Perceived Vaccine Safety Research Articles

HPV Vaccine Awareness and Uptake Among Sexually Transmitted Infections Clinic Users: A Cross-Sectional Study in Bologna, Italy.

Human Papillomavirus (HPV) infection poses a significant health risk, particularly for high-risk groups such as men who have sex with men (MSM), people living with HIV (PLHIV), and transgender individuals. Despite the availability of effective vaccines, uptake among these groups remains suboptimal due to various social and behavioral barriers (BeSD). A cross-sectional survey was conducted at the Sexually Transmitted Infections (STIs) clinic in Bologna, Italy, from 8 April to 12 April 2024 using a paper questionnaire, investigating HPV vaccine uptake and BeSD factors influencing vaccination decisions. Statistical analyses included descriptive statistics and multivariate logistic regression. Among the 236 respondents, PLHIV and transgender individuals demonstrated lower uptake rates (60.0% and 15.6%) if compared to women under 30 years old (72.7%). Concern about HPV infection varied significantly across groups, with MSM showing the highest worry (48.7%). Perceptions of vaccine safety and access were mixed, influencing vaccination decisions. Multivariate analysis indicated that age inversely correlated with infection worry (OR: 0.94, 95% CI: 0.91-0.98), while being a woman under 30 (OR: 164.0, 95% CI: 17.2-1560.18) or MSM (OR: 3.53, 95% CI: 1.37-9.11) was positively associated with vaccine uptake. The study identifies disparities in HPV vaccine uptake among STI clinic users in Bologna, Italy, emphasizing the need for targeted public health campaigns. These campaigns could engage STI clinics and address awareness, safety perceptions, and access barriers to enhance vaccination coverage among sexual and gender minorities.

Identifying influential factors using machine learning techniques on the intention to receive a COVID-19 booster dose and vaccine fatigue among partially vaccinated individuals

This study assesses COVID-19 booster intentions and hesitancy in Texas, a state known for its diversity and libertarian values. A survey was conducted with 274 participants residing in Texas between June and July 2022. The analysis examined sociodemographic and health-related factors, trusted information sources, and preventive behaviors. The survey focused on vaccinated participants and their intention to receive the booster dose, which was categorized into three outcomes: yes, no, and not sure. Machine learning techniques were employed to analyze the survey responses of vaccinated participants to identify the most critical factors. Among the participants, 113 expressed their intention to get the booster (41.2%), 107 did not plan to receive the booster (39.1%), and 54 remained undecided (19.7%). Our findings indicate that the perception of vaccine safety significantly influenced the decision to receive the booster dose. Those who reported trust in social media contacts as reliable information sources were more likely to intend to boost. Additionally, among those hospitalized when diagnosed with COVID-19, the largest proportion were unwilling to receive the booster (47.0%) compared to those who intended to receive the booster (33.3%). In contrast, most of those who believed they would be hospitalized if infected with COVID-19 intended to get the booster. Other factors did not demonstrate a significant association. Our findings are highly transferable and can offer valuable insights, particularly for countries where COVID-19 remains prevalent and are pivotal both presently and in the future for developing strategies to improve booster uptake and shape public health initiatives in epidemic and pandemic outbreaks.

Applying causal inference and Bayesian statistics to understanding vaccine safety signals using a simulation study

Community perception of vaccine safety influences vaccine uptake. Our objective was to assess current vaccine safety monitoring by examining factors that may influence the availability of post-vaccination survey data, and thereby the specificity and sensitivity of existing signal detection methods. We used causal directed acyclic graphs (DAGs) and a Bayesian posterior predictive analysis (PPA) signal detection method to understand biological and behavioural factors which may influence signal detection. The DAGs informed the data simulated for scenarios in which these factors were varied. The influence of biological factors such as severity of adverse reactions and behavioural factors such as healthcare-seeking behaviour upon survey participation was found to drive signal detection. Where there was a low prevalence of moderate to severe reactions, false signals were detected when there was a strong influence of reaction severity on both survey participation and seeking medical attention. These findings provide implications for future vaccine safety monitoring.

COVID-19 vaccine confidence and its effect on vaccine uptake among people with hypertension or diabetes mellitus in Kilimanjaro region, Tanzania

ABSTRACT COVID-19 vaccination effectively reduces disease severity, hospitalization, and mortality, particularly among individuals with chronic conditions who bear a disproportionate burden of disease complications. Vaccine confidence – belief in its safety, effectiveness, and importance – boosts uptake. However, limited data on vaccine confidence in this population hinders the development of targeted interventions. This study examined COVID-19 vaccine confidence and its impact on uptake among individuals with hypertension or diabetes mellitus in the Kilimanjaro region, Tanzania. A community-based cross-sectional study was conducted in March 2023 among 646 randomly selected adults aged ≥18 years with hypertension or diabetes mellitus in three districts of Kilimanjaro region, northern Tanzania. An interviewer-administered electronic questionnaire assessed confidence and uptake of COVID-19 vaccines in addition to related knowledge and demographic characteristics. Data analysis was done for 646 individuals who consented to participate. Multivariable logistic regression models determined the factors associated with COVID-19 vaccine confidence and its effect on vaccine uptake. The proportion of COVID-19 vaccine confidence among all 646 participants was 70% and was highest for perceived vaccine importance (80%), followed by perceived vaccine effectiveness (77%) and perceived vaccine safety (74%). Good knowledge of COVID-19 vaccines and living in the Mwanga municipal council (MC), a semi-urban district, was independently associated with confidence in the vaccines’ importance, safety, effectiveness, and overall COVID-19 vaccine confidence. Confidence in COVID-19 vaccines increased the odds of vaccine uptake. Targeted interventions to boost vaccine confidence are therefore essential to enhance vaccine uptake in this high-risk population.

Knowledge, Attitude, and Perception Regarding the Human Papillomavirus (HPV) Vaccine Among Parents at Al-Madinah Al-Munawwar: A Cross-Sectional Study.

Human papillomavirus (HPV)is the leading cause of cervical cancer in reproductive-age Saudi women. Parents' understanding and attitude regarding HPV vaccination in young girls are vital to preventing cervical cancer. This study aims to assess the knowledge, attitudes, and perceptions of parents in Al-Madinah Al-Munawwara towards the HPV vaccine and identify factors influencing their decision to vaccinate their children. A cross-sectional survey was conducted among 500 parents in Al-Madinah Al-Munawwara. A structured questionnaire was used to collect data on demographics, knowledge about HPV and the HPV vaccine, attitudes towards vaccination, and perceptions of vaccine safety and efficacy. Data were analyzed using Statistical Product and Service Solutions (SPSS, version 21; IBM SPSS Statistics for Windows, Armonk, NY). Parents have 57.6% knowledge about HPV, 69.2% perceive it as dangerous, and 29.8% know its link to cervical cancer. Physicians are the primary source, and 81.2% believe the vaccine protects HPV. Key predictors of vaccine acceptance included higher educational levels, awareness of HPV-related health risks, and recommendations from healthcare professionals. The study reveals a lack of knowledge about HPV infection and vaccines among Saudi Arabian parents, with only 7.2% having vaccinated their children, emphasizing the need for education and screening programs.

COVID-19 and influenza vaccine-hesitancy subgroups.

Health communicators are faced with the challenge that people can hesitate vaccines for different reasons. Our aim was to identify and describe the qualities of distinct COVID-19 and influenza vaccine-hesitancy subgroups to facilitate the development of tailored vaccine-hesitancy communication. In two studies, we used agglomerative hierarchical cluster analysis to identify COVID-19 (N = 554) and influenza (N = 539) vaccine-hesitancy subgroups in the general population based on nine vaccine hesitancy-related variables (intent to get vaccinated, perceived vaccine safety, perceived vaccine efficacy, perceived disease threat, perceived vaccination responsibility, perceived vaccination convenience, distrust in authorities, conspiracy mentality, and reliance on anecdotal testimonies). We identified and described six distinct COVID-19 vaccine-hesitancy subgroups (the Vaccination Positive, the Ambivalent, the Fearing Skeptic, the Unconvinced, the Constrained Skeptic, and the Vaccination Opponent), and three influenza vaccine-hesitancy subgroups (the Vaccination Positive, the Complacent, and the Vaccination Opponent), with different levels of hesitancy. We discuss the implications of the results for health communicators. Our results shed light on the (dis)similarities between people who hesitate COVID-19 and influenza vaccines and suggest that there is greater variety in hesitancy concerning COVID-19 vaccinations than influenza vaccinations. These findings can be used to design and test tailored vaccination messages.

Knowledge, attitudes, and practices associated with influenza vaccine uptake among healthcare personnel in Israel during three influenza seasons, 2016–2019

IntroductionDespite a longstanding Israel Ministry of Health recommendation that all healthcare personnel (HCP) receive a seasonal influenza vaccine, vaccine uptake among HCP remains below the country’s target of 60% coverage. To understand factors related to vaccine hesitancy, we used data from a prospective three-year (2016–2019) influenza vaccine effectiveness study among Israeli HCP to examine knowledge, attitudes, and practices (KAP) about influenza vaccination and their association with vaccine uptake. MethodsAt the start of each influenza season, all participating HCP completed a questionnaire that included questions about socio-demographic and occupational characteristics, health status, and KAP related to seasonal influenza vaccination. We extracted vaccination history from electronic medical records and employee vaccination registries. We used logistic regression models to identify demographic and occupational factors, and KAP about influenza vaccination, associated with receipt of vaccination. ResultA total of 2,126 HCP were enrolled and had available data on vaccination history. Their median age was 42 years [IQR 35–52], and 73 % self-identified as female. Influenza vaccine uptake in 2016, 2017 and 2018 was 46 %, 48 % and 47 %, respectively. Overall, 36 % of HCP had received an influenza vaccine in ≥ 4 of the eight years prior. HCP aged 35–49 years were less likely to receive influenza vaccine compared to HCP aged ≥ 50 years (OR: 0.81 [95 % CI: 0.67–0.98]). Nurses and allied personnel were less likely to receive influenza vaccine compared to physicians (OR: 0.63 [95 % CI: 0.50–0.78] and OR: 0.53 [95 % CI: 0.40–0.70], respectively). The emotional benefit of vaccination (e.g., anticipating regret if not vaccinated) and the perception of vaccine safety were factors associated with vaccine uptake (OR: 7.60 [95 % CI: 6.27–9.22] and OR: 3.43 [95 % CI:2.91–4.03], respectively). ConclusionAmong HCP at two hospitals in Israel, less than half received an annual influenza vaccine. Older HCP, physicians, and those who reported the emotional benefit of vaccination or agreed that influenza vaccines are safe were more likely to be vaccinated. Future influenza vaccination campaigns could focus on these demographic groups and tailor messages emphasizing the emotional benefits of vaccination and vaccine safety to increase seasonal influenza vaccine uptake among HCP in Israel.

Factors Related to, and Effective Interventions for, Vaccination Uptake Among Older Adults in Two Asia-Pacific Countries: A Rapid Review.

This rapid review aimed to present a comprehensive overview of barriers, facilitators, and effective interventions that promote vaccination uptake by older adults in the Asia-Pacific region. Rapid review methodology was applied, using two databases (PubMed, Embase). Articles were included if studies were conducted in Australia, Singapore, Indonesia, and the Philippines; included human population ≥50 years of age, and was published from 2016 to August 2022. Related articles were not found from Indonesia and Philippines. A total of 23 articles met the inclusion criteria, with 19 reporting on barriers and facilitators, whereas, four articles reported effective interventions to promote vaccination uptake. Among the 19 studies that identified barriers and facilitators to vaccination uptake, the more common factors were social influences (n = 8/19), perceived benefits of vaccine (n = 7/19), and perceived vaccine safety (n = 6/19). Interventions that focused on supporting clinicians were found to be effective in leading them to recommend vaccinations among older adults, such as creating awareness on the low baseline vaccination rates among older adults, provision of structured health assessment, and nurse reminders. More studies are needed to ascertain the barriers and facilitators to uptake, as well as to identify effective interventions influencing vaccine uptake among older adults in the Asia-Pacific region.

The colonial effect: Language, trust and attitudes to science as predictors of vaccine hesitancy across Africa

Perceptions of vaccine safety, importance and effectiveness are at the core of vaccine hesitancy around the world, and Africa has had its own share of vaccine revolts. This study uses the 2018 Wellcome Global Monitor on public perceptions of vaccines in 40 African countries to examine the predictors of vaccine hesitancy. It examines levels of hesitancy from a language perspective, comparing French speakers with others, mostly English speakers. Results show that French speakers were significantly more hesitant about importance and safety, while English speakers and others were more hesitant about effectiveness. This reflects the continuing influence of colonial ties on African countries. Respondents with high levels of trust in social actors (such as national government, journalists, people neighborhood, doctors and nurses) were also more hesitant about the safety and effectiveness of vaccines, indicating the importance of non-scientists in influencing vaccine hesitancy. Those with high levels of education were more likely to be hesitant about vaccines in general, indicating that having more education may have an opposite effect. Perception of science as progress was significant for all three hesitancy types, indicating that Africans with more progressive attitudes were less likely to worry about the importance, safety and effectiveness of vaccines. At the country level, there was no overarching predictor, indicating the strong role of local social and cultural factors. These findings improve our understanding of the drivers of vaccine hesitancy in Africa and provide valuable input for future vaccine policy and health-awareness campaigns.

Factors associated with vaccination intention and uptake over time in a sample of older Australians

This study sought to identify the behavioural and social drivers of vaccination in 16,745 older Australians. We analysed and compared influences on COVID-19 vaccination intention and uptake using prospectively collected survey data from the Sax Institute’s 45 and Up Study. Vaccination intention increased with older age (adjusted odds ratio [aOR]:1.03; 95 % confidence interval [CI]: 1.01–1.04; p = .002), a belief that the vaccine is important for the person’s own health (aOR: 5.17; 95 % CI: 4.23–6.24; p < .001), is safe (aOR:2.64; 95 % CI: 2.19–3.2; p < .001), and trusted by the person (aOR:6.79; 95 % CI: 5.59–8.26 p < .001); concern about contracting COVID-19 (aOR:1.78; 95 % CI: 1.47–2.17; p < .001); having enough information about COVID-19 vaccines (aOR:1.99; 95 % CI: 1.65–2.29; p < .001); a belief that most adults will receive a COVID-19 vaccine (aOR:2.31; 95 % CI: 1.93–2.77; p < .001); and a belief that family and friends wanted the person to receive a COVID-19 vaccine (aOR:6.07; 95 % CI: 5.06–7.27; p < .001). The same factors contributed to increased vaccine uptake, with the exception of age and the belief that the person had enough information about the vaccine. Concern that the vaccine will cause a serious reaction was associated with both lower intention (aOR:0.35; 95 % CI: 0.29–0.43; p < .001) and lower uptake (aOR:0.61; 95 % CI: 0.46–0.81; p < .001) while lower intention was also associated with low decisional autonomy (aOR:0.37; 95 % CI: 0.22–0.62; p < .001). Intentions changed over time and a change towards vaccination was associated with perceptions of vaccine safety. Access barriers played a role in the non-vaccination of otherwise intending older Australians. Messaging that is adaptive to safety concerns, emphasises vaccine benefits, leverages social norms, and targets people who make decisions for older Australians may be helpful for influencing vaccination intentions and increasing vaccine uptake.

Explaining the Mechanism Behind mRNA Vaccines Influences Perceived Vaccine Effectiveness but not Vaccination Intentions

Vaccine effectiveness and safety concerns can prevent people from receiving their first Covid-19 vaccines or boosters. Understanding the vaccine mechanism may lead people to perceive vaccine effectiveness appropriately. This study tested whether helping people understand the vaccine’s mechanism could improve their perceived vaccine safety and effectiveness. In a preregistered study, N = 1,548 unvaccinated or non-boosted participants were randomly presented with one of three communication formats: a fact box (a benefit-risk profile in tabular format; control condition), an expository text (i.e., a purely factual explanation) plus fact box, or an analogy plus fact box. Participants rated the vaccine’s effectiveness in preventing a Covid-19 disease, their perceived risk of getting vaccinated, and their intention to get vaccinated or boosted (depending on their vaccination status). Reading either additional text about the vaccines’ mechanism increased participants’ effectiveness ratings for the vaccine to prevent Covid-19 but did not affect risk ratings or vaccination intentions. The participants’ vaccine-related perceptions and intentions did not differ between the two text types. Elaborating on the vaccine’s mechanism of protection, in addition to presenting the benefit-risk profile of a vaccine, can lead people to perceive the vaccine effectiveness as slightly higher, yet it is insufficient to increase vaccination intentions.

I want to be safe: understanding the main drivers behind vaccination choice throughout the pandemic

BackgroundDespite being a major advancement in modern medicine, vaccines face widespread hesitancy and refusal, posing challenges to immunization campaigns. The COVID-19 pandemic accentuated vaccine hesitancy, emphasizing the pivotal role of beliefs in efficacy and safety on vaccine acceptance rates. This study explores the influence of efficacy and safety perceptions on vaccine uptake in Italy during the pandemic.MethodsWe administered a 70-item questionnaire to a representative sample of 600 Italian speakers. Participants were tasked with assessing the perceived effectiveness and safety of each vaccine dose, along with providing reasons influencing their vaccination choices. Additionally, we conducted an experimental manipulation, exploring the effects of four framing messages that emphasized safety and/or efficacy on participants’ willingness to receive a hypothetical fourth vaccine dose. Furthermore, participants were asked about their level of trust in the scientific community and public authorities, as well as their use of different information channels for obtaining COVID-19-related information.ResultsOur study reveals a dynamic shift in vaccine efficacy and safety perceptions throughout the COVID-19 pandemic, potentially influencing vaccination compliance. Initially perceived as more effective than safe, this assessment reversed by the time of the third dose. Beliefs regarding safety, rather than efficacy, played a significant role in anticipating future vaccinations (e.g., the booster dose). Safety-focused messages positively affected vaccination intent, while efficacy-focused messages showed limited impact. We also observed a changing trend in reasons for vaccination, with a decline in infection-related reasons and an increase in social related ones. Furthermore, trust dynamics evolved differently for public authorities and the scientific community.ConclusionsVaccine perception is a dynamic process shaped by evolving factors like efficacy and safety perceptions, trust levels, and individual motivations. Our study sheds light on the complex dynamics that underlie the perception of vaccine safety and efficacy, and their impact on willingness to vaccinate. We discuss these results in light of bounded rationality, loss aversion and classic utility theory.

Predictors of willingness to receive updated 2023–2024 COVID-19 booster vaccines among a convenience sample in Minnesota

ObjectivesTo determine factors associated with intention to receive recommended COVID-19 booster vaccines in 2023–2024. MethodsA cross-sectional study of 1,256 individuals at Minnesota State and County fairs was conducted to assess their intention to receive a COVID-19 booster vaccine in the coming year if recommended. The association between booster intention and multiple factors believed to influence willingness to receive the vaccine, including perceived vaccine safety, perceived risk of COVID-19, public health knowledge, fear of future pandemics, and political affiliation, were analyzed using ordinal logistic regression and adjusted odds ratios (aOR). ResultsIntention to receive a COVID-19 booster vaccine was high among our participants with 56% reporting they were extremely likely to receive the vaccine this year and another 15% reporting that they were likely to do the same. A strong association with getting a booster vaccine was found between perceived vaccine safety (aOR: 15.3, 95% CI: 10.6–22.2), perceived COVID-19 risk (aOR: 3.5, 95% CI: 2.4–5.1), pandemic fear (aOR: 3.4, 95% CI: 2.4–4.8), public health knowledge (aOR: 1.3, 95% CI: 0.9–1.8), and democrat political affiliation (aOR: 2.8, 95%CI: 1.8–4.4). ConclusionsOur study emphasizes the importance of perceived vaccine safety as a predictor of intention to accept COVID-19 vaccines and highlights the continued need to effectively communicate with the public about the safety of vaccines.

Assessing the Awareness and Attitude Towards COVID-19 Vaccination and Aids Factors among Jordanian People: A cross-sectional Study

This study aimed to evaluate the awareness and attitudes toward COVID-19 vaccination among the Jordanian population. A cross-sectional survey was conducted using a validated questionnaire. The awareness and attitudes toward the COVID-19 vaccine were assessed via five-item and seven-item scales, respectively. The survey results were analyzed using SPSS with a chi-square test and multivariable logistic regression. A total of 407 participants were enrolled, with the majority being female (74.9%), under 49 years old (73.2%), holding a bachelor's degree (57.7%), and working in the private sector (46.2%). Results revealed a fairly high level of awareness about the COVID-19 vaccine (51.4%), with no significant association between awareness and demographic characteristics. While 51.4% of the participants perceived the importance of getting the vaccine, only 37.1% agreed that the newly developed vaccine was safe, and 77.4% expressed a preference for natural immunity. The overall attitude towards COVID-19 vaccination appears cautiously optimistic, with 60.2% of respondents scoring above Bloom's 60.0% cutoff point, despite mixed opinions on vaccine safety and necessity. Moreover, attitudes towards the vaccine showed a significant association with participants' age and occupation. Among the age group of 18-29 years old, 47.6% had a positive attitude towards the vaccine, compared to 33.3% in the 30-49 years old group, and 38.5% in the ≥50 years old group. In terms of occupation, 30.7% in the public sector had a positive attitude, compared to 44.1% in the private sector and 48.5% among students. Given the mixed but cautiously optimistic attitudes towards COVID-19 vaccination observed among the Jordanian population, this study underscores the critical importance of targeted educational and communication strategies. Such initiatives should focus on enhancing the perception of vaccine safety and efficacy to improve vaccination acceptance and uptake across different age and occupational groups within Jordan.

Cross-sectional study on intention to be vaccinated against Coronavirus Disease 2019 (COVID-19) in Benin and Senegal: A structural equation modeling (SEM).

Vaccination is considered one of the solutions to the Coronavirus Disease 2019 (COVID-19) pandemic. However, a small proportion of the population were fully vaccinated in Benin (20.9%) and Senegal (7.6%) by December 2022. This study explores the determinants of intent to vaccinate. This was a cross-sectional, descriptive, and analytical study of 865 Beninese and 813 Senegalese aged 18 years and older. Marginal quota sampling by age, gender and region was adopted. Data collection, using a survey instrument based on the Random Digit Dialing method, was conducted from December 24, 2020, to January 16, 2021, in Senegal and from March 29 to May 14, 2021, in Benin. The questionnaire used the Theory of Planned Behavior and the Health Belief Model. The influence of factors was assessed using a structural equation model based on a diagonally weighted least squares estimator to account for ordered categorical data (Likert scales). In Benin and Senegal, the intention to vaccinate against COVID-19 is influenced by distinct factors. In Benin, social influence (β = 0.42, p = 0.003) and perception of vaccine safety (β = -0.53, p<0.001) play pivotal roles, suggesting those socially influenced have a higher vaccination intention. In Senegal, vaccination intentions are primarily driven by positive attitudes towards the vaccine (β = 0.65, p = 0.013) and social influence (β = 0.25, p = 0.048). This underscores the importance of individual beliefs, personal perceptions, and supportive social contexts in decision-making. Notably, positive vaccination attitudes and perceptions in both countries are strongly tied to increased social influence. While nuances exist between Benin and Senegal regarding factors influencing COVID-19 vaccination intentions, both nations underscore the pivotal roles of social influence and individual vaccination perceptions. Emphasizing trust in vaccine safety and promoting positive attitudes through effective communication are crucial for enhancing vaccination uptake in these West African countries.

Healthcare workers’ attitudes toward children getting Covid-19 vaccinations in Gaza Strip

Healthcare workers’ attitudes toward children getting Covid-19 vaccinations in Gaza Strip

Mind the gap: Concordance between perceptions regarding vaccination as declared by patients and their evaluation by their general practitioner

BackgroundThe high level of vaccine hesitancy reported in the French population may lead general practitioners to anticipate difficult discussions on this topic. We aimed to assess the extent to which general practitioners’ evaluation of their patients’ vaccine hesitancy was correlated with the real vaccine hesitancy expressed by these patients. MethodsThe study was based on two brief paper questionnaires completed in private by the general practitioner and the patient at the beginning of a medical appointment: one for the physician to evaluate on three quantitative and non-graduated visual scales (then analysed as a 0–100 scale) their patients’ perceptions regarding vaccine safety, vaccine efficacy and ‘being in favour of vaccination’; and one for the patient to express their perceptions for the same three axes using the same scales. ResultsOverall, 31 physicians participated in the study, with 540 physician-patient pairs being included. The physicians’ evaluation of patient perceptions was more positive when the physician was male (vs female), when the patient was male (vs female) and when both were males (vs both females). The median differences (in absolute values) between the physician evaluations and the patient perceptions were between 9 and 11 (on the 0–100 scale) for the three axes (vaccine safety, vaccine efficacy and ‘being in favour’). A correlation was observed between the physicians’ evaluation and the patients’ declaration (Kendall test: vaccine efficacy: tau = 0.199, p < 0.001; vaccine safety: tau = 0.234, p < 0.001; being in favour of vaccination: tau = 0.365, p < 0.001). Physicians correctly classified 83.4 % of the patients with high perceptions of vaccine safety and efficacy (>75/100 for both scales) but only 54.5 % of those with low perceptions (<75/100 for both scales). ConclusionPhysicians tend to correctly identify patients with the most favourable perceptions about vaccination but not those with the least favourable perceptions.

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

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

Understanding COVID-19 vaccine hesitancy in Pakistan: The paradigm of confidence, convenience, and complacency; A cross-sectional study.

Vaccine hesitancy is a big obstacle for vaccination programs, as is anticipated for the COVID-19 vaccination program, resulting in low uptake of vaccines thereby hindering the process of reaching herd immunity. Bearing this in mind the current study was aimed to explore the determinants of vaccine hesitancy amongst the Pakistani population. A cross-sectional study was carried out from November 2020 to March 2021. The conceptual framework of the study was based on the 3Cs (Confidence, Convenience, Complacency) model. The google-forms-based questionnaire was disseminated amongst the general population. Data collected were entered into SPSS version 26 and analyzed. Of the 421 participants, 68.4% were women. Non-healthcare workers were 55.8% of respondents. Of vaccine-hesitant individuals, 26.13% reported they were very unlikely to get vaccinated. Perception of COVID-19 vaccine was explored, which revealed 12.6% of individuals agreed the vaccine was not safe as it came out too fast, 50.6% were worried about experiencing side-effects, 18% believed the vaccine will not offer protection and 5.9% believed the vaccine would cause death. Low Practice of standard operating procedure (SOP) in non-Healthcare workers was the strongest contributor to vaccine hesitancy (OR: 5.338, p = 0.040, 95% CI: 1.082-26.330) followed by High complacency (p = 0.026) and Moderate Complacency (OR: 0.212, p = 0.007, 95% CI: 0.069-0.654) towards COVID-19 vaccination. In Healthcare workers the strongest contributor to vaccine hesitancy was having a Moderate Confidence (OR: 0.323, p = 0.042, 95% CI: 0.109-0.958) in the vaccine followed by Moderate Convenience (OR: 0.304, p = 0.049, 95% CI: 0.093-0.993) for vaccination. Campaigning and communication strategies to reaffirm confidence in the COVID-19 vaccine and educating the general population about the vaccine could lead to increased perception of vaccine safety and effectiveness thereby restoring confidence in vaccine and decreasing vaccine hesitancy. Likewise, working to increase vaccine convenience and decreasing complacency towards the COVID-19 vaccine would translate into high vaccine uptake. Vaccine hesitancy; vaccination intention, COVID-19 vaccine, vaccine confidence, complacency, convenience.

Parents’ perceptions and expectations of COVID-19 vaccination for children in Banda Aceh

Background Parents usually make the decisions on COVID-19 vaccinations for their children under the age of 18.&#x0D; Objective To explore parents' perceptions and expectations of COVID-19 vaccination for children in Banda Aceh.&#x0D; Methods This study used a qualitative design with a phenomenological approach. Data were collected through in-depth interviews of 36 parents in Banda Aceh. The data were analyzed qualitatively through thematic analysis.&#x0D; Results Three themes were studied: (1) perceptions of parents willing to have their children vaccinated against COVID-19, (2) perceptions of parents who refused or delayed their children’s vaccination against COVID-19, and (3) parents' expectations regarding COVID-19 vaccination in children. Benefits of the vaccine and government policy were among the reasons that parents were willing to have their children vaccinated. Vaccine safety concerns, lack of information, strong immunity, healthy lifestyle, and religious beliefs were the main reasons for parental refusal or delay in vaccinating their children. Reduced cases of COVID-19 and the end of the pandemic, not being infected, developing immunity, and no adverse events following immunization, face-to-face learning in schools, as well as increased education and socialization from the government, society that was critical and selective in receiving information were the expectation of parents regarding COVID-19 vaccination in children.&#x0D; Conclusion The perception of vaccine benefits and government policy influence parents to have their children vaccinated, while perception of vaccine safety concerns, lack of information, strong immunity, healthy lifestyle, and religious beliefs influence parents to refuse or delay their children being vaccinated. Parents' expectations regarding COVID-19 illness, their children’s response to the vaccine and education, as well as the government’s and society’s roles during the pandemic are qualitatively elucidated.