx SGM people in North Texas. In a cross-sectional study from June to July 2023, 134 Latinx participants completed a survey on COVID-19 vaccine rate, confidence, and hesitancy. Vaccination rates and hesitancy among SGM and cisgender heterosexual individuals were compared using the chi-square test. Fisher's exact test was used to examine the association between confidence in vaccine safety and (1) vaccine uptake and (2) vaccine hesitancy. Among Latinx SGM participants, 27.8% were unvaccinated and 24% were vaccine hesitant. Furthermore, 25.9% demonstrated no likelihood of receiving the vaccine in the future. No significant difference was observed in vaccine uptake and hesitancy between SGM and cisgender heterosexual individuals. Latinx SGM individuals with high confidence in COVID-19 vaccine safety were more likely to be vaccinated than those with low confidence. Confidence in vaccine safety is strongly correlated with vaccination status, highlighting the need for interventions to build trust and address concerns among Latinx SGM people. Such interventions must focus on intersectional sources of social vulnerability among Latinx SGM people and the diversity of Latinx and SGM identities.

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

Context: Large numbers of US adults are vaccinated, but COVID-19 vaccine hesitancy remains high. Health centers funded by the Health Resources and Services Administration (HRSA) have played a major role in COVID-19 vaccinations and have the potential to vaccinate even larger numbers of people. Objective: To identify U.S. counties with low COVID-19 vaccination rates and high rates of vaccine hesitancy, explore the characteristics of these counties and health center presence in these areas, and identify priority health centers for targeted vaccine outreach. Study Design: Cross-sectional geospatial analysis of county-level COVID-19 vaccination rates and COVID-19 vaccination hesitancy. Bivariate Local Moran's I using GeoDa software to identify clusters of counties with low COVID-19 vaccination rates and high rates of COVID-19 vaccine hesitancy. Geographic Information Systems (GIS) mapping to overlay health centers with county-level data. Setting or Dataset: U.S. counties; vaccine hesitancy data from U.S. Department of Health & Human Services Office of the Assistant Secretary for Planning and Evaluation (ASPE); vaccination rates from the Centers for Disease Control and Prevention (CDC); and data on Health Center Program awardees from the HRSA. Population studied: U.S. Counties (n=2,825) for which data on COVID-19 vaccination and COVID-19 vaccine hesitancy are available; and HRSA-funded health centers, excluding Puerto Rico and Pacific Islands (n=1,559). Outcome Measures: COVID-19 vaccine hesitancy and COVID-19 vaccination rates. Results: We identified 219 counties that are part of clusters of high rates of vaccine hesitancy and low COVID-19 vaccination rates. In general, these counties have higher rates of poverty, larger percentages of black and Hispanic populations, and are located in the Southeast (Alabama, Georgia) and West Virginia. Sixty health center awardees are located within these counties, serving almost 700,000 patients. Conclusions: While almost one-half of US adults have been vaccinated, younger adults have much lower rates of vaccination and large numbers are still unvaccinated. Further, vaccine rates vary by race and ethnicity, with less than one-fifth of Hispanic and black adults having been vaccinated. Targeting areas with high rates of vaccine hesitancy and low vaccination rates supports strategic planning, optimizes finite resources, and better assists health centers in creating culturally competent outreach addressing vaccine hesitancy.

The COVID-19 pandemic, which started in 2019, affected social, economic and political structures all over the world and pushed states to take quick and dramatic measures. Vaccine development studies, which are seen as the most effective way of combating such pandemics, started rapidly and mass vaccinations were started in a short time. However, the opposition to vaccines, which has been going on since the first days of the use of vaccines in the world, has come to the fore again against COVID-19 vaccine programs. Anti-vaccine rhetoric has slowed the pace of the fight against the pandemic. Field studies have shown that more than 50% of people experience hesitations about vaccination. The World Health Organization defines vaccine refusal or vaccine hesitancy as a global threat. Identifying the reasons for vaccine hesitancy is very important in terms of maintaining general public health. For this reason, social scientists are working on the causes of vaccine hesitancy. In the literature, religiosity and low level of education are shown among the reasons for vaccine hesitancy. However, when studies are examined, there are clues that a certain type of religiosity rather than religiosity is related to anti-vaccination. The main problem of this research is whether religiosity and education level predict COVID-19 vaccine hesitancy. In this study, the relationship between religiosity, dogmatic religiosity, education level, socio-economic level and COVID-19 awareness with vaccine hesitancy and their predictive levels are examined. The research is in correlational model and cross-sectional design. The relationship of five variables (religiosity, dogmatic religiosity, education level, socio-economic level, COVID-19 awareness) with vaccine hesitancy and their predictive levels were examined. The sample of the research consists of Muslim Turks over the age of 18. Participants were recruited using the convenience sampling method. The prepared online survey form was shared on social media platforms and the participants were reached. 322 Muslims between the ages of 18-70 (mean 30, SD=10.62) participated in the study. 65% of the participants are women and 55% are single. Ok Religious Attitude Scale, Dogmatic Religiosity Scale, Personal Information Form, COVID-19 Awareness Scale and Vaccine Hesitancy Scale were used as measures. Research findings showed that one-fifth of the participants did not receive the COVID-19 vaccine, half of them had 2 doses and the rest had different doses. Among the unvaccinated, the proportion of women and married people is higher. A negative correlation was found between age and vaccine hesitancy. While no relation could be found between education level and vaccination hesitancy, socio-economic level and vaccination hesitancy showed a negative correlation. When looking at other variables, it was found that there was no relationship between religiosity and vaccine hesitancy, but a negative relationship between COVID-19 awareness and vaccine hesitancy, and a positive relationship between religious dogmatism and vaccine hesitancy. Multiple regression analysis was performed to determine the predictive levels. In the multiple regression analysis, dogmatic religiosity, COVID-19 awareness and socio-economic level were added as a predictor, and vaccine hesitancy as an output variable. In the first step, only religious dogmatism was included in the model as a predictor. In step 3, three predictors were entered simultaneously. The findings showed that dogmatic religiosity, socio-economic status, and awareness of COVID-19 were significant predictors of vaccine hesitancy. In the first step, dogmatic religiosity alone accounts for about 3% of the variance in vaccine hesitancy. In the second step, dogmatic religiosity and socio-economic status together accounted for about 5% of the variance in vaccine hesitancy. And finally, in the third step, dogmatic religiosity, socio-economic level and awareness of COVID-19 together account for 7% of the variance in vaccine hesitancy. Considering the beta coefficients, it was seen that there was a positive correlation between dogmatic religiosity and vaccine hesitancy, and a negative correlation was found between vaccine hesitancy and socio-economic level and COVID-19 awareness. Considering the standardized regression coefficients, it is seen that the most important variable predicting vaccine hesitancy is dogmatic religiosity.