COVID-19 Vaccine Hesitancy Research Articles

Exploring COVID-19 Vaccine Intentions, Perceptions, and Uptake Among the Saudi Population.

Background The widespread hesitancy, delays in acceptance, or outright refusal to receive vaccinations, even when readily available, present a notable global challenge. This is particularly pertinent in the context of COVID-19 vaccine hesitancy, where research shows considerable variability in hesitancy rates worldwide. The primary aim of this study is to investigate COVID-19 vaccine intentions among the Saudi population using behavioral theories as a framework. Methodology A descriptive cross-sectional study was conducted in the Kingdom of Saudi Arabia from January 2022 to December 2022. An online self-administered survey was distributed via social media to reach the targeted participants. Both men and women aged >18 years were included, while non-Saudi individuals and people who are less than 18 years old were excluded. A total of 1,139 participants were included. Results The study found that about 96% of respondents were willing to receive a COVID-19 vaccination. Analyzing sociodemographic and COVID-19-related factors with vaccine intention showed that those previously diagnosed with COVID-19 were less likely to refuse vaccination (P = 0.015). Univariate analyses revealed significant differences in the health belief model (HBM) and theory of planned behavior (TPB) dimensions between willing and unwilling participants. Willing individuals perceived greater infection severity (P = 0.543), higher vaccination benefits (P < 0.01), fewer barriers (P < 0.01), more cues to action (P < 0.01), and lower infection prevention self-efficacy (P < 0.01) compared to the unwilling group. TPB dimensions also differed, with willing individuals having more favorable vaccine attitudes (P < 0.01) and stronger vaccination social norms (P < 0.01). A multivariate logistic regression indicated that having COVID-19 increased vaccine willingness likelihood (odds ratio [OR] = 2.11, 95% confidence interval [CI] 1.14-3.91). Perceived barriers (OR = 0.61, 95% CI 0.44-0.85), self-efficacy (OR = 1.96, 95% CI 1.16-3.32) from HBM, and favorable vaccine attitudes (OR = 1.55, 95% CI 1.02-2.35) from TPB were significant predictors of vaccine willingness. Conclusions The TPB highlighted the importance of attitudes and perceived norms in vaccination acceptance, suggesting their value in vaccination promotion strategies. However, further research, including prospective and interventional studies drawing from a wider array of psychological theories, is needed to develop effective interventions for promoting vaccination.

A Qualitative Exploration of Factors Associated with COVID-19 Vaccine Uptake and Hesitancy in Selected Rural Communities in Kenya

Purpose: The post-pandemic management of COVID-19 infections and any emergent outbreaks is because this endemic disease remains a public health concern. Vaccine hesitancy may continue to hamper efforts to respond to any new disease outbreaks and future epidemics. This qualitative study aimed to explore the factors influencing COVID-19 vaccine acceptance and hesitancy in Kenya to gain deeper insights into this issue. Methods: This study was implemented in western Kenya using key informant interviews. Fourteen (14) key informants were purposively selected for this study. All interviews were transcribed and analyzed using thematic analysis. The interpretation of findings was conducted within the framework of the Health Belief Model. Key findings: Knowledge was a critical factor in combatting misinformation and fostering vaccine acceptance among participants in this study. Misinformation included rumors that the vaccine lowers immunity and was intended for population control. Cues to action included influence from political and opinion leaders and observing the loss of life among unvaccinated individuals. Perceived barriers to vaccine uptake included fear of vaccine safety, side effects, long waiting times at the time of our study, fear of contracting COVID-19 at vaccination sites, family/spousal influence on vaccine uptake and fear of the unknown with the vaccine. Conclusions: The findings from this study provide insight into areas for targeted strategies for managing COVID-19 vaccinations and future pandemics. Within the framework of the Health Belief Model, this study identified salient barriers and facilitators of COVID-19 vaccine hesitancy that may be helpful to inform future pandemic responses.

COVID-19 Vaccine Hesitancy among Parents of Children Younger than 12 Years: Experience from a Tertiary Outpatient Clinic.

This study explored parents' attitudes towards vaccinating their children against COVID-19 and the rate of vaccine hesitancy in Oman. A cross-sectional, online, self-administered questionnaire, previously validated and administered between June 2021 and May 2022, was used. The questionnaire consisted of nine items. Parents of children younger than 12 years were eligible for participation. A total of 384 participants, including 207 males (54%), completed the questionnaire, resulting in an 86% response rate (384/447). The results showed that 69% of participants were hesitant to vaccinate their children aged 1-11 years. In parents of children aged 1-4 years, vaccination status was significantly associated with vaccine hesitancy (odds ratio [OR], 0.116; 95% confidence interval [CI], 0.044-0.306; p = 0.001). Furthermore, after multivariable analysis, compared to the fathers, mothers were significantly less likely to be associated with vaccine hesitancy (OR, 0.451; 95% CI, 0.240-0.848; p = 0.013).

The Link between COVID-19 Pandemic and Vaccine Hesitancy

The Link between COVID-19 Pandemic and Vaccine Hesitancy

Conservative Christianity, Anti-Vaccination Activism, and the Challenge to Secularism in Singapore

Abstract A culture war has been brewing in Singapore since 2009 when a conservative Christian group conducted a reverse takeover of a feminist civil society organization and was subsequently expelled from the organization in a publicized meeting between the two groups. Since then, the state has mediated the contestation of values between religious conservatives and liberal groups allied around issues of gender and sexuality. The culture war between the two sides has revolved around creative protests that have evaded state prohibitions against public contestations over what is legally considered private beliefs and affairs. They involve innovative hybridizations of American discourses on values and rights mixed with Asian emphases on family traditions and sentiments. The COVID-19 pandemic has, however, laid bare the adaptation of the American culture war into the Singaporean public sphere. This article looks at and analyzes COVID-19 vaccine hesitancy among conservative Christians in Singapore and their incorporation of anti-vaccination views from American Christian nationalism into secular framings, invoking legal rights and responsibilities aligned with the state’s nationalist discourse. I argue that this represents a new phase of contestation by conservatives, refashioning their religious views into secular frames of public good and morality serving the secular nation. By doing so, they implicitly challenge the state’s regulation of religion as private interests and beliefs. This altered religious activism has shifted the terms of secularism and loosened the hegemony of the state in defining these terms.

Understanding COVID-19 Vaccine Hesitancy Among Brazilian Immigrants: Prevalence, Determinants, and Global Health Implications

Background: Vaccine hesitancy extends beyond simple refusal to receive immunizations, encompassing psychological, cultural, and sociodemographic factors that influence individuals’ perceptions and decision-making regarding vaccines. Objectives: This study aimed to determine the prevalence and factors influencing COVID-19 vaccine hesitancy among Brazilian immigrants. Methods: A survey targeting Brazilian immigrants in Portugal was conducted from May to August 2020, involving 598 participants. The study explored the relationship between vaccine hesitancy and non-compliance with social distancing measures using a Poisson regression model with robust variance to calculate prevalence ratios (PRs). Results: The study identified a vaccine hesitancy rate of 15.1% among Brazilian immigrants. Older individuals (aged 50 and above) exhibited a significantly higher hesitancy, with an adjusted prevalence ratio (aPR) of 10.0 (95% CI: 1.8 - 13.6). Those adhering to a religion were 2.3 times more likely to hesitate (95% CI: 1.4 - 3.4), and a reluctance to follow social distancing measures was associated with a 10.4 times higher hesitancy rate (95% CI: 4.2 - 15.4). Highlighting these correlations is vital for developing strategies to enhance vaccine acceptance and tackle public health challenges. Conclusions: There is a notable rate of COVID-19 vaccine hesitancy among Brazilian immigrants in Portugal, significantly influenced by age, religious practice, and non-adherence to social distancing measures. Implementing targeted educational and awareness programs is recommended to reduce hesitancy and improve vaccine coverage within this community and in similar settings.

COVID-19 Vaccine Motivation and Hesitancy among a Sample of African American, Afro-Caribbean, and African Respondents in the United States.

Understanding the motivations and decisions behind COVID-19 vaccine acceptance is crucial for designing targeted public health interventions to address vaccine hesitancy. We conducted a qualitative analysis to explore COVID-19 vaccine acceptance among diverse ethnic subgroups of Black Americans in the United States. This study investigates the 2021-2022 responses of 79 African American, Afro-Caribbean, and African respondents over the age of 18 in Washington State and Texas. Respondents were asked "Do you plan to get the COVID-19 vaccination?" Qualitative responses were analyzed by content category and ethnic subgroup. Of the 79 responses, 60 expressed favorable perceptions, 16 expressed unfavorable perceptions, and 3 expressed neutral perceptions. Dominant categories among participants in favor of the vaccine included personal health (26), concern for health of family/or community members (13), and desire to protect others (11). Among the 42 vaccinated African American respondents, the primary motivation was personal health (20). The 12 unvaccinated African American respondents cited fear of side effects as their dominate motivation. Caribbean respondents cited family or elders as motivation for their decision. African respondents were nearly unanimous in taking the vaccine (13/16), citing trust in health care, protecting friends and family, and personal health as reasons. Community and personal relationships were critical decision-making factors in accepting the COVID-19 vaccine, with African Americans having the strongest hesitancy.

Trusted sources of information on COVID-19 vaccine in Uganda

BackgroundThe COVID-19 pandemic has dramatically impacted communities worldwide, particularly in developing countries. To successfully control the pandemic, correct information and more than 80% vaccine coverage in a population were required. However, misinformation and disinformation could impact this, thus increasing COVID-19 vaccine hesitancy in communities. Several studies observed the effect of misinformation and disinformation on COVID-19 vaccine acceptance and other responses to the pandemic in the African continent. Thus, the most trusted sources of information on COVID-19 vaccines are critical for the successful management and control of the pandemic. This study aimed to assess the most trusted sources of information on COVID-19 vaccines during the pandemic in Uganda.MethodsWe conducted a cross-sectional study on 587 adult population members in northern Uganda. Single-stage stratified and systematic sampling methods were used to select participants from northern Uganda. An interviewer-administered questionnaire with an internal validity of Cronbach’s α = 0.72 was used for data collection. An Institution Review Board (IRB) approved this study and Stata version 18 was used for data analysis. A Pearson Chi-square (χ2) analysis was conducted to assess associations between trusted sources of COVID-19 vaccine information and selected independent variables. Fisher’s exact test considered associations when the cell value following cross-tabulation was < 5. A P-value < 0.05 was used as evidence for an association between trusted sources of information and independent variables. All results were presented as frequencies, proportions, Chi-square or Fisher’s exact tests, and P-values at 95% Confidence Intervals (CI).ResultsIn a study of 587 participants, most were males, 335(57.1%), in the age group of 25–34 years, 180(31.4%), and the most trusted source of COVID-19 vaccine information were the traditional media sources for example, Televisions, Radios, and Newspapers, 349(33.6%). There was no significant association between sex and trusted sources of COVID-19 vaccine information. However, by age-group population, COVID-19 vaccine information was significantly associated with internet use (14.7% versus 85.3%; p = 0.02), information from family members (9.4% versus 90.6%; p < 0.01), and the Government/Ministry of Health (37.9% versus 62.1%; p < 0.01). Between healthcare workers and non-health workers, it was significantly associated with internet use (32.2% versus 67.8%; p = 0.03), healthcare providers (32.5% versus 67.5%; p < 0.018), the Government/Ministry of Health (31.1% versus 68.9%; p < 0.01), and scientific articles (44.7% versus 55.3%; p < 0.01).ConclusionThe most trusted sources of COVID-19 vaccine information in northern Uganda were Televisions, Radios, and Newspapers. The trusted sources of COVID-19 vaccine information were not significantly different between males and females. However, there were significant differences among age groups and occupations of participants with younger age groups (≤ 44 years) and non-healthcare workers having more trust in Televisions, Radios, and Newspapers. Thus, for effective management of an epidemic, there is a need for accurate communication so that misinformation, disinformation, and malinformation in the era of “infodemic” do not disrupt the flow of correct information to communities.

Education and vaccine hesitancy: Evidence from the Covid-19 pandemic

We estimate the influence of education on vaccine hesitancy focusing on the Covid-19 pandemic. To address the bias arising from the endogeneity of education, we leverage the variation introduced by an extension in school-leaving age that took place in the UK in 1972 and employ a fuzzy regression discontinuity design. We find evidence that an additional year of schooling decreases Covid-19 vaccine hesitancy.

Reach, Acceptability, and Patient Preferences of a Mobile Health-Based Survey to Assess COVID-19 Vaccine Hesitancy Among Patients Receiving Dialysis

Rationale & ObjectiveThe majority of patients with kidney failure receiving dialysis own mobile devices, but the use of mobile health (mHealth) technologies to conduct surveys in this population is limited. We assessed the reach and acceptability of a short message service (SMS) text message-based survey that assessed COVID-19 vaccine hesitancy among patients receiving dialysis. Study DesignCross-sectional SMS-based survey in January 2021. Setting& Participants: Patients receiving in-center hemodialysis, peritoneal dialysis, or home hemodialysis in a non-profit dialysis organization in New York City. Outcomes1) Reach of the SMS survey, 2) Acceptability using the 4-item Acceptability of Intervention Measure (AIM), and 3) Patient preferences for modes of survey administration. Analytical ApproachWe used Fisher’s exact tests and multivariable logistic regression to assess sociodemographic and clinical predictors of SMS survey response. Qualitative methods were used to analyze open-ended responses capturing patient preferences. ResultsAmong 1008 patients, 310 responded to the SMS survey (response rate 31%). In multivariable adjusted analyses, participants who were age 80 and above (aOR 0.49, 95% CI 0.25 – 0.96) were less likely to respond to the SMS survey compared with those aged 18 to 44. Non-Hispanic Black (aOR 0.58, 95% CI 0.39 – 0.86), Hispanic (aOR 0.31, 95% CI 0.19 – 0.51), and Asian or Pacific Islander (aOR 0.46, 95% CI 0.28 – 0.74) individuals were less likely to respond compared with non-Hispanic White participants. Participants residing in census tracts with higher Social Vulnerability Index (SVI), indicating greater neighborhood-level social vulnerability, were less likely to respond to the SMS survey (5th vs. 1st quintile aOR 0.61, 95% CI 0.37 – 0.99). Over 80% of a sample of survey respondents and non-respondents completely agreed or agreed with the Acceptability of Intervention Measure. Qualitative analysis revealed 4 drivers of patient preferences for survey administration: 1) convenience (subtopics: efficiency, multi-tasking, comfort, synchronicity); 2) privacy; 3) interpersonal interaction; and 4) accessibility (subtopics: vision, language, fatigue). LimitationsGeneralizability, length of survey. ConclusionsAn SMS text message-based survey had moderate reach among patients on dialysis and was highly acceptable, but response rates were lower in older (age ≥ 80), non-White individuals, and those with greater neighborhood-level social vulnerability. Future research should examine barriers and facilitators to mHealth among patients on dialysis to ensure equitable implementation of mHealth-based technologies.

COVID-19 Vaccine Hesitancy in a Rural Community of Nigeria

Introduction: Vaccine hesitancy is a major challenge to public health, particularly in the context of the COVID-19 pandemic. This research was aimed at examining COVID-19 vaccine hesitancy in the Idumebo Community, Irrua, Edo State, Nigeria, to understand the factors influencing vaccine acceptance and refusal. Objective: The primary objective of this research was to determine the level of knowledge, uptake, and reasons for vaccine hesitancy among residents of Idumebo, Irrua Edo State. By exploring these factors, the study aimed to provide insights that can inform targeted interventions to improve vaccine acceptance rates in the community. Method: A descriptive cross-sectional study was done among residents of age 18-60 years in Idumebo, utilizing structured questionnaires to gather data on socio-demographic characteristics, knowledge of COVID-19, and attitudes towards vaccination. Ethical considerations were prioritized, with institutional and community consent obtained before data collection. Results: The findings showed a high degree of awareness of COVID-19 among participants, with a majority acknowledging the contagious nature of the disease. However, vaccine hesitancy was observed among a subset of respondents, with reasons ranging from concerns about safety and efficacy to misinformation and mistrust. These results underscore the need for targeted educational campaigns and community engagement to address vaccine hesitancy effectively. Conclusion: It was concluded that the study brought to light the complex dynamics of COVID-19 vaccine hesitancy in the Idumebo Community, revealing the necessity of tailored interventions to address barriers to vaccine acceptance. By fostering a better understanding of community attitudes and concerns, public health authorities can develop strategies to enhance vaccine uptake and combat the spread of COVID-19 in the region.

COVID-19 Vaccine Hesitancy and Social Media Use: A lesson learnt from pandemic

Objective: This study aims to assess the level of COVID-19 vaccine hesitancy among Vietnamese adults and examine the relationship between social media use and vaccine hesitancy. Methods: A cross-sectional study was conducted from July 26 to August 10, 2021, using an online survey of 702 Vietnamese adults. The Oxford COVID-19 vaccine hesitancy scale was used to measure vaccine hesitancy. A linear regression model was used to analyze the factors associated with vaccine hesitancy. Results: Our study found that 15.1% of respondents were hesitant about receiving the COVID-19 vaccine, with an average hesitancy score of 9.52±2.66. Students and the unemployed had higher levels of hesitancy (B=0.58; 95%CI=0.02-1.15; p=0.043 and B=1.59; 95%CI=0.41-2.76, p=0.008, respectively. Hesitancy was also significantly associated with receiving positive information from social media (Facebook, Zalo) (B=-0.31; 95%CI=0.5 to -0.12; p=0.001) and trust in social media information (B=-0.45; 95%CI=-0.72 to -0.19; p=0.001). Conclusion: The results of this study highlight the need for targeted interventions to address vaccine hesitancy among Vietnamese people, particularly in the context of the shortage of vaccines and low public trust in 2021 and its practical evidence for future preparation in emerging pandemics.

Social and Structural Determinants of Health Associated with COVID-19 Vaccine Hesitancy among Older Adults in the United States.

State-level COVID-19 vaccination rates among older adults have been uneven in the United States. Due to the immunocompromised nature of older adults, vaccine hesitancy increases the risk of morbidity and mortality. This study aims to determine the association between the social determinants of health, the structural determinants of health, and COVID-19 vaccine hesitancy among older adults in the United States. Secondary data from the Health and Retirement Study (HRS) dataset were used. A descriptive analysis and multinomial multivariable logistic regression were performed to examine the association of the independent variables-gender, age, race, immigration status, marital status, broadband internet access, social security income, Medicare coverage, education, and frequency of religious service-with the dependent variable, vaccine hesitancy. Compared to the respondents with no vaccine hesitancy and without the specific predictor, the respondents who reported religious attendance at least once/week were more likely to be "somewhat hesitant", divorced respondents had higher odds of being "somewhat hesitant", and older adults aged 65-74 years were more likely to be "very hesitant" or "somewhat hesitant" about the COVID-19 vaccine. Compared to the respondents with no vaccine hesitancy and without the specific predictor, females had higher odds of being "very hesitant", "somewhat hesitant", or a "little hesitant", and African Americans were more likely to be "very hesitant", "somewhat hesitant", or a "little hesitant" about the COVID-19 vaccine. Addressing these factors may limit the barriers to vaccine uptake reported among older adults and improve herd immunity among the immunocompromised population.

COVID-19 vaccine hesitancy among adults in India: A primary study based on health behavior theories and 5C psychological antecedents model.

Despite the significant success of India's COVID-19 vaccination program, a sizeable proportion of the adult population remains unvaccinated or has received a single dose of the vaccine. Despite the recommendations of the Government of India for the two doses of the COVID-19 vaccine and the precautionary booster dose, many people were still hesitant towards the COVID-19 full vaccination. Hence, this study aimed to identify the primary behavioral and psychological factors contributing to vaccine hesitancy. Cross-sectional data was collected via a multi-stage sampling design by using a scheduled sample survey in the Gorakhpur district of Uttar Pradesh, India, between 15 July 2022 to 30 September 2022. This study has utilized three health behavior models-the Health Belief Model (HBM), the Theory of Planned Behavior (TPB), and the 5C Psychological Antecedents of vaccination, and employed bivariate and multivariable binary logistic regression model to assess the level of vaccine hesitancy and predictive health behavior of the respondents. Results indicate that among the constructs of the HBM and 5C Antecedents models, "perceived benefits", "confidence" and "collective responsibility" showed a lesser likelihood of COVID-19 vaccine hesitancy. However, in the TPB model constructs, a 'negative attitude towards the vaccine' showed a four times higher likelihood of COVID-19 vaccine hesitancy. From the future policy perspective, this study suggested that addressing the issue of 'negative attitudes towards the vaccine' and increasing the trust or confidence for the vaccine through increasing awareness about the benefits of the vaccination in India may reduce vaccine hesitancy.

Acceptability of an Incentivized Peer Referral Intervention to Address COVID-19 Vaccine Hesitancy Among Adults in Yopougon-Est, Côte d'Ivoire.

Vaccine hesitancy persists as a barrier to vaccine uptake among adults across geographies. We pilot-tested an incentivized peer referral intervention in Yopougon-Est, Côte d'Ivoire, to encourage adults who recently received COVID-19 vaccination to discuss their experiences and motivate family and friends to seek vaccination.Implementation: From May through June 2023, the intervention operated at 2 vaccination sites, where staff approached individuals immediately after receiving COVID-19 vaccination. Interested vaccine recipients received up to 9 referral coupons to distribute among their social circles, with a small financial incentive (approximately US$3) offered for each person they referred who returned to 1 of the 2 sites for COVID-19 vaccination. We collected data on numbers of people vaccinated and coupons returned. Qualitative interviews were conducted with 40 referred vaccine recipients and 7 public health officials. During the 6-week intervention, 450 newly vaccinated individuals were offered the opportunity to enroll, with 197 opting to distribute coupons. Nearly half (45%) of these peer mobilizers who distributed coupons referred at least 1 person who subsequently came in for vaccination, and most of this subset had 2 or more completed referrals. Qualitative findings revealed that coupons served as effective reminders, sparking discussions within social networks and prompting vaccine-seeking behavior. According to the referred vaccine recipients, hearing about their peers' vaccination experience influenced uptake. Vaccine recipients and public health officials found the small referral incentive acceptable. Officials noted the intervention's potential utility and cost effectiveness, suggesting possible sustainability. This incentivized peer referral intervention, capitalizing on peer networks and social norms, holds promise for increasing vaccine uptake in Yopougon-Est and potentially in other vaccination contexts globally. Practitioners can leverage the implementation guide and training materials we developed to replicate the intervention at larger scale and assess impact on vaccination trends.

COVID-19 Vaccine Acceptance and Hesitancy among People Living with HIV: Review and Meta-Analysis.

This study aims to estimate the COVID-19 vaccine acceptance and hesitancy among people living with HIV (PLWHA). A search for observational studies was conducted in five databases and preprinted literature. Summary estimates were pooled using a random effects model and meta-regression. Of 150 identified studies, 31 were eligible (18,550 PLWHA). The weighted prevalence of COVID-19 vaccine hesitancy overall was 29.07% among PLWHA (95%CI = 24.33-34.32; I² = 98%,) and that of vaccine acceptance was 68.66% (95%CI = 62.25-74.43; I² = 98%). Higher hesitancy prevalence was identified in low/lower-middle income countries (35.05; 95% CI = 19.38-54.78). The heterogeneity was explained by the risk of bias, region, and year of data collection. The findings conclude that the COVID-19 vaccine hesitancy rate remains high, especially in low-income countries. Evidence-informed interventions aimed at increasing COVID-19 vaccine acceptance at the national and individual levels ought to be designed to increase COVID-19 vaccine acceptance among PLWHA.

Hesitancy Towards COVID-19 Vaccine Among Students of Medical and Allied Health Sciences in Khyber Pakhtunkhwa.

To measure COVID-19 vaccine hesitancy and its associated factors among medical and allied health sciences students of Khyber Pakhtunkhwa. This cross-sectional survey was conducted online using Google survey platform in March 2021. Study population comprised of medical and allied health sciences students studying in medical/allied health sciences academic institutes in Khyber Pakhtunkhwa. The web-based online link was provided to around 800 students to fill in the questionnaire via email, WhatsApp and/or social media network. Response rate was around 50%. The main outcome variable was vaccine hesitancy. Factors associated with vaccine hesitancy were explored by bivariate and multivariate regression analysis. Out of 398 medical and allied health sciences students, there were 193 (48.5%) males and 205 (51.5%) females with mean age was 22.6± 2.8 years. The vaccine hesitancy rate was found to be 52.8%. A significant relationship between vaccine hesitancy and gender was observed. Other factors including lack of adequate knowledge about vaccines (p < 0.001), Chinese origin of vaccines (p < 0.001), lack of knowledge that vaccination can reduce the chances of acquiring infection (p < 0.001), fear of potential side effects (p < 0.001) and hidden agenda behind free forceful vaccination (p = 0.045), were found to be main barriers or reasons responsible for COVID-19 vaccine hesitancy among medical and allied health sciences students. Important associated barriers with COVID-19 vaccine hesitancy included gender, lack of information, fear of side effects, lack of trust in imported and Chinese vaccines, and perception of hidden agenda behind COVID-19 vaccination.

A Latent Profile Analysis of COVID-19 and Influenza Vaccine Hesitancy among Economically Marginalized Hispanic Mothers of Children under Five Years of Age in the US.

Rates of COVID-19 and influenza vaccine coverage among Hispanic young children continue to be low in comparison to other racial and ethnic groups in the United States. This study utilized a person-centered approach to understand COVID-19 and influenza vaccination hesitancy for young children under the age of five among 309 economically marginalized Hispanic mothers. Drawing on the cultural health belief model, in 2022, following FDA approval of the COVID-19 vaccine for young children, a latent profile analysis was conducted from which three profiles emerged. The Low Acculturation group (Profile 1), was notable for lower acculturation, moderate cultural medical mistrust, lower access to vaccines, and higher financial security. Compared to Profile 1, the two remaining profiles had higher acculturation and lower levels of financial security, but differed in that the High Acculturation group (Profile 2) had higher vaccine accessibility and the Moderate Acculturation group (Profile 3) had higher cultural medical mistrust. Relative to other profiles, Low Acculturation mothers were more likely to plan to vaccinate their child against current and seasonal COVID-19 and seasonal influenza, report that their child's health provider recommended the COVID-19 shot and reported lower COVID-19 and influenza vaccine mistrust. However, they also reported lower vaccine accessibility and moderate levels of cultural medical mistrust. The study highlights the importance of developing person-centered public health strategies that draw on Hispanic cultural values and consider diversity within lower income Hispanic populations to increase future pediatric COVID-19 and flu vaccination coverage among young Hispanic children.

Anxiety and fear of COVID-19 as potential mechanisms to explain vaccine hesitancy among adults.

Vaccine hesitancy is a significant global problem resulting from the interaction of multiple factors, including mental health factors. However, the association of COVID-19 vaccine hesitancy with mental health has not been well-examined, especially in Arab culture. This study aims to identify the correlation between anxiety/fear of COVID-19 and vaccine hesitancy among Saudi adults. An online-based survey was administered to 558 participants from all regions of Saudi Arabia using the snowball technique. However, this sample may not be representative of the Saudi adult population. Participants responded to the Questionnaire of Vaccine Hesitancy, the COVID-19-Anxiety Questionnaire (C-19-A), and the Fear of COVID-19 Scale (FCV-19S). Data were analyzed on vaccine uptake, vaccine hesitancy, coronavirus infection, and demographic variables. The predictive factors of vaccine hesitancy were examined in one model using multiple regression analysis by the Enter method (P= 0.05). COVID-19 anxiety and fear have significant correlations with vaccine hesitancy (Phi=0.33, P=0.017; Phi=0.29, P=0.013, respectively). Anxiety and fear were higher among unhesitating participants (t =2.469, P=0.014; t=2.025, P=0.043, respectively). Participants who had previously been infected with coronavirus were more likely to be hesitant (X2=23.126, P=0.000). Participants who scored high in anxiety were more likely to be vaccinated (F=3.979, P=0.019) and have a secondary school or college education (F=4.903 P=0.002). COVID-19 anxiety, gender, and coronavirus infection significantly predicted vaccine hesitancy. Anxiety and fear of COVID-19 are among the most important factors correlated with vaccine hesitancy; unhesitant people are more likely to have anxiety and fear. COVID-19 anxiety significantly predicted vaccine hesitancy. We recommend integrating psychological care into vaccination plans to help increase the uptake rate during potential subsequent pandemics. Relevant intervention programs can be designed to help increase vaccine acceptance, deal with vaccine hesitancy, and relieve psychological symptoms during major pandemics. Psychologists can provide awareness messages, counselling seminars, online mentoring, or telemental health outreach.

Sociodemographic Trends and Correlation between Parental Hesitancy towards Pediatric COVID-19 Vaccines and Routine Childhood Immunizations in the United States: 2021-2022 National Immunization Survey-Child COVID Module.

Multiple factors may influence parental vaccine hesitancy towards pediatric COVID-19 vaccines and routine childhood immunizations (RCIs). Using the United States National Immunization Survey-Child COVID Module data collected from parents/guardians of children aged 5-11 years, this cross-sectional study (1) identified the trends and prevalence estimates of parental hesitancy towards pediatric COVID-19 vaccines and RCIs, (2) examined the relationship between hesitancy towards pediatric COVID-19 vaccines and RCIs, and (3) assessed trends in parental hesitancy towards RCIs by sociodemographic characteristics and behavioral and social drivers of COVID-19 vaccination. From November 2021 to July 2022, 54,329 parents or guardians were interviewed. During this 9-month period, the proportion of parents hesitant about pediatric COVID-19 vaccines increased by 15.8 percentage points (24.8% to 40.6%). Additionally, the proportion of parents who reported RCIs hesitancy increased by 4.7 percentage points from November 2021 to May 2022 but returned to baseline by July 2022. Over nine months, parents' concerns about pediatric COVID-19 infections declined; however, parents were increasingly worried about pediatric COVID-19 vaccine safety and overall importance. Furthermore, pediatric COVID-19 vaccine hesitancy was more prevalent among parents of children who were White (43.2%) versus Black (29.3%) or Hispanic (26.9%) and those residing in rural (51.3%) compared to urban (28.9%) areas. In contrast, RCIs hesitancy was higher among parents of children who were Black (32.0%) versus Hispanic (24.5%) or White (23.6%). Pediatric COVID-19 vaccine hesitancy was 2-6 times as prevalent among parents who were RCIs hesitant compared to those who were RCIs non-hesitant. This positive correlation between parental hesitancy towards pediatric COVID-19 vaccines and RCIs was observed for all demographic and psychosocial factors for unadjusted and adjusted prevalence ratios. Parent-provider interactions should increase vaccine confidence, shape social norms, and facilitate behavior change to promote pediatric vaccination rates.