Vaccine Attitudes Research Articles

Co-designing and pilot testing a digital game to improve vaccine attitudes and misinformation resistance in Ghana

ABSTRACT Misinformation related to vaccines has been shown to potentially negatively impact public perceptions and intentions to vaccinate in many contexts including COVID-19 vaccination in Ghana. Psychological inoculation – where recipients are warned about the misleading techniques used in misinformation – is a potential intervention which could preemptively boost public resistance against misinformation. Cranky Uncle Vaccine is an interactive, digital game that applies inoculation, offering a scalable tool building public resilience against vaccine misinformation and promoting positive health-related behaviors. In this study, we document the process of developing and testing a West African version of Cranky Uncle Vaccine, with co-design workshops and a pilot test conducted in urban and peri-urban areas of the Greater Accra region of Ghana with 829 young people who had access to mobile and computer devices. The average age was 21.8 and participants were highly educated (median education level “Some/all university”) with slightly more females (51.2%) than males (48.4%). Pilot participants filled out surveys before and after playing the game, measuring vaccine attitudes (pre-game M = 3.4, post-game M = 3.6), intent to get vaccinated (pre-game M = 3.5, post-game M = 3.6), and discernment between vaccine facts and fallacies (pre-game AUC = 0.72, post-game AUC = 0.75). We observed a significant improvement in attitudes toward vaccines, with players demonstrating increased likelihood to get vaccinated after completing the game. Among players who indicated that they were unlikely to get vaccinated in the pre-game survey (N = 52, or 6.3% of participants), just over half of these participants (53%) switched to likely to get vaccinated after playing the game. Perceived reliability of vaccine facts remained the same, while perceived reliability of vaccine fallacies significantly decreased, indicating improved ability to spot misleading arguments about vaccines. These results demonstrate the effectiveness of a digital game in building public resilience against vaccine misinformation as well as improving vaccine attitudes and intent to get vaccinated.

When low social trust undermines social marketing campaigns: The impact of social trust on the effectiveness of COVID-19 vaccination campaigns

Background Although COVID-19 social marketing vaccination campaigns have been developed and vigorously promoted to encourage citizens to vaccinate against COVID-19, many people have not responded to vaccination campaigns. Very little is known about the extent to which vaccination campaigns are effective at overcoming people’s resistance to getting the vaccine. Focus of the Article Integrating social trust into the elaboration likelihood model, the current study proposes a model to analyse the effectiveness of COVID-19 social marketing vaccination campaigns and to examine the extent to which social trust plays a role in influencing people’s perceptions of the effectiveness of COVID-19 social media vaccination campaigns. Research Hypotheses The study proposes hypotheses regarding the influence of argument quality and source credibility in COVID-19 vaccination campaigns on individuals’ perceptions of campaign usefulness. In addition, it suggests that source credibility and perceived usefulness of these campaigns play a role in shaping individuals’ attitudes toward COVID-19 vaccination. Furthermore, the study posits that both attitude and perceived usefulness contribute to individuals’ intentions to take the COVID-19 vaccine. Lastly, the study hypothesises that perceived social trust moderates the impact of perceived usefulness on vaccination intentions. Importance to the Social Marketing Field The study holds significant importance in the field of social marketing for several reasons. Firstly, it contributes to a deeper understanding of the dynamics influencing individuals’ perceptions, attitudes, and intentions related to COVID-19 vaccination campaigns. Secondly, by examining the impact of argument quality, source credibility, and social trust, the study provides valuable insights into the factors that can enhance or hinder the success of vaccination campaigns. The inclusion of perceived social trust as a moderating factor in the study further enhances its importance in the field of social marketing. Understanding the role of social trust in influencing the relationship between perceived usefulness and vaccination intentions is crucial for designing context-specific strategies that account for the broader societal dynamics. Methods Online survey data were obtained from 413 adult South Africans. The partial least squares structural equation modelling technique was used to examine the model and test the hypotheses. Results The study found that the quality of arguments in vaccination campaigns and the credibility of the message sources affected how people viewed the usefulness of the messages and their overall attitudes. Surprisingly, although attitudes influenced individuals’ intentions to get the COVID-19 vaccine, the perceived usefulness of the campaign had no direct impact on vaccination intentions. Notably, the results revealed that low social trust played a role in making the perceived usefulness of the COVID-19 vaccination campaign message insignificant in predicting vaccination intentions. Recommendations for Research/Practice Social marketers aiming to improve vaccination attitudes and intentions should focus on two key strategies: emphasising the usefulness of vaccination by highlighting its benefits and leveraging credible sources like healthcare professionals and community leaders to enhance message trust. In addition, this study emphasises the crucial role of social trust in shaping individual responses to vaccination campaigns. Building trust in governing institutions, healthcare systems, and science can significantly impact vaccination acceptance and promotion. Limitations The limitations include potential social desirability bias influencing responses, the need for longitudinal data to establish causality, and the possibility of other influential factors beyond the study’s scope, such as culture and health literacy.

The Effect of Parents' Fear of COVID-19 and Some Variables on Their Childhood Vaccination Attitudes According to the Health Belief Model: A Cross-Sectional Study

Objective: The study sought to explore the relationship of parents’ fear of COVID-19 and some variables with childhood vaccination attitudes according to the Health Belief Model during the COVID-19 pandemic. Methods: This research employed a descriptive – correlation design, with 263 participants consisting of parents with children aged 0-6 included in the study. An online survey was used to collect data. Results: The mean COVID-19 fear score of the participants was 19.71±6.46. As the COVID-19 fear score of the participants increased, their perceived benefit (β=.12; p

A systematic review of student vaccine attitudes and vaccine policy on college and university campuses, 2000–2022

Objective: To summarize the literature 1) evaluating college student knowledge and attitudes toward vaccines and 2) examining associations between vaccine uptake and school-dependent variables. Methods: We reviewed all U.S.-based English-language primary literature published between January 1, 2000 and September 20, 2022 available online in PubMed/MEDLINE and SCOPUS databases. The initial search included studies mentioning college/university, vaccine/immunization, and one of the following terms: prevention, delivery, acceptance, uptake, or policy. Study screening, quality assessment, and data extraction were performed by author pairs using Covidence, a web-based screening and data extraction tool for conducting systematic reviews. Results: Out of 58 studies, 37 (64%) used survey methodology and 5 (9%) were randomized controlled trials. Forty studies focused on HPV vaccines. Easy access to vaccines, perceived vulnerability to disease, self-efficacy, and social norms influenced vaccine decision-making. Conclusion: While studies assessing student awareness, social norms, and message framing for vaccine uptake on campuses exist, mostly for the HPV vaccine, few have evaluated college vaccine policy.

Changes in Attitudes towards Influenza and Pneumococcal Vaccination during the Subsiding COVID-19 Pandemic-Results of a Longitudinal Survey Study among Risk Groups in Germany between 2021 and 2023.

In many countries, an increase in influenza and pneumococcal vaccination rates was observed during the COVID-19 pandemic. We examined how attitude, risk perception and knowledge towards influenza and pneumococcal vaccines of at-risk patients developed when the COVID-19 pandemic subsided and if COVID-19 vaccination attitude (VA) was still associated with the attitudes towards the two other vaccines. We used longitudinal data from two surveys conducted in Germany in 2021 and 2023 among persons with chronic diseases. We assessed VA, risk perception, vaccination knowledge and further psychological determinants of vaccine acceptance. Structural equation modelling using full information maximum likelihood was used to estimate multivariate regressions with planned missing data. Among 543 respondents, the influenza and pneumococcal vaccination rates remained relatively stable between 2021 and 2023. VA also remained unchanged at a moderately positive level, while COVID-19 VA decreased. A constantly positive association between COVID-19 VA and influenza as well as pneumococcal VA was found, independent from a general VA. The perceived danger of influenza increased between 2021 and 2023 and was among the strongest predictors of influenza VA. Also at the subsiding pandemic, COVID-19 VA was constantly associated with the influenza and pneumococcal VA. It seems sensible to take these aspects into account when designing future vaccination campaigns for at-risk patients. DRKS00024561. Registered 9 March 2021.

Pediatric Oncology Providers' HPV Vaccine Knowledge, Attitude, Self-Efficacy, and Practice after Communication Training: A Comparison with a National Survey.

Human papillomavirus (HPV) vaccinations prevent HPV infection and related cancers. Despite being at higher risk of secondary cancers linked to HPV, childhood cancer survivors (CCS) are undervaccinated. This study aimed to compare pediatric oncology providers' knowledge, attitudes, self-efficacy, and practices regarding HPV vaccination among those who participated in a multilevel educational HPV vaccine program with those of a national sample of oncology providers. Between February and March 2023, 39 providers from five pediatric oncology clinics in Texas completed online surveys, assessing knowledge about CCS risk for HPV-related cancers, attitudes towards the HPV vaccine, and confidence in recommending the vaccine to CCS. The results were compared with a national survey of providers conducted in 2019 (n = 195). The findings showed that providers who participated in our program had greater knowledge of CCS increased risk for HPV-related cancers (96% vs. 38%; p < 0.001); greater confidence in discussing and recommending the HPV vaccine (100% vs. 66%, p < 0.001) and addressing parental concerns (100% vs. 69%, p < 0.001); and a more positive attitude about oncology providers than general pediatricians, recommending (96% vs. 71%; p = 0.006) and administering the HPV vaccine to CCS (96% vs. 53%, p < 0.001). This study underscores the importance of educating oncology providers about the increased risk of CCS and improving their self-efficacy to recommend the HPV vaccine, promoting vaccination in the oncology setting.

Development and validation of the COVID-19 vaccine beliefs scale for the Chinese population

BackgroundAt present, there is no culturally appropriate scale designed to measure Chinese people’s attitudes and beliefs about COVID-19 vaccines. Understanding people’s attitudes and beliefs about vaccines can help policy makers and health care professionals better evaluate local beliefs to increase vaccine coverage and minimize COVID-19 vaccine hesitancy.MethodsWe developed a COVID-19 vaccine attitudes and beliefs scale comprising items based on qualitative research data. We then conducted an explorative and confirmatory factor analysis using data from two online sources.ResultsThe 26-item vaccine belief scale includes a five-factor model: vaccine benefit (VB), vaccine concern (VC), observing others’ reactions to vaccination (VR), the influence of authority and others toward vaccination (VI), and common sense about vaccination (VS). The multivariate analysis results showed that VB (OR = 1.065, 95% CI 1.035–1.097), VR (OR = 0.878, 95% CI 0.832–0.927), and VS (OR = 1.076, 95% CI 1.032–1.122) were associated with the intention to receive the vaccine. These results implied that VC (OR = 0.957, 95% CI 0.928–0.987) could predict the choice not to be vaccinated. A correlation between beliefs about vaccines and conspiracy theories and fear of COVID-19 was also found and discussed.ConclusionsThese findings suggest that the locally designed and culturally sensitive scale has good reliability and validity. The questionnaire provides researchers with a standardized assessment tool to measure Chinese people’s beliefs about the COVID-19 vaccine.

Developing and validating a framework to explain cruise travel intention in the United States: a crisis management perspective

PurposeThis study aims to extend the cognitive appraisal theory by developing and validating a conceptual framework to illustrate how travelers' behavioral intention is generated via a multi-stage evaluation of health-related variables.Design/methodology/approachSEM and moderator analysis were conducted to examine the theoretical framework (post-intervention event travel intention) and to investigate how the appraisal process differs across travelers with various attitudes toward vaccination.FindingsThis study found that cruise travel intention was positively influenced by the perceived hedonic value and perceived trustworthiness and negatively influenced by perceived infection risk. Furthermore, whereas perceived hedonic value, perceived trustworthiness and perceived risk of infection were all predicted by crisis management, the dimensions of crisis management operated differently. In addition, vaccination attitudes amplified the unfavorable effect of perceived risk on intention.Originality/valueDrawing on the CAT, this study developed and validated a conceptual framework to integrate crisis management with customers' behavioral intentions. This study extends existing cruise travel intention theory by demonstrating how post-pandemic travelers' behavioral intention is generated via a multi-stage appraisal-reappraisal process based on the evaluations of infection risks and cruise line crisis management.

Pediatric Coronavirus Disease 2019 Vaccine Experiences, Practices, and Attitudes in Rural Primary Care Clinicians

ObjectivePediatric coronavirus disease 2019 (COVID-19) vaccination rates remain low in rural areas. A strong clinician recommendation improves vaccine uptake, but the pediatric COVID-19 vaccine recommendation practices of rural primary care clinicians have not been reported. Our objectives were to describe, among rural Colorado pediatric clinicians: 1) recommendation practices for COVID-19 vaccine compared to influenza and school-entry required vaccines, and 2) personal attitudes. MethodsFrom July to October 2023, surveys were distributed to clinicians in rural Colorado identified as pediatric vaccine providers in counties designated as rural through the Colorado Immunization Information System using mail and email. ResultsOf 89 survey respondents, 37% of clinicians strongly recommended COVID-19 vaccines for children 6 months–5 years old, compared to 79% for influenza (P = 0.05) and 92% for school-entry required vaccines (P = 0.04). For children 6–11 and 12–17 years old, 43% and 44% of clinicians strongly recommended COVID-19 vaccines, respectively, compared to 71% and 70% for influenza (P < 0.01), and 91% for school-entry required vaccines (P < 0.01). Forty four percent of clinicians agreed that COVID-19 vaccines are important for pediatric patients. The most common clinician-perceived challenges to discussing pediatric COVID-19 vaccines included a lack of parent interest in more information (76% “somewhat” or “strongly” agree), lack of ability to change parents’ minds (71%), and concerns that the vaccines are too political (40%). ConclusionsMost rural Colorado clinicians do not strongly recommend pediatric COVID-19 vaccines compared to influenza and school-entry required vaccines. Efforts to improve pediatric COVID-19 vaccine uptake should aim to strengthen clinicians’ recommendations of these vaccines.

“My children will grow up more healthy than me because of the vaccinations they received”: Using the migrant health trajectory model to understand Vietnamese American parents’ attitudes towards vaccinations and the U.S. healthcare system

Previous studies have examined the rationales affluent white American parents give for distrusting vaccinations and the U.S. healthcare system; fewer studies have investigated the vaccine- and healthcare-related attitudes of foreign-born parents who have resettled in the U.S. Drawing on 40 in-depth interviews with Vietnamese American parents who emigrated from Vietnam and reside in Southern California, this study finds that these parents favor vaccinations and trust the U.S. healthcare system. However, contrary to the “good” refugee and “model” minority stereotypes, which racializes Asian Americans as blindly adhering to authority to assimilate, these Vietnamese Americans reported purposefully agreeing to vaccinations because they believe that vaccines are a privileged prevention strategy, ensured by the U.S. healthcare system to safeguard their and their children's livelihoods. Interview participants chronicled their social experiences as refugees, particularly their upbringing in Vietnam (where they witnessed vaccine and healthcare inequities) and their emigration to and resettlement in the U.S. (a social setting they believe has an abundance of advantageous health resources) as social factors influencing their vaccination and healthcare standpoints. By attending to Vietnamese American parents' unique emigration health trajectories, this study highlights how vaccination and healthcare attitudes are social acts shaped by interlinking socio-historical, -political, and -cultural contexts.

Vaccination Status, Vaccine Awareness and Attitudes, and Infection Control Behaviors of Japanese College Students: A Comparison of 2021 and 2023.

Background: Now that the spread of COVID-19 has been controlled, it is important to investigate changes in young people's perceptions of the vaccine and their behavior toward infection. The objectives of this study were as follows: (1) to investigate the association between Omicron strain vaccination rates among college students, their perceptions of the vaccine, and past adverse reactions to the vaccine; (2) to compare 2021 (when COVID-19 was spreading) and 2023 (when COVID-19 was strained) to identify changes in attitudes toward vaccination and motivations for vaccination and changes in infection prevention behavior. Methods: This cross-sectional survey was conducted via e-mail from 5 January to 30 January 2023. All students at Hiroshima University were sent an e-mail, which provided them access to the survey form and requested their cooperation. The questionnaire consisted of 33 items related to attributes, vaccination status, adverse reactions after vaccination, motivation for vaccination, perception of the vaccine, presence of coronavirus infection, sequelae, and infection prevention measures. Results: A total of 1083 students responded to the survey. Over 50% of the students were vaccinated with the Omicron booster. Regarding trust in vaccines, the majority of both male and female respondents said they had some trust in vaccines, although this was less than that observed in the 2021 survey. As for infection control measures, only 2% of males and 0.3% of females answered that they did not take any infection control measures. The most common response was "wear a mask", as in the 2021 survey, with 476 men (96.6%) and 575 women (99.5%). Conclusions: The survey showed a high Omicron-responsive vaccination rate of more than 50%. In addition, more than 99% of the students were found to be taking measures to prevent infection, such as wearing masks.

Vaccine practices, literacy, and hesitancy among parents in the United Arab Emirates.

Immunisation is one of public health's greatest success stories, yet, annually, 20 million children miss out entirely or partially on routine immunisation. National immunisation estimates have the United Arab Emirates (UAE) lagging behind with 4% of children under the age of 1 not having received any vaccines. Vaccine hesitancy is considered one of the biggest barriers to vaccination. This study aims to evaluate the UAE's parents' vaccination attitudes and practices as well as estimate vaccine hesitancy's prevalence and determinants. This cross-sectional, descriptive study collected data from parents across the UAE during the months of March and April 2024. The 60-item questionnaire included the Parental Attitudes towards Childhood Vaccines scale (PACV), the Vaccine Hesitancy Scale, and the Digital Vaccine Literacy (DVL) scale. Univariate, bivariate (chi-squared test), and multivariate (logistic regression) analyses were conducted. A total of 550 responses were retained. 84.55% of participants were female (n = 465/550), half were middle-aged (31-45 years old), and 21.09% (n = 116/550) were healthcare workers. 94.36% (n = 519/550) had their child/children receive all mandated vaccines. Only 39.82% (n = 219/550) found their level of knowledge about childhood vaccinations to be good/excellent. 70.11% (n = 386/550) of participants had high digital vaccine literacy. More than 95% had positive attitudes towards measles, meningitis, and pertussis vaccines. 14.00% (n = 77/550) were identified as vaccine-hesitant according to the PACV. Overall, using general practitioner/ paediatrician as a knowledge source, digital vaccine literacy, perceived children's vaccine knowledge, and nationality were associated with lower vaccine hesitancy status. Vaccine hesitancy exists and is prevalent in the UAE; however, the majority of participants reported high trust in vaccines, the local healthcare systems and physicians. Vaccine hesitancy can be tackled but will require tailored solutions and proactive healthcare workers.

The importance of ‘dread risk’ for vaccine communication

ABSTRACT Background Perceptions of ‘dread risk,’ information source beliefs, and trust in these sources are important variables towards understanding vaccine attitudes. The main objective of this research was to learn the associations among these phenomena and, particularly, how these variables may impact our understanding of vaccine attitudes. Methods In the summer of 2020, a total of 336 (M age = 53.55; SD age = 18.58) participants answered an online Qualtrics survey about their ‘dread risk’ perceptions of vaccines, their information source beliefs (e.g. credible, easy-to-access, etc.), trust in information sources, and vaccine attitudes. Results Results suggest participants had generally low levels of negative vaccine attitudes (M = 3.27; SD = 1.40). Regression analyses to predict negative vaccine attitudes found ‘dread risk’ perceptions to be the most significant predictor (beta = .61, p < .001), over and above information source beliefs and trust in information sources (F (9, 320) = 75.07, p < .001; adjusted R 2 = .67). Age was also significantly and negatively correlated with ‘dread risk’ (r = -.22, p < .001). Conclusions Results suggest that vaccine communication efforts should continue to identify individuals’ ‘dread risk’ perceptions about vaccines and emphasize this content in messaging. Future research should aim to understand more about the relationships between negative vaccine attitudes, ‘dread risk’ perceptions, information source beliefs, and trust in information sources to better predict vaccine-related decisions, (in)actions, and to support effective vaccine communication.

A Survey on Population Perceived Factors Influencing COVID-19 Vaccination in South Indian Districts.

The COVID-19 pandemic has posed unprecedented challenges to global public health, necessitating the rapid development and distribution of vaccines. Despite the availability of effective vaccines, vaccination uptake remains varied across different regions and populations. This study aims to investigate the factors influencing COVID-19 vaccination uptake in South Indian districts, with a focus on understanding public perceptions. Utilizing a cross-sectional survey methodology, data were collected from a representative sample of residents in selected South Indian districts. The survey explored a range of variables including demographic characteristics, knowledge and awareness about COVID-19 vaccines, perceived risks and benefits, trust in healthcare systems, and sources of vaccine-related information. The preliminary analysis indicates that vaccine uptake is significantly influenced by factors such as age, educational level, and socioeconomic status. High levels of vaccine hesitancy were associated with misinformation, concerns about vaccine safety and efficacy, and distrust in government and healthcare authorities. Conversely, individuals with higher education levels and those who received accurate information from trusted sources showed a greater willingness to get vaccinated. Social and cultural beliefs also played a crucial role in influencing vaccination attitudes, stressing the need for the importance of culturally sensitive health communication strategies.The study investigates a range of factors, including demographic characteristics such as age, gender, education level, and socio-economic status, as well as psychological and social determinants like the perceived risk of COVID-19, trust in vaccines, and the influence of misinformation. This study underscores the need for targeted public health interventions to address vaccine hesitancy and improve vaccination rates in South India. By identifying the key factors influencing vaccination decisions, policymakers and healthcare providers can develop more effective communication and outreach programs tailored to the unique needs and concerns of the population. Enhanced efforts in education, transparency, and community engagement are essential to fostering greater public trust and achieving higher vaccination coverage.

What determinants of COVID-19 vaccine hesitancy among Chinese nursing students? A cross-sectional study.

The coronavirus disease 2019 (COVID-19) continues to threaten human health, and health professionals, including nursing students, usually work in healthcare frontiers with a high risk of infection. Vaccination is currently one of the most effective preventive measures. This study aimed to explore the determinants of COVID-19 vaccine hesitancy in nursing students. In November 2022, a sample of undergraduate nursing students was recruited from several medical schools in Anhui Province, China, and an online cross-sectional survey was conducted using the questionnaire star platform (Wenjuanxin). A Chi-square test was used to explore vaccine hesitancy among nursing students with different social demographic characteristics and vaccine attitudes. Binary logistic regression analysis was then used to determine the influence factors of vaccine hesitancy among nursing students. A total of 1,090 valid samples were collected in this study. Of these, 27.06% (295) of nursing students reported COVID-19 vaccine hesitancy. The results showed "the need to go out of town recently" (OR = 0.670), "very confident that the outbreak could be controlled sustainably" (OR = 0.393), "feeling at risk of infection" (OR = 0.658), "not being worried/being generally worried about the vaccine's safety" (OR = 0.226 and OR = 0.686, respectively), and "not being worried about the vaccine's effectiveness" (OR = 0.411). These five factors are protective factors associated with COVID-19 vaccine hesitancy in nursing students. The factors "considering the country completely safe from an outbreak" (OR = 3.436), "considering themselves safe because others are vaccinated" (OR = 2.239), and "Agreeing that other protective measures can be relaxed after vaccination with the COVID-19 vaccine" (OR = 2.007) are risk factors associated with COVID-19 vaccine hesitancy among nursing students (P < 0.05). Overall, relatively few nursing students had COVID-19 vaccine hesitancy. Schools and relevant institutions still need to actively guide them to improve their confidence in the COVID-19 vaccine, strengthen the prevention and control measures of the epidemic, and improve their awareness of the crisis to improve the vaccination rate to reduce the COVID-19 vaccine hesitancy in nursing students.

Resilience throughout COVID-19: Unmasking the realities of COVID-19 and vaccination facilitators, barriers, and attitudes among Black Canadians.

Black communities have suffered disproportionately higher numbers of COVID-19 cases and deaths in Canada. Recognizing the significance of supporting targeted strategies with vulnerable populations extends beyond the COVID-19 pandemic, as it addresses longstanding health disparities and promotes equitable access to healthcare. The present study investigated 1) experiences with COVID-19, 2) COVID-19's impact, and 3) factors that have influenced COVID-19 vaccine acceptance and uptake among stakeholders and partners from the Federation of Black Canadians' (FBC). We conducted semi-structured interviews with 130 individuals and four focus groups with FBC, including stakeholders and partners, between November 2021 and June 2022. The semi-structured interviews and focus group discussions were conducted virtually over Zoom and lasted about 45 minutes each. Conversations from interviews and focus groups were transcribed and coded professionally using team-based methods. Themes were developed using an inductive-deductive approach and defined through consensus. The deductive approach was based on Consolidated Framework for Implementation Research (CFIR) domains and constructs. First, regarding experiences with COVID-19, 36 codes were identified and mapped onto 13 themes. Prominent themes included 39 participants who experienced highly severe COVID-19 infections, 25 who experienced stigma, and 18 who reported long recovery times. Second, COVID-19 elicited lifestyle changes, with 23 themes emerging from 62 codes. As many as 97 participants expressed feelings of isolation, while 63 reported restricted mobility. Finally, participants discussed determinants that influenced their vaccination decisions, in which 46 barriers and four facilitators were identified and mapped onto nine overarching themes. Themes around the CFIR domains Individuals, Inner Setting, and Outer Setting were most prominent concerning vaccine adoption. As for barriers associated with the constructs limited available resources and low motivation, 55 (41%) and 46 (34%) of participants, respectively, mentioned them most frequently. Other frequently mentioned barriers to COVID-19 vaccines fell under the construct policies & laws, e.g., vaccine mandates as a condition of employment. Overall, these findings provide a comprehensive and contextually rich understanding of pandemic experiences and impact, along with determinants that have influenced participants' vaccination decisions. Furthermore, the data revealed diverse experiences within Black communities, including severe infections, stigma, and vaccine-related challenges, highlighting the importance of targeted interventions, support, and consideration of social determinants of health in addressing these effects.

Identifying patterns and profiles of vaccination hesitancy among nurses for tailoring healthcare policies in the UK: A cross-sectional study.

To profile the characteristics of nurses with varying levels of vaccine hesitancy toward the COVID-19 and influenza vaccines. In many countries across the world, healthcare workers, and nurses in particular, display significant reluctance toward COVID-19 and influenza vaccines due to concerns about safety, distrust in healthcare policies, and media influences. To address this, a proposed approach involves profiling nurses to tailor vaccination campaigns and to improve acceptance rates and public health outcomes. This cross-sectional study adopted the Vaccination Attitudes Examination scale to assess hesitancy toward COVID-19 and influenza vaccines among 294 registered nurses in the UK between March and July 2023. A K-means cluster analysis was performed. The Strengthening the Reporting of Observational Studies in Epidemiology guidelines were adopted. Three profiles were identified. Profile A showed low vaccination hesitancy, profile B showed average hesitancy, and profile C showed high hesitancy toward vaccines. The highest concern for all profiles was related to unforeseen future effects of vaccination. Profile C had more nurses in early career roles, whereas nurses in profiles A and B were in more senior roles. Profile A showed higher educational attainment. Nurses in profile C used Snapchat more, whereas nurses in profile A used Twitter more frequently. This study identified specific characteristics associated with higher levels of vaccination hesitancy in nursing. Unforeseen future effects of vaccination are a core aspect to consider in promoting vaccination. Policies and vaccination campaigns should be targeted on early career nurses and should deliver tailored messages to dispel misinformation about unforeseen future effects of vaccination through specific social media platforms. Senior nurses should be involved as role models in promoting vaccination. These results are key for enhancing an evidence-based approach to implementing global health policies in healthcare.

Attitudes towards the Tick-Borne Encephalitis Vaccine among Children's Guardians: A Cross-Sectional Survey Study in Poland.

This cross-sectional survey study aimed to assess the attitudes and knowledge of children's guardians in Poland towards tick-borne encephalitis (TBE) and its vaccine, as well as to compare these attitudes to those regarding other infectious diseases and their vaccines. Data were collected through anonymous questionnaires, both paper-based and online, from 3030 respondents across Poland, with the majority being from TBE-endemic areas. The survey included questions on demographic characteristics, general vaccination beliefs, and specific perceptions of TBE and its vaccine. Statistical analysis revealed significant associations between willingness to vaccinate against TBE and factors such as general vaccination attitudes, information sources, vaccine safety ratings, and perceptions of disease severity. Results indicated that guardians from larger cities and those with fewer children were more likely to vaccinate. Additionally, parents who supported general vaccinations were significantly more willing to vaccinate against TBE. The study concludes that enhancing public awareness about the safety and importance of the TBE vaccine, especially in endemic regions, is crucial for improving vaccination rates. Targeted public health interventions addressing misconceptions and providing accurate information are essential strategies to increase TBE vaccine uptake and protect children from this serious disease.

Understanding Students' Vaccination Literacy and Perception in a Middle-Income Country: Case Study from Kazakhstan.

Vaccination is a critical public health measure for preventing infectious diseases, but its acceptance varies globally, influenced by factors like vaccine hesitancy. This study examines attitudes and vaccination literacy among Kazakh students, providing insights into global immunization strategies. A cross-sectional survey was conducted with 3142 students from various Kazakh universities. The HLS19-VAC instrument assessed vaccination literacy, while additional questions evaluated beliefs and attitudes toward vaccines. Data were analyzed to determine associations between vaccine-related beliefs and literacy. The mean vaccination literacy score was 84.74. Most students agreed on the importance (83.4%), safety (79.1%), effectiveness (80.9%), and religious compatibility (77.8%) of vaccines. Positive beliefs significantly correlated with higher literacy scores. Past vaccination behavior, age, gender, and location showed varied associations, with past vaccination status and higher age showing a positive correlation. Positive beliefs about vaccinations were strongly associated with higher vaccination literacy among Kazakh students. Educational interventions that reinforce positive beliefs may improve vaccination literacy and increase vaccination rates. This study underscores the importance of understanding vaccination attitudes to enhance public health strategies in middle-income countries.

Profiling vaccine hesitancy in nursing to tailor public healthcare policies: A cross-sectional international study.

Vaccine hesitancy is a complex issue of global concern. As nurses play a vital role in delivering patient care and shaping public opinions on vaccines, interventions to address vaccine hesitancy in nursing are imperative. As such, identifying profiles of characteristics and attitudes contributing to hesitancy may help identify specific areas of focus to target tailored global vaccination uptake campaigns. The purpose of this study was to profile the characteristics and attitudes contributing to hesitancy toward COVID-19 and Influenza vaccines in the nursing community. This multisite, cross-sectional study recruited 1967 registered nurses and 1230 nursing students from the United Kingdom, Finland, and Italy between March and September 2023. Data collection involved an online survey adopting the Vaccination Attitudes Examination (VAX) Scale, the Bergen Social Media Addiction Scale, and questions pertaining to sociodemographic and occupational characteristics. A k-means cluster analysis was used to identify various clusters of hesitancy based on the VAX Scale. One-way ANOVA and chi-square tests were used to identify significant differences in sociodemographic characteristics, occupational factors, vaccination attitudes, and social media usage between the clusters. Three distinct clusters were identified. Profile A showed high vaccine confidence, profile B displayed slight hesitancy, and profile C reported high levels of hesitancy. In profile C, higher levels of vaccine hesitancy were identified in younger, less experienced nurses with lower educational attainment. While older nurses with higher educational attainment, who were in senior roles, were more vaccine-confident and had a consistent history of accepting the Influenza and COVID-19 vaccinations (profile A). The study found Italian nurses highly hesitant (profile C), British nurses highly confident (profile A), and Finnish nurses evenly distributed between confident, slightly hesitant, and highly hesitant (profiles A, B, and C, respectively). In addition, more frequent usage of Instagram and TikTok was associated with vaccine hesitancy (profiles B and C), and LinkedIn and X were more common among vaccine-confident individuals (profile A). This study has identified specific sociodemographic and occupational factors that are related to vaccine hesitancy in an international sample of nurses. Additionally, attitudes contributing to hesitancy were identified, with worries about unforeseen future effects of the vaccine being identified as a critical attitude that may undermine confidence and increase hesitancy in nursing. This study also sheds light on the influence that social media platforms have on vaccine hesitancy and, as such, indicates which platforms are effective to disseminate vaccination campaigns to global nursing communities. Global vaccination campaigns should focus on specific profiles and clusters to promote vaccination in the international nursing community. Empowering nurses early in their careers will help to instill positive vaccination behaviors, ensuring a sustained uptake of vaccinations throughout the individual's career and beyond, with an impact on promoting vaccination at the public health level as well.