Determinants Of Vaccine Hesitancy Research Articles

PSUN143 Perspectives of Patients Attending Endocrinology Clinic About COVID-19 Vaccination.

Abstract Introduction The outbreak of coronavirus disease 2019 (COVID-19) was initially detected in Wuhan, China in December 2019. It spread rapidly, and in March 2020, the World Health Organization (WHO) declared a worldwide pandemic. In May 2020, the 73rd World Health Assembly issued a resolution recognizing the role of extensive immunization as a global public-health goal for preventing and stopping transmission of COVID-19. Vaccine hesitancy is a great threat in fighting the COVID-19 pandemic, as it prevents populations from reaching target thresholds of coverage necessary for herd immunity. It is important to know the determinants of vaccine hesitancy so that we can develop tools to combat it. The goal of our study was to evaluate patient perspectives on vaccination in our outpatient Endocrinology clinics. Methods We created a 7-question survey study which was offered to all patients waiting to be seen in our three Endocrinology clinic locations. We distributed and collected data from all clinics over a 3-week period (5/31/21-6/18/21). We used descriptive statistics to analyze this data. Results We collected 446 responses between three clinic locations, one urban and two suburban. 361 patients (81%) reported planning to or already having received the COVID-19 vaccine. 29 patients (7%) reported being unsure and 56 patients (13%) reported they did not plan to get vaccinated. Among 85 patients with vaccine hesitancy, 51% are blacks, 35% are whites, 24% reported concerns related to side effects, 13% felt COVID was not as bad as the media portrays, 14% did not believe in vaccines and 29% wanted more data on side effects and efficacy before receiving it. Hesitancy is higher among blacks which is statistically significant (P = 0.035) and slightly higher at the urban compared to the suburban clinics (20% Vs. 15%; p=0.197). On chi square analysis, this had no significant difference. Discussion In the United States, COVID-19 vaccine acceptance ranged from 60 to 79% in five surveys among the general population. The rate of vaccination acceptance is higher in our study compared to general population. We suspect this is related to our clinic patients having better vaccine counseling as most patients have multiple risk factors for severe infection. The results did show higher vaccine hesitancy among black patients and those seen in our urban clinics suggesting the need for improvement in health literacy in these populations. Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m.

Understanding Vaccine Hesitancy with Application of Latent Dirichlet Allocation to Reddit Corpora

Objectives: To understand the vaccine-hesitant behavior among social media user cohorts; to identify the underlying factors that contribute to vaccine hesitancy; to help policymakers make informed decisions to improve the success rate of vaccination campaigns. Methods: Latent Dirichlet Allocation (LDA)—a popular topic modeling technique—was used to extract topics from the Reddit corpus on vaccine hesitancy discussion. The corpus was extracted from Reddit’s API using PRAW—The Python Reddit API Wrapper. The corpus contained 2996 comments, retrieved from the following subreddits:r/askreddit, r/antivax, r/antivaccine, and r/AntiVaxxers; determinants of Vaccine hesitancy were generated from the corpus using Standard LDA and Mallet LDA models. Findings: By applying Latent Dirichlet Allocation, we were able to identify the underlying factors that contribute either directly or indirectly toward vaccine-hesitant behavior. Some of the interesting factors of contribution include, but are not limited to rapture, depopulation agenda, the immigrant crisis at the Southern US border, etc. Given that the dataset we used contained a majority of input from people living in the United States, the results are rational; however, the same factors may or may not be contributors worldwide. The topics generated by the standard LDA were less precise and comprehensible than the topics generated by the mallet LDA model. Although a number of contributions have been made in this specific area i.e., understanding the vaccine-hesitant behavior, none report how political and religious factors contribute to the outcome. At a surface level, even though it is well-known that religious and political factors contribute to vaccine hesitancy, our unique Reddit corpus and the methodology as mentioned earlier let us identify fascinating and novel factors that have not been reported elsewhere. Novelty: Research to identify the factors that contribute toward vaccine hesitancy is fairly common, especially while the coronavirus pandemic was at its peak. Existing research works predominantly use surveys and other traditional methodologies to identify the factors that contribute toward the said phenomena. The application of Natural language Processing, viz., Latent Dirichlet Allocation could bring out the best latentvariables which cannot be identified using the aforementioned methodologies. This research is fairly novel by the methodology adopted and by the results obtained. Keywords: Vaccine hesitancy; Coronavirus; Latent Dirichlet Allocation; Bayesian Statistics; Reddit

Sociodemographic predictors of and main reasons for COVID-19 vaccine hesitancy in eastern Oslo: a cross-sectional study

BackgroundVaccines are an essential public health strategy to curb viral infection spreading that hinge on vaccine uptake which may be threatened by vaccine hesitant individuals. This study aims to identify sociodemographic predictors of vaccine hesitancy, main reasons for vaccine hesitancy, and how these reasons are explained by sociodemographic characteristics during the COVID-19 pandemic.MethodsA cross-sectional study (N = 5 442) was carried out in June 2021. A web-based survey was conducted among six eastern districts in Oslo with high infection pressure. Sociodemographic variables included gender, age, country of birth, education, and household income. Binary logistic regression models were used to explore predictors of both vaccine hesitancy and specific reasons for hesitancy.ResultsVaccine hesitancy was low overall (5.8%). Findings indicate that participants with younger ages, lower education, and lower household income, and those born outside of Norway were prone to vaccine hesitancy. Over half of the vaccine hesitant sample cited barriers relating to confidence in the vaccines. Women and participants born in Norway were more likely hesitant due to fear of side effects and there being little experience with the vaccines. Otherwise, complacency barriers such as not feeling that they belonged to a risk group (46.1%), not needing the vaccines (39.1%), and wanting the body to develop natural immunity (29.3%) were frequently selected by participants.ConclusionDifferent determinants of vaccine hesitancy among population groups demonstrate the need for clear public health communication about the risks, benefits, and importance of vaccines. Future studies with a larger sample should verify current findings and further explore the role of convenience barriers in health literacy and language. Health authorities should take these results into account and develop different public health strategies targeted at vulnerable population groups during the current and future pandemics to increase vaccine uptake and reach sufficient immunization.

An Overview of Strategies to Improve Vaccination Compliance before and during the COVID-19 Pandemic.

The debate on vaccination mandate was fuelled over the past two years by the COVID-19 pandemic. This study aimed at overviewing vaccination strategies and corresponding vaccine coverages for childhood vaccinations before the pandemic and for SARS-CoV-2 in high-income countries. A qualitative comparison was also performed between the two contexts: unlike for childhood vaccinations, only one European country (Austria) imposed generalised COVID-19 mandates, most countries preferring targeted mandates for higher-risk categories (Italy, Greece) or workers in key public services (Finland, Australia, New Zealand, UK, Germany). Many countries (Norway, Sweden, Netherlands, Portugal, Spain) confirmed their traditional voluntary vaccination approach also for COVID-19, while others (Slovenia and Hungary), historically relying on compulsory vaccination strategies, surprisingly opted for voluntary SARS-CoV-2 vaccination, with unsatisfactory results in terms of immunisation rates. However, no tangible relationship was generally found between vaccination policies and immunisation coverages: data show that, unlike some countries with mandates, countries where vaccinations are merely recommended could achieve higher coverages, even beyond the recommended 95% threshold. The COVID-19 experience has enriched pre-existent vaccination strategy debates by adding interesting elements concerning attitudes towards vaccines in a novel and unexplored context. Interpreting the available results by considering the different cultural contexts and vaccine hesitancy determinants can help to better understand the complexity of the relationship between policies and achieved coverages.

Demography and determinants of incomplete immunization in children aged 1–5 years and vaccine-hesitancy among caregivers: An Eastern Indian perspective

BackgroundWorld Health Organization (WHO) declared vaccine-hesitancy (VH) as an emerging threat to global health. There are limited studies from developing countries, especially from Eastern India, addressing parental VH's determinants and its impact on childhood immunization. Current study aims to assess the prevalence of incomplete immunization in children and parental VH, explore the socio-demographic determinants, and delineate their interconnections. Material and methodsIn this hospital-based, cross-sectional study vaccination cards or parents’ recall method were used to inquire about immunization status and the Likert-vaccine hesitancy scale (VHS) developed by WHO Strategic Advisory Group Experts on Immunization (SAGE) was utilized as an instrument to measure VH. Multivariate analyses were performed to identify the independent predictors. ResultsThe prevalence of incomplete immunization and VH were 18.9% and 41.6% respectively. Significant predictors of incomplete immunization were maternal education, socioeconomic status, gender, and place of delivery. Most responders believed vaccines are effective (99%), important for child's health (98%) and most vaccines offered by the government are beneficial (95%) but were also concerned about serious adverse effects (41%) and feared about new vaccines carrying more risk than old vaccines (16%). Maternal education and family type were significant determinants of VH. Incomplete immunization was significantly prevalent among children with vaccine-hesitant caregivers, though it was not found to be an independent predictor in multivariate analysis. ConclusionsThis study emphasizes the magnitude of the issue of incomplete immunization, VH, and unravels its contributing factors which will help public-health care providers with a roadmap to prioritize resources and focus on preventable measures like health education, ensuring institutional births, and free health-service delivery expansion to increase immunization coverage. Caregivers’ VH is a major roadblock to attaining better immunization coverage which can be tackled through proper counselling to improve their health literacy.

Cross-cultural adaptation and validation of the 5C scale to identify factors associated with COVID-19 and influenza vaccine hesitancy among healthcare workers in Cape Town, South Africa – a protocol

Background: Healthcare workers are at an increased risk of acquiring vaccine-preventable diseases and are known to be reliable sources of information for the patients and their relatives. Knowledge and attitudes of healthcare workers about vaccines are thus important determinants of their own vaccination uptake and their intention to recommend vaccinations to their patients. However, culturally adapted tools and studies to address vaccine uptake and hesitancy as well as related behaviors among healthcare workers in the Global South are limited. Methods: We propose a mixed methods project to understand the extent and determinants of vaccination hesitancy among healthcare workers and construct a validated scale to measure this complex and context-specific phenomenon in Cape Town. We will summarize responses as counts and percentages for categorical variables and means with standard deviations (or medians with inter quartile ranges) for continuous variables. We will run the Shapiro-Wilks test to assess the normality. Analysis of the variance, chi-square tests, and equivalents will be conducted as appropriate for group comparisons. Logistic regression models will also be performed to assess association between variables. We will focus on the seasonal influenza and COVID-19 vaccines. We will use an existing tool developed and validated in Germany and the United States of America to measure five psychological determinants of vaccination (referred to as the 5C scale), as the basis to develop and validate a scale to measure the scope and determinants of vaccine hesitancy and acceptance among healthcare workers in Cape Town. Discussion and conclusion: Through this study, we hope to expand the scientific evidence base on vaccination acceptance and demand among healthcare workers in South Africa and build resources to enable better understanding of, detection, and response to vaccination hesitancy in Cape Town.

Political views and science literacy as indicators of vaccine confidence and COVID-19 concern.

SummaryIntroductionThe distrust, delay and refusal of vaccinations represent serious threats to global public health. As demonstrated by the dramatic worldwide impact of the COVID-19 pandemic, adequate vaccine coverage against infectious diseases is essential towards the preservation and function of virtually every aspect of our society. While the determinants of vaccine hesitancy and pandemic concern have been widely investigated, conflicting evidence exists with regards to their association with education levels and political views.MethodsThis study aimed to investigate whether science literacy levels and standpoint on social and economic matters are associated with different levels of vaccine confidence and COVID-19 concern. An online survey was circulated amongst participants recruited via convenience sampling, and data were analysed using non-parametric statistical tests.ResultsThe survey (n = 389) highlighted that participants who studied Science at General Certificate of Secondary Education level have a lower vaccine confidence than those with both lower and higher levels of science education. Participants with neutral/centrist political views expressed lower confidence than those with a libertarian social stance or a left-wing economic stance. A higher concern with the COVID-19 pandemic was associated with lower levels of science education, libertarian social views, and left-wing economic views.ConclusionsThe present study provides novel insight on the educational and political factors associated with vaccine hesitancy and pandemic concern within a British population sample.

Incorporating Fuzzy Cognitive Inference for Vaccine Hesitancy Measuring

Vaccine hesitancy plays a key role in vaccine delay and refusal, but its measurement is still a challenge due to multiple intricacies and uncertainties in factors. This paper attempts to tackle this problem through fuzzy cognitive inference techniques. Firstly, we formulate a vaccine hesitancy determinants matrix containing multi-level factors. Relations between factors are formulated through group decision-making of domain experts, which results in a fuzzy cognitive map. The subjective uncertainty of linguistic variables is expressed by fuzzy numbers. A double-weighted method is designed to integrate the distinguished decisions, in which the subjective hesitancy is considered for each decision. Next, three typical scenarios are constructed to identify key and sensitive factors under different experimental conditions. The experimental results are further discussed, which enrich the approaches of vaccine hesitancy estimation for the post-pandemic global recovery.

Nurses' Influenza Vaccination and Hesitancy: A Systematic Review of Qualitative Literature.

Vaccine hesitancy (VH) is defined as “delaying or refusing a secure vaccine despite its availability”. This hesitancy affects caregivers and more specifically nurses. The purpose of this study is to assess determinants of influenza VH in the nurse’s community. We conducted a systematic review of qualitative literature according to criteria of Preferred Reporting Items for Systematic Review and Meta-Analysis and Enhancing Transparency in Reporting the synthesis of Qualitative Research from 2009 until October 2020. Eleven qualitative studies analysed (ten thematic content analyses and one grounded theory method) found three main factors in VH. The first determinant was the benefit–risk equation considered as unfavourable due to an ineffective vaccine and fears about adverse effects as the pain of the injection. Wrong immunological beliefs brought into hesitancy. Disease barriers (hand washing and masks) and personal immunity were regarded as more effective than the vaccine. Lastly, dehumanised vaccination and the difficulties of access to healthcare were institutional determinants. Nurses ask for a vaccine promotion by hierarchy and doctors with transparent information and respect for autonomy. The availability of vaccines and methods of pain control seem to be some tracks to reduce nurses’ VH.

COVID-19 Vaccine Hesitancy in Pakistan: A Mini Review of the Published Discourse.

This minireview provides a summary of the main findings, features, as well as limitations and gaps in the current epidemiologic research on COVID-19 vaccine hesitancy (VH) in Pakistani population. For this purpose, data on VH studies were extracted from January 2020 to October 2021, using a systematic review and meta-analysis approach. Literature review and other narrative studies were excluded. There exists a significant heterogeneity in the reported vaccine hesitancy in the population (pooled estimates from random-effects meta-analysis: 35% (95% CI, 28–43%). However, none of the co-variables included in the studies explained the observed variance/heterogeneity in the moderator analysis models. In this minireview and critical appraisal of current VH research, we conclude that an in-depth analysis of COVID-19 vaccine hesitancy in a representative sample of Pakistani population is crucial to measure the magnitude of VH as well to explore and identify the determinants of VH in Pakistani population. This is an important step toward informing intervention and policy design and to address this issue at its root cause. To this end, focused, methodologically robust and hypothesis-driven VH research is needed using a wide range of co-variables to support a detailed coverage of the individual and environmental level VH attributes.

Self-Reported COVID-19 Vaccine Hesitancy and Willingness to Pay: A Cross-Sectional Survey in Thailand.

This study aimed to estimate the prevalence and influencing factors of COVID-19 vaccine hesitancy and willingness to pay in Thailand. A descriptive cross-sectional study was conducted from 13 September 2021 to 14 January 2022. Data were collected using an online questionnaire consisting of demographic characteristics, COVID-19 vaccine hesitancy (delay in acceptance and denying vaccination), determinants of vaccine hesitancy (complacency, convenience, and confidence), and willingness to pay. The general Thai population aged ≥18 years were surveyed. Among 705 respondents, 10.4% reported hesitancy, with significant determinants being low complacency and confidence in the vaccine; low convenience was not a significant determinant. Multivariate analysis revealed vaccine hesitancy among women, those with higher education, non-healthcare workers, and those who lived in rural areas. Furthermore, 77.2% of respondents were willing to pay, with the majority willing to pay in the range of THB 501–1000 ( USD 1 = THB 33) per dose. Increased monthly income, no impact of COVID-19 on income, and time period (before mRNA vaccine availability) significantly affected willingness to pay.

Research priorities to reduce the impact of COVID-19 in low- and middle-income countries.

BackgroundThe COVID-19 pandemic has caused disruptions to the functioning of societies and their health systems. Prior to the pandemic, health systems in low- and middle-income countries (LMIC) were particularly stretched and vulnerable. The International Society of Global Health (ISoGH) sought to systematically identify priorities for health research that would have the potential to reduce the impact of the COVID-19 pandemic in LMICs.MethodsThe Child Health and Nutrition Research Initiative (CHNRI) method was used to identify COVID-19-related research priorities. All ISoGH members were invited to participate. Seventy-nine experts in clinical, translational, and population research contributed 192 research questions for consideration. Fifty-two experts then scored those questions based on five pre-defined criteria that were selected for this exercise: 1) feasibility and answerability; 2) potential for burden reduction; 3) potential for a paradigm shift; 4) potential for translation and implementation; and 5) impact on equity.ResultsAmong the top 10 research priorities, research questions related to vaccination were prominent: health care system access barriers to equitable uptake of COVID-19 vaccination (ranked 1st), determinants of vaccine hesitancy (4th), development and evaluation of effective interventions to decrease vaccine hesitancy (5th), and vaccination impacts on vulnerable population/s (6th). Health care delivery questions also ranked highly, including: effective strategies to manage COVID-19 globally and in LMICs (2nd) and integrating health care for COVID-19 with other essential health services in LMICs (3rd). Additionally, the assessment of COVID-19 patients’ needs in rural areas of LMICs was ranked 7th, and studying the leading socioeconomic determinants and consequences of the COVID-19 pandemic in LMICs using multi-faceted approaches was ranked 8th. The remaining questions in the top 10 were: clarifying paediatric case-fatality rates (CFR) in LMICs and identifying effective strategies for community engagement against COVID-19 in different LMIC contexts.InterpretationHealth policy and systems research to inform COVID-19 vaccine uptake and equitable access to care are urgently needed, especially for rural, vulnerable, and/or marginalised populations. This research should occur in parallel with studies that will identify approaches to minimise vaccine hesitancy and effectively integrate care for COVID-19 with other essential health services in LMICs. ISoGH calls on the funders of health research in LMICs to consider the urgency and priority of this research during the COVID-19 pandemic and support studies that could make a positive difference for the populations of LMICs.

Determinants of Vaccine Hesitancy and Refusal in Children of District Swabi Khyber Pakhtunkhwa, Pakistan

OBJECTIVES: The objective of the study was to evaluate factors associated with vaccine hesitancy and refusal at District Swabi, Khyber Pakhtunkhwa. METHODOLOGY: This cross-sectional study was conducted at a teaching hospital of Khyber Pakhtunkhwa District Swabi over a period of four months. Children between the ages of 9 months to 10 years from the local population admitted to the children ward/daycare centre were included in the study. Parents were inquired about vaccination status and in case of no vaccination or partial vaccination; then the reason was inquired after proper informed consent. Data were collected by using a structured proforma and analyzed using SPSS-24. RESULTS: A total of 828 children were included in this study. Out of these 492 (59.4%) were male and 336 (40.6%) were females. Of the total 828 children, 753 (90.9%) were vaccinated up to date, 48 (5.8%) were not vaccinated and 27 (3.3%) were partially vaccinated. Under vaccinated were 75 patients, 52% were left out due to misconception/beliefs, 6% patients were having issues due to living far away, 2.7% patients could not be vaccinated due to presence of other diseases and 37.3% due to lack of knowledge regarding vaccination. A significant correlation was found between the vaccination status of children and aforementioned reasons (p-value ≤0.001). CONCLUSION: The most common cause of not vaccinating children with polio vaccines was misconceptions/beliefs and lack of knowledge of the parents.

An Overview of Vaccine Hesitancy

Vaccine hesitancy can be defined as “the delay in acceptance or refusal of vaccinations despite availability of vaccination services” and is a complex and multi-faceted threat to global health. This article examines the determinants of vaccine hesitancy and its impact during the COVID-19 pandemic. We explore current Canadian law surrounding vaccines and various ethical and empirical arguments for and against mandatory vaccination policies. While vaccine hesitancy can be addressed through coercive measures or mandatory policies, we discuss how vaccine hesitancy is built upon mistrust and the importance of bridging perspectives between vaccine hesitant individuals and healthcare professionals.

Acceptance of covid-19 vaccine among the healthcare providers in India.

By increasing immunity, the corona virus disease-19 (COVID-19) vaccine is expected to reduce the rate of infection and severity of infection, as well as the rate of hospitalisation. Healthcare providers (HCPs) can provide a good example when it comes to their health habits. HCPs are believed to have the best vaccine acceptance rates because they are open-minded and informed. By concentrating on COVID-19 vaccine attitudes among HCPs in India, the current study gives a clear picture of vaccine acceptability. A cross-sectional observational study approach was used. Participants in the study gave their informed permission. Snowball sampling was employed to spread the survey around social media platforms (mostly WhatsApp groups and email IDs). The survey was open from April 1 through April 30, 2021, and a total of 316 responses were received. SPSS software, version 25, was used for statistical analysis (SPSS, Inc., Chicago, IL, USA). The participants' average age was 32.8 ± 9.7, with 57% of them being male. 16.5% of the 316 individuals had a history of chronic illness. 40.5% had ever experienced COVID-19 symptoms, and 24.1% had been diagnosed with COVID-19 while on duty. Only 16.5% strongly agreed that they could get COVID-19 in the near future, and 48.1% disputed that obtaining COVID-19 infection would make them very unwell. Only 40.5% of participants were concerned about the possible side effects of the vaccine, while 63.2% were not concerned about the possible side effects of the vaccine. Only 39.2% were concerned about the affordability (high price) of vaccines. The majority (95%) of participants agreed to be vaccinated when sufficient information was provided, and only 31.7% agreed to be vaccinated if they were vaccinated free of charge. Due to the high level of current willingness among healthcare professionals to accept COVID-19 vaccines, these data may not be available to the general public. Understanding the complex and interrelated factors that influence vaccination decisions and the determinants of vaccine hesitancy in a particular population is essential to inform interventions to improve immunization coverage.

Determinants of Measles Vaccine Hesitancy among Sudanese Parents in Khartoum State, Sudan: A Cross-Sectional Study.

Determinants of vaccine hesitancy are not yet well understood. This study aims to assess measles vaccine hesitancy and characterize its determinants among Sudanese parents in Omdurman in Khartoum State. A community-based cross-sectional quantitative study was conducted in Khartoum State in February 2019. The Parent Attitudes about Childhood Vaccination (PACV) was used to measure measles vaccine hesitancy. Questions about the sociodemographic characteristics of the family, the perception of the parents about the measles vaccine, and the parental exposure to information were asked. Proportions of vaccine hesitancy and coefficients of linear regression were computed. Five hundred parents were recruited for the study. We found that a significant proportion of participants (about 1 in 5 parents) had hesitations regarding the measles vaccine. Significant predictors of measles vaccine hesitancy were parental exposure to anti-vaccination information or materials (β = −0.478, p-value < 0.001), the parents’ perception of the effectiveness of measles vaccines (β = 0.093, p-value = 0.020), the age of the mother (β = 0.112, p-value = 0.017), the birth rank of the child (β = −0.116, p-value = 0.015), and the total number of the children in the family (β = 0.098, p-value = 0.013). Vaccination access issues were the common justification for parental vaccination hesitancy. Our findings indicate that investment in vaccine communication as well as addressing access issues might be an effective intervention for improving measles vaccine acceptance and, ultimately, measles vaccine coverage.

Evaluating Rates and Determinants of COVID-19 Vaccine Hesitancy for Adults and Children in the Singapore Population: Strengthening Our Community's Resilience against Threats from Emerging Infections (SOCRATEs) Cohort.

COVID-19 vaccines are crucial for achieving sufficient immunisation coverage to manage the pandemic, but vaccine hesitancy persists. This study aimed to investigate the prevalence and determinants of vaccine hesitancy in adults and in parents for vaccinating their children using an integrated social cognition model. A community-based cohort in Singapore [N = 1623] completed a survey (wave 25) between June and July 2021 which measured their risk perceptions, distress, trust, vaccination beliefs, and vaccine intentions/behaviours. Results indicated low rates of hesitancy (9.9%) for own vaccination, with most concerns citing side effects, safety, and hasty development. Remaining respondents were vaccinated (69%) or intended to vaccinate (21%). The multivariable model (non-vaccinated respondents) indicated that, living with people in poor health, subjective norm, moral norm, benefits, and necessity of vaccination were associated with lower vaccine hesitancy (R2 Cox & Snell: 51.4%; p < 0.001). Hesitancy rates were higher for children’s vaccination (15.9%), with male gender, lower perceived vaccine benefits, high COVID-19 risk perceptions, vaccination concerns, and necessity beliefs associated with higher odds of parental vaccine hesitancy (R2 Cox & Snell = 36.4%; p < 0.001). While levels of vaccine acceptance are high, more targeted messages are needed. For adults’ vaccination, more emphasis should be on benefits and social gains, while for parental hesitancy, messages related to safety should be prioritised.

Understanding the determinants of vaccine hesitancy among adolescents: a systematic review

Abstract Background The WHO defines vaccine hesitancy (VH) as ‘a delay in acceptance or refusal of vaccines despite the availability of vaccine services'. In spite of the models explaining VH and the tools used to address it, VH still represents a current problem and has been declared one of the top ten global health threats by WHO in 2019. This is mainly true for the adolescents who represents 25% of the global population. This systematic review aims to address the determinants of VH in this target population. Methods PubMed, Web of Science and Scopus were searched to retrieve articles, published in English, assessing adolescents' attitudes and confidence towards vaccinations with any study design (qualitative or quantitative) from the inception until Dec 2020. A methodological quality assessment of the articles was performed based on the study designs. Results Out of 14,704 articles, 20 studies were included in the qualitative analysis. Ten out of 20 studies were evaluated as of “good quality”, while nine had “moderate quality” and only one had “poor quality”. Factors associated to a positive attitude towards vaccination included knowledge of vaccine preventable diseases, the awareness of vaccines, their efficacy, safety and free of charge, higher education level and active involvement in decision-making. An association between VH and socio-economic conditions was also highlighted. Conclusions This systematic review elucidated a better understanding of the determinants of VH among the adolescent population. Adolescence represents a crucial phase of life in which boys and girls begin to make significant choices about their health and develop attitudes and behaviours that continue into adulthood. Indeed, their concerns and needs in respect to vaccination should be widely examined and taken into consideration to plan tailored interventions to promote vaccination and reduce VH. Key messages Vaccine hesitancy among adolescents is a major global health priority. This problem is little studied and further studies and initiatives aimed at increasing awareness of the problem should be deserved.

An Analysis of the Determinants of Vaccine Hesitancy. Can the World Learn from the US Experience?

While efforts to vaccinate the general public have been trending in a positive direction, Vaccine Hesitancy is a global issue. Many infectious disease physicians, epidemiologists, and Public Health Authorities fear that Vaccine Hesitancy will indefinitely prolong the pandemic, as the Delta Variant currently ravages through the unvaccinated population. In an attempt to understand this global phenomenon, we looked at the United States’ vaccine rollout. In particular, we examined the determinants of vaccine hesitancy in the USA. Our empirical model reveals that Vaccine Hesitancy is significantly impacted by factors such as Median Income, Political Affiliation, Percentage of population that is White/Caucasian, Total Cases, Individuals without Health Insurance, and Education level. We use data from all 50 states in the US. Policy makers in other countries can greatly benefit from the findings of our empirical results. Some incentive structures should be introduced as quickly as possible to achieve a high vaccination rate in the country. Our goal is to use the United State’s experience of Vaccine Hesitancy as a baseline of sorts for the greater global community to understand, and reduce hesitancy in their vaccine rollouts.

Demographic and KAP determinants of COVID-19 vaccine hesitancy and vaccine refusal: a cross-sectional study in Indian population

Background: Recent rise in vaccine non-acceptance is a threat to global health, especially with the ongoing COVID-19 pandemic. Examining the intentions of the Indian population towards the COVID-19 vaccine and the determinants of vaccine hesitancy and vaccine refusal is of utmost importance.Methods: We conducted a cross-sectional web-based anonymous survey, using pre-validated questionnaires. Demographic and knowledge, attitude, and practice characteristics were collected, and a binary logistic regression was applied to analyse the association between these characteristics and the participants’ intention to for the COVID-19 vaccine. Reasons for vaccine non-acceptance were then determined using a pre-validated vaccine hesitancy questionnaire.Results: Out of the 1172 non-vaccinated participants, 190 (16.2%) refused vaccination, and 219 (18.6%) were hesitant. Adequate knowledge about the COVID-19 disease, made people less likely to be hesitant for vaccination (OR=0.39; 95% CI=0.27-0.57), and less likely to refuse it (OR=0.41; 95% CI=0.27-0.61). Females had a higher tendency to refuse the vaccination (OR=1.47; 95% CI=1.02-2.14), or to be hesitant for it (OR=1.80; 95% CI=1.29-2.52). Social media played an important role in decreasing vaccination refusal (OR=0.40; 95% CI=0.22-0.73), when compared to evidence-based literature.Conclusions: Knowledge about the COVID-19 disease can help people make a more informed decision towards vaccination, and social media can be utilised as a medium to address the gaps in knowledge of the Indian population.