Vaccine Confidence Research Articles

Perceptions of COVID-19 Among Unvaccinated Hispanics.

Introduction: Despite the availability of an effective COVID-19 vaccine, uptake had been low in Midwestern Hispanic communities. A small qualitative study was undertaken to better understand perceptions of COVID-19 disease and prevention among unvaccinated Hispanic adults. Methods: Individual interviews were conducted, in Spanish, with adults (n = 20) who had not been vaccinated for COVID-19. Interview questions were guided by the Theory of Planned Behavior. Results: Participants (n = 20) were Hispanic adults (male = 5; female = 15). One overarching theme, lack of trust, emerged from the data. Perceived barriers to vaccination included emotions, personal values and myths. Recommendations by trusted health providers and willingness to receive education emerged as facilitators to COVID vaccine uptake. Conclusion: Members of the Kansas City Chapter of National Association of Hispanic Nurses used findings from this study to tailor strategies to enhance vaccine confidence in their local community. The chapter partnered with the local health department and Hispanic-serving organizations to provide COVID-19 education and vaccine access.

Online food delivery in the post-pandemic era: moderating role of vaccine confidence

PurposeIn the post-pandemic period and following widespread inoculation against the infection, this research aims to pinpoint the variables that affect consumers' behavioural intentions (BIs) towards online food delivery (OFD) services. The study goes further to investigate the potential impact of vaccine confidence (VC) in modifying the association between consumers' BI to utilise OFD services and their actual usage behaviour (UB).Design/methodology/approachUsing information gathered through a structured questionnaire from 372 Indian customers, a proposed model based on the technology acceptance model (TAM) and theory of planned behaviour (TPB) models was put to the test using structural equation modelling (SEM).FindingsResults demonstrate that perceptions of ease of use, attitude (ATT) and perceived behavioural control (PBC) have a favourable and significant impact on behaviour intention amongst Indian OFD users. Contrary to what the TAM and TPB models had predicted, perceived usefulness (PU) and subjective norms (SN) did not significantly affect the BI of the sample of Indian OFD users. Furthermore, the association between BI and actual UB of OFD users is not moderated by the consumers' VC.Practical implicationsThe study contributes by shedding light on the variables that affect Indian OFD users' BIs after the coronavirus disease 2019 (COVID-19) pandemic era and mass immunisation and whether VC has a role to play in affecting consumer behaviour, which will aid OFD service providers, eateries and marketers in redesigning their marketing plans.Originality/valueThe present study is the first in making a literary contribution through analysis of the moderating effect of VC on the relationship between BI and actual UB. Additionally, this study presents evidence from India, one of the first nations to implement widespread COVID-19 inoculation.

Evaluation of the COVID-19 Vaccination Campaign ¡Ándale! ¿Qué Esperas? in Latinx Communities in California, June 2021-May 2022.

The 12-month vaccination campaign ¡Ándale! ¿Qué Esperas? was launched to increase COVID-19 vaccination rates in Latinx populations in California by expanding community outreach. The objectives of this evaluation were to (1) determine predictors of vaccination rates and (2) identify barriers to vaccination and potential solutions. Five community partners in California serving Latinx populations with high social vulnerability participated in the ¡Ándale! ¿Qué Esperas? campaign. Community health workers were hired to deliver outreach (virtual, one-on-one, group based, and information dissemination), vaccinations, and supportive services. We collected data on outreach strategy used (method and location), number of vaccinations provided and reasons for delay, and number of times that supportive services were provided. We used regression models to assess significant predictors of vaccinations and supportive services. Community health workers (N = 146) hired from June 1, 2021, through May 31, 2022, performed outreach engagements (n = 6297) and supportive services (n = 313 796), resulting in 130 413 vaccinations and 28 660 vaccine appointments. The number of vaccinations administered was significantly higher at events in which supportive services were provided versus not provided (coefficient = 34.02; 95% CI, 3.34-64.68; P = .03). The odds ratio of supportive services was 3.67 (95% CI, 1.76-7.55) during virtual outreach and 2.95 (95% CI, 2.37-3.69) during one-on-one outreach (P < .001 for both) as compared with information dissemination encounters. Vaccination concerns were reported among 55.0% of vaccinated survey respondents (67.7%, vaccine confidence; 51.7%, access). Supportive services facilitate vaccinations, ease transportation and time barriers, and instill confidence among working-class racial and ethnic minority populations.

Mothers’ perceptions and attitudes about HPV vaccination initiation among 9- and 10-year-olds

ABSTRACT HPV vaccination has potential to prevent 90% of HPV-associated cancers. The Advisory Committee on Immunization Practices recommends HPV vaccination for 11- and 12-year-olds, but vaccine initiation can start at age 9. The purpose of this study was to explore perceptions about starting HPV vaccination at a younger age to inform future interventions that promote initiation at ages 9 and 10 years. This was part of a larger study about vaccine hesitancy among racially/ethnically diverse parents of adolescents in the Greater Newark Area of New Jersey. We thematically analyzed transcripts from 16 interviews with English- and Spanish-speaking mothers who had at least one child ≤ 10 years. Analyses focused on perceptions of HPV-related disease risk, attitudes toward HPV vaccination need, and vaccine confidence specifically for 9- and 10-year-olds. Few parents with young adolescents reported receiving vaccination recommendations, and only one reported series initiation before age 11. Mothers’ hesitation about younger HPV vaccination initiation revolved around: 1) low perceived necessity among English-speaking mothers due to young adolescents not being sexually active, 2) concerns about potential side effects associated with vaccinating prepubescent adolescents, and 3) a desire for adolescents to be old enough to provide assent. Participants were not opposed to younger initiation but wanted and relied on pediatricians to inform them about vaccination for younger adolescents. These findings suggest mothers are willing to vaccinate at younger ages after clear provider recommendations. Equipping providers with evidence about vaccine safety and cancer prevention communication strategies may promote initiation and timely completion at younger ages.

Designing and testing social media campaign messages to promote COVID-19 vaccine confidence among rural adults: A community-engaged approach featuring rural community leader and clinician testimonials

Despite the growing availability of effective COVID-19 vaccines in rural communities in the United States, widespread vaccine hesitancy delays COVID-19 vaccine coverage in rural communities and threatens to worsen pre-pandemic rural–urban disparities in other vaccination rates, including influenza and routine pediatric immunizations. Therefore, there is an urgent need to develop communication-based interventions to improve vaccine confidence in rural America. This study demonstrates the efficacy of a community-engaged approach to developing social media campaign messages in promoting COVID-19 vaccine uptake and pro-vaccine social diffusion among rural adults. Using a community-engaged approach, we developed social media campaign videos varying in (a) featured messengers (clinicians versus community leaders) and (b) the presence of personal testimonials. We conducted a national online experiment (N = 1,364 rural adults) in spring 2022. We found that videos featuring clinicians serving rural communities and their testimonials increased (a) vaccination intentions in the unvaccinated group (4-point scale, b = 0.23, p =.015) and (b) intention to discuss the messages with others (4-point scale, b = 0.14, p =.037), share the message (4-point scale, b = 0.15, p =.026), and promote the vaccines to others (9-point scale, b = 0.48, p =.013). Results suggest that vaccine promotional social media campaigns targeting rural populations can benefit from including clinician testimonials.

Willingness to receive and recommend hypothetical mpox vaccination and associated factors in Chinese adults: a community-based survey in Shenzhen, China

ObjectivesChina may face new threats to public health due to the increased risk of imported mpox (monkeypox) cases. However, research gaps exist in the acceptance of mpox vaccination and potential associated factors in the Chinese population. Study designWe conducted a cross-sectional study targeting community residents in Shenzhen, China, from August 5 to September 7 2022. MethodsA self-administered questionnaire was used to collect information about demographic and health characteristics, mpox-related perceptions, and attitudes towards mpox vaccination. Multivariable logistic regression models were applied to detect the factors associated with willingness to receive and recommend mpox vaccination. ResultsA total of 2293 community residents were included in the analyses (average age: 34.03, female: 72.6%). Among the participants, 76.9% were aware of mpox, 62.1% were aware of the global mpox outbreak, but only 53.6% had a high knowledge level of mpox. Males had a higher proportion of high knowledge (56.9% vs 52.3%, P＜0.05) and a lower proportion of high worry (30.2% vs 45.4%, P＜0.05) than females. Approximately 69.1% of the participants were willing to vaccinate against mpox, and 69.6% were willing to recommend mpox vaccination to people around them, in which no gender difference was found. The obstacle reported most among people hesitant to receive vaccination was concerning the safety and side-effects, whereas it changed to be concerning the suitability due to individual health differences among people hesitant to recommend mpox vaccines. Factors associated with the willingness to receive and recommend mpox vaccination included having a history of influenza vaccination, having a history of COVID-19 vaccination, being aware of the global mpox outbreak, having a high knowledge level of mpox, and having a high level of mpox-related worry. ConclusionsThis study identified a moderate willingness to receive and recommend mpox vaccination among Chinese adults. Without gender differences, willingness to receive and recommend mpox vaccination was significantly associated with mpox-related perceptions, such as awareness, knowledge, and worry. Authoritative and up-to-date information is needed to help the general population improve public confidence in mpox vaccines in China.

COVID-19 Vaccination Messengers, Communication Channels, and Messages Trusted Among Black Communities in the USA: a Review.

Black and African American adults exhibited higher levels of mistrust and vaccine hesitancy and lower levels of vaccination throughout the COVID-19 pandemic. Vaccination and booster uptake remains disproportionately low among Black adults. We conducted a systematic review of empirical research published between February 2021 and July 2022 from five electronic databases and the grey literature. We screened studies that assessed COVID-19 vaccination information needs and preferences as well as communication strategies among Black adults in the USA. We extracted data, then analyzed and synthesized results narratively. Twenty-two articles were included: 2 interventions, 3 experimental surveys, 7 observational surveys, 8 qualitative inquiries, and 2 mixed methods studies. Studies reported credible and preferred COVID-19 vaccination information sources/messengers, channels, and content. Commonly trusted messengers included personal health care providers, social network connections, and church/faith leaders. Electronic outreach (e.g., email, text messages), community events (e.g., forums, canvassing), and social media were popular. Black communities wanted hopeful, fact-based messages that address racism and mistrust; persuasive messages using collective appeals about protecting others may be more influential in changing behavior. Future communication strategies aiming to increase vaccine confidence and encourage COVID-19 booster vaccination among Black communities should be developed in partnership with community leaders and local health care providers to disseminate trauma-informed messages with transparent facts and collective action appeals across multiple in-person and electronic channels.

Identifying beliefs driving COVID-19 vaccination: Lessons for effective messaging

ABSTRACT Increasing vaccination acceptance has been essential during the COVID-19 pandemic and in preparation for future public health emergencies. This study aimed to identify messaging strategies to encourage vaccine uptake by measuring the drivers of COVID-19 vaccination among the general public. A survey to assess COVID-19 vaccination acceptance and hesitancy was advertised on Facebook in February–April 2022. The survey included items asking about COVID-19 vaccination status and participant demographics, and three scales assessing medical mistrust, perceived COVID-19 risk, and COVID-19 vaccine confidence (adapted from the Oxford COVID-19 vaccine confidence and complacency scale). The main outcome was vaccination, predicted by patient demographics and survey scale scores. Of 1,915 survey responses, 1,450 (75.7%) were included, with 1,048 (72.3%) respondents reporting they had been vaccinated. In a multivariable regression model, the COVID-19 vaccine confidence scale was the strongest predictor of vaccination, along with education level and perceived COVID-19 risk. Among the items on this scale, not all were equally important in predicting COVID-19 vaccination. The items that best predicted vaccination, at a given score on the COVID-19 vaccine confidence scale, included confidence that vaccine side effects are minimal, that the vaccine will work, that the vaccine will help the community, and that the vaccine provides freedom to move on with life. This study improved our understanding of perceptions most strongly associated with vaccine acceptance, allowing us to consider how to develop messages that may be particularly effective in encouraging vaccination among the general public for both the COVID-19 pandemic and future public health emergencies.

Barriers to COVID-19 vaccine uptake: classification and the role of Health Literacy and Media Literacy.

Vaccination is one of the most influential and cost-effective health interventions for preventing and reducing COVID-19 diseases. Unfortunately, the majority of the world's population is deprived of vaccination. Health Literacy (HL) and Media Literacy (ML) are essential to the COVID-19 vaccination. The present study investigates the barriers to COVID-19 vaccine uptake, focusing on classification and the roles of HL and ML. A cross-sectional study was conducted among people 18-65 years old in Sarab City, located in East Azerbaijan, Iran, between September to October 2020. Multistage cluster sampling was employed to recruit 298 people from Health Care Services Centers (HCCs). The results of this research demonstrated that about 32.6% of participants reported that they have fully injected COVID-19 vaccines. Also, HL was positively associated with ML (r = 0.214, p < 0.05). Barriers of COVID-19 vaccine uptake were classified into personal, interpersonal, group and organizational, society and decision-making factors. Besides, barriers to the COVID-19 vaccine were significantly correlated with HL (r = -0.298, p < 0.05) and ML (r = 0.266, p < 0.05). Additionally, in the hierarchical regression model, demographic characteristics accounted for 8.2% of the variation in barriers to the COVID-19 vaccine (F = 4.34; p = 0.001), that monthly income (ß = -0.237; p < 0.05) and marriage statues (ß = 0.131; p < 0.05) were statistically associated with low barriers. HL as predictor variables explained an additional 14.4% of variation in barriers of COVID-19 vaccine (F = 53.84; p < 0.001) and ML explained an extra 9.2% of the variation (F = 38.83; p < 0.001). In total, demographic characteristics, HL dimensions and ML were able to explain 31.8% of the variation in barriers to COVID-19 vaccine. According to the findings, various strategies are needed to increase the COVID-19 vaccination uptake. This is due to the fact that barriers to COVID-19 vaccination uptake are multifactorial. These facts can help health policymakers and healthcare providers design media-based interventions to reduce barriers to COVID-19 vaccination uptake among adults. Enhancing vaccine HL and ML for adults and improving vaccine confidence are of high priority.

COVID-19 Vaccine Hesitancy Among US Adults: Safety and Effectiveness Perceptions and Messaging to Increase Vaccine Confidence and Intent to Vaccinate.

Public health agencies have a critical role in providing effective messaging about mitigation strategies during a public health emergency. The objectives of this study were (1) to understand perceptions of COVID-19 vaccines, including concerns about side effects, safety, and effectiveness and how these perceptions influence vaccine decision-making among US adults and (2) to learn what messages might motivate vaccine uptake. In April and May 2021, we conducted 14 online focus groups with non-Hispanic English-speaking and English- and Spanish-speaking Hispanic adults (N = 99) not vaccinated against COVID-19. We oversampled adults aged 18-39 years and rural residents and systematically assessed 10 test messages. Researchers used a standardized guide and an a priori codebook for focus group discussions, coding transcripts, and thematic analysis. Vaccine hesitancy factors included fear of the unknown; long-term side effects, including infertility; and beliefs that the vaccines were developed too quickly and were not sufficiently effective. Motivating factors for receiving vaccination included the ability to safely socialize and travel. Health care providers were considered important trusted messengers. Participants were critical of most messages tested. Messages that came across as "honest" about what is not yet known about COVID-19 vaccines were perceived more positively than other messages tested. Messages were seen as ineffective if perceived as vague or lacking in data and specificity. Messages that were simple and transparent about what is unknown about vaccines relative to emerging science were viewed most favorably. Health care providers, friends, and family were considered influential in vaccination decision-making. Findings underscore the benefits of research-informed strategies for developing and disseminating effective messages addressing critical issues in a public health emergency.

The impact of national income and vaccine hesitancy on country-level COVID-19 vaccine uptake.

The rapid development and rollout of COVID-19 vaccines helped reduce the pandemic's mortality burden. The vaccine rollout, however, has been uneven; it is well known that vaccination rates tend to be lower in lower income countries. Vaccine uptake, however, ultimately depends on the willingness of individuals to get vaccinated. If vaccine confidence is low, then uptake will be low, regardless of country income level. We investigated the impact on country-level COVID-19 vaccination rates of both national income and vaccine hesitancy. We estimated a linear regression model of COVID-19 vaccine uptake across 145 countries; this cross-sectional model was estimated at each of four time points: 6, 12, 18, and 24 months after the onset of global vaccine distribution. Vaccine uptake reflects the percentage of the population that had completed their primary vaccination series at the time point. Covariates include per capita GDP, an estimate of the percentage of country residents who strongly disagreed that vaccines are safe, and a variety of control variables. Next, we estimated these models of vaccine uptake by country income (countries below, and above the international median per capita GDP) to examine whether the impact of vaccine hesitancy varies by country income. We find that GDP per capita has a pronounced impact on vaccine uptake at 6 months after global rollout. After controlling for other factors, there was a 22 percentage point difference in vaccination rates between the top 20% and the bottom 20% of countries ranked by per capita GDP; this difference grew to 38% by 12 months. The deleterious impact of distrust of vaccine safety on vaccine uptake became apparent by 12 months and then increased over time. At 24 months, there was a 17% difference in vaccination rates between the top 20% and the bottom 20% of countries ranked by distrust. The income stratified models reveal that the deleterious impact of vaccine distrust on vaccine uptake at 12 and 24 months is particularly evident in lower income countries. Our study highlights the important role of both national income and vaccine hesitancy in determining COVID-19 vaccine uptake globally. There is a need to increase the supply and distribution of pandemic vaccines to lower-income countries, and to take measures to improve vaccine confidence in these countries.

Potential determinants of childhood COVID-19 vaccine confidence among the primary school's stakeholders in Bangladesh: A cross-sectional study to assess the effects of education.

Rapid corona virus disease 2019 (COVID-19) vaccination drives aimed to immunize primary school-aged youth have a potential for health safety and supportive academic attainment. This study aimed to identify the potential factors influencing childhood COVID-19 vaccine confidence among the primary school's stakeholders in Bangladesh and assess the effects of health education on vaccine confidence and receptivity. This cross-sectional study used a bilingual, multi-item, closed-ended, anonymous questionnaire adopted from the extant literature studies on the topic. Data were collected purposively by the face-to-face interview approach. In total, 627 primary school's stakeholders participated in this study. The binary logistic regressions and Chi-square tests were employed to investigate and rationalize the study-outlined objectives where <0.05 was considered statistically significant. The pooled childhood vaccine confidence and receptivity against COVID-19 was 91% (95% CI 89-93) among the primary school's stakeholders. The regression analysis revealed that of eight potential determinants of vaccine confidence, "safety" and "effectiveness" had a highly significant (P = 0.006, P = 0.001, respectively) and positive association and "efficacy" had a significant (P = 0.03) and positive association, while "rumor" had a highly significant (P = 0.000) and negative association with childhood vaccine confidence. The analysis also showed that"health education" had a significant (P = 0.04) and positive association with childhood vaccine confidence and receptivity against COVID-19. Although the odds ratio for receiving childhood vaccine was found to be 0.6, the result was insignificant (P > 0.05) in the Chi-squared test. Hence, there was no vaccine-hesitant risky recipient group identified in implementing upcoming childhood COVID-19 vaccination programs. This study confirms the importance of a positive perception of vaccine safety, efficacy, effectiveness, and health education for vaccine confidence under any circumstances. Childhood COVID-19 vaccine confidence is Improved if vaccination data become more available to the guardians and school community. Public health education would be considered a preferred approach for building trust and fostering childhood vaccine confidence against COVID-19 in Bangladesh.

Evaluation of intentions to get vaccinated against influenza, COVID 19, pertussis and to get a future vaccine against respiratory syncytial virus in pregnant women

IntroductionPregnant women (PW) are at increased risk of complications due to seasonal influenza and Covid-19. Immunization during pregnancy against pertussis and respiratory syncytial virus (RSV) protects newborns from severe diseases. Our aim was to assess intentions to get vaccinated against seasonal influenza, COVID-19, pertussis and RSV in PW and to identify factors associated with intentions. MethodsCross-sectional survey in PW followed at a University Hospital in France assessing their knowledge, and attitudes toward vaccination against influenza, Covid-19, and RSV during pregnancy. Primary outcome was intention to receive each vaccine or potential vaccine. Univariable and multivariable analysis were carried out to identify factors associated with intentions to get vaccinated for each vaccine. ResultsAmong the 1199 PW followed during the study period, 310 completed the questionnaire. Intentions to get vaccinated were respectively 43.9 %, 36.8 %, 36.1 % and 39.4 % against influenza, Covid-19, pertussis and RSV. Overall confidence in vaccines using 5C-model, recommendation by a healthcare professional (HCP), good knowledge about diseases and vaccines and previous influenza vaccination were associated with flu vaccine acceptance with respective adjusted odds ratios and 95 % Confidence Intervals (aOR) 1.69 (1.09–2.61) by one-point increase in confidence score, 4.89 (2.24–10.7), 1.56 by one-point increase in knowledge score (1.26–1.93), 13.5 and (5.3–34.3). Confidence was also associated with Covid-19 and RSV vaccine acceptance with respective aOR and 95 % CI 2.63 (1.7–4.07) and 1.92 (1.3–2.84). For pertussis, previous flu vaccination or pertussis vaccination in the last 5 years were predictors of pertussis vaccine acceptance during the pregnancy with respective aOR and 95 % CI 1.97 (1.1–3.84) and 2.9 (1.6–5.18). ConclusionConfidence is associated with seasonal influenza, COVID-19 and RSV vaccines acceptance in pregnant women. Receiving a recommendation from a HCP was strongly associated with acceptance of influenza vaccine. Recent vaccination against pertussis was not a barrier to pertussis vaccine acceptance during pregnancy.

Beyond Information Provision: Analysis of the Roles of Structure and Agency in COVID-19 Vaccine Confidence in Ethnic Minority Communities.

People from Black and Asian backgrounds are more likely to die from COVID-19 but less likely to be vaccinated, threatening to exacerbate health inequalities already experienced by ethnic minority groups. The literature suggests that mistrust rooted in structural inequality (including socioeconomic position and experience of racism) may be a key barrier to COVID-19 vaccine uptake. Understanding and addressing structural inequality is likely to lead to longer-term impacts than information alone. The aim of this study is to draw on health and sociological theories of structure and agency to inform our understanding of how structural factors influence vaccine confidence. We conducted qualitative interviews and focus groups with 22 people from London and the surrounding areas from December 2021 to March 2022. Fourteen participants were members of the public from ethnic minority backgrounds, and seven were professionals working with the public to address concerns and encourage vaccine uptake. Our findings suggest that people from ethnic minority backgrounds make decisions regarding COVID-19 vaccination based on a combination of how they experience external social structures (including lack of credibility and clarity from political authority, neglect by health services, and structural racism) and internal processes (weighing up COVID-19 vaccine harms and benefits and concerns about vaccine development and deployment). We may be able to support knowledge accumulation through the provision of reliable and accessible information, particularly through primary and community care, but we recommend a number of changes to research, policy and practice that address structural inequalities. These include working with communities to improve ethnicity data collection, increasing funding allocation to health conditions where ethnic minority communities experience poorer outcomes, greater transparency and public engagement in the vaccine development process, and culturally adapted research recruitment processes.

Champions for School Health-An NASN Initiative to Increase Vaccine Confidence, Equity, and Uptake in COVID-19 and School-Required Vaccinations: Part 2.

NASN, with generous funding from Kaiser Permanente (KP) and partnered with the Institute for Educational Leadership, developed and implemented the Champions for School Health (CSH) grant initiative. The CSH initiative awarded 54 Implementation Grants in two funding cycles in 2022, funding school districts and community-based organizations (CBOs) to increase access to the pediatric COVID-19 vaccine as well as school-required immunizations and to increase vaccine confidence among underserved populations in KP's footprint: California, Colorado, Georgia, Hawaii, Maryland, Oregon, Virginia, Washington, and the District of Columbia. These grantees administered a total of 17,630 COVID-19 vaccines to individuals ages 5 or older and 34,025 routine immunizations, of which 8,233 school-required vaccinations went to children of ages 5-11 years. Over 851,000 people were reached by vaccine education events in all nine KP markets. A notable takeaway from the project's results was the new partnerships created and the continuation of existing partnerships by the grantees. NASN's implementation of the CSH initiative and results provides a model and a source of critical data on how school health services and community-based organizations can partner to provide hyper-local responses to community/public health crises. This Part 2 article provides an overview of the key results of the project.

Attitudes and perceptions of Italian Students in Healthcare Settings on COVID-19 vaccines and vaccinations strategies, one year after the immunization campaign.

The topic of vaccine confidence is increasingly relevant, particularly due to the COVID-19 pandemic and the global distribution of COVID-19 vaccines. This issue is even more critical for students in healthcare settings, given their future role not only as vaccine recipients but also as advocates for vaccination. In light of this, achieving a good level of vaccine acceptance is crucial. Hence, the aim of our study was to evaluate the attitudes and perceptions of healthcare students regarding vaccines and COVID- 19 vaccination. Medical and pharmaceutical area students attended an Elective Teaching Activity on COVID-19 vaccines and vaccination campaign, organized at the University of Florence (Italy) and participated in filling two anonymous questionnaires. The first questionnaire was submitted before the Elective Teaching Activity was focused on students' attitudes and perceptions toward vaccines. The second questionnaire was designed to evaluate the students' satisfaction with the course topics. Both descriptive and inferential analyses were performed on the results. In addition, the Vaccine Confidence Index was calculated to evaluate the propensity of students toward vaccinations. A total of 423 students attended the Elective Teaching Activity in the early beginnings of 2022. Overall, students have shown greater confidence in vaccines, compared to COVID-19 vaccines, especially as regards the safety profile. Students' Vaccine Confidence Index was very close to 0.25 value, which indicates being in favor of vaccinations. Nevertheless, in the satisfaction questionnaire filled in at the end of the course, the percentage of students in favor of COVID-19 vaccination increased for both medical (from 94% to 99%) and pharmaceutical area students (from 81% to 97%). Our study suggests that educational activities such as this Elective Teaching Activity, could be considered an effective teaching strategy to improve vaccine acceptance rates among students in healthcare settings.

Co-Designing a Mobile-Based Game to Improve Misinformation Resistance and Vaccine Knowledge in Uganda, Kenya, and Rwanda

Misinformation can decrease public confidence in vaccines, and reduce vaccination intent and uptake. One strategy for countering these negative impacts comes from inoculation theory. Similar to biological vaccination, inoculation theory posits that exposure to a weakened form of misinformation can develop cognitive immunity, reducing the likelihood of being misled. Online games offer an interactive, technology-driven, and scalable solution using an active form of inoculation that engages and incentivizes players to build resilience against misinformation. We document the development of the critical thinking game Cranky Uncle Vaccine. The game applies research findings from inoculation theory, critical thinking, humor in science communication, and serious games. The game content was iterated through a series of co-design workshops in Kampala (Uganda), Kitale (Kenya), and Kigali (Rwanda). Workshop participants offered feedback on cartoon character design, gameplay experience, and the game’s content, helping to make the game more culturally relevant and avoid unintended consequences in East African countries. Our co-design methodology offers an approach for further adaptation of the Cranky Uncle Vaccine game to other regions, as well as a template for developing locally relevant interventions to counter future infodemics.

Factors Associated with COVID-19 Vaccine Hesitancy and Case Status among New Jersey Secondary Educational Professionals.

Vaccine hesitancy remains a societal problem, including during the COVID-19 pandemic. New Jersey (NJ) Safe Schools Program provides work-based learning training to supervisory-level career-technical-vocational education teachers and administrators who have to consider varied state and local mandates concerning COVID-19 vaccination and exemptions. In early 2022, we distributed an online survey via PsychData to individuals trained between 2014 and 2022 to understand NJ teachers' practices and concerns regarding COVID-19 vaccines. Overall, 269 completed the survey. We stratified data by vaccination status, number of doses, booster status, age, teaching experience, gender, race, county of work, and COVID-19 diagnosis status. Overall, results suggested differences in COVID-19-related concerns, including access to, perceptions of, and confidence in COVID-19 vaccines and COVID-19-related practices. About 90.7% received the initial vaccine; 77.7% received the booster. About half the participants had received a positive COVID-19 diagnosis by the time of the survey; they were less likely to get the vaccine or booster if they had received the initial vaccine. Data suggested differences in levels of COVID-19-related concerns and confidence in, or importance of, vaccines when comparing different demographic factors and vaccination practices. The data informs efforts to understand factors affecting vaccine hesitancy among educational professionals.

Leveling the Research Playing Field: Decolonizing Global Health Research Through Web-Based Platforms.

Global health research has traditionally been rooted in colonialism, with some investigators in high-income countries leading and managing research and investigators in low- and middle-income countries serving as implementing partners. The Community Health Worker-Led Intervention for Vaccine Information and Confidence (CIVIC) Project, conducted in India and led jointly by India- and US-based investigators, leveraged web-based platforms to facilitate a more horizontal, inclusive, and balanced approach to partnerships between researchers and the community. Using web-based platforms to conduct research was found to be an effective strategy to engage researchers at all levels and combat systemic barriers associated with in-person activities such as power, economic, social, and gender dynamics. Connecting online for research meetings created a more equitable environment for community members to engage meaningfully with research. Further, by conducting research through web-based platforms, we found that we were able to strengthen the diversity of participants, provide a space for more marginalized groups to speak up, and minimize logistical barriers to attendance. Harnessing web-based approaches in research provides a pathway toward opportunities to promote equity and contribute to the decolonization of global health spaces.

Assessing vaccine hesitancy and health literacy using a new Italian vaccine confidence index and a modified Italian medical term recognition test: A cross-sectional survey on Italian parents

ABSTRACT The decline in children’s vaccination coverage and the resurgence of preventable infectious diseases draw attention to parents’ vaccine hesitancy. Our study introduces two validated tools to independently assess vaccine hesitancy and health literacy among parents with school-age children. We developed a Vaccine Confidence Index (VCI) from 10 Likert items, exploring their relationships through exploratory and confirmatory factor analyses. We modified the IMETER (Italian medical term recognition test) to measure health literacy. We assessed the internal consistency of the modified IMETER and the 10 Likert items using Cronbach’s alpha test (α) and McDonald’s omega total coefficient (ω) with good results (ω = 0.92, α = 0.90; ω = 0.87, α = 0.82 respectively). We used these tools within a questionnaire conducted on 743 parents recruited from pediatric clinic waiting rooms in Italy, collecting demographic data, information sources on vaccines and vaccine-preventable diseases knowledge. The VCI resulting from factor analyses consisted of six items on a ten-point Likert scale, reflecting the ratio of positive to negative items. The survey revealed significant variations in the VCI according to individual features such as education, use of social networks, or Health institutions as sources of information. Multivariate logistic regression identified an association between vaccine intention and the VCI. Health literacy was functional for 91.2% of participants, but knowledge about vaccine-preventable diseases was generally low. The VCI showed no significant association with health literacy and vaccine-preventable diseases knowledge. The VCI and the modified IMETER effectively assess vaccination attitude and health literacy, offering valuable public health tools for tailoring vaccination campaigns to hesitant population subgroups.