COVID-19 Vaccine Hesitancy Research Articles

COVID-19 Vaccine Hesitancy Among People Living with HIV: A Systematic Review and Meta-Analysis.

Vaccine hesitancy is one of the top 10 threats to global health, which affects the prevalence and fatality of vaccine-preventable diseases over the world. During the COVID-19 pandemic, people living with HIV (PLWH) may have higher risks of infection, more serious complications, and worse prognosis without the protection of the COVID-19 vaccine. A systematic review and meta-analysis aiming to evaluate the prevalence of COVID-19 vaccine hesitancy among PLWH was conducted using PubMed, Embase, and Web of Science databases for studies published between January 1, 2020, and August 31, 2022. The pooled prevalence with a corresponding 95%CI of COVID-19 vaccine hesitancy among PLWH was reported. Subgroup analysis was conducted to explore variation in prevalence across different categories. 23 studies with a total of 19,922 PLWH were included in this study. The prevalence of COVID-19 vaccine hesitancy among PLWH was 34.0%, and the influencing factors included male, influenza vaccination experience, and a CD4 count of more than 200 cells/mm3. Subgroup analysis did not identify significant causes of heterogeneity but showed that the prevalence of COVID-19 vaccine hesitancy among PLWH varies by study period, region, and race. Although all PLWH are recommended to receive the COVID-19 vaccine, a large proportion of them remain hesitant to be vaccinated. Therefore, governments and relevant institutions should take specific measures to encourage and promote vaccination to improve the coverage of the COVID-19 vaccine among PLWH.

Using social media surveys and interventions to address vaccine hesitancy in Saudi Arabia

Background: Countering COVID-19 vaccine hesitancy has been a challenge in Saudi Arabia, one of the countries affected most by the pandemic in the Eastern Mediterranean Region. Aims: To identify information needs, perceived benefits, concerns, trusted information sources, social norms, and predictors for COVID-19 vaccine uptake in Saudi Arabia and identify effective messaging strategies to increase vaccination intentions among the unvaccinated. Method: Between March and April 2021, we conducted an online cross-sectional survey (N = 2883), and in part, a randomized experiment for unvaccinated participants (n = 675) in Saudi Arabia using Facebook Ads and Messenger. Unvaccinated participants were randomly assigned to 1 of 5 message conditions and after message exposure, participants were asked if they planned to take the COVID-19 vaccine. Results: In total, 2883 adults participated in the survey. All message framings worked equally well, with no statistically significant difference between the arms. Approximately 80% of the participants across all message conditions said they intended to vaccinate. However, participants wanted to know more about the vaccines; about 35% wanted to know more about vaccine efficacy, 31.5% about safety, 26.8% about health authority’s recommendation, and 3.7% about where to get the vaccines. Health workers (61.4%) and scientists and epidemiologists (25.7%) were the most trusted sources. Others were family members (7.5%), community leaders (2.2%), religious leaders (1.6%), friends (1.4%), and celebrities and social media influencers (0.2%). Conclusion: Vaccine hesitancy can be overcome by understanding individuals’ decision-making processes and using effective risk communication targeted to their needs.

Policies and cultural beliefs: Community perceptions about COVID-19 vaccine hesitancy in Indonesia.

Vaccine hesitancy is a global concern and a significant threat to COVID-19 vaccination programs. This study aimed to explore vaccine hesitancy from the perspective of the Indonesian community related to policies and cultural beliefs. A descriptive qualitative approach was utilized in this study. Twenty participants were recruited from various settings to ensure the representation of experiences in different contexts in Indonesia. Audio-recorded, semi-structured, individual, in-depth interviews were carried out. Content analysis was performed to identify the main key themes. Twenty participants were recruited from various regions of Java Island, Indonesia. The participants revealed hesitancy about the COVID-19 vaccine, including the themes of mistrust, controversy, and the culture and beliefs of the community. This study highlights COVID-19 vaccine hesitancy in Indonesia, which may have implications for the community's perceptions and beliefs regarding the uptake of the COVID-19 vaccine. The trust issue remains a major challenge to convincing the community to accept the vaccine at the grassroots level. Targeted education and communication strategies are essential in addressing trust issues surrounding COVID-19 vaccines among critical stakeholders and religious leaders in Indonesia. Public health nursing plays a crucial role in fostering community acceptance and ensuring the success of vaccination programs.

COVID-19 Vaccine Hesitancy and Associated Factors among Adults and Adolescents Attending COVID-19 Vaccination Centre of South India-A Cross-Sectional Study

Introduction: Challenges related to the acceptance and refusal of COVID-19 vaccination (vaccine hesitancy)emerged as a significant problem worldwide.Objectives: 1. To study socio-demographic profile of the study participants.2.To assess association betweensociodemographic characteristics and vaccine hesitancy among study participants.3. To find out the reasons for vaccination hesitancy among study participants.Methodology: A cross-sectional study was conducted at COVID-19 vaccination centre, in South India. Studyparticipants included were subjects who were due for COVID-19 vaccine. Total sample size was 385.Data wascollected by interview technique.Results: Majority,311(80.8%) of the respondents were urban residents and were in 18-30 age group. Malerespondents were higher 227, (59.0%) than female,158(41.0%). Regarding reasons for COVID-19 vaccine hesitancy, majority, 107 (27.8%) reported they were unaware of vaccination schedule followed by 97 (25.2%) not getting time to go for vaccination and 49 (12.7%) respondents reported fear of side effects of COVID-19 vaccine. We found statistically significant association between COVID-19 vaccine hesitancy and socio-demographic variables like their residence, age, gender, type of family, educational level, marital status and co-morbidity. Conclusion: Regardless of the source of vaccine hesitancy, interventions to encourage vaccination by simplifying messages and emphasizing benefits can be effective.

COVID-19 vaccine hesitancy and associated factors among medical students in Tanzania: evidence from the Catholic University of Health and Allied Science, Mwanza region

Background: Since the outbreak of COVID-19, the government of Tanzania has made efforts and initiatives to protect its citizens. These efforts and control measures are lined with WHO guidelines and the National response plan for controlling the COVID-19 outbreak. Unlike other control measures, the Vaccine remained a promised solution to end the COVID-19 pandemic. Therefore, this study aims to determine the COVID-19 hesitancy level and associated factors among medical students. Furthermore, it aims to provide valuable insights and information that can be applied in future immunization campaigns/strategies to improve vaccination rates among this particular group of future medical professionals during the pandemic. Methods: This is an analytical cross-sectional survey conducted to assess the COVID-19 vaccine hesitancy and associated factors among 580 undergraduate medical students at the Catholic University of Health and Allied Science (CUHAS) in Mwanza region, Tanzania. Data was collected through a questionnaire and analyzed using STATA version 18.0 to extract descriptive and inferential statistics to determine the factors influencing COVID-19 vaccine hesitancy in this particular group of future medical professionals. All the statistics were obtained at a 5% significant level. Results: The vaccine hesitancy was 75.6% (95% CI, 71.9%-79.2%). Thus, more than half of the medical student 54.3% do not trust the efficacy of the COVID-19 vaccine with AOR 2.96 (95% CI, 1.80-4.86, p-value<0.001); likewise, the safety of Vaccine AOR 0.1.89 (95% CI, 1.11-3.21, p-value=0.019). Further, students who do not prefer free riding (i.e., letting others get the vaccine and believing to get the beneficial effect of herd immunity without being vaccinated) were less likely to deny the Vaccine than those who prefer free riding AOR 0.31 (95% CI, 0.31, 0.13-0.75, p-value=0.009). Despite insignificant odds, too much politics behind the COVID-19 vaccine influences vaccine hesitancy with AOR 1.14 (95% CI, 0.61-2.15, p-value=0.676). Conclusion: The study concludes that despite the efforts to communicate public health information to encourage people to overcome vaccine hesitancy and receive Vaccines, the reluctance to get vaccinated against COVID-19 remains higher than the acceptance rate among medical students.

The role of media in Covid-19 vaccine hesitancy

The role of media in Covid-19 vaccine hesitancy

The experience of traumatic events, psychological distress, and social support: links to COVID-19 vaccine hesitancy and trends with age in a group of older Australians

BackgroundVaccination is important to reduce disease-associated morbidity and mortality in an ageing global population. While older adults are more likely than younger adults to accept vaccines, some remain hesitant. We sought to understand how traumatic events, psychological distress and social support contribute to older adults’ intention to receive a COVID-19 vaccine and whether these experiences change with age.MethodsWe analysed survey data collected as part of the Sax Institute’s 45 and Up Study in a population of Australian adults aged 60 years and over. Data were derived from the COVID Insights study; a series of supplementary surveys about how participants experienced the COVID-19 pandemic.ResultsHigher intention to receive a COVID-19 vaccine was associated with greater social support (adjusted odds ratio (aOR):1.08; 95%CI:1.06–1.11; p <.001) while lower intention was associated with personally experiencing a serious illness, injury or assault in the last 12 months (aOR:0.79; 95% CI:0.64–0.98; p =.03). Social support and the experience of traumatic events increased significantly with age, while psychological distress decreased.ConclusionsThere may be factors beyond disease-associated risks that play a role in vaccine acceptance with age. Older Australians on the younger end of the age spectrum may have specific needs to address their hesitancy that may be overlooked.

Causes and Effects of COVID-19 Vaccine Hesitancy Among Pregnant Women and its Association with Adverse Maternal, Placental, and Perinatal Outcomes.

Populations identified to be severely affected by COVID-19, such as pregnant patients, require special consideration in vaccine counseling, access, and provider education. Maternal infection with COVID-19 poses a significant risk to the maternal-fetal dyad with known adverse placenta destruction [1-5]. Despite the widespread access and availability of vaccinations, vaccine hesitancy continues to persist and is highly prevalent in pregnant populations [6-9]. Addressing the multitude of social ecological factors surrounding vaccine hesitancy can aid in providing holistic counseling [10]. However, such factors are foremost shaped by maternal concern over possible fetal effects from vaccination. While changes in policy can help foster vaccine access and acceptance, increasing global provider education and incorporation of motivational interviewing skills are the first steps towards increasing maternal acceptance.

A qualitative inquiry on drivers of COVID-19 vaccine hesitancy among adults in Kenya.

COVID-19 vaccination rates have been low among adults in Kenya (36.7% as of late March 2023) with vaccine hesitancy posing a threat to the COVID-19 vaccination program. This study sought to examine facilitators and barriers to COVID-19 vaccinations in Kenya. We conducted a qualitative cross-sectional study in two purposively selected counties in Kenya. We collected data through 8 focus group discussions with 80 community members and 8 in-depth interviews with health care managers and providers. The data was analyzed using a framework approach focusing on determinants of vaccine hesitancy and their influence on psychological constructs. Barriers to COVID-19 vaccine uptake were related to individual characteristics (males, younger age, perceived health status, belief in herbal medicine, and the lack of autonomy in decision making among women - especially in rural settings), contextual influences (lifting of bans, myths, medical mistrust, cultural and religious beliefs), and COVID-19 vaccine related factors (fear of unknown consequences, side-effects, lack of understanding on how vaccines work and rationale for boosters). However, community health volunteers, trusted leaders, mandates, financial and geographic access influenced COVID-19 vaccine uptake. These drivers of hesitancy mainly related to psychological constructs including confidence, complacency, and constraints. Vaccine hesitancy in Kenya is driven by multiple interconnected factors. These factors are likely to inform evidence-based targeted strategies that are built on trust to address vaccine hesitancy. These strategies could include gender responsive immunization programs, appropriate messaging and consistent communication that target fear, safety concerns, misconceptions and information gaps in line with community concerns. There is need to ensure that the strategies are tested in the local setting and incorporate a multisectoral approach including community health volunteers, religious leaders and community leaders.

Encouraging Positive Dialog Toward COVID-19 Vaccines on Social Media Using Hope Appeals, Celebrity Types, and Emoticons

ABSTRACT This study examined the effects of hope appeals, celebrity endorser types, and valence of emoticons on COVID-19 vaccine confidence, hesitancy, and intention to receive the COVID-19 vaccine. The potential moderating effects of parasocial identification were also assessed. Experiment 1 was a 2 (hope appeals: high vs. low personal relevance) x 3 (celebrity types: politicians vs. scientists vs. athletes) between-subjects experiment with a sample of U.S. adults (N = 363). Experiment 2 was a 2 (hope appeals: high vs. low personal relevance) x 3 (valence of emoticons: positive vs. neutral vs. negative) between-subjects experiment with a sample of U.S. adults (N = 369). Findings indicated that COVID-19 vaccine messages with politician endorsement and low personal relevance significantly influenced intention to receive the COVID-19 vaccine. Moreover, COVID-19 vaccine messages with neutral emoticons significantly impacted COVID-19 vaccine confidence and COVID-19 vaccine hesitancy. Parasocial identification with the endorser was also found to play a role in affecting vaccine hesitancy. Implications for future research in vaccine communication are discussed.

Toward trustworthy COVID-19 interventions: Building vaccine trust through community-university partnerships.

Prior research identifies trust as critical to increase vaccine acceptance and uptake. However, few intervention studies have sought to develop or test strategies for bolstering vaccine-related trust. To address this gap, this exploratory study identifies features of COVID-19 vaccine hesitancy interventions that can promote or undermine trust across three interconnected domains: institutional, interpersonal, and product (the vaccine itself). We draw on focus groups (N = 27 participants) with community and university partners involved with hosting COVID-19 testing and vaccine events in underserved Oklahoma communities. Focus groups explored participants' experiences serving community health needs and elicited feedback on proposed vaccine hesitancy interventions. Proposed interventions included two technology-based strategies (text message reminders and tablet-based testimonials and education) and one dialogue-based strategy (anti-body test interpretation). We find that community partners perceived local universities as trustworthy institutions because of their association with popular sports programs, academic credentials, and proximity, creating opportunities to address vaccine-related distrust through community-university partnerships. The most promising intervention strategies for building interpersonal trust included engaging in one-on-one dialogue and using autonomy enhancing approaches. Finally, interventions that successfully encouraged vaccine trust did so by incorporating personalized health information about individuals' potential level of protection and susceptibility to the COVID-19 virus. These findings can inform future public health efforts to create trustworthy vaccine hesitancy interventions.

Validation of the questionnaire "Pregnancy Vaccine Hesitancy Scale (pVHS)" toward COVID-19 vaccine for Malaysian pregnant women.

Pregnancy is one of the risks for severe COVID-19 infection, and receiving a vaccination is one of the effective methods to reduce disease severity. However, COVID-19 vaccine hesitancy among pregnant women remains an issue. This study aims to develop and validate the pregnancy Vaccine Hesitancy Scale (pVHS) toward COVID-19 vaccine for Malaysian pregnant women. An 8-item Malay language pregnancy Vaccine Hesitancy Scale (pVHS-M) for COVID-19 was adapted from the adult Vaccine Hesitancy Scale and validated using Exploratory Factor Analysis. Six expert panels were involved in content validity, and ten pregnant women were involved in face validity. A cross-sectional study on 200 pregnant women was conducted between October 2022 and March 2023 at the Obstetrics and Gynaecology Clinic, Universiti Sains Malaysia, Kelantan. The item-level content validity index is 1.00, demonstrating good relevance of the eight items used to assess COVID-19 vaccine hesitancy. The item-level face validity index obtained is 0.99, indicating that the items were clear and comprehensible. The Cronbach alpha score was 0.944, with factor loadings ranging from 0.79 to 0.89. The pVHS-M demonstrated good internal consistency, indicating that it is a valid and reliable tool for assessing COVID-19 vaccine hesitancy among pregnant women.

Perceptions, Knowledge, and Attitudes of Elderly Turkish Individuals Regarding Covid-19 Vaccine Hesitancy

Vaccination activities aim to prevent contagious diseases, deaths, and permanent sequels caused by these diseases. Due to the Covid-19 virus, which has affected the whole world, all people have been directly affected by the negative effects of this virüs. Especially since the elderly population is more affected by this virus, it has become the group most exposed to social isolation. Şanlıurfa is accepted as the lowest province in Turkey in terms of Covid-19 vaccination rate. This study was conducted among 507 elderly people, aged 60 and older who lived in Şanlıurfa, between 01.07.2022 and 30.07.2022. The average of the confidence perception sub-dimension was found as 3.14 and the average of conspiracy theories in the sub-dimension was found as 2.79 on the scale used for the study. 35.1% of the participants stated that they did not trust in Covid-19 vaccine, and 64.9% of them stated that they trust it. 23.9% of elderly people who participated in the study stated that they did not receive any vaccine and 43.6% of them stated that they received 2 doses. To the question, “would you get the covid-19 vaccine again?” only 18.7% of the participants (95) answered yes, and 81.3% of them (412) answered no. Informing elderly individuals and families by healthcare professionals about the dangers of the Covid-19 virus and the reliability of vaccines developed against this virus will increase the vaccination rate.

Factors associated with vaccine hesitancy against COVID-19 among adults in Europe: a descriptive study analysis applying socio-ecological framework

ObjectiveThis study aimed to explore the factors associated with COVID-19 vaccine hesitancy in Europe among adults by using the Socio-Ecological Model.ResultsThis cross-sectional study used secondary data collected from respondents residing in 27 EU countries at the time of May 2021. The outcome was vaccine hesitancy against COVID-19, and the total sample size of 23,606 was analysed by binary logistic regression, as well as McKelvey and Zavonoia’s R2. After adding each level of variables, the model found the significant and increased association with vaccine hesitancy in younger age groups (21–39 years and 40–60 years vs. 65 years+), who left full-time education at a young age (16–19 years), those with manual jobs, those with children at home, individuals residing in small towns, and beliefs related to the vaccine. Together, the levels explained 49.5% of the variance associated with vaccine hesitancy, and the addition to each variable layer increased the variance. This highlights the need to consider broad factors at multiple levels to enhance vaccine acceptance and uptake.

Heritage and hesitancy: how preference for traditional Chinese medicine influences vaccine attitudes.

Vaccine hesitancy, amplified by the COVID-19 pandemic, is a pressing public health challenge. This study investigates the association between Traditional Chinese Medicine (TCM) preference and COVID-19 vaccine hesitancy within China. The study uses data from the 2021 Chinese General Social Survey (CGSS) (N = 2,690). Logistic regressions and Karlson-Holm-Breen (KHB) method are employed to analyzed the relationship between TCM preference and vaccine hesitancy. The study reaffirms prior findings by revealing a robust and stable association between TCM preference and vaccine hesitancy, which remains unaffected by socioeconomic and demographic confounders, as well as institutional trust dynamics of healthcare system. Contrary to expectations, TCM enthusiasts do not exhibit vaccine hesitancy based on divergent epistemological views concerning vaccine risks and immunity acquisition compared to biomedicine. This research enriches understandings of the intricate relations between healthcare paradigms and vaccine attitudes, inviting further inquiry into the role of CAM in shaping vaccination behaviors across different cultures and contexts. The insights bear significant public health implications for enhancing vaccine acceptance and coverage, particularly among populations where CAM practices wield substantial influence.

Protocol for a community-based digital storytelling pilot intervention to reduce Hispanic parents' vaccine hesitancy to immunize their children against COVID-19.

COVID-19 vaccines, currently available to children over six months old, are a powerful method of reducing the risk of COVID-19-related hospitalizations and death. However, vaccination rates among Hispanic children remain suboptimal, primarily due to parental vaccine hesitancy. Health communication researchers have suggested using culturally aligned storytelling to reduce vaccine hesitancy; however, few studies have evaluated this approach for Hispanic parents of unvaccinated children. Working with community health workers, we will engage Hispanic parents who were previously hesitant to vaccinate their child(ren) against COVID-19 but currently support vaccination. We will ask them to share their stories of conversion in COVID-19 vaccine perspectives to help other parents overcome their mistrust of COVID-19 vaccines. We will then assess the feasibility and acceptability of a web-based pilot digital storytelling intervention based on these conversion stories vs. an information-only control among 80 parents and/or legal guardians of children who are not up-to-date with COVID-19 vaccines. We will also examine pre- to post-intervention changes in vaccine perceptions, hesitancy, intentions, and uptake of children's COVID-19 vaccination at two months post-intervention. If our pilot study demonstrates feasibility and acceptability while reducing COVID-19 vaccine hesitancy and increasing vaccine uptake, we will conduct a full-scale randomized controlled trial to examine the effectiveness of the DST intervention to reduce vaccine hesitancy.

Exploring Factors Influencing COVID-19 Vaccine Hesitancy and Refusal: A Study in Italy during the Vaccine Rollout.

The availability of an effective vaccine against COVID-19 virus marked a crucial moment in the fight against its pandemic spread. Although distribution of the vaccine began in December 2020, high acceptance rates and repeated administrations are needed to achieve widespread immunization, but hesitation toward the vaccine persists to this day. To identify psychological variables and other factors associated with vaccine hesitancy, we conducted a study from August 2021 to October 2022. An Internet-based survey gathered data from 137 Italian adults, exploring attitudes, sociodemographic characteristics, psychological variables, and immunization behavior. The results analysis showed that gender (69.2% of vaccine-adverse people were males), education (years of education was negatively correlated with vaccine hesitancy), and religion (not declaring oneself religious or atheist was more likely to be associated with hesitancy toward the vaccine) were the variables influencing attitudes toward the vaccine. Other psychological variables differentiated people with opposite attitudes toward the vaccine: high scores on the Conspiracy Mentality Questionnaire (CMQ) and Core Belief Inventory (CBI) were positively correlated with vaccine hesitancy, indicating that individuals with more pronounced core belief violation, due to the pandemic, tend to express higher levels of vaccine hesitancy. Finally, a linear regression analysis confirmed the role of participants' conspiracy mentality as a valid predictor for vaccine hesitancy.

Partisan divide and Racial/Ethnic disparities in COVID-19 vaccine hesitancy among Parents/Guardians and vaccine uptake among children in the U.S.

ObjectivesWe undertook an observational study to assess the impact of state-level partisanship and parents’/guardians’ race/ethnicity on their degree of COVID-19 vaccine hesitancy. Material and MethodsWe observed a pooled cross-section of 59,280 U.S. adults residing with children in the same household between June 29 and November 14, 2022. Using household-weighted logistic regression models, we evaluated the association between partisanship, race/ethnicity, and vaccine hesitancy, while controlling for other social determinants of COVID-19 vaccine hesitancy. Results and ConclusionsWe found that children were less likely to receive a COVID-19 vaccine if they resided in Republican as compared to Democratic states, with the difference in probability greatest among those households where parents/guardians identified as White. We also found that children were less likely to receive a COVID-19 vaccine if their parents/guardians identified as White as compared to any other race/ethnicity, with the differences in probability greatest among households in Republican states.

Leveraging Artificial Intelligence to Predict Health Belief Model and COVID-19 Vaccine Uptake Using Survey Text from US Nurses.

We investigated how artificial intelligence (AI) reveals factors shaping COVID-19 vaccine hesitancy among healthcare providers by examining their open-text comments. We conducted a longitudinal survey starting in Spring of 2020 with 38,788 current and former female nurses in three national cohorts to assess how the pandemic has affected their livelihood. In January and March-April 2021 surveys, participants were invited to contribute open-text comments and answer specific questions about COVID-19 vaccine uptake. A closed-ended question in the survey identified vaccine-hesitant (VH) participants who either had no intention or were unsure of receiving a COVID-19 vaccine. We collected 1970 comments from VH participants and trained two machine learning (ML) algorithms to identify behavioral factors related to VH. The first predictive model classified each comment into one of three health belief model (HBM) constructs (barriers, severity, and susceptibility) related to adopting disease prevention activities. The second predictive model used the words in January comments to predict the vaccine status of VH in March-April 2021; vaccine status was correctly predicted 89% of the time. Our results showed that 35% of VH participants cited barriers, 17% severity, and 7% susceptibility to receiving a COVID-19 vaccine. Out of the HBM constructs, the VH participants citing a barrier, such as allergic reactions and side effects, had the most associated change in vaccine status from VH to later receiving a vaccine.

Determinants of Vaccine Hesitancy among African American and Black Individuals in the United States of America: A Systematic Literature Review.

Despite the crucial role the COVID-19 vaccine played in curbing the pandemic, a significant portion of Black and African American individuals expressed hesitancy toward being vaccinated. This review aimed to identify the determinants of COVID-19 vaccine hesitancy among Black and African American individuals in the U.S. The literature search was conducted in December 2022 according to the PRISMA criteria focusing on empirical studies. Data extraction methods, critical appraisal, and secondary thematic analysis were conducted on both quantitative and qualitative studies. Sixteen quantitative studies identified the key factors associated with vaccine hesitancy, such as confidence in vaccine effectiveness, safety, and trust in the healthcare system. Fourteen qualitative studies revealed major themes of mistrust, fear, and information needs, including historical mistrust, concerns about the vaccine development process, and contemporary institutional mistrust. The synthesis of quantitative and qualitative findings derived from this review provides a nuanced understanding of the determinants of vaccine hesitancy in Black and African American communities in the U.S., offering a foundation for the development of evidence-based interventions. Mistrust in the healthcare system, fear, and informational gaps on vaccine safety and effectiveness were identified as significant barriers to vaccination, demanding targeted interventions.