Understanding Vaccine Hesitancy Research Articles

Understanding Vaccine Hesitancy in U.S. Prisons: Perspectives from a Statewide Survey of Incarcerated People.

Much of the American response to the COVID-19 pandemic was characterized by a divergence between general public opinion and public health policy. With little attention paid to individuals incarcerated during this time, there is limited direct evidence regarding how incarcerated people perceived efforts to mediate the harms of COVID-19. Prisons operate as a microcosm of society in many ways but they also face unique public health challenges. This study examines vaccine hesitancy-and acceptance-among a sample of individuals incarcerated within adult prisons in Pennsylvania. Using administrative records as well as rich attitudinal data from a survey of the incarcerated population, this study identifies a variety of social and historical factors that are-and are not-associated with an incarcerated person's willingness to receive the COVID-19 vaccine. Our findings highlight vaccination challenges unique to the carceral context and offer policy recommendations to improve trust in credible health messengers and health service provision for this often overlooked but vulnerable population.

Hesitant or Confident: A Qualitative Study Examining Latinos' Perceptions of COVID-19 Vaccines in Arizona.

This study aimed to understand vaccine hesitancy and confidence toward the COVID-19 vaccines among Latino adults in Arizona. Latinos (n = 71) aged 18 years or older who resided in Arizona participated in 14 focus groups between February and June 2021. Theoretical thematic analysis was used to examine drivers of these two behaviors, namely, vaccine hesitancy and confidence toward the COVID-19 vaccines, using the COM-B model, comprising capability, opportunity, and motivation factors that generate a behavior. Vaccine hesitancy stemmed from the need for vaccine information (capability factor) and fear of the vaccines, religious beliefs, and perceived barriers stemming from government mistrust (motivation factors). Vaccine confidence arose from trust in science and doctors (capability factor), and a fear of getting sick, protection against COVID-19, getting vaccinated as a civic duty, and a desire to return to normal life (motivation factors). The influence of opportunity factors, such as having access to vaccinations, were not discussed as contributing to vaccine confidence or hesitancy. As predicted by the COM-B model, factors reflecting capabilities and motivations contributed to vaccine hesitancy and confidence, all of which need to be considered in public health messaging. These factors can be targeted to facilitate efforts to promote vaccine uptake and reduce the spread of COVID-19.

Understanding vaccine hesitancy: a call for more social science in RNA vaccine research

Understanding vaccine hesitancy: a call for more social science in RNA vaccine research

Psychological reactance, misinformation, and distrust: A mixed methods analysis of COVID-19 vaccine uptake.

Assessing perceptions of the COVID-19 vaccines is essential for understanding vaccine hesitancy and for improving uptake during public health emergencies. In the complicated landscape of COVID-19 vaccine mandates and rampant misinformation, many individuals faced challenges during vaccination decision-making. The purpose of our mixed methods study is to elucidate factors affecting vaccine decision-making and to highlight the discourse surrounding the COVID-19 vaccines in diverse and underserved communities. This mixed methods study was conducted in Arizona, Florida, Minnesota, and Wisconsin between March and November 2021, combining a cross-sectional survey (n = 3593) and focus groups (n = 47). The groups least likely to report receiving a vaccination were non-Hispanic Whites, Indigenous people, males, and those with moderate socioeconomic status (SES). Those indicating high and low SES reported similar vaccination uptake. Focus group data highlighted resistance to mandates, distrust, misinformation, and concerns about the rapid development surrounding the COVID-19 vaccines. Psychological reactance theory posits that strongly persuasive messaging and social pressure can be perceived as a threat to freedom, encouraging an individual to take action to restore that freedom. Our findings indicate that a subsection of participants felt pressured to get the vaccine, which led to weaker intentions to vaccinate. These results suggest that vaccine rollout strategies should be reevaluated to improve and facilitate informed decision-making.

COVID-19 Vaccine Hesitancy among Unvaccinated Adults: A Cross-Sectional Exploratory Analysis of Vaccination Intentions in Italy Related to Fear of Infection.

From the initial COVID-19 outbreak, Italy was the first Western country to be seriously affected by the pandemic. Understanding vaccine hesitancy can help efforts to achieve broad vaccination coverage. The objectives of this research were to determine the extent of vaccine hesitancy in Italy and to understand the characteristics of those segments of the population with some hesitancy. Between January and February 2021, 41,473 subjects answered the second questionnaire delivered in phase II of the web-based EPICOVID19 survey. Among the included adult volunteers living in Italy, 4653 (11.2%) reported having previously received at least one dose of the COVID-19 vaccine. In the sample of 36,820 respondents, all not vaccinated (age 51.1 ± 13.5; 59.7% female; 63.6% high level of education), the comparison between hesitant and inclined participants was accompanied by percentages and odds ratios. A total of 2449 individuals were hesitant (6.7% of the unvaccinated ones). Hesitancy was higher among women (OR = 1.48; 95%CI: 1.36-1.62); it was highest in the 50-59 and 40-49 age groups and among those with a lower educational level. A higher level of education was associated with a lower proportion of hesitancy (5.54%) compared with 9.44% among respondents with a low level of education (OR = 0.56; 95%CI: 0.46-0.68). Hesitancy was most common in subjects who did not report fear of infection (12.4%, OR = 4.0; 95%CI: 3.46-4.61). The results can guide the design of tailored information and communication campaigns through considering objective and subjective characteristics.

COVID-19 Vaccine Mandates and Vaccine Hesitancy among Black People in Canada.

COVID-19 vaccine mandates increased vaccination rates globally. Implemented as a one-size-fits-all policy, these mandates have unintended harmful consequences for many, including Black Canadians. This article reports findings on the interconnectedness of vaccine mandates and vaccine hesitancy by describing a range of responses to mandatory COVID-19 vaccination policies among Black people in Canada. Using qualitative research methods, semi-structured interviews with 36 Black people living in Canada aged 18 years and over across 6 provinces in Canada were conducted. Participants were selected across intersectional categories including migration status, income, religion, education, sex, and Black ethnicity. Thematic analysis informed the identification of key themes using Foucauldian notions of biopower and governmentality. Our results show how the power relations present in the ways many Black people actualize vaccine intentions. Two main themes were identified: acceptance of the COVID-19 vaccine in the context of governmentality and resistance to vaccine mandates driven by oppression, mistrust, and religion. COVID-19 vaccine mandates may have reinforced mistrust of the government and decreased confidence in the COVID-19 vaccine. Policy makers need to consider non-discriminatory public health policies and monitor how these policies are implemented over time and across multiple sectors to better understand vaccine hesitancy.

Understanding vaccine hesitancy in US and UK frontline workers – The role of economic risk

Drawing upon a comparative qualitative study of frontline workers in the US and UK this research confirms Bazzoli and Probsts’ (2022) emphasis on employment instability as a limiting boundary condition for effective implementation of a strong safety climate. It suggests that there is no positive relationship between risk of Covid-19 infection and frontline worker attitudes toward the vaccine because of their exposure throughout the pandemic. The notion of moral disengagement is problematic because of the tension between the vaccine hesitancy of frontline workers and the pro-social roles they fulfilled in the pandemic. Their exposure, underpinned by dependence on non-standard contracts and limited access to sick pay, informed vaccine hesitancy. Trust in management, but also perceptions of economic risk and safety in the work environment, shape vaccine behaviour and point to the importance of workplace health and safety policies. The research suggests the necessity of work-related variables in exploring vaccine hesitancy, but also consideration of the wider political economy of legal, health and welfare systems in both countries, including hostile migration environments. While vaccination was more politicised in the US, the intersection of race and class were key factors in both countries because of the predominance of BME and BIPOC workers in essential work during the pandemic and disproportionate exposure to the virus.

COVID-19 vaccine hesitancy among healthcare workers and its associated factors: A systematic review

Abstract Background The COVID-19 pandemic is considered one of the most significant public health crises in the 21st century. Healthcare workers (HCWs) as frontliners are at a greater risk of infection compared to the general population. HCWs can influence the general public's decisions when it comes to their health, particularly vaccination. Vaccine hesitancy can be a threat to controlling pandemics, at times when timely interventions are needed to save lives and reduce the burden on healthcare systems. Understanding vaccine hesitancy among HCWs can inform policy change and better pandemic preparedness. Methods This systematic review investigated vaccine hesitancy and its associated factors among HCWs following the approval of the first COVID-19 vaccine. Searches were run in three databases on eligible studies published between December 2, 2020, and June 15, 2022. Results We included 24 studies with a total of 74,739 [241- 12,610] HCWs from 12 countries including the United States, China, Germany, Belgium, Switzerland, and Greece. Most studies were conducted shortly after vaccine approval. The average prevalence of vaccine hesitancy across the studies was 24%. Factors associated with vaccine hesitancy among HCWs were classified using a five categories ‘5C model': confidence, complacency, convenience, communication, and context. Age, gender, healthcare profession, a history of flu vaccination, a positive history of COVID-19 infection, and confidence in COVID-19 vaccine safety were the most commonly identified factors associated with vaccine hesitancy. Conclusions This review suggests that the reasons underlying vaccine hesitancy among HCWs are multifactorial and might be unrelated to vaccine availability. Future studies could study vaccine hesitancy on a wider timeline following vaccines approval, to understand whether low uptake reflects hesitancy or a delay in vaccination. Understanding vaccine hesitancy among HCWs is crucial for pandemic preparedness and control. Key messages • Understanding vaccine hesitancy among healthcare workers and its underlying factors is crucial for pandemic preparedness and response. • Vaccine hesitancy among healthcare workers is multifactorial and may be unrelated to the availability of vaccines. Future research should expand on this topic to understand factors underlying it.

“Messengers matter”: Assessing the impact of racially concordant care on vaccine hesitation

With the rise in COVID-related deaths among the unvaccinated, understanding coronavirus vaccine hesitancy is critical to maintaining public health. Previous research has shown that sociodemographic factors, such as race, are essential for understanding vaccine hesitancy; yet, the specific factors driving racial disparities in vaccination continue to be a matter of intense debate. This study uses a novel survey experiment to uncover the linkages between race, physician trust, and vaccine hesitancy. Using a standard prompt on the release of the COVID-19 vaccine, it tests whether patient-physician race concordance affects the likelihood of vaccine uptake among US citizens. Analyses reveal that racially concordant care has a negligible effect on vaccine hesitancy, but does ameliorate other harmful beliefs regarding one's likelihood of experiencing discrimination and racism in healthcare more generally. These findings suggest that increasing diversity in the medical field should be paired with efforts to address systemic inequalities to promote increased vaccination.

Perspectives and experiences of COVID-19 vaccination in people with autoimmune and inflammatory rheumatic disease

ObjectivePeople with autoimmune and inflammatory rheumatic disease (AIIRD) are at an increased risk of morbidity from COVID-19. While COVID-19 vaccination is effective at reducing disease complications, there have been significant levels of vaccine hesitancy in people with AIIRD. We aimed to understand vaccine hesitancy and promote shared decision-making by describing the experiences and perspectives of people with AIIRD who had concerns with COVID-19 vaccinations. MethodsAdults with AIIRD on immunosuppressive medications who expressed concerns regarding the COVID-19 vaccination were purposively sampled until thematic saturation. Individual semi-structured interviews were conducted and analysed using reflexive thematic analysis. ResultsSixteen adults with an AIIRD were interviewed. Thematic analysis yielded four themes: heightened sense of vulnerability; determining individual suitability; desperate for freedom and relief; deterred by scepticism. ConclusionsThe perspectives of people with AIIRD towards the COVID-19 vaccination were shaped by a sense of vulnerability. The decision-making experience was challenging, resulting from struggles with handling information, dealing with external pressures, and facing negativity. Practice ImplicationsA collaborative approach, involving close family and friends and avoiding negativity and pressure can improve engagement and support decision-making around COVID-19 vaccination. Clearly addressing potential risks of vaccination may prevent subsequent regret and hesitancy if they arise.

Vaccine Hesitancy and Attitudes Toward Elite Knowledge in the United States During COVID-19

To be effective, the battle against COVID-19 and other pandemics must address the social dimensions of the crisis. The objective of this study was to assess whether negative attitudes toward elite knowledge were associated with vaccine hesitancy in the United States during COVID-19. Attitudes toward elite knowledge were assessed using three measures: (a) the Epistemological Style Inventory’s ‘naive realism’ subscale, (b) a measure about supporting education to foster understanding of politics, and (c) a populism scale. Vaccine hesitancy was measured using a 9-item adaptation of the Vaccine Hesitancy Scale used by the World Health Organization. Multiple regression results revealed that naïve realism (.184, p < .001) and populism (.356, p < .001) were positively associated with vaccine hesitancy, while support of political education (−.296, p < .001) was negatively associated with vaccine hesitancy. These results indicate that to fully understand vaccine hesitancy, the role of attitudes toward elite knowledge must be considered.

Unvaccinated, Just Like Everybody Else. Vaccine Hesitancy in a Romanian Religious Community

Abstract Vaccine hesitancy was a widespread phenomenon during the COVID-19 pandemic. It held back large-scale immunization in countries where vaccines were available and it aggravated the pandemic. The way we understand vaccine hesitancy in postmodern societies emphasizes individual risks, reflexivity, and patients making informed decisions. But how is vaccine hesitancy experienced in traditional communities? We explored answers to this question through ethnographic interviews conducted in the least vaccinated village in Romania. In this Pentecostal community, vaccination decisions were made at the community level, where an informal norm of vaccine refusal was dominant. This norm emerged through two types of interactions – local and mediated interactions – as collective discussions were centred on religious interpretations of Biblical fragments and on information from TV shows and social media about the adverse effects of vaccines. People formed symbolic alliances with influential actors in their community who were unvaccinated, such as the mayor and the pastor, and with citizens from Western European countries who also refused COVID-19 vaccination. Mainstream fears of vaccination were expressed during the interviews, concerning paralysis and death resulting from vaccination and mistrust in official authorities. Vaccination accentuated pre-existing differences in status, demarcating people with a high level of education working at the village hall, who were vaccinated, from those with a lower socio-economic status, who were not vaccinated.

Understanding vaccine hesitancy with PCV13 in children: Results of a survey in Shanghai, China.

A questionnaire survey for parents of children under 5 years of age was conducted to analyze vaccine hesitancy with the 13-valent pneumococcal conjugate vaccine (PCV13) in Shanghai, China. A total of 892 valid questionnaires were collected. Descriptive statistical methods, Chi-square test and effect size of Cohen were used. Among participants, 421 (48.8%) had children who had been vaccinated with PCV13 before the survey while 227 (26.73%) planned vaccination with PCV13 in the future. The main reasons for not receiving vaccination were the fear of adverse reactions (79, 26.7%), beyond vaccination age (69, 23.3%), and no need to vaccinate (44, 14.9%). Reducing vaccine hesitancy and increasing vaccination willingness can be achieved through health interventions, lower vaccine prices, and the adjustment of vaccination strategies.

Knowledge Gaps, Cognition and Media Learning: Designing Tailored Messages to Address COVID-19 Communication Inequalities

Various health and crisis studies have demonstrated support for the existence of knowledge gaps—a hypothesis suggesting that information will reach those in the lower socioeconomic status last, worsening health disparities. At the point at which COVID-19 vaccines were becoming widely accessible, the present study surveyed 651 Black Americans to understand vaccine hesitancy, intentions, and media learning variations after exposure to different types of social media posts about the COVID-19 vaccine. Although exposure to any of the message conditions in our study resulted in a decrease in vaccine hesitancy, we found mixed support for the knowledge gap hypothesis. Results show that lack of knowledge because of socioeconomic status is not a key factor driving vaccine hesitancy among Black Americans. Instead, public communication (government) campaigns may consider focusing on strategies to target Black American communities by age to improve media learning, and consider increasing social control and communal message functions to increase cognitive processing of pro-vaccine messages, and over the longer term, influence COVID-19 vaccine hesitancy and uptake.

International Medical Corps’ Approach to Solving COVID-19 Vaccine Hesitancy

To promote equity and better ensure outbreak control in low-resource areas, International Medical Corps surveyed people in countries around the world to better understand vaccine hesitancy.

Broad perspectives in understanding vaccine hesitancy and vaccine confidence: an introduction to the special issue.

The World Health Organization has designated vaccine hesitancy and vaccine confidence among the most pressing issues in global health. The COVID-19 pandemic has made vaccine hesitancy and vaccine confidence particularly salient and urgent. The purpose of this special issue is to highlight a broad range of perspectives on these critical issues. We have included a total of 30 papers that address issues related to vaccine hesitancy and vaccine confidence across multiple levels of the Socio-Ecological Model. We have organized the empirical papers into the following sections: individual-level beliefs, minority health and health disparities, social media and conspiracy beliefs, and interventions. In addition to the empirical papers, three commentaries are included in this special issue.

Health Misinformation on Social Media and its Impact on COVID-19 Vaccine Inoculation in Jordan

It is vital to understand the nature of misinformation disseminated online regarding the COVID-19 vaccination. This understanding will enhance governments’ efforts and strategies to combat the factors which hinder vaccine uptake. Vaccine hesitancy has always been a challenge which has accompanied vaccine rollouts. Misinformation regarding the COVID-19 vaccination, along with the ambiguous narratives around the origin of the virus, has played a role in vaccine hesitancy among Jordanians. The online activity generated by social media during the pandemic, due to people’s fear of the virus, their general anxiety and curiosity, and their desire for updates, made social media an even more fertile environment for misinformation than ever before. During the COVID-19 pandemic in Jordan, misinformation on social media platforms amplified the scale of fears around the safety of the vaccination programme. Therefore, this study offers an exploration of, and insight into, the thoughts and experiences of a sample of 30 Jordanian citizens who are hesitant about COVID-19 vaccination. This study uses a qualitative approach in order to further understand vaccine hesitancy and the nature of misinformation surrounding it, using semi-structured, face-to-face interviews with participants. It found that low levels of information about health, misconceptions about the COVID-19 vaccine, and the spread of misinformation on social media were all causes of vaccine hesitancy in Jordan. Facebook and WhatsApp were the principal social media networks identified in this study as spreading misinformation about the vaccine. The study sample reported that they believed in the conspiracy theories discussed on these two platforms. Furthermore, videos of influencers and anti-vaccination medical doctors from overseas played a part in misleading individuals regarding inoculation against COVID-19. Additionally, other factors were also identified and are discussed in this study.

Identifying Barriers and Enablers to Vaccine uptake from Immunizers and Individuals Receiving a COVID-19 Vaccine in Saskatchewan

Background: Vaccine hesitancy presents a challenge to public health, especially during a global pandemic. Understanding reasons for vaccine hesitancy in local populations may help policymakers and public health practitioners increase vaccine uptake. Objective: We surveyed individuals receiving a COVID-19 vaccine and immunizers in Saskatchewan, Canada and categorized their responses according to the Theoretical Domains Framework. This provides policymakers with evidence-based suggestions for behaviour change interventions that may promote vaccine uptake among hesitant individuals. Methods: Two online surveys were developed to better understand vaccine hesitancy in Saskatchewan: one aimed at individuals receiving a vaccination and the other at immunizers. Both surveys were available for a one-week period when vaccination uptake had plateaued in Saskatchewan. Individuals receiving a vaccine were asked what made them decide to get a vaccine, and both groups were asked what they thought would promote vaccine uptake among hesitant individuals. Responses were analyzed thematically based on the Theoretical Domains Framework and reported descriptively. Results: Individuals receiving a COVID-19 vaccine indicated that mandates and restrictions and having a positive attitude toward COVID-19 vaccines were the most common reasons for receiving a vaccine. Immunizers most frequently indicated that media issues led to vaccine hesitancy and that having access to, and trust in, reputable information sources would enable more vaccine hesitant individuals to seek a COVID-19 vaccination. Conclusion: Mandates and restrictions, promoting positive attitudes towards vaccines, and ensuring people have access to, and trust in, reputable information sources, are key enablers for promoting vaccine uptake among vaccine hesitant individuals.

Health Security, Vaccine Hesitancy and Post-Truth: A Case of COVID-19 in Pakistan

Many existing studies and researches have shown the link between vaccine hesitancy and rurality. To test the validity of this assertion, this paper uses COVID-19 vaccine as a reference case and tries to understand vaccine hesitancy in urban communities through the conceptual lens of post-truth. The argument enunciated in the paper is based on data gathered through an online survey, conducted from May to October 2021. Thematically, this paper identified two themes: ‘mistrust’ and ‘misinformation’, revealing the coupling effect of the themes and the intersection of vaccine hesitancy and post-truth in two urban (Islamabad and Rawalpindi) communities of Pakistan. While the discussions were contextual, this paper epistemically shows that the reality of COVID-19 was blurred by misinformation which translated into cynicism, mistrust and hesitancy for COVID-19 vaccine and the outcome proved why health security must be taken seriously, especially in the post-truth era.

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